Search results for: basic cardiac life support

Authors: Fan Zhang

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In the process of urbanization in China, the new rural construction is in the ascendant, which is becoming more and more popular. Under the driving effect of rural urbanization, the house pattern and tectonic methods of traditional vernacular houses have shown great differences from the family structure and values of contemporary peasant families. Therefore, it is particularly important to find a prototype, form and strategy, to make a balance between the traditional memory and modern functional requirements. In order for research to combine the regional culture with modern life, under the situation of the current batch production of new rural residence, Badie village, in Linhai, Zhejiang province, is taken as the case. This paper aims to put forward a prototype which can not only meet the demand of modern life but also ensure the continuation of traditional culture and historical context for the new rural dwellings design. This research not only helps to extend the local context in the construction of the new site but also contributes to the fusion of old and new rural dwellings in the old site construction. Through the study and research of this case, the research methodology and results can be drawn as reference for the new rural construction in other areas.

Keywords: badie village, design strategy, new rural dwellings, regional context, regional expression

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Authors: Su-Lin Yu

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In recent years, we have witnessed the growing scholarship on transnational theorizing and activism within disability. In particular, the universalizing discourses of disability formulated in the Global North seem inadequate in engaging the vast diversity of discourses of disability that emerge in global and local policies as well as the everyday experiences of disabled people in the Global South. This study will further consider the future possibilities of how Taiwanese and global disability studies might interchange disability knowledge. First, this study will determine how a local literature of disability can be formed in Taiwan by examining life writings written by Taiwanese disabled women. Both the texts and the personal experiences are treated as social products which can, through their discourses, offer insight into the socio-cultural practices and norms of disability and womanhood in Taiwan. This paper argues that more than by the impairment in itself, the experiences of disabled women are shaped by the social and cultural discourses and practices that define disability and womanhood as well as the normative roles, places, and contexts associated with them. Simultaneous analysis of disability and womanhood exemplifies the way in which disability operates in a complex interaction with the socio-cultural discourses and practices of womanhood, thus producing gender-differentiated disabling obstacles for disabled women. Another purpose of this study is to gain an understanding of the transformative experience of women with disabilities and their perceptions of the self. Designed to provide positive, realistic pictures of the lives of women with disabilities and the social, economic, and political issues they face, their life writings demonstrate how they as disabled women simultaneously struggle with writing a new identity and creating an ethical narrative. These strong and articulate women construct narratives that attempt to recount the remarkable journey that transformed them from dependent women to community activists and writers who speak forcefully about the needs of people with disabilities. More than a story of one woman's struggle for independence, their writing, then, is a testimony to the importance of community building and organizing to enable local people with disabilities to live fulfilling lives.

Keywords: gender, disability, representation, agency

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Authors: Naci Büyükkaracığan

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Artificial neural networks (ANN) is an electrical model based on the human brain nervous system and working principle. Artificial neural networks have been the subject of an active field of research that has matured greatly over the past 55 years. ANN now is used in many fields. But, it has been viewed that artificial neural networks give better results in particular optimization and control systems. There are requirements of optimization and control system in many of the area forming the subject of civil engineering applications. In this study, the first artificial intelligence systems are widely used in the solution of civil engineering systems were examined with the basic principles and technical aspects. Finally, the literature reviews for applications in the field of civil engineering were conducted and also artificial intelligence techniques were informed about the study and its results.

Keywords: artificial neural networks, civil engineering, Fuzzy logic, statistics

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Authors: Pei-Jun Xue, Ming-Yu Hsiao

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Language is the emblem of a culture, representing the extension of cultural life. In addition, it is also an important tool for communication and message transmission. It carries not only information but also covers the self-conscious of the information constructor as well as the situational experiences of users from different backgrounds. Moreover, design can be regarded as a language, a dynamic process of coding and decoding. With the designers’ experiences in everyday life, they bring them into the products’ experiences. Considered from the aspects of atmosphere and the five senses, a designer should consider and reconsider how to communicate the messages effectively to suit the users’ needs. In the process of language learning, we should understand the construction behind it and the rules of the compositions of language codes. Regarding the understanding of the design of works or the form of product construction, it is necessary for us to understand the coding system during the process of product construction. The form (signifiers) and meanings (signified) of Chinese characters are closely related. At the same time, it is also a process of simplifying the complicated to the simple. This study discusses the chinese characters that used in the cultural symbols construction, and analysis of existing products by Peirce's semiotic triangles. Through people's cognition of Chinese characters and constitute method, help to understand the way of construction product symbol.

Keywords: cultural-creative product design, cultural product, cultural symbols, linguistic symbols

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Authors: Robin Becker, Maike Eilers, Nane Roetmann, Manfred Helmus

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The shortage of junior staff in the construction industry is a problem that will be further exacerbated in the coming years by the retirement of the baby-boom generations (1955-1969) from employment. In addition, the current working conditions in the field of construction management are not attractive for young professionals. A survey of students revealed a desire for an increase in flexibility and an improved work-life balance in everyday working life. Students of civil engineering and architecture are basically interested in a career in construction management but have reservations due to the image of the profession and the current working conditions. A survey among experts from the construction industry shows that the profession can become more attractive. This report provides recommendations for action in the form of working modules to improve the working conditions of employees. If these are taken into account, graduates can be attracted to the profession of construction management, and existing staff can be retained more effectively. The aim of this report is to show incentives for employers to respond to the wishes and needs of their current and future employees to the extent that can be implemented.

Keywords: modern construction management, construction industry, work modules, shortage of junior staff, sustainable personnel management, making construction management more attractive, working time model

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Authors: Huang Gui

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This paper supplies some possible approaches of the death penalty reform in China basic on the analyzing the reformation conducted by the Ninth Amendment. There now are 46 crimes punishable by death, and this penalty still plays a significant role in the criminal punishment structure. In order to abolish entirely the death penalty in Penal Code, the legislature of China should gradually abolish the death penalty for the nonviolent crimes and then for the nonlethal violent crimes and finally for the lethal violent crimes. In the case where the death penalty has not yet been abolished completely, increasing the applicable conditions of suspension of execution of death penalty and reducing the scope of applicable objects (elderly defendant and other kinds of special objects) of death penalty would be an effective road to control and limit the use of death penalty in judicial practice.

