Search results for: therapeutic benefits

Authors: Shuailing Cui, Nakajiam Naoto

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The tourism industry has experienced significant growth worldwide since the end of World War II. Tourists are drawn to suburban areas during weekends and holidays to explore historical and cultural heritage sites. Since the 1970s, there has been a resurgence in population growth in metropolitan areas, which has fueled the demand for suburban tourism and facilitated its development. The construction of infrastructure, such as railway lines and arterial roads, has also supported the growth of tourism. Tourists engaging in various activities can have a significant impact on the destinations they visit. Tourism has not only affected the local economy but has also begun to alter the social structures, culture, and lifestyle of the destinations visited. In addition, the growing number of tourists has affected the local commercial structure and daily life of suburban residents. Therefore, there is a need to figure out how tourism activities influence the residential environment of the tourist destination and how this influence changes over time. This study aims to analyze the transformation of the relationship between tourism activities and the residential environment in the Naka-Uji area of Uji City, Kyoto Prefecture. Specifically, it investigates how the growth of the tourism industry has influenced the local residential environment and how this influence has changed over time. The findings of the study indicate that the growth of tourism in the Naka-Uji area has had both positive and negative effects on the local residential environment. On the one hand, the tourism industry has created job opportunities and improved local economic conditions. On the other hand, it has also caused environmental degradation, particularly in terms of increased traffic and the construction of parking lots. The study also found that the development of the tourism industry has influenced the social structures, culture, and lifestyle of residents. For instance, the increase in the number of tourists has led to changes in the commercial structure and daily life of suburban residents. The study highlights the importance of collaboration and shared benefits among stakeholders in tourism development, particularly in terms of preserving the cultural and natural heritage of tourist destinations while promoting sustainable development. Overall, this study contributes to the growing body of research on the impact of tourism on suburban areas. It provides insights into the complex relationships between tourism, the natural environment, the local economy, and residential life and emphasizes the need for sustainable tourism development in suburban areas. The findings of this study have important implications for policymakers, urban planners, and other stakeholders involved in promoting regional revitalization and sustainable tourism development.

Keywords: tourism, residential environment, suburban area, metropolis

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Authors: Shuailing CUI, Nakajima Naoto

Abstract:

The tourism industry has experienced significant growth worldwide since the end of World War II. Tourists are drawn to suburban areas during weekends and holidays to explore historical and cultural heritage sites. Since the 1970s, there has been a resurgence in population growth in metropolitan areas, which has fueled the demand for suburban tourism and facilitated its development. The construction of infrastructure, such as railway lines and arterial roads, has also supported the growth of tourism. Tourists engaging in various activities can have a significant impact on the destinations they visit. Tourism has not only affected the local economy but has also begun to alter the social structures, culture, and lifestyle of the destinations visited. In addition, the growing number of tourists has affected the local commercial structure and daily life of suburban residents. Therefore, there is a need to figure out how tourism activities influence the residential environment of the tourist destination and how this influence changes over time. This study aims to analyze the transformation of the relationship between tourism activities and the residential environment in the Naka-Uji area of Uji City, Kyoto Prefecture. Specifically, it investigates how the growth of the tourism industry has influenced the local residential environment and how this influence has changed over time. The findings of the study indicate that the growth of tourism in the Naka-Uji area has had both positive and negative effects on the local residential environment. On the one hand, the tourism industry has created job opportunities and improved local economic conditions. On the other hand, it has also caused environmental degradation, particularly in terms of increased traffic and the construction of parking lots. The study also found that the development of the tourism industry has influenced the social structures, culture, and lifestyle of residents. For instance, the increase in the number of tourists has led to changes in the commercial structure and daily life of suburban residents. The study highlights the importance of collaboration and shared benefits among stakeholders in tourism development, particularly in terms of preserving the cultural and natural heritage of tourist destinations while promoting sustainable development. Overall, this study contributes to the growing body of research on the impact of tourism on suburban areas. It provides insights into the complex relationships between tourism, the natural environment, the local economy, and residential life, and emphasizes the need for sustainable tourism development in suburban areas. The findings of this study have important implications for policymakers, urban planners, and other stakeholders involved in promoting regional revitalization and sustainable tourism development.

Keywords: tourism, residential environment, suburban area, metropolis

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Authors: A. Drapeaux, S. Aviles, E. Garfoot

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Stem cell injections are a promising alternative treatment for hip osteoarthritis. Current literature has focused on short-term outcomes for both knee and hip osteoarthritis; however, there is a significant gap for longitudinal benefits for hip OA and limited firm conclusions due to small sample sizes. The purpose of this prospective study was to determine longitudinal changes in pain, function, and radiographs following bone marrow concentrate injection (BMAC) into the osteoarthritic hip joint. Methods: A prospective, cross-sectional study was conducted over the course of 12 months at an orthopedic practice. The study recruited 15 osteoarthritic pre-surgical hips with mild to moderate osteoarthritic severity who were scheduled to undergo hip arthroscopy. Data was collected at both pre-operative and post-operative time frames. Data collected included: hip radiographs, i-HOT-33 questionnaire data, BMAC autologous volume, and demographics. Questionnaire data was captured using Qualtrics XM software, and participants were sent an anonymous link at the following time frames: pre-operative, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Radiographic changes and BMAC volume were collected and reviewed by an orthopedic surgeon and sent to the primary investigator. Data was exported and analyzed in IBM-SPSS. Results: A total of 15 hips from 15 participants (mean age: 49, gender: 50% males, 50% females, BMI: 29.7) were used in the final analysis. Summative i-HOT 33 mean scores significantly changed between pre-operative status and 2-6 weeks post-operative status (p <.001) and pre-operative status and 3-6 months post-operative status (p <.001). There were no significant changes between other post-operative phases or between pre-operative status and 12 months post-operative. Significant improvements were found between summative i-HOT 33 mean (p<.001), daily pain (p<.001), daily sitting (p=.02), daily distance walked (p =.003), and daily limp (p=0.03) and post-operative status (2-6 weeks). No significant differences between demographic variables (gender, age, tobacco use, or diabetes) and i-HOT 33 summative mean scores. Discussion/Implications: The purpose of this study was to determine longitudinal changes in pain and function following a hip joint bone marrow concentrate injection. Results indicate that participants experience a significant improvement in pain and function between pre-operative and 2-6 weeks and 3-6 months post-injection. Participants also self-reported a significant change in average daily pain with sitting and walking between pre-operation and 2-6 weeks post-operative. This study includes a larger sample size of hip osteoarthritis cases; however, future research is warranted to include random controlled trials with a larger sample size.

