Search results for: administration practices

Authors: Kaznah Alshammari, Thomas Beach, Yacine Rezgui

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Technological advances in the construction sector are helping to make smart cities a reality by means of cyber-physical systems (CPS). CPS integrate information and the physical world through the use of information communication technologies (ICT). An increasingly common goal in the built environment is to integrate building information models (BIM) with the Internet of Things (IoT) and sensor technologies using CPS. Future advances could see the adoption of digital twins, creating new opportunities for CPS using monitoring, simulation, and optimisation technologies. However, researchers often fail to fully consider the security implications. To date, it is not widely possible to assimilate BIM data and cybersecurity concepts, and, therefore, security has thus far been overlooked. This paper reviews the empirical literature concerning IoT applications in the built environment and discusses real-world applications of the IoT intended to enhance construction practices, people’s lives and bolster cybersecurity. Specifically, this research addresses two research questions: (a) how suitable are the current IoT and CPS security stacks to address the cybersecurity threats facing digital twins in the context of smart buildings and districts? and (b) what are the current obstacles to tackling cybersecurity threats to the built environment CPS? To answer these questions, this paper reviews the current state-of-the-art research concerning digital twins in the built environment, the IoT, BIM, urban cities, and cybersecurity. The results of these findings of this study confirmed the importance of using digital twins in both IoT and BIM. Also, eight reference zones across Europe have gained special recognition for their contributions to the advancement of IoT science. Therefore, this paper evaluates the use of digital twins in CPS to arrive at recommendations for expanding BIM specifications to facilitate IoT compliance, bolster cybersecurity and integrate digital twin and city standards in the smart cities of the future.

Keywords: BIM, cybersecurity, digital twins, IoT, urban cities

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Authors: Sireen Irsheid

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Despite concerted efforts to improve education attainment with progress in recent years, student achievement and attainment remain among the most significant challenges for school districts across the United States. Many scholars have argued that students who do not complete high school do not drop out of school voluntarily but are ‘pushed out’ of schools through multiple mechanisms related to structural and socioeconomic barriers, behavioral health challenges, pedagogical practices, and administrative procedures. Extant literature has shown that living in historically disadvantaged neighborhoods or attending under-resourced schools exacerbates student-level risk factors for grade retention and school pushout. Most efforts to respond to the school pushout phenomenon have focused on individual characteristics of students, with relatively little attention to addressing these multiple system-level characteristics related to perpetuating inequities. This study is built on a growing body of social justice-oriented research concerned with the systemic influences that shape the experiences and mental health challenges of young people. Specifically, this study examined how young people who have been experiencing education inequities make meaning and navigate the structural factors related to neighborhood and school disinvestment and access to resources and supports, and their risk for school pushout. Furthermore, schools as political, cultural, and ideologically reproductive spaces often serve as sites of resistance and can support students who are impacted by educational inequity. Study findings provide education, neighborhood, school psychology, social work practice, and policy considerations.

Keywords: education policy, mental health, school prison nexus, school pushout, structural trauma

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Authors: Ismaila Oladunni Muhammed, Adegbenga Raphael Ashiru

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Construction industry has been attributed to be the engine growth of Nigerian economic and infrastructural development. It promotes infrastructural development and grows an average output of Nigerian Gross Domestic Profit. However, from this great prospect, yearly reports show that consistent accidents on construction sites in Zamfara State has affected a substantial number of workers as they become temporarily or permanently disabled, thereby making many construction sites a death trap. This posed a great threat to the industry’s sustainability, de- motivate workers from working in the industry, and further have negative impact on the economy as well. It is as a result of high construction site accident currently experiencing in Zamfara state that this research was carried out to appraise the sustainability of health and safety of construction workers on sites. The proper practice and compliance to Construction Health and safety laws are very vital to the output and growth of Zamfara State construction sector. However, a quantitative approach was adopted to justify the aforesaid statement which will provide a broader understanding of the study. Descriptive statistical analysis was obtained through Statistical Package for the Social Sciences (SPSS Version 20). Furthermore, the findings from the research highlighted that the performance and output of construction workers on construction sites depends on the proper practice of health and safety. The research findings also recommended ways to enhance employers and employee’s compliance with existing laws guiding health and safety on Zamfara State construction sites. Nevertheless, the purpose of the paper is to appraise the sustainability of Health and Safety on Zamfara State construction sites. This study further provided thorough information for resolving challenges of construction sites accidents to improve construction firm productivity and also ensured construction worker’s safety on site.

Keywords: construction industry, health and safety regulations, causes of accident, construction safety practices

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Authors: Samuel Pimpong

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In most liberal and constitutional democracies, the media serves as a dominant power in the construction of the fundamental building blocks for the consolidation of democratic governance. However, the extent to which the media can enhance democratic consolidation in a country depends to a large extent on the independence of the media, the robustness of legislative frameworks and the safety of journalists in discharging their duties without fear or favor. This study sought to examine pertinent issues, practices and challenges facing the media in Ghana’s Fourth Republic and attempts to make recommendations regarding the way forward. The work adopted a qualitative study approach. A total of sixteen (16) participants were purposively selected for face-to-face interviews. The study hinges on the democratic participant media theory and the development media theory. Primary data was analyzed via thematic analysis procedure. The study revealed that although Ghana has repealed its criminal libel laws, nonetheless other statutory Acts, such as the Electronic Communications Act 2008 (ACT 775) and the Criminal and other offences Act 1960 (Act 29), among others continue to stifle freedom of expression. On the other hand, press freedom is being abused by the use of fake content publication. Further, the study revealed that the absence of a comprehensive regulatory structure impedes the activities carried out by the media. Consequently, the study recommends a regulatory structure to oversee media activities and content, as the National Media Commission (NMC) lacks the authority to do so. In this direction, the study recommends a limitation on the role of the National Communications Authority (NCA) to administer broadcasting signals and transfer its licensing and sanctioning powers to the NMC in order to create one sole and completely independent media regulatory authority that deals with all media related issues.