Keywords: death penalty, the eighth amendment, the ninth amendment, suspension of execution of death, immediate execution of death, China

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Authors: Lou J. Pino, Mark Campbell, Matthew J. Kennedy, Ashleigh C. Kennedy

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A concussion is complex and nuanced, with cognitive rest being a key component of recovery. Cognitive overexertion during rehabilitation from a concussion is associated with delayed recovery. However, daily living imposes cognitive demands that may be unavoidable and difficult to quantify. Therefore, a portable tool capable of alerting patients before cognitive overexertion occurs could allow patients to maintain their quality of life while preventing symptoms and recovery setbacks. EEG allows for a sensitive measure of cognitive exertion. Clinical 32-lead EEG headsets are not practical for day-to-day concussion rehabilitation management. However, there are now commercially available and affordable portable EEG headsets. Thus, these headsets can potentially be used to continuously monitor cognitive exertion during mental tasks to alert the wearer of overexertion, with the aim of preventing the occurrence of symptoms to speed recovery times. The objective of this study was to test an algorithm for predicting cognitive exertion from EEG data collected from a portable headset. EEG data were acquired from 10 participants (5 males, 5 females). Each participant wore a portable 4 channel EEG headband while completing 10 tasks: rest (eyes closed), rest (eyes open), three levels of the increasing difficulty of logic puzzles, three levels of increasing difficulty in multiplication questions, rest (eyes open), and rest (eyes closed). After each task, the participant was asked to report their perceived level of cognitive exertion using the NASA Task Load Index (TLX). Each participant then completed a second session on a different day. A customized machine learning model was created using data from the first session. The performance of each model was then tested using data from the second session. The mean correlation coefficient between TLX scores and predicted cognitive exertion was 0.75 ± 0.16. The results support the efficacy of the algorithm for predicting cognitive exertion. This demonstrates that the algorithms developed in this study used with portable EEG devices have the potential to aid in the concussion recovery process by monitoring and warning patients of cognitive overexertion. Preventing cognitive overexertion during recovery may reduce the number of symptoms a patient experiences and may help speed the recovery process.

Keywords: cognitive activity, EEG, machine learning, personalized recovery

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Authors: Seon Soon Choi

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Magnesium alloy has been widely used in structure such as an automobile. It is necessary to consider probabilistic characteristics of a structural material because a fatigue behavior of a structure has a randomness and uncertainty. The purpose of this study is to find the characteristics of the cumulative distribution function (CDF) of the grown crack size at a specified fatigue crack propagation life and to investigate a statistical crack propagation in magnesium alloys. The statistical fatigue data of the grown crack size are obtained through the fatigue crack propagation (FCP) tests under different maximum fatigue load conditions conducted on the replicated specimens of magnesium alloys. The 3-parameter Weibull distribution is used to find the CDF of grown crack size. The CDF of grown crack size in case of larger maximum fatigue load has longer tail in below 10 percent and above 90 percent. The fatigue failure occurs easily as the tail of CDF of grown crack size becomes long. The fatigue behavior under the larger maximum fatigue load condition shows more rapid propagation and failure mode.

Keywords: cumulative distribution function, fatigue crack propagation, grown crack size, magnesium alloys, maximum fatigue load

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Authors: Hüseyin Altubaş, Hasret Aktaş, A. Mücahid Zengin

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Children determine the direction of the power of consumption. They affect the decisions of their parents but they also reached to a significant purchasing power themselves. Children, who are turning interactive behavior to normal behavior are becoming the decision makers in a company’s survival. Companies that analyze this effective target audience can communicate successfully with children. Children, who are interactive individuals, are closer to advertising. They are almost talking better with advertising. They are not afraid to express their likings, as well as their dislikes. Children have an interactive lifestyle and they were exposed to the vast changes in technology after year 2000. They do not know a life without internet, they spend mobile life in internet. This Z generation is the new determinants of brands. Z generation finds it appropriate to be brand ambassadors and they completely changed traditional media and traditional consumer behavior. These children live social reality with virtual reality and they feed brands differently. Brands that interact with Z generation are affected by this feeding positively, while brands that keep interaction in traditional levels are affected negatively. In this research we examine the communication, advertising and brand behaviors of Z generation. We especially analyze this generation’s interaction with social media brands and their interactive attitudes.

Keywords: social media, Z generation, children, advertising, brand choice

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Authors: Pia Moschall, Kathrin Sackmann

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Considering a purchasing volume of around two trillion Euros per year, which equals about 14% of the European Union’s gross domestic product, European public authorities have significant market power. Making use of this market power by prioritizing the procurement of green products and services offers a great potential to contribute to the Green New Deal. The market demand that is created by Green Public Procurement (GPP) sets incentives for European producers to design and develop Green Products and Eco-Innovations. However, most procurement still does not consider environmental criteria. The goal of the work is to encourage the adaptation of GPP in the European Union. To this end, the drivers for the adaptation were investigated over different case studies. The paper analyzes good-practice cases from European authorities from 2010 to 2020 that were provided by the European Commission. This analysis was guided by Philipp Mayring’s method of qualitative content analysis, whereby the inductively formed categories led to the identification of nine major drivers. The most important ones are ‘use of official guidelines and standards, ‘political support and requirements as well as ‘market research and involvement.’ Further, the paper discusses mutual dependencies between several drivers and how to exploit them. A supporting infrastructure was identified as a crucial factor for the successful adaption of green public procurement. In the next step, the work aims to examine on which administrative level the single drivers can be implemented most effectively. Practical implications of this research are recommendations on how to create a supporting structure on a municipal, federal and national level, including training for the responsible staff, support tools, as well as guidelines and standards for involved stakeholders.