Keywords: adult stem cell, orthopedics, osteoarthritis (hip), patient outcome assessment

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Authors: Tran Thi Thuy Oanh, Nguyen Ngoc Bao Tran

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In the view of Cognitive Linguistics (CL), knowledge and experience of things and events are used by human beings in expressing concepts, especially in their daily life. The human conceptual system is considered to be fundamentally metaphorical in nature. It is also said that the way we think, what we experience, and what we do everyday is very much a matter of language. In fact, language is an integral factor of cognition in that CL is a family of broadly compatible theoretical approaches sharing the fundamental assumption. The relationship between language and thought, of course, has been addressed by many scholars. CL, however, strongly emphasizes specific features of this relation. By experiencing, we receive knowledge of lives. The partial things are ideal domains, we make use of all aspects of this domain in metaphorically understanding abstract targets. The paper refered to applying this theory on pragmatics lessons for major English students at University of Foreign Language Studies - The University of Da Nang, Viet Nam. We conducted the study with two third – year students groups studying English pragmatics lessons. To clarify this study, the data from these two classes were collected for analyzing linguistic perspectives in the view of CL and traditional concepts. Descriptive, analytic, synthetic, comparative, and contrastive methods were employed to analyze data from 50 students undergoing English pragmatics lessons. The two groups were taught how to transfer the meanings of expressions in daily life with the view of CL and one group used the traditional view for that. The research indicated that both ways had a significant influence on students' English translating and interpreting abilities. However, the traditional way had little effect on students' understanding, but the CL view had a considerable impact. The study compared CL and traditional teaching approaches to identify benefits and challenges associated with incorporating CL into the curriculum. It seeks to extend CL concepts by analyzing metaphorical expressions in daily conversations, offering insights into how CL can enhance language learning. The findings shed light on the effectiveness of applying CL in teaching and learning English pragmatics. They highlight the advantages of using metaphorical expressions from daily life to facilitate understanding and explore how CL can enhance cognitive processes in language learning in general and teaching English pragmatics to third-year students at the UFLS - UDN, Vietnam in personal. The study contributes to the theoretical understanding of the relationship between language, cognition, and learning. By emphasizing the metaphorical nature of human conceptual systems, it offers insights into how CL can enrich language teaching practices and enhance students' comprehension of abstract concepts.

Keywords: cognitive linguisitcs, lakoff and johnson, pragmatics, UFLS

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Authors: Lorena Blasco-Arcas, Francesca Pucciarelli

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Business contexts have become globalised and digitalised, which requires that managers develop a strong sense of cross-cultural intelligence while working in geographically distant teams by means of digital technologies. How to better equip future managers on these kinds of skills has been put forward as a critical issue in Business Schools. In pursuing these goals, higher education is shifting from a passive lecture approach, to more active and experiential learning approaches that are more suitable to learn skills. For example, through the use of case studies, proposing plausible business problem to be solved by students (or teams of students), these institutions have focused for long in fostering learning by doing. Though, case studies are no longer enough as a tool to promote active teamwork and experiential learning. Moreover, digital advancements applied to educational settings have enabled augmented classrooms, expanding the learning experience beyond the class, which increase students’ engagement and experiential learning. Different authors have highlighted the benefits of digital engagement in order to achieve a deeper and longer-lasting learning and comprehension of core marketing concepts. Clickers, computer-based simulations and business games have become fairly popular between instructors, but still are limited by the fact that are fictional experiences. Further exploration of real digital platforms to implement real, live projects in the classroom seem relevant for marketing and business education. Building on this, this paper describes the development of an experiential learning activity in class, in which students developed a communication campaign in teams using the BuzzFeed platform, and subsequently implementing the campaign by using other social media platforms (e.g. Facebook, Instagram, Twitter…). The article details the procedure of using the project for a marketing module in a Bachelor program with students located in France, Italy and Spain campuses working on multi-campus groups. Further, this paper describes the project outcomes in terms of students’ engagement and analytics (i.e. visits achieved). the project included a survey in order to analyze and identify main aspects related to how the learning experience is influenced by the cultural competence developed through working in geographically distant and culturally diverse teamwork. Finally, some recommendations to use project-based social media tools while working with virtual teamwork in the classroom are provided.

Keywords: cultural competences, experiential learning, social media, teamwork, virtual group work

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Authors: Marine Agogue, Beatrice Parguel, Emilie Canet

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Defined as receptive attention to and awareness of present events and experience, mindfulness has grown in popularity over the past 30 years to become a trendy buzzword in business media, which regularly reports on its organizational benefits. Mindfulness would enhance or impede creative thinking depending on the type of meditation. Specifically, focused-attention meditation (focusing attention on one object instead of being open to perceive and observe any sensation or thought) would not be or negatively correlated to creativity. This research explores whether mood, in its two dimensions (i.e., hedonic tone, activation level), could mediate this potentially negative effect. The rationale is that focused-attention meditation is likely to improve hedonic tone but, in the meantime, damage activation level, resulting in opposite effects on creativity through the mediation effect of creative self-efficacy, i.e., the belief that one can perform successfully in an ideation setting. To test this conceptual model, a survey was administered to 97 subjects (53% women, mean age: 25 years), randomly assigned to three conditions (a 10-minute focused-attention meditation session vs. a 10-minute psychometric tests session vs. a control condition) and asked to participate in the egg creative task. Creativity was measured in terms of fluency, expansivity, and originality, the other variables using existing scales: hedonic tone (e.g., joyful, happy), activation level (e.g., passive, sluggish), creative self-efficacy (e.g., ‘I felt confident in my ability to do the task effectively’) and self-perceived creativity (e.g., ‘I have lots of original ideas’). The chains of mediation were tested using PROCESS macro (model 6) and controlled for subjects’ gender, age, and self-perceived creativity. Comparing the mindfulness and the control conditions, no difference appeared in terms of creativity, nor any mediation chain by hedonic tone. However, subjects who participated in the meditation session felt less active than those in the control condition, which decreased their creative self-efficacy, and creativity (whatever the indicator considered). Comparing the mindfulness and the psychometric tests conditions, analyses showed that creativity was higher in the psychometric tests condition. As previously, no mediation chain appeared by hedonic tone. However, subjects who participated in the meditation session felt less active than those in the psychometric tests condition, which decreased their creative self-efficacy, and creativity. These findings confirm that focused-attention meditation does not enhance creativity. They demonstrate an emotional underlying mechanism based on activation level and suggest that both positive and active mood states have the potential to enhance creativity through creative self-efficacy. In the end, they should discourage organizations from trying to nudge creativity using mindfulness ad hoc devices.