Keywords: media, constitutional democracy, democratic consolidation, fourth republic

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Authors: Ashley R. Logsdon, Becky F. Antle, Cynthia M. Kamer

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This study examines the cost and benefits of a family treatment drug court in an urban county in a southeastern state. Additionally, this cost analysis will provide a detailed description of the type and cost of activities to produce the services provided to child welfare families. This study utilized return-on-investment analysis, which uses child welfare practices, disaggregates them into separate activities and estimates costs for these activities including child-level placement data for total cost of care for the child. Direct and indirect costs were considered as well as saving calculations what costs would be associated with child welfare outcomes both short and long term. The costs included were general program costs (salaries, drug screens, transportation, childcare, parent education, program evaluation, visitation, incentives) or personnel costs for other team members (judges, court administrators, child welfare workers, child welfare supervisors, and community mental health provider). The savings that were used in the study were length of time in out of home care, Medicaid costs, substance exposed births, emergency room utilization and jail/probation costs. This study documents an overall savings of between $168,993.30 and $837,993.30. The total savings per family divided by the 40 families who have participated in the program was between $4,224.83 to $20,949.83 per family. The results of this cost benefit analysis are consistent with prior research documenting savings associated with out of home care and jail/probation; however, there are also unique contributions of this study to the literature on cost effectiveness of family treatment drug courts. We will present recommendations for further utilization of family treatment drug courts and how to expand the current model.

Keywords: child welfare, cost analysis, family drug court, family treatment drug court

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Authors: Ubaid Ur Rahman, Waqar Younas, Sooraj Kumar Chhabira

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Environmentally sustainable building construction has experienced significant growth during the past 10 years at international level. This paper shows that the conceptual framework adopts sustainability techniques in construction to develop environment friendly building called green building. Waste occurs during the different construction phases which causes the environmental problems like, deposition of waste on ground surface creates major problems such as bad smell. It also gives birth to different health diseases and produces toxic waste agent which is specifically responsible for making soil infertile. Old recycled building material is used in the construction of new building. Sustainable construction is economical and saves energy sources. Sustainable construction is the major responsibility of designer and project manager. The designer has to fulfil the client demands while keeping the design environment friendly. Project manager has to deliver and execute sustainable construction according to sustainable design. Steel is the most appropriate sustainable construction material. It is more durable and easily recyclable. Steel occupies less area and has more tensile and compressive strength than concrete, making it a better option for sustainable construction as compared to other building materials. New technology like green roof has made the environment pleasant, and has reduced the construction cost. It minimizes economic, social and environmental issues. This paper presents an overview of research related to the material use of green building and by using this research recommendation are made which can be followed in the construction industry. In this paper, we go through detailed analysis on construction material. By making suitable adjustments to project management practices it is shown that a green building improves the cost efficiency of the project, makes it environmental friendly and also meets future generation demands.

Keywords: sustainable construction, green building, recycled waste material, environment

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Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

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Background And Objective: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects And Methods: A retrospective audit was conducted for packed red cell transfusion ordering practice over a period from March 2017 to march 2018. All consecutive patients admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger. Results: During the study period, n=13 patients underwent a haematopoietic stem cell transplant. There were n=10 males and n=3 females. One patient was less than 15 years of age, while rests were adults. Median age±SD was 26.5±14.5 years (12∼54 years). The underlying diagnosis included Aplastic anemia (n=4), Thalassemia major (n=1), Multiple Myeloma (n=3), Acute leukemia (n=3), Hodgkin's lymphoma (n=1), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204, while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gr/dl. Conclusion: The results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international criteria and pioneer country in BMT transplantation. Also, we hope that our blood consumption become less than it is now.

Keywords: blood consumption, C: T ratio, PRBCs, stem cell transplant, tabriz, Iran

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Authors: M. Johnson, R. Faggian, V. Sposito

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A participatory and engaged approach is key in connecting agricultural managers to sustainable agricultural systems to support and optimize production in Victoria’s food bowl. A sustainable intensification (SI) approach is well documented globally, but participation rates amongst Victorian farmers is fragmentary, and key outcomes and implementation strategies are poorly understood. Improvement in decision-support management tools and a greater understanding of the productivity gains available upon implementation of SI is necessary. This paper reviews the current understanding and uptake of SI practices amongst farmers in one of Victoria’s premier food producing regions, the Goulburn Broken; and it spatially analyses the potential for this region to adapt to climate change and optimize food production. A Geographical Information Systems (GIS) approach is taken to develop an interactive decision-support tool that can be accessible to on-ground agricultural managers. The tool encompasses multiple criteria analysis (MCA) that identifies factors during the construction phase of the tool, using expert witnesses and regional knowledge, framed within an Analytical Hierarchy Process. Given the complexities of the interrelations between each of the key outcomes, this participatory approach, in which local realities and factors inform the key outcomes and help to strategies for a particular region, results in a robust strategy for sustainably intensifying production in key food producing regions. The creation of an interactive, locally embedded, decision-support management and education tool can help to close the gap between farmer knowledge and production, increase on-farm adoption of sustainable farming strategies and techniques, and optimize farm productivity.

Keywords: agriculture, decision-support management tool, Geographic Information System, GIS, sustainable intensification

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Authors: Nikitha Francis, Anjana Hoode, Vinitha George, Jayashree S. Bhat

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The interaction between cognition and language, referred as cognitive-communication, is very intricate, involving several mental processes such as perception, memory, attention, lexical retrieval, decision making, motor planning, self-monitoring and knowledge. Cognitive-communication disorders are difficulties in communicative competencies that result from underlying cognitive impairments of attention, memory, organization, information processing, problem solving, and executive functions. Traumatic brain injury (TBI) is an acquired, non - progressive condition, resulting in distinct deficits of cognitive communication abilities such as naming, word-finding, self-monitoring, auditory recognition, attention, perception and memory. Cognitive-communication intervention in TBI is individualized, in order to enhance the person’s ability to process and interpret information for better functioning in their family and community life. The present case report illustrates the cognitive-communicative behaviors and the intervention outcomes of an adult with TBI, who was brought to the Department of Audiology and Speech Language Pathology, with cognitive and communicative disturbances, consequent to road traffic accident. On a detailed assessment, she showed naming deficits along with perseverations and had severe difficulty in recalling the details of the accident, her house address, places she had visited earlier, names of people known to her, as well as the activities she did each day, leading to severe breakdowns in her communicative abilities. She had difficulty in initiating, maintaining and following a conversation. She also lacked orientation to time and place. On administration of the Manipal Manual of Cognitive Linguistic Abilities (MMCLA), she exhibited poor performance on tasks related to visual and auditory perception, short term memory, working memory and executive functions. She attended 20 sessions of cognitive-communication intervention which followed a domain-general, adaptive training paradigm, with tasks relevant to everyday cognitive-communication skills. Compensatory strategies such as maintaining a dairy with reminders of her daily routine, names of people, date, time and place was also recommended. MMCLA was re-administered and her performance in the tasks showed significant improvements. Occurrence of perseverations and word retrieval difficulties reduced. She developed interests to initiate her day-to-day activities at home independently, as well as involve herself in conversations with her family members. Though she lacked awareness about her deficits, she actively involved herself in all the therapy activities. Rehabilitation of moderate to severe head injury patients can be done effectively through a holistic cognitive retraining with a focus on different cognitive-linguistic domains. Selection of goals and activities should have relevance to the functional needs of each individual with TBI, as highlighted in the present case report.