Keywords: content analysis, green public procurement, public authorities, sustainable procurement

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Authors: Kedarnath Awati

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Some parallels between Indian Art Music and Western Art Music, such as the identity of the basic heptatonic scale structure, are quite obvious and need no further discussion. Other parallels are far less obvious, and it is one of them that the author is interested in. Specifically, the author would like to make a serious claim that in both types of music, there is an unspoken dependence on melody. Yes, it is true that the techniques that the two systems use for elaboration are very, very different: Western music uses the techniques of harmony, counterpoint, orchestration and motivic variation, while the Indian systems, both the Hindustani and the Carnatic traditions use the technique of raagdaari. The reason that this point is barely spoken about is that both in the West as well as in India, artists tend to think of melody as something elementary or as something 'given'. The Indian musicians would much rather dwell upon this or that meend or taan or other technical device, while the West thinks that melody is passé and would rather discuss the merits and demerits of spectralism and perhaps serialism. The author would like to explore this theme further in his paper.

Keywords: Indian art music, Western art music, melody, raagdaari, motivic variation.

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Authors: Yasmin Sayed, Hala Hamdy, Hafez Bazaraa, Hanaa Rady, Sherif Elanwary

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Intravenous and inhaled magnesium sulfate (MgSO₄) had been recently used as an adjuvant therapy in cases suffering from the wheezy chest. Objective: We aimed to determine the possible change in the hemodynamic state in cases received intravenous or inhaled MgSO₄ in comparison to cases received standard treatment in critically ill infants and children with the wheezy chest. Methods: A randomized controlled trial comprised 81 patients suffering from wheezy chest divided into 3 groups. In addition to bronchodilators and systemic steroids, MgSO₄ was given by inhalation in group A, intravenously in group B, and group C didn't receive MgSO₄. The hemodynamic state was determined by assessment of blood pressure, heart rate, capillary refill time and the need for shock therapy or inotropic support just before and 24 hours after receiving treatment in 3 groups. Results: There was no significant difference in the hemodynamic state of the studied groups before and after treatment. Means of blood pressure were 102.2/63.2, 105.1/64.8 before and after inhaled MgSO₄; respectively. Means of blood pressure were 105.5/64.2, 104.1/64.9 before and after intravenous MgSO₄; respectively. Means of blood pressure were 107.4/62.8, 104.4/62.1 before and after standard treatment, respectively. There was a statistically insignificant reduction of the means of the heart rate in group A and group B after treatment rather than group C. There was no associated prolongation in capillary refill time and/or the need for inotropic support or shock therapy after treatment in the studied groups. Conclusion: MgSO₄ is a safe adjuvant therapy and not associated with significant alteration in the hemodynamic state in critically ill infants and children with the wheezy chest.

Keywords: critically ill infants and children, inhaled MgSO₄, intravenous MgSO₄, wheezy chest

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Authors: Jisoo Kim, Jin-Young Choi, MinSu Lee, Sunmook Lee

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Effects of ceramic nanoparticles on the improvement of durability of bone fixation devices have been investigated by assessing the durability of nanocomposite materials consisting of bioabsorbable polymer and ceramic nanoparticles, which could be applied for bone fixation devices such as plates and screws. Various composite ratios were used for the synthesis of nanocomposite materials by blending polylactic acid (PLA) and polyglycolic acid (PGA) as bioabsorbable polymer, and hydroxyapatite (HA) and tri-calcium phosphate (TCP) as ceramic nanoparticles. It was found that the addition of ceramic nanoparticles significantly enhanced the mechanical properties of the bone fixation devices compared to those fabricated with pure biopolymers. Particularly, the layer-by-layer approach for the fabrication of nanocomposites also had an effect on the improvement of bending strength. Durability tests were performed by measuring the changes in the bending strength of nanocomposite samples under varied temperature conditions for the accelerated degradation tests. It was found that Weibull distribution was the most proper one for describing the life distribution of devices in the present study. The mean lifetime was predicted by adopting Arrhenius Eq. Model for Stress-Life relationship.

Keywords: bioabsorbable, bone fixation device, ceramic nanoparticles, durability assessment, nanocomposite

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Authors: Kanda Janyam, Piyaporn Vijit

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Background: As a consequence of sustained declines in fertility and mortality during the last three decades of the 20th century, Thailand faces a rapidly growing population of older persons. This demographic change directly affect Thailand workforce. Therefore, the study of health promotion behaviour of the older employees will benefit the employers as they can then develop the preparation for promoting well-being in older persons. Purpose: The current study aims to investigate health promotion behaviour and factors related to health promotion behaviour of older employees in factory. Methodology: The research instrument was questionnaire on health promotion behaviour and semi-structured interviews. The questionnaire was launched with 326 employees aged between 45-59 years in three factories in Songkhla Province, southern Thailand. The data collection started in December 2011. The data were analysed with mean, standard deviation, and correlation. Results: The results revealed that overall health promotion behaviour of the older employees in factory was at a high level. Moreover, when considered by aspect, it was found that their responsibility for health, nutrition, success in life, interpersonal relationship were at a high level while stress management, and exercise were at a moderate level. The results from correlation analysis indicated that the overall health promotion behaviour was positively related to knowledge of health promotion behaviour, attitude toward health promotion behaviour, health perception, the policy of health promotion, participation in health promotion activities, convenience in obtaining health promotion services, health resources, advice from people supporting health, and information received from the media. In addition, the results of the interviews with four key informants helped to confirm the factors related to health promotion behaviour of older employees in factory. Therefore, health promotion for elderly employees in factory is likely to be successful, if the support is given to the four health promotion factors that are divided into: leading factors consisting of attitude toward health promotion behaviour, and health perception, and supporting factors consisting of advice from other people, and information on health from various media. Practical implications: The results of the study identified the factors related to health promotion behaviour of older employees in factory. Such information will benefit employers as they can then develop specific strategies to increase their staffs’ well-being and, hence, presumably enhance the organization productivity.