Keywords: creativity, mindfulness, creative self-efficacy, experiment

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Authors: Bronwyn Griffin, Caroline Acton, Tona Gillen, Roy Kimble

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Background: Bicycle riding is a common recreational activity enjoyed by many children throughout Australia that has been associated with the usual caveat of benefits related to exercise and recreation. Given Australia was the first country in the world to introduce cyclist helmet laws in 1991, very few publications have reviewed paediatric cycling injuries (fatal or non-fatal) since. Objectives: To identify trends in children (0-16 years) who required admission for greater than 24 hours following a bicycle-related injury (fatal and non-fatal) in Queensland. Further, to discuss changes that have occurred in paediatric cycling injury trends in Queensland since a prominent local study/publication in 1995. This paper aims to establish evidence to inform interventions promoting safer riding to parents, children and communities. Methods: Data on paediatric (0-16 years) cycling injuries in Queensland resulting in hospital admission more than 24 hours across three tertiary paediatric hospitals in Brisbane between November 2008-June 2015 was compiled by the Paediatric Trauma Data Registry for non-fatal injuries. The Child Death Review Team at the Queensland Families and Childhood Commission provided data on fatalities in children <17years from (June 2004 –June 2015). Comparing trends to a local study published in 1995 Results: Between 2008-2015 there were 197 patients admitted for greater than 24 hours following a cycling injury. The median age was 11 years, with males more frequently involved (n=139, 87%) compared to females. Mean length of stay was three days, with 47 (28%) children admitted to PICU, location of injury was most often the street (n=63, 37%). Between 2004 –2015 there were 15 fatalities (Incidence rate 0.25/100,000); all were male, 14/15 occurred on the street, with eight stated to have not been wearing a helmet, 11/15 children came from the least advantaged socio-economic group (SEIFA) compared to a local publication in 1995, finding of 94 fatalities between (1981-1992). Conclusions: There has been a notable decrease in incidence of fatalities between the two time periods with incidence rates dropping from 1.75-0.25/100,000. More statistics need to be run to ascertain if this is a true reduction or perhaps a decrease in children riding bicycles. Injuries that occur on the street that come in contact with a car remain of serious concern. The purpose of this paper is not to discourage bicycle riding among child and adolescent populations, rather, inform parents and the wider community about the risks associated with cycling in order to reduce injuries associated with this sport, whilst promoting safe cycling.

Keywords: paediatric, cycling, trauma, prevention, emergency

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Authors: Cao Bin, Yuan Yi, Wang Qiang, Amor Abdelkader, Ali Reza Kamali, Diogo Montalvão

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The study of the electrodynamic behavior of non-ferrous particles in time-varying magnetic fields is a promising area of research with wide applications, including recycling of non-ferrous metals, mechanical transmission, and space debris. The key technology for recovering non-ferrous metals is eddy current separation (ECS), which utilizes the eddy current force and torque to separate non-ferrous metals. ECS has several advantages, such as low energy consumption, large processing capacity, and no secondary pollution, making it suitable for processing various mixtures like electronic scrap, auto shredder residue, aluminum scrap, and incineration bottom ash. Improving the separation efficiency of mixtures with different particle sizes in ECS can create significant social and economic benefits. Our previous study investigated the influence of particle size on separation efficiency by combining numerical simulations and separation experiments. Pearson correlation analysis found a strong correlation between the eddy current force in simulations and the repulsion distance in experiments, which confirmed the effectiveness of our simulation model. The interaction effects between particle size and material type, rotational speed, and magnetic pole arrangement were examined. It offer valuable insights for the design and optimization of eddy current separators. The underlying mechanism behind the effect of particle size on separation efficiency was discovered by analyzing eddy current and field gradient. The results showed that the magnitude and distribution heterogeneity of eddy current and magnetic field gradient increased with particle size in eddy current separation. Based on this, we further found that increasing the curvature of magnetic field lines within particles could also increase the eddy current force, providing a optimized method to improving the separation efficiency of fine particles. By combining the results of the studies, a more systematic and comprehensive set of optimization guidelines can be proposed for mixtures with different particle size ranges. The separation efficiency of fine particles could be improved by increasing the rotational speed, curvature of magnetic field lines, and electrical conductivity/density of materials, as well as utilizing the eddy current torque. When designing an ECS, the particle size range of the target mixture should be investigated in advance, and the suitable parameters for separating the mixture can be fixed accordingly. In summary, these results can guide the design and optimization of ECS, and also expand the application areas for ECS.

Keywords: eddy current separation, particle size, numerical simulation, metal recovery

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Authors: Yazmin Pineda Zapata

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Leading a complete school and culture transformation can be a daunting task for any administrator. This is especially true when change agents are advocating for inclusive reform in their schools. As leaders embark on this journey, they must ascertain that an inclusive environment is not a place, a classroom, or a resource setting; it is a place of acceptance nurtured by supportive and meaningful learning opportunities where all students can thrive. A qualitative approach, phenomenology, was used to investigate principals’ actions and behaviors that supported inclusive schooling for students with disabilities. Specifically, this study sought to answer the following research question: How do leaders develop and maintain inclusive education? Fourteen K-12 principals purposefully selected from various sources (e.g., School Wide Integrated Framework for Transformation (SWIFT), The Maryland Coalition for Inclusive Education (MCIE), The Arc of Texas Inclusion Works organization, The Association for Persons with Severe Handicaps (TASH), the CAL State Summer Institute in San Marcos, and the PEAK Parent Center and/or other recognitions were interviewed individually using a semi-structured protocol. Upon completion of data collection, all interviews were transcribed and marked using A priori coding to analyze the responses and establish a correlation among Villa and Thousand’s five organizational supports to achieve inclusive educational reform: Vision, Skills, Incentives, Resources, and Action Plan. The findings of this study reveal the insights of principals who met specific criteria and whose schools had been highlighted as exemplary inclusive schools. Results show that by implementing the five organizational supports, principals were able to develop and sustain successful inclusive environments where both teachers and students were motivated, made capable, and supported through the redefinition and restructuring of systems within the school. Various key details of the five variables for change depict essential components within these systems, which include quality professional development, coaching and modeling of co-teaching strategies, collaborative co-planning, teacher leadership, and continuous stakeholder (e.g., teachers, students, support staff, and parents) involvement. The administrators in this study proved the valuable benefits of inclusive education for students with disabilities and their typically developing peers. Together, along with their teaching and school community, school leaders became capable stakeholders that promoted the vision of inclusion, planned a structured approach, and took action to make it a reality.