Keywords: cognitive-communication, executive functions, memory, traumatic brain injury

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Authors: Daniel Alati

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Recent high-profile terrorist events in Canada, the United Kingdom and Europe – the London Bridge attacks, the terrorist attacks in Nice, France and Barcelona, Spain, the 2014 Ottawa Parliament attacks and the 2017 attacks in Edmonton – have all raised levels of public and academic concern with so-called “lone-wolf” and “radicalized” terrorism. Similarly, several countries outside of the “Western” world have been dealing with radicalization to violent extremism for several years. Many South East Asian countries, including Indonesia, Malaysia, Singapore and the Philippines have all had experience with what might be described as ISIS or extremist-inspired acts of terrorism. Indeed, it appears the greatest strength of groups such as ISIS has been their ability to spread a global message of violent extremism that has led to radicalization in markedly different jurisdictions throughout the world. These markedly different jurisdictions have responded with counter-radicalization strategies that warrant further comparative analysis. This paper utilizes an inter-disciplinary legal methodology. In doing so, it compares legal, political, cultural and historical aspects of the counter-radicalization strategies employed by Canada, the United Kingdom and several South East Asian countries (Indonesia, Malaysia, Singapore and the Philippines). Whilst acknowledging significant legal and political differences between these jurisdictions, the paper engages in these analyses with an eye towards understanding which best practices might be shared between the jurisdictions. In doing so, it presents valuable findings of a comparative nature that are useful to both academic and practitioner audiences in several jurisdictions.

Keywords: Canada, United Kingdom and South East Asia, comparative law and politics, radicalization to violent extremism, terrorism

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Authors: Kalaashini Ramachandran, Maznah Dahlui, Nik Daliana Nik Farid

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WHO recommends all babies to be exclusively breastfed and donor milk is the next best alternative in the absence of mother’s own milk. The establishment of a human milk bank (HMB) is still being debated due to religious concerns in Malaysia leading to informal milk sharing practices, but little is known on the knowledge, attitude and perception of women towards HMB and its benefits. This study hypothesizes that there is no association between knowledge and attitude and the acceptance towards the establishment of human milk bank among Malaysian women and healthcare providers. The aim of this study is to determine the drivers and barriers among Malaysian towards the acceptance of an HMB. A cross-sectional study with 367 participants was enrolled within a period of 3 months to answer an online self-administered questionnaire. Data on sociodemographic, knowledge on breastfeeding benefits, knowledge and attitude on HMB and its specific issues were analyzed in terms of frequency and then proceed to multiple logistic regression. Majority of the respondents are of Islamis religion (73.3%), have succeesfully completed their tertiary education (82.8%), and are employed (70.8%). Only 55.9% of respondents have heard of an HMB stating internet as their main source of information but a higher prevalence is agreeable to the establishment of a human milk bank (67.8%). Most respondents have a good score on knowledge of breastfeeding benefits and on HMB specific issues (70% and 54.2% respectively) while 63.8% of them have a positive attitude towards HMB. In the multivariate analysis, mothers with a good score on general knowledge of breastfeeding (AOR: 1.715) were more likely to accept the establishment of an HMB while Islamic religion was negatively associated with its establishment (AOR:0.113). This study has found a high prevalence rate of mothers who are willing to accept the establishment of an HMB. This action can be potentially shaped by educating mothers on the benefits of breastfeeding as well as addressing their religious concerns so the establishment of a religiously abiding HMB in Malaysia may be accepted without compromising their belief or the health benefit of donor milk.

Keywords: acceptability, attitude, human milk bank, knowledge

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Authors: Shyaka Eugene

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The efficient and safe demolition of structures is a critical challenge in civil engineering and construction. This study focuses on the development of optimal demolition strategies by investigating the crack propagation behavior in beams induced by soundless cracking agents. It is commonly used in controlled demolition and has gained prominence due to its non-explosive and environmentally friendly nature. This research employs a comprehensive experimental and computational approach to analyze the crack initiation, propagation, and eventual failure in beams subjected to soundless cracking agents. Experimental testing involves the application of various cracking agents under controlled conditions to understand their effects on the structural integrity of beams. High-resolution imaging and strain measurements are used to capture the crack propagation process. In parallel, numerical simulations are conducted using advanced finite element analysis (FEA) techniques to model crack propagation in beams, considering various parameters such as cracking agent composition, loading conditions, and beam properties. The FEA models are validated against experimental results, ensuring their accuracy in predicting crack propagation patterns. The findings of this study provide valuable insights into optimizing demolition strategies, allowing engineers and demolition experts to make informed decisions regarding the selection of cracking agents, their application techniques, and structural reinforcement methods. Ultimately, this research contributes to enhancing the safety, efficiency, and sustainability of demolition practices in the construction industry, reducing environmental impact and ensuring the protection of adjacent structures and the surrounding environment.

Keywords: expansion pressure, energy release rate, soundless chemical demolition agent, crack propagation

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Authors: Danute Jablonskyte-Rasce, Laura Masilionyte

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The field experiments of different farming systems were conducted at Joniškėlis Experimental Station of the Lithuanian Research Centre for Agriculture and Forestry in 2006–2016. The soil of the experimental site was Endocalcari-Endohypogleyic Cambisol (CMg-n-w-can). The research was designed to identify the effects of dry matter and nitrogen accumulated in the above-ground biomass of various catch crops grown after winter wheat on soil mineral nitrogen variation during the autumn and spring period in the presence of intensive leaching complex. Research was done in the soil differing in humus status in the organic and sustainable cropping systems by growing various plant mixtures as catch crops: narrow-leafed lupine (Lupinus angustifolius L.) and oil radish (Raphanus sativus var. Oleifera L.), white mustard (Sinapis alba L.) and buckwheat (Fagopyrum exculentum Moench.) and white mustard as a sole crop. All crop and soil management practices have shown optimal efficiency in late autumn – stubble breaking, catch crops and straw used during the post-harvest period of the main crops, reduced Nmin migration into deeper (40–80 cm) soil layer. The greatest Nmin reduction in the 0–40 cm soil layer during the period from late autumn to early spring was identified in the sustainable cropping system having applied N30 for the promotion of straw mineralization and with no catch crops cultivation. The sustainable cropping system, having applied N30 for straw mineralization and growing white mustard in combination with buckwheat as catch crops, Nmin difference in the spring compared with its status in the autumn in the soil low and moderate in humus was lower by 70.1% and 34.2%, respectively.