Keywords: health promotion behavior, older, employee, factory

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Authors: Svetlana Petrikova, Alexander Yu Kostinskiy

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Management of research evaluation in the Higher School of Economics (HSE) originates from the HSE Academic Fund created in 2004 to facilitate and support academic research and presents its results to international academic community. As the means to inspire the applicants, science projects went through competitive selection process evaluated by the group of experts. Drastic development of HSE, quantity of applied projects for each Academic Fund competition and the need to coordinate the conduct of expert evaluation resulted in founding of the Office for Research Evaluation in 2013. The Office’s primary objective is management of research evaluation of science projects. The standards to conduct the evaluation are defined as follows: - The exercise of the process approach, the unification of the functioning of department. - The uniformity of regulatory, organizational and methodological framework. - The development of proper on-line evaluation system. - The broad involvement of external Russian and international experts, the renouncement of the usage of own employees. - The development of an algorithm to make a correspondence between experts and science projects. - The methodical usage of opened/closed international and Russian databases to extend the expert database. - The transparency of evaluation results – free access to assessment while keeping experts confidentiality. The management of research evaluation of projects is based on the sole standard, organization and financing. The standard way of conducting research evaluation at HSE is based upon Regulations on basic principles for research evaluation at HSE. These Regulations have been developed from the moment of establishment of the Office for Research Evaluation and are based on conventional corporate standards for regulatory document management. The management system of research evaluation is implemented on the process approach basis. Process approach means deployment of work as a process, which is the aggregation of interrelated and interacting activities processing inputs into outputs. Inputs are firstly client asking for the assessment to be conducted, defining the conditions for organizing and carrying of the assessment and secondly the applicant with proper for the competition application; output is assessment given to the client. While exercising process approach to clarify interrelation and interacting main parties or subjects of the assessment are determined and the way for interaction between them forms up. Parties to expert assessment are: - Ordering Party – The department of the university taking the decision to subject a project to expert assessment; - Providing Party – The department of the university authorized to provide such assessment by the Ordering Party; - Performing Party – The legal and natural entities that have expertise in the area of research evaluation. Experts assess projects in accordance with criteria and states of expert opinions approved by the Ordering Party. Objects of assessment generally are applications or HSE competition project reports. Mainly assessments are deployed for internal needs, i.e. the most ordering parties are HSE branches and departments, but assessment can also be conducted for external clients. The financing of research evaluation at HSE is based on the established corporate culture and traditions of HSE.

Keywords: expert assessment, management of research evaluation, process approach, research evaluation

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Authors: Bruce Hunter

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Background: The transition for student veterans from military service to higher education can be a challenging endeavor, especially for those pursuing an education in nursing. While the experiences and perspectives of each student veteran is unique, their successful integration into an academic environment can be influenced by a complex array of barriers and facilitators. This mixed-methods study aims to explore the themes and concepts that can be found in the transition experiences of student veterans in nursing education, with a focus on identifying the barriers they face and the facilitators that support their success. Methods: This study utilizes an explanatory mixed-methods approach. The research participants include student veterans enrolled in nursing programs across three academic institutions in the Southeastern United States. Quantitative Phase: A Likert scale instrument is distributed to a sample of student veterans in nursing programs. The survey assesses demographic information, academic experiences, social experiences, and perceptions of institutional support. Quantitative data is analyzed using descriptive statistics to assess demographics and to identify barriers and facilitators to the transition. Qualitative Phase: Two open-ended questions were posed to student veterans to explore their lived experiences, barriers, and facilitators during the transition to nursing education and to further explain the quantitative findings. Thematic analysis with line-by-line coding is employed to identify recurring themes and narratives that may shed light on the barriers and facilitators encountered. Results: This study found that the successful academic integration of student veterans lies in recognizing the diversity of values and attitudes among student veterans, understanding the potential challenges they face, and engaging in initiative-taking steps to create an inclusive and supportive academic environment that accommodates the unique experiences of this demographic. Addressing these academic and social integration concerns can contribute to a more understanding environment for student veterans in the BSN program. Conclusion: Providing support during this transitional period is crucial not only for retaining veterans, but also for bolstering their success in achieving the status of registered nurses. Acquiring an understanding of military culture emerges as an essential initial step for nursing faculty in student veteran retention and for successful completion of their programs. Participants found that their transition experience lacked meaningful social interactions, which could foster a positive learning environment, enhance their emotional well-being, and could contribute significantly to their overall success and satisfaction in their nursing education journey. Recognizing and promoting academic and social integration is important in helping veterans experience a smooth transition into and through the unfamiliar academic environment of nursing education.

Keywords: nursing, education, student veterans, barriers, facilitators

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Authors: Xue Bai, Ranran He, Chang Liu

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Care planning before the onset of intensive care needs can benefit older adults’ psychological well-being and increases families’ ability to manage caregiving crises and cope with care transitions. Effective care planning requires collaborative ‘team-work’ in families. However, future care planning has not been substantially examined in intergenerational or family contexts, let alone among immigrant families who have to face particular challenges in parental caregiving. From a family systems perspective, this study intends to explore the extent, processes, and contents of intergenerational care planning of Mainland immigrant ageing families in Hong Kong and to examine the intergenerational congruence and discrepancies in the care planning process. Adopting a qualitative research design, semi-structured in-depth interviews were conducted with 17 adult child-older parent pairs and another 33 adult children. In total, 50 adult children who migrated to Hong Kong after the age of 18 with more than three years’ work experience in Hong Kong had at least one parent aged over 55 years old who was not a Hong Kong resident and considered his/herself as the primary caregiver of the parent were recruited. Seventeen ageing parents of the recruited adult children were invited for dyadic interviews. Scarcity of caregiving resources in the context of cross-border migration, intergenerational discrepancies in care planning stages, both generations’ struggle and ambivalence toward filial care, intergenerational transmission of care values, and facilitating role of accumulated family capital in care preparation were primary themes concluded from participants’ narratives. Compared with ageing parents, immigrant adult children generally displayed lower levels of care planning. Although with a strong awareness of parents’ future care needs, few adult children were found engaged in concrete planning activities. This is largely due to their uncertainties toward future life and career, huge work and living pressure, the relatively good health status of their parents, and restrictions of public welfare policies in the receiving society. By contrast, children’s cross-border migration encouraged ageing parents to have early and clear preparation for future care. Ageing parents mostly expressed low filial care expectations when realizing the scarcity of family caregiving resources in the cross-border context. Even though they prefer in-person support from children, most of them prepare themselves for independent ageing to prioritize the next generation’s needs or choose to utilize paid services, welfare systems, friend networks, or extended family networks in their sending society. Adult children were frequently found caught in the dilemma of desiring to provide high quality and in-person support for their parents but lacking sufficient resources. Notably, a salient pattern of intergenerational transmission in terms of family and care values and ideal care arrangement emerged from intergenerational care preparation. Moreover, the positive role of accumulated family capital generated by a reunion in care preparation and joint decision-making were also identified. The findings of the current study will enhance professionals’ and service providers’ awareness of intergenerational care planning in cross-border migration contexts, inform services to alleviate unpreparedness for elderly care and intergenerational discrepancies concerning care arrangements and broaden family services to encompass intergenerational care planning interventions. Acknowledgment: This study is supported by a General Research Grant from the Research Grants Council of the HKSAR, China (Project Number: 15603818).