Keywords: Inclusive education, leaders, principals, shared-decision making, shared leadership, special education, sustainable change

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Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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Authors: Mounir Soule, Hindatou Saidou, Razafimahefa, Mohamed Thani Ibouroi

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High levels of habitat fragmentation and loss are the main drivers of plant species extinction. They reduce the habitat quality, which is a determining factor for the reproduction of plant species, and generate strong selective pressures for habitat selection, with impacts on the reproduction and survival of individuals. The Comorian’s yam (Dioscorea comorensis) is one of the most threatened plant species of the Comoros archipelago. The species faces one of the highest rates of habitat loss worldwide (9.3 % per year) and is classified as Endangered in the IUCN red list. Despite the nutritional potential of this tuber, the Comorian’s yam cultivation remains neglected by local populations due probably to lack of knowledge on its nutritional importance and the factors driving its spatial distribution and development. In this study, we assessed the nutritional characteristics of Dioscorea comorensis and the drivers of spatial distribution and abundance to propose conservation measures and improve crop yields. To determine the nutritional characteristics, the Kjeldahl method, the Soxhlet method, and Atwater's specific calorific coefficients methods were applied for analyzing proteins, lipids, and caloric energy respectively. In addition, atomic absorption spectrometry was used to measure mineral particles. By combining species occurrences with ecological (habitat types), climatic (temperature, rainfall, etc.), and physicochemical (soil types and quality) variables, we assessed habitat suitability and spatial distribution of the species and the factors explaining the origin, persistence, distribution and competitive capacity of a species using a Species Distribution Modeling (SDM) method. The results showed that the species contains 83.37% carbohydrates, 6.37% protein, and 0.45% lipids. In 100 grams, the quantities of Calcium, Sodium, Zinc, Iron, Copper, Potassium, Phosphorus, Magnesium, and Manganese are respectively 422.70, 599.41, 223.11, 252.32, 332.20, 780.41, 444.17, 287.71 and 220.73 mg. Its PRAL index is negative (- 9.80 mEq/100 g), and its Ca/P (0.95) and Na/K (0.77) ratios are less than 1. This species provides an energy value of 357.46 Kcal per 100 g, thanks to its carbohydrates and minerals and is distinguished from others by its high protein content, offering benefits for cardiovascular health. According to our SDM, the species has a very limited distribution, restricted to forests with higher biomass, humidity, and clay. Our findings highlight how distribution patterns are related to ecological and environmental factors. They also emphasize how the Comoros yam is beneficial in terms of nutritional quality. Our results represent a basic knowledge that will help scientists and decision-makers to develop conservation strategies and to improve crop yields.

Keywords: Dioscorea comorensis, nutritional characteristics, species distribution modeling, conservation strategies, crop yields improvement

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Authors: M. Roberts

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We Are Undefeatable - is a mass marketing behaviour change campaign that aims to support the least active people living with long term health conditions to be more active. This is an important issue to address because people with long term conditions are an historically underserved community for the sport and physical activity sector and the least active of those with long term conditions have the most to gain in health and wellbeing benefits. The campaign has generated a significant change in the way physical activity is communicated and people with long term conditions are represented in the media and marketing. The goal is to create a social norm around being active. The campaign is led by a unique partnership of organisations: the Richmond Group of Charities (made up of Age UK, Alzheimer’s Society, Asthma + Lung UK, Breast Cancer Now, British Heart Foundation, British Red Cross, Diabetes UK, Macmillan Cancer Support, Rethink Mental Illness, Royal Voluntary Service, Stroke Association, Versus Arthritis) along with Mind, MS Society, Parkinson’s UK and Sport England, with National Lottery Funding. It is underpinned by the COM-B model of behaviour change. It draws on the lived experience of people with multiple long term conditions to shape the look and feel of the campaign and all the resources available. People with long term conditions are the campaign messengers, central to the ethos of the campaign by telling their individual stories of overcoming barriers to be active with their health conditions. The central messaging is about finding a way to be active that works for the individual. We Are Undefeatable is evaluated through a multi-modal approach, including regular qualitative focus groups and a quantitative evaluation tracker undertaken three times a year. The campaign has highlighted the significant barriers to physical activity for people with long term conditions. This has changed the way our partnership talks about physical activity but has also had an impact on the wider sport and physical activity sector, prompting an increasing departure from traditional messaging and marketing approaches for this audience of people with long term conditions. The campaign has reached millions of people since its launch in 2019, through multiple marketing and partnership channels including primetime TV advertising and promotion through health professionals and in health settings. Its diverse storytellers make it relatable to its target audience and the achievable activities highlighted and inclusive messaging inspire our audience to take action as a result of seeing the campaign. The We Are Undefeatable campaign is a blueprint for physical activity campaigns; it not only addresses individual behaviour change but plays a role in addressing systemic barriers to physical activity by sharing the lived experience insight to shape policy and professional practice.

Keywords: behaviour change, long term conditions, partnership, relatable

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Authors: Raquel Camprubí

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Cultural tourism has been postulated as relevant motivation for tourist over the world during the last decades. In this context, museums are the main attraction for cultural tourists who are seeking to connect with the history and culture of the visited place. From the point of view of an urban destination, museums and other cultural resources are essential to have a strong tourist supply at the destination, in order to be capable of catching attention and interest of cultural tourists. In particular, museums’ challenge is to be prepared to offer the best experience to their visitors without to forget their mission-based mainly on protection of its collection and other social goals. Thus, museums individually want to be competitive and have good positioning to achieve their strategic goals. The life cycle of the destination and the level of maturity of its tourism product influence the need of tourism agents to cooperate and collaborate among them, in order to rejuvenate their product and become more competitive as a destination. Additionally, prior studies have considered an approach of different models of a public and private partnership, and collaborative and cooperative relations developed among the agents of a tourism destination. However, there are no studies that pay special attention to museums and the strategic alliances developed to obtain mutual benefits. Considering this background, the purpose of this study is to analyze in what extent museums of a given urban destination have established strategic links and relations among them, in order to improve their competitive position at both individual and destination level. In order to achieve the aim of this study, the city of Girona (Spain) and the museums located in this city are taken as a case study. Data collection was conducted using in-depth interviews, in order to collect all the qualitative data related to nature, strengthen and purpose of the relational ties established among the museums of the city or other relevant tourism agents of the city. To conduct data analysis, a Social Network Analysis (SNA) approach was taken using UCINET software. Position of the agents in the network and structure of the network was analyzed, and qualitative data from interviews were used to interpret SNA results. Finding reveals the existence of strong ties among some of the museums of the city, particularly to create and promote joint products. Nevertheless, there were detected outsiders who have an individual strategy, without collaboration and cooperation with other museums or agents of the city. Results also show that some relational ties have an institutional origin, while others are the result of a long process of cooperation with common projects. Conclusions put in evidence that collaboration and cooperation of museums had been positive to increase the attractiveness of the museum and the city as a cultural destination. Future research and managerial implications are also mentioned.