Keywords: soil nitrogen, catch crops, ecological and sustainable farming systems, Cambisol

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Authors: Mei-Ching Ho

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Graduate-level writing practices have gained increasing scholarly attention in recent years. Due to its discipline-specific conventions and requirements, research writing can cause various levels of anxiety for native English speaking and English as a second/foreign language (ESL/EFL) postgraduate students. Although many studies have investigated how writing anxiety can negatively affect writing performance, self-efficacy, and disciplinary discourse socialization process, relatively few have examined the impact of writing anxiety from the perspectives of postgraduate students in EFL contexts. This study aims to 1) examine the level of and the relationship between research writing anxiety and self-efficacy among Taiwanese EFL students at the master's and doctoral levels and 2) to uncover the causes of students' research writing anxiety. The data was collected from an adapted version of Second Language Writing Anxiety Inventory (SLWAI) and Research Writing Self-Efficacy Scale with 218 EFL graduate students in engineering-related fields at two research-oriented universities in Taiwan. A pilot study was conducted to ensure the construct and content validity of the instruments. Semi-structured interviews were also undertaken with 30 survey respondents to better understand the causes of their writing anxiety. The results revealed that while both master's and doctoral students had low to moderate research writing anxiety and self-efficacy, the doctoral students with more experiences in writing research papers in English were more anxious but not necessarily more confident than the master's students. A significantly weak negative correlation was found between the two constructs. The contributing factors for these results include different degree of writing exigency, perceived importance and types of writing tasks, writing for publication as graduation thresholds, and mentoring relationship with thesis/dissertation advisers. The study also identified several causes of graduate-level writing anxiety, of which writing under time constraints and concern on linguistic and rhetorical proficiency appeared to be the major concern. Pedagogical implications regarding facilitating graduate students' writing process and reducing anxiety will also be drawn.

Keywords: writing affect, writing anxiety, writing self-efficacy, EFL, postgraduate students

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Authors: Alvarez M., Chapela M. J., Balboa E., Rubianes D., Sinde E., Fernandez de Ana C., Rodríguez-Blanco A.

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The gut microbiota plays an important role as gut inflammation could contribute to colorectal cancer development; however, this role is still not fully understood, and tools able to prevent this progression are yet to be developed. The main objective of this study was to monitor the effects of a mushroom extracts formulation in gut microbial community composition of an Azoxymethane (AOM)/Dextran sodium sulfate (DSS) mice model of inflammation-linked carcinogenesis. For the in vivo study, 41 adult male mice of the C57BL / 6 strain were obtained. 36 of them have been induced in a state of colon carcinogenesis by a single intraperitoneal administration of AOM at a dose of 12.5 mg/kg; the control group animals received instead of the same volume of 0.9% saline. DSS is an extremely toxic polysaccharide sulfate that causes chronic inflammation of the colon mucosa, favoring the appearance of severe colitis and the production of tumors induced by AOM. Induction by AOM/DSS is an interesting platform for chemopreventive intervention studies. This time the model was used to monitor gut microbiota changes as a result of supplementation with a specific mushroom extracts formulation previously shown to have prebiotic activity. The animals have been divided into three groups: (i) Cancer + mushroom extracts formulation experimental group: to which the MicoDigest2.0 mushroom extracts formulation developed by Hifas da Terra S.L has been administered dissolved in drinking water at an estimated concentration of 100 mg / ml. (ii) Control group of animals with Cancer: to which normal water has been administered without any type of treatment. (iii) Control group of healthy animals: these are the animals that have not been induced cancer or have not received any treatment in drinking water. This treatment has been maintained for a period of 3 months, after which the animals were sacrificed to obtain tissues that were subsequently analyzed to verify the effects of the mushroom extract formulation. A microbiological analysis has been carried out to compare the microbial communities present in the intestines of the mice belonging to each of the study groups. For this, the methodology of massive sequencing by molecular analysis of the 16S gene has been used (Ion Torrent technology). Initially, DNA extraction and metagenomics libraries were prepared using the 16S Metagenomics kit, always following the manufacturer's instructions. This kit amplifies 7 of the 9 hypervariable regions of the 16S gene that will then be sequenced. Finally, the data obtained will be compared with a database that makes it possible to determine the degree of similarity of the sequences obtained with a wide range of bacterial genomes. Results obtained showed that, similarly to certain natural compounds preventing colorectal tumorigenesis, a mushroom formulation enriched the Firmicutes and Proteobacteria phyla and depleted Bacteroidetes. Therefore, it was demonstrated that the consumption of the mushroom extracts’ formulation developed could promote the recovery of the microbial balance that is disrupted in the mice model of carcinogenesis. More preclinical and clinical studies are needed to validate this promising approach.

Keywords: carcinogenesis, microbiota, mushroom extracts, inflammation

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Authors: Armenio Lopes, Carlos Ferreira

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In the specific context of the Iberian Union between 1580 and 1640, characteristics emerged in Portuguese architecture that stood out from the main architectural production of the period. Recognised and identified aspects that had begun making their appearance decades before (1521) became significantly more marked during the Hapsburg-Spanish occupation. Distinctive even from the imperialist language of Spain, this trend would endure even after the restoration of independence (1706), continuing through to the start of the age of absolutism. Or perhaps not. This trend, recognised as Plain Style (Kubler), associated with a certain scarcity of resources, involved a certain formal and decorative simplification, as well as a particular set of conventions that would subsequently mark the landscape. This expression could also be seen as a means of asserting a certain spirit of independence as the Iberian Union breathed its last. The image of a simple, bare-bones architecture with purer design lines is associated by various authors –most notably Kubler– with the narratives of modernism, to whose principles it is similar, in a context-specific to the period. There is a contrast with some of the exuberance of the baroque or its expression in the Manueline period, in a similar fashion to modernism's responses to nineteenth-century eclecticism. This assertion and practice of simple architecture, drafted from the interpretation of the treaties, and highlighting a certain classical inspiration, was to become a benchmark in the theory of architecture, spanning the Baroque and Mannerism, until achieving contemporary recognition within certain originality and modernity. At a time when the baroque and its scenography became generally very widespread, it is important also to recognise the role played by plain style architecture in the construction of a rather complex and contradictory waterfront landscape, featuring promises of exuberance and more discrete practices.