Keywords: intergenerational care planning, mainland immigrants in Hong Kong, migrant family, older adults

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Authors: Ting-I Lin

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Purpose: This article explores the care experience of a 34-year-old female breast cancer patient who was admitted to the intensive care unit after undergoing a modified radical mastectomy. The patient discovered a lump in her right breast during a self-examination and, after mammography and ultrasound-guided biopsy, was diagnosed with a malignant tumor in the right breast. The tumor measured 1.5 x 1.4 x 2 cm, and the patient underwent a modified radical mastectomy. Postoperatively, she exhibited feelings of inferiority due to changes in her appearance. Method: During the care period, we engaged in conversations, observations, and active listening, using Gordon's Eleven Functional Health Patterns for a comprehensive assessment. In collaboration with the critical care team, a psychologist, and an oncology case manager, we conducted an interdisciplinary discussion and reached a consensus on key nursing issues. These included pain related to postoperative tumor excision and disturbed body image due to changes in appearance after surgery. Result: During the care period, a private space was provided to encourage the patient to express her feelings about her altered body image. Communication was conducted through active listening and a non-judgmental approach. The patient's anxiety level, as measured by the depression and anxiety scale, decreased from moderate to mild, and she was able to sleep for 6-8 hours at night. The oncology case manager was invited to provide education on breast reconstruction using breast models and videos to both the patient and her husband. This helped rebuild the patient's confidence. With the patient's consent, a support group was arranged where a peer with a similar experience shared her journey, offering emotional support and encouragement. This helped alleviate the psychological stress and shock caused by the cancer diagnosis. Additionally, pain management was achieved through adjusting the dosage of analgesics, administering Ultracet 37.5 mg/325 mg 1# Q6H PO, along with distraction techniques and acupressure therapy. These interventions helped the patient relax and alleviate discomfort, maintaining her pain score at a manageable level of 3, indicating mild pain. Conclusion: Disturbance in body image can cause significant psychological stress for patients. Through support group discussions, encouraging patients to express their feelings, and providing appropriate education on breast reconstruction and dressing techniques, the patient's self-concept was positively reinforced, and her emotions were stabilized. This led to renewed self-worth and confidence.

Keywords: breast cancer, modified radical mastectomy, acupressure therapy, Gordon's 11 functional health patterns

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Authors: Laura Southgate

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The Association of Southeast Asian Nations (ASEAN), as well as much of the scholarship on the organisation, celebrates its ability to uphold the principle of regional autonomy, understood as upholding the norm of non-intervention by external powers in regional affairs. Yet, in practice, this has been repeatedly violated. This dichotomy between rhetoric and practice suggests an interesting avenue for further study. The East Timor crisis (1975-1999) has been selected as a case-study to test the dynamics of ASEAN state resistance to sovereignty violation in two distinct timeframes: Indonesia’s initial invasion of the territory in 1975, and the ensuing humanitarian crisis in 1999 which resulted in a UN-mandated, Australian-led peacekeeping intervention force. These time-periods demonstrate variation on the dependent variable. It is necessary to observe covariation in order to derive observations in support of a causal theory. To establish covariation, my independent variable is therefore a continuous variable characterised by variation in convergence of interest. Change of this variable should change the value of the dependent variable, thus establishing causal direction. This paper investigates the history of ASEAN’s relationship to the norm of non-intervention. It offers an alternative understanding of ASEAN’s history, written in terms of the relationship between a key ASEAN state, which I call a ‘vanguard state’, and selected external powers. This paper will consider when ASEAN resistance to sovereignty violation has succeeded, and when it has failed. It will contend that variation in outcomes associated with vanguard state resistance to sovereignty violation can be best explained by levels of interest convergence between the ASEAN vanguard state and designated external actors. Evidence will be provided to support the hypothesis that in 1999, ASEAN’s failure to resist violations to the sovereignty of Indonesia was a consequence of low interest convergence between Indonesia and the external powers. Conversely, in 1975, ASEAN’s ability to resist violations to the sovereignty of Indonesia was a consequence of high interest convergence between Indonesia and the external powers. As the vanguard state, Indonesia was able to apply pressure on the ASEAN states and obtain unanimous support for Indonesia’s East Timor policy in 1975 and 1999. However, the key factor explaining the variance in outcomes in both time periods resides in the critical role played by external actors. This view represents a serious challenge to much of the existing scholarship that emphasises ASEAN’s ability to defend regional autonomy. As these cases attempt to show, ASEAN autonomy is much more contingent than portrayed in the existing literature.