Keywords: cultural tourism, competitiveness, museums, Social Network analysis

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Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

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Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

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Authors: Edna Negron-Martinez

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Our time's global challenges and trends —like those associated with climate change, demographics displacements, growing health inequalities, and increasing burden of diseases— have complex connections to the determinants of health. Information on the burden of disease causes and prevention is fundamental for public health actions, like preparedness and responses for disasters, and recovery resources after the event. For instance, there is an increasing consensus about key findings of the effects and connections of the global burden of disease, as it generates substantial healthcare costs, consumes essential resources and prevents the attainment of optimal health and well-being. The goal of this research endeavor is to promote a comprehensive understanding of the connections between social, environmental, and economic influences on health. These connections are illustrated by pulling from clearly the core curriculum of multidisciplinary areas —as urban design, energy, housing, and economy— as well as in the health system itself. A systematic review of primary and secondary data included a variety of issues as global health, natural disasters, and critical pollution impacts on people's health and the ecosystems. Environmental health is challenged by the unsustainable consumption patterns and the resulting contaminants that abound in many cities and urban settings around the world. Poverty, inadequate housing, and poor health are usually linked. The house is a primary environmental health context for any individual and especially for more vulnerable groups; such as children, older adults and those who are sick. Nevertheless, very few countries show strong decoupling of environmental degradation from economic growth, as indicated by a recent 2017 Report of the World Bank. Worth noting, the environmental fraction of the global burden of disease in a 2016 World Health Organization (WHO) report estimated that 12.6 million global deaths, accounting for 23% (95% CI: 13-34%) of all deaths were attributable to the environment. Among the environmental contaminants include heavy metals, noise pollution, light pollution, and urban sprawl. Those key findings make a call to the significance to urgently adopt in a global scale the United Nations post-2015 Sustainable Development Goals (SDGs). The SDGs address the social, environmental, and economic factors that influence health and health inequalities, advising how these sectors, in turn, benefit from a healthy population. Consequently, more actions are necessary from an inter-sectoral and systemic paradigm to enforce an integrated sustainability policy implementation aimed at the environmental, social, and economic determinants of health.

Keywords: building capacity for workforce development, ecological and environmental health effects of pollution, public health education, sustainability

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Authors: Bianca Price, Jennifer Stokes

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Academic and social support systems are critical for students in enabling education; these support systems have the potential to enhance the student experience whilst also serving a vital role for student retention. In the context of international moves toward widening university participation, Australia has developed enabling programs designed to support underrepresented students to access to higher education. The purpose of this study is to examine the effectiveness of a mentor program based within an enabling course. This study evaluates how the mentor program supports new students to develop social networks, improve retention, and increase satisfaction with the student experience. Guided by Social Learning Theory (SLT), this study highlights the benefits that can be achieved when students engage in peer-to-peer based mentoring for both social and learning support. Whilst traditional peer mentoring programs are heavily based on face-to-face contact, the present study explores the difference between mentors who provide face-to-face mentoring, in comparison with mentoring that takes place through the virtual space, specifically via a virtual community in the shape of a Facebook group. This paper explores the differences between these two methods of mentoring within an enabling program. The first method involves traditional face-to-face mentoring that is provided by alumni students who willingly return to the learning community to provide social support and guidance for new students. The second method requires alumni mentor students to voluntarily join a Facebook group that is specifically designed for enabling students. Using this virtual space, alumni students provide advice, support and social commentary on how to be successful within an enabling program. Whilst vastly different methods, both of these mentoring approaches provide students with the support tools needed to enhance their student experience and improve transition into University. To evaluate the impact of each mode, this study uses mixed methods including a focus group with mentors, in-depth interviews, as well as engaging in netnography of the Facebook group ‘Wall’. Netnography is an innovative qualitative research method used to interpret information that is available online to better understand and identify the needs and influences that affect the users of the online space. Through examining the data, this research will reflect upon best practice for engaging students in enabling programs. Findings support the applicability of having both face-to-face and online mentoring available for students to assist enabling students to make a positive transition into University undergraduate studies.

Keywords: enabling education, mentoring, netnography, social learning theory

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Authors: Dorota M. Michalak

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The agricultural sector, due to the growing demand for food and over-exploitation of the natural environment, contributes to the deepening of climate change, on the one hand, and on the other hand, shrinking freshwater resources, as a negative effect of climate change, threaten the food security of each country. Therefore, adaptation measures to climate change should take into account effective water management and seek solutions ensuring food production at an unchanged or higher level, while not burdening the environment and not contributing to the worsening of the negative consequences of climate change. The problems of Poland's water management result not only from relatively small, natural water resources but to a large extent on the low efficiency of their use. Appropriate agricultural practices and state solutions in this field can contribute to achieving significant benefits in terms of economical water management in agriculture, providing a greater amount of water that could also be used for other purposes, including for purposes related to environmental protection. The aim of the article is to determine the level of use of water resources in Polish agriculture and the advancement of measures aimed at adapting Polish agriculture in the field of water management to climate change. The study provides knowledge about Polish legal regulations and water management tools, the shaping of water policy of Polish agriculture against the background of EU countries and other sources of energy, and measures supporting Polish agricultural holdings in the effective management of water resources run by state budget institutions. In order to achieve the above-mentioned goals, the author used research tools such as the analysis of existing sources and a survey conducted among five groups of entities, i.e. agricultural advisory centers and departments, agricultural, rural and environmental protection departments, regional water management boards, provincial agricultural chambers and restructuring and modernization of agriculture. The main conclusion of the analyses carried out is the low use of water in Polish agriculture in relation to other EU countries, other sources of intake in Poland, as well as irrigation. The analysis allows us to observe another problem, which is the lack of reporting and data collection, which is extremely important from the point of view of the effectiveness of adaptation measures to climate change. The results obtained from the survey indicate a very low level of support for government institutions in the implementation of adaptation measures to climate change and the water management of Polish farms. Some of the basic problems of the adaptation policy to change climate with regard to water management in Polish agriculture include a lack of knowledge regarding climate change, the possibilities of adapting, the available tools or ways to rationalize the use of water resources. It also refers to the lack of ordering procedures and the separation of responsibility with a proper territorial unit, non-functioning channels of information flow and practically low effects.

Keywords: water management, adaptation policy, agriculture, climate change

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Authors: Tom Elias, Kiran G. Shirlal

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Coastal erosion is one of the major issue faced by maritime countries, globally. More than 1200 km stretch of Indian coastline is marked eroding. There have been numerous attempts to impede the erosion rate and to attain equilibrium beach profiles. High cost and unavailability of natural rocks forced coastal engineers to find alternatives for conventional hard options like seawalls and groynes. Geosynthetic containment systems, emerged in the mid 20th century proved promising in catering coastal protection in countries like Australia, Germany and United States. The present study aims at reviewing Indian timeline of protection works that uses geosynthetic containment systems. Indian exploration regarding geosynthetic containment system dates back to early 2000s. Generally, protection structures use geosynthetics in the form of Geotubes, Geocontainers, and Geobags with Geotubes being most widely used in the form of submerged reefs, seawalls, groynes and breakwaters. Sand and dredged waste are used to fill these containment systems with calculated sand fill ratio. Reviewing the prominent protection works constructed in the east and west coast of India provides an insight into benefits and the difficulties faced by the practical installation. Initially, geosynthetic structures were considered as a temporary protection method prior to the construction of some other hard structure. Later Dahanu, Hamala and Pentha experiences helped in establishing geotubes as an alternative to conventional structures. Nearshore geotubes reefs aimed to attain equilibrium beach served its purpose in Hamala and Dahanu, Maharashtra, while reef constructed at Candolim, Goa underwent serious damage due to Toe Scour. In situ filling by pumping of sand slurry as in case of Shankarpur Seawall, West Bengal remains as a major concern. Geosynthetic systems supplemented by gabions and rock armours improves the wave dissipation, stability and reflection characteristics as implied in Pentha Coast, Odisha, Hazira, Gujarat and Uppada, Andhra Pradesh. Keeping improper design and deliberate destruction by vandals apart, geosynthetic containment systems offer a cost-effective alternative to conventional coastal protection methods in India. Additionally, geosynthetics supports marine growth in its surface which enhances its demand as an eco-friendly material and encourages usage.