Keywords: Carlos Mardel, Lisbon's waterfront, plain style, urban image on the waterfront

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Authors: Mbonigaba Swale

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Malaria is an infection or disease caused by parasites (Plasmodium Falciparum — causes severe Malaria, plasmodium Vivax, Plasmodium Ovale, and Plasmodium Malariae), transmitted by bites of infected anopheles (female) mosquitoes to humans. These vectors comprise of two types in Africa, particularly in Uganda, i.e. anopheles fenestus and Anopheles gambaie (‘example Anopheles arabiensis,,); feeds on man inside the house mainly at dusk, mid-night and dawn and rests indoors and makes them effective transmitters (vectors) of the disease. People in both urban and rural areas have consistently become prone to repetitive attacks of malaria, causing a lot of deaths and significantly increasing the poverty levels of the rural poor. Malaria is a national problem; it causes a lot of maternal pre-natal and antenatal disorders, anemia in pregnant mothers, low birth weights for the newly born, convulsions and epilepsy among the infants. Cumulatively, it kills about one million children every year in sub-Saharan Africa. It has been estimated to account for 25-35% of all outpatient visits, 20-45% of acute hospital admissions and 15-35% of hospital deaths. Uganda is the leading victim country, for which Rakai and Masaka districts are the most affected. So, it is not clear whether these abhorrent situations and episodes of recurrences and failure to cure from the disease are a result of poor diagnosis, prescription and dosing, treatment habits and compliance of the patients to the drugs or the ethical domain of the stake holders in relation to the main stream methodology of malaria management. The research is aimed at offering an alternative approach to manage and deal absolutely with problem by using a knowledge based software model of Artificial Intelligence (Al) that is capable of performing common-sense and cognitive reasoning so as to take decisions like the human brain would do to provide instantaneous expert solutions so as to avoid speculative simulation of the problem during differential diagnosis in the most accurate and literal inferential aspect. This system will assist physicians in many kinds of medical diagnosis, prescribing treatments and doses, and in monitoring patient responses, basing on the body weight and age group of the patient, it will be able to provide instantaneous and timely information options, alternative ways and approaches to influence decision making during case analysis. The computerized system approach, a new model in Uganda termed as “Software Aided Treatment” (SAT) will try to change the moral and ethical approach and influence conduct so as to improve the skills, experience and values (social and ethical) in the administration and management of the disease and drugs (combination therapy and generics) by both the patient and the health worker.

Keywords: knowledge based software, management, treatment, diagnosis

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Authors: H. Z. M. Chong, M. E. Y. Leong, G. L. Khor, S. C. Loke

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Vitamin D insufficiency is reported to be prevalent among women living in different altitudes including the equator where sunshine is available throughout the year. Multiple factors for vitamin D insufficiency include poor intake of vitamin D rich food and inadequate sun exposure, especially among women working indoor with a sedentary lifestyle. Furthermore, Muslim women in Malaysia whose attire covers the entire body are likely to receive poor sun exposure. This research determined serum vitamin D status, vitamin D intake and sun exposure of women aged 20-45 years of different ethnicity in Kuala Lumpur, Malaysia. Blood samples were collected from 106 women for determination of serum 25(OH)D levels. Information about vitamin D intake and sun exposure were obtained by interviewing the subjects using pre-tested questionnaires. The overall mean serum 25(OH)D was found to be 29.9 ± 14 nmol/L. Vitamin D deficiency and insufficiency was prevalent and highest among the Malay women. Less than ten percent of the subjects in this study met the sufficient vitamin D level recommendation of ≥50 nmol/L. Intake of vitamin D rich food such as oily fishes was poor across the different ethnicity. Other dietary sources of vitamin D in the diet were fortified bread and skim milk. On the other hand, the median sunlight exposure of the subjects was 3.9 hours per week. The Malay women reported to have the highest duration being exposed to the sun. Nevertheless, due to cultural clothing practices, these women had the least body surface area exposed to sunlight, resulting in the lowest calculated sun index score compared to the Chinese and the Indians. Low intake of vitamin D rich foods and sun exposure were negatively correlated with serum 25(OH)D level. In conclusion, intake of food sources rich in vitamin D and adequate body surface area exposed to the sun are essential to ensure healthy vitamin D level. Supplementation of vitamin D may be recommended to women whom unable to meet these recommendations.

Keywords: serum 25-OH, sun exposure, vitamin D food frequency, vitamin D deficiency

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Authors: Robert Rorie, Lisa Fern

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The integration of Unmanned Aircraft Systems (UAS) into the National Airspace System (NAS) poses a variety of technical challenges to UAS developers and aviation regulators. In response to growing demand for access to civil airspace in the United States, the Federal Aviation Administration (FAA) has produced a roadmap identifying key areas requiring further research and development. One such technical challenge is the development of a ‘detect and avoid’ system (DAA; previously referred to as ‘sense and avoid’) to replace the ‘see and avoid’ requirement in manned aviation. The purpose of the DAA system is to support the pilot, situated at a ground control station (GCS) rather than in the cockpit of the aircraft, in maintaining ‘well clear’ of nearby aircraft through the use of GCS displays and alerts. In addition to its primary function of aiding the pilot in maintaining well clear, the DAA system must also safely interoperate with existing NAS systems and operations, such as the airspace management procedures of air traffic controllers (ATC) and collision avoidance (CA) systems currently in use by manned aircraft, namely the Traffic alert and Collision Avoidance System (TCAS) II. It is anticipated that many UAS architectures will integrate both a DAA system and a TCAS II. It is therefore necessary to explicitly study the integration of DAA and TCAS II alerting structures and maneuver guidance formats to ensure that pilots understand the appropriate type and urgency of their response to the various alerts. This paper presents a concept of interoperability for the two systems. The concept was developed with the goal of avoiding any negative impact on the performance level of TCAS II (understanding that TCAS II must largely be left as-is) while retaining a DAA system that still effectively enables pilots to maintain well clear, and, as a result, successfully reduces the frequency of collision hazards. The interoperability concept described in the paper focuses primarily on facilitating the transition from a late-stage DAA encounter (where a loss of well clear is imminent) to a TCAS II corrective Resolution Advisory (RA), which requires pilot compliance with the directive RA guidance (e.g., climb, descend) within five seconds of its issuance. The interoperability concept was presented to 10 participants (6 active UAS pilots and 4 active commercial pilots) in a medium-fidelity, human-in-the-loop simulation designed to stress different aspects of the DAA and TCAS II systems. Pilot response times, compliance rates and subjective assessments were recorded. Results indicated that pilots exhibited comprehension of, and appropriate prioritization within, the DAA-TCAS II combined alert structure. Pilots demonstrated a high rate of compliance with TCAS II RAs and were also seen to respond to corrective RAs within the five second requirement established for manned aircraft. The DAA system presented under test was also shown to be effective in supporting pilots’ ability to maintain well clear in the overwhelming majority of cases in which pilots had sufficient time to respond. The paper ends with a discussion of next steps for research on integrating UAS into civil airspace.