Keywords: ASEAN, east timor, intervention, sovereignty

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Authors: Luísa Pedro, José Pais-Ribeiro, João Páscoa Pinheiro

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Multiple Sclerosis (MS) is a chronic disease of the central nervous system that affects more often young adults in the prime of his career and personal development, with no cure and unknown causes. The most common signs and symptoms are fatigue, muscle weakness, changes in sensation, ataxia, changes in balance, gait difficulties, memory difficulties, cognitive impairment and difficulties in problem solving. MS is a relatively common neurological disorder in which various impairments and disabilities impact strongly on function and daily life activities. The aim of this study is to examine the implications of the program of self-regulation in the perception of illness and mental health (psychological well-being domain) in MS patients. MS is a relatively common neurological disorder in which various impairments and disabilities impact strongly on function and daily life activities. The aim of this study is to examine the implications of the program of self-regulation in the perception of illness and mental health (psychological well-being domain) in MS patients. After this, a set of exercises was implemented to be used in daily life activities, according to studies developed with MS patients. We asked the subjects the question “Please classify the severity of your disease?” and used the domain of psychological well-being, the Mental Health Inventory (MHI-38) at the beginning (time A) and end (time B) of the program of self-regulation. We used the Statistical Package for the Social Sciences (SPSS) version 20. A non-parametric statistical hypothesis test (Wilcoxon test) was used for the variable analysis. The intervention followed the recommendations of the Helsinki Declaration. The age range of the subjects was between 20 and 58 years with a mean age of 44 years. 58.3 % were women, 37.5 % were currently married, 67% were retired and the mean level of education was 12.5 years. In the correlation between the severity of the disease perception and psychological well before the self-regulation program, an obtained result (r = 0.26, p <0.05), then the self-regulation program, was (r = 0.37, p <0.01), from a low to moderate correlation. We conclude that the program of self-regulation for physical activity in patients with MS can improve the relationship between the perception of disease severity and psychological well-being.

Keywords: psychological well-being, multiple sclerosis, self-regulation, physical activity

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Authors: Alexey Yu. Martynov, Sulejman Bayramov

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Introduction: The myocardial bridging is the most common anomaly of the coronary arteries (CA). Depending on the examination method, the frequency of detected myocardial bridges (MB) varies in a rather wide range. The typical clinical manifestations of MB are angina pectoris, arrhythmias, sudden cardiac death. Objective: To study the incidence of MB in patients hospitalized with coronary artery disease (CAD). To assess clinical manifestations of MB in patients admitted with CAD. Materials and methods: A retrospective analysis of 19159 case histories of patients admitted at clinical city hospital in Moscow from 01.01.2018 to 31.12 2019 with CAD was performed. 9384 patients’ coronary angiographies (CAG) were examined for MB. The localization of MB, the degree of coronary contraction by MB, the number of MB, isolated MB and combined with CAD were assessed. The clinical manifestations of MB were determined. Results: MB was detected in 52 patients all with one myocardial bridge. 20 patients with MB have intact CA, and 32 patients have MB combined with CAD. Among 20 patients with intact CA: I degree of MB contraction (up to 50%) was detected in 9 patients. Clinical manifestations in five cases were angina pectoris, in 3 myocardial infarction (MI) - 1 patients with ST segment elevation MI (STEMI), 2 without ST segment elevation MI (NSTEMI), 1 post-infarction cardiosclerosis (PICS). Stable angina II FC in 3, III FC in 1, vasospastic angina (VSA) in 1 patient. II degree of MB contraction (up to 50-70%) was determined in 9 patients: in seven cases angina pectoris was detected, 1 NSTEMI, 1 PICS. Stable angina II FC in 3, III FC in 1, VSA in 3 patients. III degree of MB contraction (> 70%) detected in 2 patients. II FC stable angina in one case, PICS in another. Among 32 patients having MB combined with CAD I degree of MB contraction was observed in 20 patients. Clinical manifestations in 12 cases were angina pectoris in 8 II FC and in 4 III FC, 7 MI 6 with STEMI and 1 NSTEMI, 1 PICS. II degree of MB contraction was detected in 7 patients, 4 of them had angina pectoris, 3 MI 2 with STEMI and 1 NSTEMI. Stable angina II FC in 3, VSA in 1 patients. III degree of MB contraction was diagnosed in five patients. In two cases, II FC and III FC stable angina were observed, 2 MI with STEMI and NSTEMI, 1 PICS. Conclusions: MB incidence is one in 368 patients with CAD. The most common involvement (68%) is MB combined with CA atherosclerotic lesions. MB with intact CA are detected in one-third (32%) of patients. The first-degree MB contraction is most frequent condition. MI is more often detected in intact CA with first degree MB than in the second degree. The degree of MB contraction was not correlated with the severity of the clinical manifestations.

Keywords: clinical manifestations, coronary angiography, coronary artery disease, myocardial bridging, myocardial infarction, stable angina

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Authors: Xiaowei Zhang, Min Xu, Saeid Habibi, Fengjun Yan, Ryan Ahmed

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Recently, Electric Vehicles (EVs) have received extensive consideration since they offer a more sustainable and greener transportation alternative compared to fossil-fuel propelled vehicles. Lithium-Ion (Li-ion) batteries are increasingly being deployed in EVs because of their high energy density, high cell-level voltage, and low rate of self-discharge. Since Li-ion batteries represent the most expensive component in the EV powertrain, accurate monitoring and control strategies must be executed to ensure their prolonged lifespan. The Battery Management System (BMS) has to accurately estimate parameters such as the battery State-of-Charge (SOC), State-of-Health (SOH), and Remaining Useful Life (RUL). In order for the BMS to estimate these parameters, an accurate and control-oriented battery model has to work collaboratively with a robust state and parameter estimation strategy. Since battery physical parameters, such as the internal resistance and diffusion coefficient change depending on the battery state-of-life (SOL), the BMS has to be adaptive to accommodate for this change. In this paper, an extensive battery aging study has been conducted over 12-months period on 5.4 Ah, 3.7 V Lithium polymer cells. Instead of using fixed charging/discharging aging cycles at fixed C-rate, a set of real-world driving scenarios have been used to age the cells. The test has been interrupted every 5% capacity degradation by a set of reference performance tests to assess the battery degradation and track model parameters. As battery ages, the combined model parameters are optimized and tracked in an offline mode over the entire batteries lifespan. Based on the optimized model, a state and parameter estimation strategy based on the Extended Kalman Filter (EKF) and the relatively new Smooth Variable Structure Filter (SVSF) have been applied to estimate the SOC at various states of life.