Keywords: coastal protection, geotubes, geobags, geocontainers

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Authors: Pantea Salehizadeh, Martin P. Bucknall, Robert Driscoll, Jayashree Arcot, George Srzednicki

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Banana is one of the most important crops produced in large quantities in tropical and sub-tropical countries. Of the total plant material grown, approximately 40% is considered waste and left in the field to decay. This practice allows fungal diseases such as Sigatoka Leaf Spot to develop, limiting plant growth and spreading spores in the air that can cause respiratory problems in the surrounding population. The pseudostem is considered a waste residue of production (60 to 80 tonnes/ha/year), although it is a good source of dietary fiber and volatile organic compounds (VOC’s). Strategies to process banana pseudostem into palatable, nutritious and marketable food materials could provide significant social and economic benefits. Extraction of VOC’s with desirable odor from dried and fresh pseudostem could improve the smell of products from the confectionary and bakery industries. Incorporation of banana pseudostem flour into bakery products could provide cost savings and improve nutritional value. The aim of this study was to determine the effects of drying methods and different banana species on the profile of volatile aroma compounds in dried banana pseudostem. The banana species analyzed were Musa acuminata and Musa balbisiana. Fresh banana pseudostem samples were processed by either freeze-drying (FD) or heat pump drying (HPD). The extraction of VOC’s was performed at ambient temperature using vacuum distillation and the resulting, mostly aqueous, distillates were analyzed using headspace solid phase microextraction (SPME) gas chromatography – mass spectrometry (GC-MS). Optimal SPME adsorption conditions were 50 °C for 60 min using a Supelco 65 μm PDMS/DVB Stableflex fiber1. Compounds were identified by comparison of their electron impact mass spectra with those from the Wiley 9 / NIST 2011 combined mass spectral library. The results showed that the two species have notably different VOC profiles. Both species contained VOC’s that have been established in literature to have pleasant appetizing aromas. These included l-Menthone, D-Limonene, trans-linlool oxide, 1-Nonanol, CIS 6 Nonen-1ol, 2,6 Nonadien-1-ol, Benzenemethanol, 4-methyl, 1-Butanol, 3-methyl, hexanal, 1-Propanol, 2-methyl- acid، 2-Methyl-2-butanol. Results show banana pseudostem VOC’s are better preserved by FD than by HPD. This study is still in progress and should lead to the optimization of processing techniques that would promote the utilization of banana pseudostem in the food industry.

Keywords: heat pump drying, freeze drying, SPME, vacuum distillation, VOC analysis

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Authors: Minji Seo

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Fashion stakeholders are becoming increasingly aware of technological innovation in manufacturing. In 2020, the COVID-19 pandemic caused transformations in working patterns, such as working remotely rather thancommuting. To enable smooth remote working, 3D fashion design software is being adoptedas the latest trend in design and production. The majority of fashion designers, however, are still resistantto this change. Previous studies on 3D fashion design software solely highlighted the beneficial and detrimental factors of adopting design innovations. They lacked research on the relationship between resistance factors and the adoption of innovation. These studies also fell short of exploringthe perspectives of users of these innovations. This paper aims to investigate the key drivers and barriers of employing 3D fashion design software as wellas to explore the challenges faced by designers.It also toucheson the governmental support for digital manufacturing in Seoul, South Korea, and London, the United Kingdom. By conceptualising local support, this study aims to provide a new path for industrial clusters to optimise digital apparel manufacturing. The study uses a mixture of quantitative and qualitative approaches. Initially, it reflects a survey of 350 samples, fashion designers, on innovation resistance factors of 3D fashion design software and the effectiveness of local support. In-depth interviews with 30 participants provide a better understanding of designers’ aspects of the benefits and obstacles of employing 3D fashion design software. The key findings of this research are the main barriers to employing 3D fashion design software in fashion production. The cultural characteristics and interviews resultsare used to interpret the survey results. The findings of quantitative data examine the main resistance factors to adopting design innovations. The dominant obstacles are: the cost of software and its complexity; lack of customers’ interest in innovation; lack of qualified personnel, and lack of knowledge. The main difference between Seoul and London is the attitudes towards government support. Compared to the UK’s fashion designers, South Korean designers emphasise that government support is highly relevant to employing 3D fashion design software. The top-down and bottom-up policy implementation approach distinguishes the perception of government support. Compared to top-down policy approaches in South Korea, British fashion designers based on employing bottom-up approaches are reluctant to receive government support. The findings of this research will contribute to generating solutions for local government and the optimisation of use of 3D fashion design software in fashion industrial clusters.

Keywords: digital apparel production, industrial clusters, innovation resistance, 3D fashion design software, manufacturing, innovation, technology, digital manufacturing, innovative fashion design process

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Authors: Dinesh Munjurulimana, Anil Tiwari, Tingwen Li, Carlos Pereira, Sreekanth Pannala, John Waters

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With the rapid transition to electric vehicles (EVs) across the globe, car manufacturers are in need of integrated and lightweight solutions for the battery packs of these vehicles. An integral part of a battery pack is the battery tray, which constitutes a significant portion of the pack’s overall weight. Based on the functional requirements, cost targets, and packaging space available, a range of materials –from metals, composites, and plastics– are often used to develop these battery trays. This paper considers the design and development of integrated thermoplastic-intensive battery trays, using the available packaging space from a representative EV battery pack. Presented as a proposed alternative are multiple concepts to integrate several connected systems such as cooling plates and underbody impact protection parts of a multi-piece incumbent battery pack. The resulting digital prototype was evaluated for several mechanical performance measures such as mechanical shock, drop, crush resistance, modal analysis, and torsional stiffness. The performance of this alternative design is then compared with the incumbent solution. In addition, insights are gleaned into how these novel approaches can be optimized to meet or exceed the performance of incumbent designs. Preliminary manufacturing feasibility of the optimal solution using injection molding and other commonly used manufacturing methods for thermoplastics is briefly explained. Then numerical and analytical evaluations are performed to show a representative Pareto front of cost vs. volume of the production parts. The proposed solution is observed to offer weight savings of up to 40% on a component level and part elimination of up to two systems in the battery pack of a typical battery EV while offering the potential to meet the required performance measures highlighted above. These conceptual solutions are also observed to potentially offer secondary benefits such as improved thermal and electrical isolations and be able to achieve complex geometrical features, thus demonstrating the ability to use the complete packaging space available in the vehicle platform considered. The detailed study presented in this paper serves as a valuable reference for researches across the globe working on the development of EV battery packs – especially those with an interest in the potential of employing alternate solutions as part of a mixed-material system to help capture untapped opportunities to optimize performance and meet critical application requirements.