Keywords: detect and avoid, interoperability, traffic alert and collision avoidance system (TCAS II), unmanned aircraft systems

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Authors: Abrar Al-Hasan

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Objectives: There is ongoing discourse regarding the potential risks to health professionals' reputations and credibility arising from their personal social media use. However, the specific impacts on professional credibility and the health professional-client relationship remain largely unexplored. This study aims to investigate the type and frequency of the content posted by health professionals on their Instagram accounts and its influence on their credibility and the professional-client relationship. Methodology: In a controlled field study, participants reviewed randomly assigned mock Instagram profiles of health professionals. Mock profiles were constructed according to gender (female/male), social media usage (high/low), and social media richness (high/ low), with richness increasing from posts to stories to reels and personal content type (high /low). Participants then rated the profile owners’ credibility on a visual analog scale. An analysis of variance compared these ratings, and mediation analyses assessed the influence of credibility ratings on participants' willingness to become clients of the mock health professional. Results: Results from 315 participants showed that health professionals with personal Instagram profiles displaying high social media richness were perceived as more credible than those with lower social media richness. Low social media usage is perceived as more credible than high social media usage. Personal content type is perceived as less credible as compared to those with low personal content type. Contributions: These findings provide initial evidence of the impact of health professionals' personal online disclosures on credibility and the health professional-client relationship. Understanding public perceptions of professionalism and credibility is essential for informing e-professionalism guidelines and promoting best practices in social media use among health professionals.

Keywords: credibility, consumer behavior, social media, media richness, healthcare professionals

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Authors: C. van den Berg, C. Pokpas

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Popular discourse touts entrepreneurship as a universal solution for underdevelopment, unemployment, and poverty. Moreover, claims are made that women and other disadvantaged groups can achieve material and personal success through digital entrepreneurship. This paper examines the potential of digital technology in entrepreneurial ventures to stimulate economic growth for marginalized groups and communities. Although digital entrepreneurship is hailed as a means to empower under-resourced and socially marginalized people, these opportunities still exist within the confines of existing social and cultural practices. The perspectives of female digital entrepreneurs in developing countries are sorely understudied, particularly concerning an understanding of the complex underlying socio-cultural factors impeding women’s entrepreneurial behaviors. This qualitative study, guided by a feminist phenomenological perspective, focused on the experiences of digital female entrepreneurs in the Western Cape of South Africa. Data were collected via semi-structured interviews and analyzed through the interpretative phenomenological analysis (IPA) approach to determine the relationships between digital entrepreneurship and structural and agential enabling conditions. Findings show that digital entrepreneurship is not a panacea for economic growth in marginalized groups and communities and highlight the importance of addressing socio-cultural gender inequality to enable successful entrepreneurial activity. The paper concludes with recommendations for specialized training initiatives aimed at female entrepreneurs that address internalized constraints and barriers that keep women subservient and measures to shift gender and power beliefs. The outcome will benefit the stimulation of gender-specific public policies to develop a successful digital start-up ecosystem further.

Keywords: digital innovation, female digital entrepreneurs, feminist phenomenology, gender, marginalised communities

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Authors: Jay Martin L. Dionaldo

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This study aimed to develop a causal model on the performance of the basic education teachers in the Division of Malaybalay City for the school year 2018-2019. This study used the responses of 300 randomly selected basic education teachers of Malaybalay City, Bukidnon. They responded to the three sets of questionnaires patterned from the National Education Association (2018) on instructional leadership of teachers, the questionnaire of Caluza et al., (2017) for information and communications technology competencies and the questionnaire on the teachers’ performance using the Individual Performance Commitment and Review Form (IPCRF) adopted by the Department of Education (DepEd). Descriptive statistics such as mean for the description, correlation for a relationship, regression for the extent influence, and path analysis for the model that best fits teachers’ performance were used. Result showed that basic education teachers have a very satisfactory level of performance. Also, the teachers highly practice instructional leadership practices in terms of coaching and mentoring, facilitating collaborative relationships, and community awareness and engagement. On the other hand, they are proficient users of ICT in terms of technology operations and concepts and basic users in terms of their pedagogical indicators. Furthermore, instructional leadership, coaching and mentoring, facilitating collaborative relationships and community awareness and engagement and information and communications technology competencies; technology operations and concept and pedagogy were significantly correlated toward teachers’ performance. Coaching and mentoring, community awareness and engagement, and technology operations and concept were the best predictors of teachers’ performance. The model that best fit teachers’ performance is anchored on coaching and mentoring of the teachers, embedded with facilitating collaborative relationships, community awareness, and engagement, technology operations, and concepts, and pedagogy.

Keywords: information and communications technology, instructional leadership, coaching and mentoring, collaborative relationship

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Authors: Henry Prihanto Nugroho

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This paper suggests education tourism as an option into developing more sustainable mass tourism. Identifying the potential of education tourism and developing a sustainable packages will have an impact on social economic development in the area. Indonesia especially Yogyakarta can increase their tourism earnings by tapping into this growing market phenomenon. Educational tourism, a growing part in the world tourism market, has attracted great attention because of its direct impact on the community and as an alternative strategy for poverty alleviation. Tourism is considered as one of the main industries and sectors highly contributing to economic development in Indonesia especially in Yogyakarta, this region can be an ideal case for studying the issue of educational tourism in Universitas Gadjah Mada. This paper tries to introduce the educational tourism as an important alternative source of the economy accelerator in the context of Yogyakarta Indonesia. This paper also aims to discuss the education tourism potential at the University of Gadjah Mada, Yogyakarta Indonesia then to create and established an Education Tourism package at Gadjah Mada University. Education Tourism is a means to empower academics, local community, local businesses, and to improve the economic welfare. Methods: Focus group discussions, direct observation, survey and best practice method. Conclusion: There is a positive relationship between attitude, environmental impact, economic impact, and socio-cultural impacts and practice in the field when the potential is seized. The findings incorporate insights into the socio-cultural and economic potential of education tourism and practices related to community development at the University of Gadjah Mada, Yogyakarta Indonesia by creating an Education Tourism Packages that will suit the needs of the tourist. Educational tourism can create sustainable development for local communities, academic society, universities, and stakeholders.