Keywords: lithium-ion batteries, genetic algorithm optimization, battery aging test, parameter identification

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Authors: A.Chayaporn Kaoropthai, B. Onjaree Natakuatoong, C. Nagul Cooharojananone

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The first year is usually the most critical year for university students. Generally, a considerable number of first-year students worldwide drop out of university every year. One of the major reasons for dropping out is failing. Although they are supposed to have mastered sufficient English proficiency upon completing their high school education, most first-year students are still novices in academic reading. Due to their lack of experience in academic reading, first-year students need significant support from teachers to help develop their academic reading skills. Reading strategies training is thus a necessity and plays a crucial role in classroom instruction. However, individual differences in both students, as well as teachers, are the main factors contributing to the failure in not responding to each individual student’s needs. For this reason, reading strategies training inevitably needs a diagnosis of students’ academic reading skills levels before, during, and after learning, in order to respond to their different needs. To further support reading strategies training, scaffolding is proposed to facilitate students in understanding and practicing using reading strategies under the teachers’ guidance. The use of the Intelligent Tutoring Systems (ITSs) as a tool for diagnosing students’ reading problems will be very beneficial to both students and their teachers. The ITSs consist of four major modules: the Expert module, the Student module, the Diagnostic module, and the User Interface module. The application of Artificial Intelligence (AI) enables the systems to perform diagnosis consistently and appropriately for each individual student. Thus, it is essential to develop the Intelligent Scaffolding Diagnostic Reading Strategies Tutoring Systems to enhance first-year students’ academic reading skills. The systems proposed will contribute to resolving classroom reading strategies training problems, developing students’ academic reading skills, and facilitating teachers.

Keywords: academic reading, intelligent tutoring systems, scaffolding, university students

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Authors: Mahmood Shamshiri

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While visual sensation is the key gate for human-being to understand the world, visual impairment is one of the common cause of disability around the world. There is no doubt about the importance of eye sight in daily life among people, even it is understood the best gift of God to human-beings in many societies. Blind people are admitted to hospital for different health issues. Nurses and other health professionals who provide care for this group of patients need to understand their patients. Understanding the lived experience of blind people helps nurses to expand their knowledge regarding blind patients in order to provide a holistic care and improve the quality of care for blind patients. This phenomenological inquiry aimed to describe the meaning of discipline in daily life of blind people admitted in hospital. An interpretive phenomenology underpinned the philosophical approach of the study. While the interpretive phenomenology played as an umbrella role in the overall point of the study, the six methodical activities which introduced by van Manen helped the researchers to conduct the study. ‘Disciplined care for disciplined patients’ was the main theme emerged from dialogues of blind patients about their daily life in the hospital. Almost all of participants called themselves as disciplined people. The theme ‘disciplined care for disciplined patients’ appeared from four sub-themes including discipline through careful touching and listening, discipline as the ideal way of existence, discipline the preferred way of being independent, desire to take disciplined and detailed care, reactions to the undisciplined caring culture. This phenomenological inquiry to the experiences of patients with blindness in hospital revealed that they commonly are disciplined people and want to be cared in well-organized caring environment. Furthermore, they need to be familiar with the new caring environment. Well-organized and familiar environment help blind patients to increase the level of independency. In addition, blind patients prefer a detail informed and disciplined caring culture. Health professionals have to consider the concept of disciplined care in order to provide a holistic and comprehensive competent care.

Keywords: disciplined people, disciplined care, lived experience, patient with blindness

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Authors: Peter J. H. Carnell, Panayiotis Theophanous

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Natural gas due to its cleaner combustion characteristics is expected to be the most widely used fuel in the move towards less polluting and renewable energy sources. Thus, the developed world is supplied by a complex network of gas pipelines and natural gas is becoming a major source of fuel. Natural gas delivered directly from the well will differ in composition from gas derived from LNG or produced by anaerobic digestion processes. Each will also have specific contaminants and properties although gas from all sources is likely to enter the distribution system and be blended to provide the desired characteristics such as Higher Heating Value and Wobbe No. The absence of a standard gas composition poses problems when the gas is used as a chemical feedstock, in specialised furnaces or on gas turbines. The chemical industry has suffered in the past as a result of variable gas composition. Transition metal catalysts used in ammonia, methanol and hydrogen plants were easily poisoned by sulphur, chlorides and mercury reducing both activity and catalyst expected lives from years to months. These plants now concentrate on purification and conditioning of the natural gas feed using fixed bed technologies, allowing them to run for several years and having transformed their operations. Similar technologies can be applied to the power industry reducing maintenance requirements and extending the operating life of gas turbines.

Keywords: gas composition, gas conditioning, gas turbines, power generation, purification

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Authors: Sven Borén, Henrik Ny

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Ambitions within the EU for moving towards sustainable transport include major emission reductions for fossil fuel road vehicles, especially for buses, trucks, and cars. The electric driveline seems to be an attractive solution for such development. This study first applied the Framework for Strategic Sustainable Development to compare sustainability effects of today’s fossil fuel vehicles with electric vehicles that have batteries or hydrogen fuel cells. The study then addressed a scenario were electric vehicles might be in majority in Europe by 2050. The methodology called Strategic Lifecycle Assessment was first used, were each life cycle phase was assessed for violations against sustainability principles. This indicates where further analysis could be done in order to quantify the magnitude of each violation, and later to create alternative strategies and actions that lead towards sustainability. A Life Cycle Assessment of combustion engine cars, plug-in hybrid cars, battery electric cars and hydrogen fuel cell cars was then conducted to compare and quantify environmental impacts. The authors found major violations of sustainability principles like use of fossil fuels, which contribute to the increase of emission related impacts such as climate change, acidification, eutrophication, ozone depletion, and particulate matters. Other violations were found, such as use of scarce materials for batteries and fuel cells, and also for most life cycle phases for all vehicles when using fossil fuel vehicles for mining, production and transport. Still, the studied current battery and hydrogen fuel cell cars have less severe violations than fossil fuel cars. The life cycle assessment revealed that fossil fuel cars have overall considerably higher environmental impacts compared to electric cars as long as the latter are powered by renewable electricity. By 2050, there will likely be even more sustainable alternatives than the studied electric vehicles when the EU electricity mix mainly should stem from renewable sources, batteries should be recycled, fuel cells should be a mature technology for use in vehicles (containing no scarce materials), and electric drivelines should have replaced combustion engines in other sectors. An uncertainty for fuel cells in 2050 is whether the production of hydrogen will have had time to switch to renewable resources. If so, that would contribute even more to a sustainable development. Except for being adopted in the GreenCharge roadmap, the authors suggest that the results can contribute to planning in the upcoming decades for a sustainable increase of EVs in Europe, and potentially serve as an inspiration for other smaller or larger regions. Further studies could map the environmental effects in LCA further, and include other road vehicles to get a more precise perception of how much they could affect sustainable development.