Keywords: thermoplastics, lightweighting, part integration, electric vehicle battery packs

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Authors: James Gallagher, Phillip Benachour

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As location aware mobile technologies become ever more omnipresent, the prospect of exploiting their context awareness to enforce learning approaches thrives. Utilizing the growing acceptance of ubiquitous computing, and the steady progress both in accuracy and battery usage of pervasive devices, we present a case study of remote location viewing, how the application can be utilized to support mobile learning in situ using an existing scenario. Through the case study we introduce a new innovative application: Mobipeek based around a request/response protocol for the viewing of a remote location and explore how this can apply both as part of a teacher lead activity and informal learning situations. The system developed allows a user to select a point on a map, and send a request. Users can attach messages alongside time and distance constraints. Users within the bounds of the request can respond with an image, and accompanying message, providing context to the response. This application can be used alongside a structured learning activity such as the use of mobile phone cameras outdoors as part of an interactive lesson. An example of a learning activity would be to collect photos in the wild about plants, vegetation, and foliage as part of a geography or environmental science lesson. Another example could be to take photos of architectural buildings and monuments as part of an architecture course. These images can be uploaded then displayed back in the classroom for students to share their experiences and compare their findings with their peers. This can help to fosters students’ active participation while helping students to understand lessons in a more interesting and effective way. Mobipeek could augment the student learning experience by providing further interaction with other peers in a remote location. The activity can be part of a wider study between schools in different areas of the country enabling the sharing and interaction between more participants. Remote location viewing can be used to access images in a specific location. The choice of location will depend on the activity and lesson. For example architectural buildings of a specific period can be shared between two or more cities. The augmentation of the learning experience can be manifested in the different contextual and cultural influences as well as the sharing of images from different locations. In addition to the implementation of Mobipeek, we strive to analyse this application, and a subset of other possible and further solutions targeted towards making learning more engaging. Consideration is given to the benefits of such a system, privacy concerns, and feasibility of widespread usage. We also propose elements of “gamification”, in an attempt to further the engagement derived from such a tool and encourage usage. We conclude by identifying limitations, both from a technical, and a mobile learning perspective.

Keywords: context aware, location aware, mobile learning, remote viewing

Procedia PDF Downloads 290

Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

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Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

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Authors: Esraa A. Khalil, Mohamed N. AbouZeid

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Building materials selection is critical for the sustainability of any project. The choice of building materials has a huge impact on the built environment and cost of projects. Building materials emit huge amount of carbon dioxide (CO₂) due to the use of cement as a basic component in the manufacturing process and as a binder, which harms our environment. Energy consumption from buildings has increased in the last few years; a huge amount of energy is being wasted from using unsustainable building and finishing materials, as well as from the process of heating and cooling of buildings. In addition, the construction sector in Egypt is taking a good portion of the economy; however, there is a lack of awareness of buildings environmental impacts on the built environment. Using advanced building materials and different wall systems can help in reducing heat consumption, the project’s initial and long-term costs, and minimizing the environmental impacts. Red Bricks is one of the materials that are being used widely in Egypt. There are many other types of bricks such as Autoclaved Aerated Concrete (AAC); however, the use of Red Bricks is dominating the construction industry due to its affordability and availability. This research focuses on the New Egyptian Administrative Capital as a case study to investigate the potential of the influence of using different wall systems such as AAC on the project’s cost and the environment. The aim of this research is to conduct a comparative analysis between the traditional and most commonly used bricks in Egypt, which is Red Bricks, and AAC wall systems. Through an economic and environmental study, the difference between the two wall systems will be justified to encourage the utilization of uncommon techniques in the construction industry to build more affordable, energy efficient and sustainable buildings. The significance of this research is to show the potential of using AAC in the construction industry and its positive influences. The study analyzes the factors associated with choosing suitable building materials for different projects according to the need and criteria of each project and its nature without harming the environment and wasting materials that could be saved or recycled. The New Egyptian Administrative Capital is considered as the country’s new heart, where ideas regarding energy savings and environmental benefits are taken into consideration. Meaning that, Egypt is taking good steps to move towards more sustainable construction. According to the analysis and site visits, there is a potential in reducing the initial costs of buildings by 12.1% and saving energy by using different techniques up to 25%. Interviews with the mega structures project engineers and managers reveal that they are more open to introducing sustainable building materials that will help in saving the environment and moving towards green construction as well as to studying more effective techniques for energy conservation.

Keywords: AAC blocks, building material, environmental impact, modern construction, new Egyptian administrative capital

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Authors: Marc Romero-Estonllo, Judith Ramos-Castro, Yaiza San Miguel, Beatriz Rodríguez-Garrido, Carmela Monterroso

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Mining activity is among the main sources of trace and heavy metal(loid) pollution worldwide, which is a hazard to human and environmental health. That is why several projects have been emerging for the remediation of such polluted places. Phytomanagement strategies draw good performances besides big side benefits. In this work, a glasshouse assay with trace element polluted soils from an old Cu mine ore (NW of Spain) which forms part of the PhytoSUDOE network of phytomanaged contaminated field sites (PhytoSUDOE Project (SOE1/P5/E0189)) was set. The objective was to evaluate improvements induced by the following phytoremediation-related treatments. Three increasingly complex amendments alone or together with plant growth (Populus nigra L. alone and together with Tripholium repens L.) were tested. And three different rhizosphere bioinocula were applied (Plant Growth Promoting Bacteria (PGP), mycorrhiza (MYC), or mixed (PGP+MYC)). After 110 days of growth, plants were collected, biomass was weighed, and tree length was measured. Physical-chemical analyses were carried out to determine pH, effective Cation Exchange Capacity, carbon and nitrogen contents, bioavailable phosphorous (Olsen bicarbonate method), pseudo total element content (microwave acid digested fraction), EDTA extractable metals (complexed fraction), and NH4NO3 extractable metals (easily bioavailable fraction). On plant material, nitrogen content and acid digestion elements were determined. Amendment usage, plant growth, and bioinoculation were demonstrated to improve soil fertility and/or plant health within the time span of this study. Particularly, pH levels increased from 3 (highly acidic) to 5 (acidic) in the worst-case scenario, even reaching 7 (neutrality) in the best plots. Organic matter and pH increments were related to polluting metals’ bioavailability decrements. Plants grew better both with the most complex amendment and the middle one, with few differences due to bioinoculation. Using the less complex amendment (just compost) beneficial effects of bioinoculants were more observable, although plants didn’t thrive very well. On unamended soils, plants neither sprouted nor bloomed. The scheme assayed in this study is suitable for phytomanagement of these kinds of soils affected by mining activity. These findings should be tested now on a larger scale.