Keywords: education tourism, Gadjah Mada, sustainable, tourism

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Authors: Renee Fabian, Jordan Davidson

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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

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Authors: Ya-Ching Fu, An-Kuo Chou, Boon-Fatt Tan, Chi-Nien Chen, Wen-Chien Yang, Pou-Leng Cheong

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Blind oro-/naso-pharyngeal suction and feeding tube placement are very common practices in neonatal intensive care unit. Though esophageal perforation is a rare complication of these instrumentations, its prevalence is highest in extremely premature neonates. Due to its association with significant morbidity (including respiratory deterioration, pneumothorax, and sepsis) and even mortality, it is an important issue to prevent this iatrogenic complication in the field of premature care. We demonstrate an esophageal perforation in an extreme-low-birth-weight neonate after oro-gastric tube placement. This female baby weighing 680 grams was delivered by caesarean section at 25 weeks of gestational age. She initially received oro-tracheal intubation with mechanical ventilation which was smoothly weaned to non-invasive positive-pressure ventilation at 7-day-old. However, after insertion of a 5-French oro-gastric tube, the baby’s condition suddenly worsened with apnea requiring mechanical ventilation. Her chest radiogram showed the oro-gastric tube in right pleural space, and thus another oro-gastric tube was replaced, and its position was radiographically confirmed. The malpositioned tube was then removed. The baby received 2-week course of intravenous antibiotics for her esophageal perforation. Feeding was then reintroduced and increased to full feeds in a smooth course. She was discharged at 107-day-old. Esophageal perforation in newborn is very rare. Sudden respiratory deterioration in a neonate after naso-/oro-gastric tube placement should alarm us to consider esophageal perforation, and further radiological investigation is required for the diagnosis. Tube materials, patient condition, and age are major risk factors of esophageal perforation. The use of softer tube material, such as silicone, in extreme premature baby might prevent this fetal complication.

Keywords: esophageal perforation, preterm, newborn, feeding tube

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Authors: Aguiar-Castillo Lidia, Perez-Jimenez Rafael

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The integration of gamification in educational settings aims to enhance student engagement and motivation through game design elements in learning activities. This paper introduces "Gamipulation," the subtle manipulation of students via gamification techniques serving hidden agendas without explicit consent. It highlights the need to distinguish between beneficial and exploitative uses of gamification in education, focusing on its potential to psychologically manipulate students for purposes misaligned with their best interests Through a literature review and expert interviews, this study presents a conceptual framework outlining gamipulation's features. It examines ethical concerns like gradually introducing desired behaviors, using distraction to divert attention from significant learning objectives, immediacy of rewards fostering short-term engagement over long-term learning, infantilization of students, and exploitation of emotional responses over reflective thinking. Additionally, it discusses ethical issues in collecting and utilizing student data within gamified environments. Key findings suggest that while gamification can enhance motivation and engagement, there's a fine line between ethical motivation and unethical manipulation. The study emphasizes the importance of transparency, respect for student autonomy, and alignment with educational values in gamified systems. It calls for educators and designers to be aware of gamification's manipulative potential and strive for ethical implementation that benefits students. In conclusion, this paper provides a framework for educators and researchers to understand and address gamipulation's ethical challenges. It encourages developing ethical guidelines and practices to ensure gamification in education remains a tool for positive engagement and learning rather than covert manipulation.

Keywords: gradualness, distraction, immediacy, infantilization, emotion

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Authors: Azza A. Ali, Mona G. Khalil, Hemat A. Elariny, Shereen S. El Shaer

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Background: Aluminium (Al) is very abundant metal in the earth’s crust. It is a constituent of cooking utensils, medicines, cosmetics, some foods and food additives. Salts of Al are widely used in the treatment of drinking water for purification purposes. Excessive and prolonged exposure to Al causes oxidative stress and impairment of many physiological functions. Its accumulation in liver and kidney causes hepatotoxicity and nephrotoxicity. Social isolation (SI) or Protein malnutrition (PM) also increases oxidative stress and may enhance the toxicity of Al as well as the degeneration in liver and kidney. Epigallocatechin-3-gallate (EGCG) is the most abundant catechin in green tea and has strong antioxidant as well as anti-inflammatory activities and can protect against oxidative stress-induced degenerations. Objective: To study the influence of stress or PM on Al-induced nephrotoxicity and hepatotoxicity in rats, as well as on the potential role of EGCG in providing protection. Methods: Rats received daily AlCl3 (70 mg/kg, IP) for three weeks (Al-toxicity groups) except one normal control group received saline. Al-toxicity groups were divided into four treated and four untreated groups; treated rats received EGCG (10 mg/kg, IP) together with AlCl3. One group of both treated and untreated rats served as control for each of them, and the others were subjected to either stress (mild using isolation or high using electric shock) or to PM (10% casein diet). Specimens of liver and kidney were used for assessment of levels of inflammatory mediators as TNF-α, IL6β, nuclear factor kappa B (NF-κB), oxidative stress (MDA, SOD, TAC, NO), Caspase-3 and for DNA fragmentation as well as for histopathological examinations. Biochemical changes were also measured in the serum as total lipids, cholesterol, triglycerides, glucose, proteins, bilirubin, creatinine and urea as well as the level of Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and lactate deshydrogenase (LDH). Results: Nephrotoxicity and hepatotoxicity induced by Al were enhanced in rats exposed to stress and to PM. The influence of stress was more pronounced than PM. Al-toxicity was indicated by the increase in liver and kidney MDA, NO, TNF-α, IL-6β, NF-κB, caspase-3, DNA fragmentation and in ALT, AST, ALP, LDH and total lipids, cholesterol, triglycerides, glucose, proteins, bilirubin, creatinine and urea levels, together with the decrease in total proteins, SOD, TAC. EGCG provided protection against hazards of Al as indicated by the decrease in MDA, NO, TNF-α, IL-6β, NF-κB, caspase-3 and DNA fragmentation as well as in levels of ALT, AST, ALP, LDH and total lipids, cholesterol, triglycerides, glucose, proteins, bilirubin, creatinine and urea in liver and kidney, together with the increase in total proteins, SOD, TAC and confirmed by histopathological examinations. It provided more pronounced protection in high stressful conditions than in mild one than in PM. Conclusion: Stress have a bad impact on Al-induced nephrotoxicity and hepatotoxicity more than PM. Thus it can clarify and maximize the role of EGCG in providing protection. Consequently, administration of EGCG is advised with excessive Al-exposure to avoid nephrotoxicity and hepatotoxicity especially in populations more subjected to stress or PM.