Keywords: strategic, electric vehicles, sustainability, LCA

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Authors: Peter Schnell, Phillip Haag

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In the course of the structural transformation of the construction industry, the integration of industrialization and digitization has led to the development of construction methods with an increased degree of prefabrication, such as system or modular construction. Compared to conventional construction, these innovative construction methods are characterized by modified structural and procedural properties and expand the range of construction services. Faced with the supply side, it is possible to identify construction-specific customer types with different characteristics and certain preferences as far as the choice of construction method is concerned. The basis for this finding was qualitative expert interviews. By evaluating the stereotypical customer needs, a corresponding segmentation of the demand side can be made along with the basic orientation and decision behavior. This demarcation supports the target- and needs-oriented customer approach and contributes to cooperative and successful project management.

Keywords: differentiation of customer types, modular construction methods, conventional construction methods, stereotypical customer types

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Authors: Öznur Saribaş, Si̇bel Kahraman Çeti̇ntaş

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It is aimed to compare target volume and critical organ doses by using CyberKnife (CK) in accelerated partial breast irradiation (APBI) in patients with early stage breast cancer. Three different virtual plans were made for Iris, fixed and multi-leaf collimator (MLC) for 5 patients who received radiotherapy in the CyberKnife system. CyberKnife virtual plans were created, with 6 Gy per day totaling 30 Gy. Dosimetric parameters for the three collimators were analyzed according to the restrictions in the NSABP-39/RTOG 0413 protocol. The plans ensured critical organs were protected and GTV received 95 % of the prescribed dose. The prescribed dose was defined by the isodose curve of a minimum of 80. Homogeneity index (HI), conformity index (CI), treatment time (min), monitor unit (MU) and doses taken by critical organs were compared. As a result of the comparison of the plans, a significant difference was found for the duration of treatment, MU. However, no significant difference was found for HI, CI. V30 and V15 values of the ipsi-lateral breast were found in the lowest MLC. There was no significant difference between Dmax values for lung and heart. However, the mean MU and duration of treatment were found in the lowest MLC. As a result, the target volume received the desired dose in each collimator. The contralateral breast and contralateral lung doses were the lowest in the Iris. Fixed collimator was found to be more suitable for cardiac doses. But these values did not make a significant difference. The use of fixed collimators may cause difficulties in clinical applications due to the long treatment time. The choice of collimator in breast SBRT applications with CyberKnife may vary depending on tumor size, proximity to critical organs and tumor localization.

Keywords: APBI, CyberKnife, early stage breast cancer, radiotherapy.

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Authors: Samereh Abdoli, Amit Vora, Anusha Vora

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Background: Diabetes burnout is one of the most common contributors to decreased quality of life, poor psychosocial well-being, and increased morbidity, mortality and diabetes cost. While the term diabetes burnout is widely accepted particularly in type 1 diabetes (T1D), the state of the science on diabetes burnout is lacking a systematic approach to overcome diabetes burnout. Objective: The study aimed to explore the strategies to overcome burnout by integrating the voices of individuals with T1D. Methods: In this study, we applied a descriptive qualitative design using YouTube videos produced by individuals with T1D. Seven YouTube videos (Austria= 1, U.S=6) with the highest rate of views which met the inclusion criteria were analyzed using a qualitative content analysis approach. Results: Participants verbalized overcoming diabetes burnout as a 'difficult hole to climb out of' which make them empowered. Themes that describes their strategies to overcome burnout in T1D, in general, include; 'make plan and take action', 'start with small steps', 'ask for help', 'get engage in diabetes community' and 'do not be perfect'. Future Work: These findings can begin the examination of different strategies to overcome diabetes burnout, which may change the course of action for diabetes care and management to improve quality of diabetes care and quality of life.

Keywords: diabetes burnout, type 1 diabetes, qualitative research, YouTube videos

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Authors: Feyza Daloglu

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This paper scrutinizes the Ottoman years of Wasif Jawharriyeh’s memoir, The Storyteller of Jerusalem, within the framework of citadinite, employed by the Open Jerusalem Project. Open Jerusalem Project uses the term citadinite to describe “the dynamic identity relationship city dwellers have with each other and their urban environment.” While Jerusalem and Jerusalemite identity have usually been analyzed within religious, national, or colonial frameworks, citadinite offers a fresh perspective by turning its lens to the urban identity of its citizens in the 19th and 20th centuries to overcome the shortcomings of usual frameworks. Wasif Jawharriyeh is a proud Jerusalemite and a Greek Orthodox Arab, who spent his childhood and teenage years under the Ottoman Empire. His memoir reveals a great deal of urbanity and a strong sense of Jerusalemite identity which appears to be favored over other forms of identities - Arab, Christian - in the late empire years. Through citadinite, this paper aims to discuss aspects of Jerusalemite identity and key points of urban life in the late Ottoman holy city with the guidance of a very lively and social Ottoman citizen and at that time a young musician, Wasif Jawharriyeh.

Keywords: arab memoir, cityscape, jerusalem identity, ottoman city, urban life

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