Keywords: aided phytoremediation, mine pollution, phytostabilization, soil pollution, trace elements

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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Authors: Headman Hebe, Arnold Taringa

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Background of the study: The benefits derived from Environmental and Sustainability Education (ESE) go beyond obtaining knowledge about the environment and the impact of human beings on the environment. Hence, it is sensible to expose learners to various resources that could enable meaningful environment-inclined pedagogy. The schoolgrounds, where they are utilised to promote ESE, benefit holistic learner development. However, empirical evidence, globally, suggests that young children’s contact with nature is declining due to urbanization, safety concerns by parents/guardians, and greater dependency on technology. Modern children spend much time on videogames and social media with very little time in the natural environment. Furthermore, national education departments in numerous countries have made tangible efforts to embed environmental and place-based learning to their school curricula. South Africa is one of those countries whose national school education curriculum advocates for ESE in pedagogy. Nevertheless, there is paucity of research conducted in South Africa on schoolgrounds as potential enablers of ESE and tools to foster a connection between youngsters and the natural environment. Accordingly, this study was essential as it seeks to determine the extent to which environmental learning is accommodated in pedagogy. Significantly, it investigates efforts made to use schoolgrounds for pedagogical purposes to connect children with the natural environment. Therefore, this study was conducted to investigate the accessibility and use of schoolgrounds for environment-inclined pedagogy in Natural and Social Sciences in two schools located in the Mpumalanga Province of South Africa. It tries to answer the question: To what extent are schoolgrounds used to promote environmental and sustainability education in the selected schools?The sub-questions: How do teachers and learners perceive the use of schoolgrounds for environmental and sustainability education activities? How does the organization of schoolgrounds offer opportunities for environmental education activities and accessibility for learners? Research method: This qualitative–interpretive case study used purposive and convenient sampling for participant selection. Forty-six respondents: 40 learners (twenty grade 7 learners per school), 2 school principals and 4 grade 7 participated in this study. Data collection tools were observations, interviews, audio-visual recordings and questionnaires while data analysis was done thematically. Major findings: The findings of the study point to: The lack of teacher training and infrastructure in the schoolgrounds and, no administrative support. Unclear curriculum guidelines on the use of schoolgrounds for ESE. The availability various elements in the schoolgrounds that could aid ESE activities. Learners denied access to certain parts of the schoolgrounds. Lack of time and curriculum demands constrain teachers from using schoolgrounds.

Keywords: affordances, environment and sustainability education, experiential learning, schoolgrounds

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Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern

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BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.

Keywords: clinical registry, Delphi survey, quality indicators, quality of care

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Authors: Abdulwakeel B. Raji

Abstract:

This paper introduces a concept of an intelligent virtual learning environment that involves communication between learners and an artificially intelligent teaching agent in an attempt to replicate classroom learning interactions. The benefits of this technology over current e-learning practices is that it creates a virtual classroom where real time adaptive learning interactions are made possible. This is a move away from the static learning practices currently being adopted by e-learning systems. Over the years, artificial intelligence has been applied to various fields, including and not limited to medicine, military applications, psychology, marketing etc. The purpose of e-learning applications is to ensure users are able to learn outside of the classroom, but a major limitation has been the inability to fully replicate classroom interactions between teacher and students. This study used comparative surveys to gain information and understanding of the current learning practices in Nigerian universities and how they compare to these practices compare to the use of a developed e-learning system. The study was conducted by attending several lectures and noting the interactions between lecturers and tutors and as an aftermath, a software has been developed that deploys the use of an artificial intelligent teaching-agent alongside an e-learning system to enhance user learning experience and attempt to create the similar learning interactions to those found in classroom and lecture hall settings. Dialogflow has been used to implement a teaching-agent, which has been developed using JSON, which serves as a virtual teacher. Course content has been created using HTML, CSS, PHP and JAVASCRIPT as a web-based application. This technology can run on handheld devices and Google based home technologies to give learners an access to the teaching agent at any time. This technology also implements the use of definite clause grammars and natural language processing to match user inputs and requests with defined rules to replicate learning interactions. This technology developed covers familiar classroom scenarios such as answering users’ questions, asking ‘do you understand’ at regular intervals and answering subsequent requests, taking advanced user queries to give feedbacks at other periods. This software technology uses deep learning techniques to learn user interactions and patterns to subsequently enhance user learning experience. A system testing has been undergone by undergraduate students in the UK and Nigeria on the course ‘Introduction to Database Development’. Test results and feedback from users shows that this study and developed software is a significant improvement on existing e-learning systems. Further experiments are to be run using the software with different students and more course contents.

Keywords: virtual learning, natural language processing, definite clause grammars, deep learning, artificial intelligence

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Authors: Daniela Pellin, Wilson Engelmann

Abstract:

Brazil has sought to accelerate your development through technology and innovation as a response to the global influences, which has received in internal management practices. For this, it had edited the Brazilian Law of Innovation 13.243/2016. However observing the Law overestimated economic aspects the respective application will not consider the stakeholders and the technological risks because there is no legal treatment. The economic exploitation and the technological risks must be controlled by limits of democratic system to find better social development to contribute with the economics agents for making decision to conform with global directions. The research understands this is a problem to face given the social particularities of the country because there has been the literal import of the North American Triple Helix Theory consolidated in developed countries and the negative consequences when applied in developing countries. Because of this symptomatic scenario, it is necessary to create adjustment to conduct the management of the law besides social democratic interests to increase the country development. For this, therefore, the Government will have to adopt some conducts promoting side by side with universities, civil society and companies, informational transparency, catch of partnerships, create a Confort Letter document for preparation to ensure the operation, joint elaboration of a Manual of Good Practices, make accountability and data dissemination. Also the Universities must promote informational transparency, drawing up partnership contracts and generating revenue, development of information. In addition, the civil society must do data analysis about proposals received for discussing to give opinion related. At the end, companies have to give public and transparent information about investments and economic benefits, risks and innovation manufactured. The research intends as a general objective to demonstrate that the efficiency of the propeller deployment will be possible if the innovative decision-making process goes through the institutional logic. As specific objectives, the American influence must undergo some modifications to better suit the economic-legal incentives to potentiate the development of the social system. The hypothesis points to institutional model for application to the legal system can be elaborated based on emerging characteristics of the country, in such a way that technological risks can be foreseen and there will be global conformity with attention to the full development of society as proposed by the researchers.The method of approach will be the systemic-constructivist with bibliographical review, data collection and analysis with the construction of the institutional and democratic model for the management of the Law.

Keywords: development, governance of law, institutionalization, triple helix

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