Keywords: aluminum, stress, protein malnutrition, nephrotoxicity, hepatotoxicity, epigallocatechin-3-gallate, rats

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Authors: Tanira Kingi, Oscar Montes Oca, Reina Tamepo

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The introduction of the Climate Change Response (Zero Carbon) Amendment Act (2019) and the National Policy Statement for Freshwater Management (2020) both contain underpinning statements that refer to the principles of the Treaty of Waitangi and cultural concepts of stewardship and environmental protection. Maori interests in New Zealand’s agricultural, forestry, fishing and horticultural sectors are significant. The organizations that manage these investments do so on behalf of extended family groups that hold inherited interests based on genealogical connections (whakapapa) to particular tribal units (iwi and hapu) and areas of land (whenua) and freshwater bodies (wai). This paper draws on the findings of current research programmes funded by the New Zealand Agricultural Greenhouse Gas Research Centre (NZAGRC) and the Our Land & Water National Science Challenge (OLW NSC) to understand the impact of cultural knowledge and imperatives on agricultural GHG and freshwater mitigation and land-use change decisions. In particular, the research outlines mitigation and land-use change scenario decision support frameworks that model changes in emissions profiles (reductions in biogenic methane, nitrous oxide and nutrient emissions to freshwater) of agricultural and forestry production systems along with impacts on key economic indicators and socio-cultural factors. The paper also assesses the effectiveness of newly introduced partnership arrangements between Maori groups/organizations and key government agencies on policy co-design and implementation, and in particular, decisions to adopt mitigation practices and to diversify land use.

Keywords: co-design and implementation of environmental policy, indigenous environmental knowledge, Māori land tenure and agribusiness, mitigation and land use change decision support frameworks

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Authors: Chad Van Schoelandt, Chara Kokkiou

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This paper discusses Socrates’ fundamental views of morality and freedom in Plato’s Phaedo through examining the fittingness of resentment and related emotional responses. In different parts of the dialogue there seems to be two kinds of emotional justification, which seem to explain different types of appeal that Socrates makes in order to defend his own emotional responses and make recommendations to others. The upshot of this paper is to bring out the connection between different emotional responses and beliefs. In particular, it focuses on the unfittingness of the Strawsonian resentment. If one, taking a rationalistic approach, agrees that some emotions, such as resentment, have a cognitive or belief-like component, then people reacting differently to the same situation suggests differences in their judgments and beliefs. However, at times, including in Socrates’s direction to his friends in the Phaedo, emotions are justified by pragmatic appeal, independent of the beliefs associated with the emotion. In any case, there are both fittingness-based and pragmatic factors that determine and condition the warrant of an emotional response. Overall, an emotion is fitting when the agent’s beliefs indicate that the conditions of appropriatedness are met. Socrates views resentment and sorrow as unfitting due to the mismatch with his own moral beliefs and his teaching to others. At the same time, Socrates argues that his friends’ expression of sorrow at his last moments is unseemly because it is not included in the widely accepted social practices, though the emotion itself is not necessarily unfitting. Socrates’s unexpected emotional response to his death, namely his lack of resentment and sorrow, implies a different belief system and indicates his students’ lack of understanding of the actual implications of his views. Thus, the paper will bring out how complicated Socrates’s ideas were even for people who had a sustained engagement with his ideas. Overall, the paper will illuminate how these two parties (Socrates – friends) view different moral duties, namely the individual duty to philosophy, which signifies a meaningful life, and the civic duty to obey the law, which signals Socrates’ death.

Keywords: Emotions, freedom, morality, Plato

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Authors: Lucia Liu, Matthew Koziol

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Obsessive-compulsive disorder (OCD), a long-lasting anxiety disorder involving recurrent, intrusive thoughts, affects over 2 million adults in the United States. Transcranial magnetic stimulation (TMS) stands out as a noninvasive, cutting-edge therapy that has been shown to reduce symptoms in patients with treatment-resistant OCD. The Food and Drug Administration (FDA) approved protocol pairs TMS sessions with individualized symptom provocation, aiming to improve the susceptibility of brain circuits to stimulation. However, limited standardization or guidance exists on how to conduct symptom provocation and which methods are most effective. This study aims to compare the effect of internal versus external techniques to induce obsessional stress in a clinical setting during TMS therapy. Two symptom provocation methods, (i) Asking patients thought-provoking questions about their obsessions (internal) and (ii) Requesting patients to perform obsession-related tasks (external), were employed in a crossover design with repeated measurement. Thirty-six treatments of NeuroStar TMS were administered to each of two patients over 8 weeks in an outpatient clinic. Patient One received 18 sessions of internal provocation followed by 18 sessions of external provocation, while Patient Two received 18 sessions of external provocation followed by 18 sessions of internal provocation. The primary outcome was the level of self-reported obsessional stress on a visual analog scale from 1 to 10. The secondary outcome was self-reported OCD severity, collected biweekly in a four-level Likert-scale (1 to 4) of bad, fair, good and excellent. Outcomes were compared and tested between provocation arms through repeated measures ANOVA, accounting for intra-patient correlations. Ages were 42 for Patient One (male, White) and 57 for Patient Two (male, White). Both patients had similar moderate symptoms at baseline, as determined through the Yale-Brown Obsessive Compulsive Scale (YBOCS). When comparing obsessional stress induced across the two arms of internal and external provocation methods, the mean (SD) was 6.03 (1.18) for internal and 4.01 (1.28) for external strategies (P=0.0019); ranges were 3 to 8 for internal and 2 to 8 for external strategies. Internal provocation yielded 5 (31.25%) bad, 6 (33.33%) fair, 3 (18.75%) good, and 2 (12.5%) excellent responses for OCD status, while external provocation yielded 5 (31.25%) bad, 9 (56.25%) fair, 1 (6.25%) good, and 1 (6.25%) excellent responses (P=0.58). Internal symptom provocation tactics had a significantly stronger impact on inducing obsessional stress and led to better OCD status (non-significant). This could be attributed to the fact that answering questions may prompt patients to reflect more on their lived experiences and struggles with OCD. In the future, clinical trials with larger sample sizes are warranted to validate this finding. Results support the increased integration of internal methods into structured provocation protocols, potentially reducing the time required for provocation and achieving greater treatment response to TMS.

Keywords: obsessive-compulsive disorder, transcranial magnetic stimulation, mental health, symptom provocation

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