Search results for: intervention programs for alcohol offenders

Authors: Anar Koli

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After the Paris agreement in 2015, a comprehensive initiative both from the developed and developing countries towards the adaptation to climate change is emerging. The Global Environmental Facility (GEF), which is financing a global portfolio of adaptation projects and programs in over 124 countries is playing a significant role to a new financing framework that included the concept of “climate-resilient development”. However, both the adaptation and sustainable development paradigms remain continuously contested, especially the role of the multilateral institutions with their technical and financial assistance to the developing world. Focusing on the adaptation initiatives of the GEF, this study aims to understand to what extent the global multilateral institutions, particularly the GEF is contributing to the climate-resilient development. From the political ecology perspective, the argument of this study is that the global financial framework is highly politicized, and understanding the contribution of the global institutions of the global climate change needs to be related both from the response and causal perspectives. A holistic perspective, which includes the contribution of the GEF as a response to the climate change and as well the cause of global climate change, are needed to understand the broader environment- political economic relation. The study intends to make a critical analysis of the way in which the political economy structure and the environment are related along with the social and ecological implications. It does not provide a narrow description of institutional responses to climate change, rather it looks at how the global institutions are influencing the relationship of the global ecologies and economies. This study thus developed a framework combining the global governance and the political economy perspective. This framework includes environment-society relation, environment-political economy linkage, global institutions as the orchestra, and division between the North and the South. Through the analysis of the GEF as the orchestra of the global governance, this study helps to understand how GEF is coordinating the interactions between the North and the South and responding the global climate resilient development. Through the other components of the framework, the study explains how the role of the global institutions is related to the cause of the human induced global climate change. The study employs a case study based on both the quantitative and qualitative data. Along with the GEF reports and data sets, this study draws from an eclectic range of literature from a range of disciplines to explain the broader relation of the environment and political economy. Based on a case study on GEF, the study found that the GEF has positive contributions in bringing developing countries’ capacity in terms of sustainable development goal, local institutional development. However, through a critical holistic analysis, this study found that this contribution to the resilient development helps the developing countries to conform the fossil fuel based capitalist political economy. The global governance institution is contributing both to the pro market based environment society relation and, to the consequences of this relation.

Keywords: climate change adaptation, global environmental facility (GEF), political economy, the north -south relation

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Authors: Christian Andrä, Luisa Zimmermann, Christina Müller

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Introduction: The positive relation between physical activity and cognition is commonly known. Relevant studies show that in everyday school life active breaks can lead to improvement in certain abilities (e.g. attention and concentration). A beneficial effect is in particular attributed to moderate activity. It is still unclear whether active breaks are beneficial after relatively short phases of cognitive load and whether the postulated effects of activity really have an immediate impact. The objective of this study was to verify whether an active break after 18 minutes of cognitive load leads to enhanced attention/concentration performance, compared to inactive breaks with voluntary mobile phone activity. Methodology: For this quasi-experimental study, 36 students [age: 14.0 (mean value) ± 0.3 (standard deviation); male/female: 21/15] of a secondary school were tested. In week 1, every student’s maximum heart rate (Hfmax) was determined through maximum effort tests conducted during physical education classes. The task was to run 3 laps of 300 m with increasing subjective effort (lap 1: 60%, lap 2: 80%, lap 3: 100% of the maximum performance capacity). Furthermore, first attention/concentration tests (D2-R) took place (pretest). The groups were matched on the basis of the pretest results. During week 2 and 3, crossover testing was conducted, comprising of 18 minutes of cognitive preload (test for concentration performance, KLT-R), a break and an attention/concentration test after a 2-minutes transition. Different 10-minutes breaks (active break: moderate physical activity with 65% Hfmax or inactive break: mobile phone activity) took place between preloading and transition. Major findings: In general, there was no impact of the different break interventions on the concentration test results (symbols processed after physical activity: 185.2 ± 31.3 / after inactive break: 184.4 ± 31.6; errors after physical activity: 5.7 ± 6.3 / after inactive break: 7.0. ± 7.2). There was, however, a noticeable development of the values over the testing periods. Although no difference in the number of processed symbols was detected (active/inactive break: period 1: 49.3 ± 8.8/46.9 ± 9.0; period 2: 47.0 ± 7.7/47.3 ± 8.4; period 3: 45.1 ± 8.3/45.6 ± 8.0; period 4: 43.8 ± 7.8/44.6 ± 8.0), error rates decreased successively after physical activity and increased gradually after an inactive break (active/inactive break: period 1: 1.9 ± 2.4/1.2 ± 1.4; period 2: 1.7 ± 1.8/ 1.5 ± 2.0, period 3: 1.2 ± 1.6/1.8 ± 2.1; period 4: 0.9 ± 1.5/2.5 ± 2.6; p= .012). Conclusion: Taking into consideration only the study’s overall results, the hypothesis must be dismissed. However, more differentiated evaluation shows that the error rates decreased after active breaks and increased after inactive breaks. Obviously, the effects of active intervention occur with a delay. The 2-minutes transition (regeneration time) used for this study seems to be insufficient due to the longer adaptation time of the cardio-vascular system in untrained individuals, which might initially affect the concentration capacity. To use the positive effects of physical activity for teaching and learning processes, physiological characteristics must also be considered. Only this will ensure optimum ability to perform.

Keywords: active breaks, attention/concentration test, cognitive performance capacity, heart rate, physical activity

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Authors: Chiara Barone

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In Naples, the visible architecture is only what emerges from the underground. Caves and tunnels cross it in every direction, intertwining with each other. They are not natural caves but spaces built by removing what is superfluous in order to dig a form out of the material. Architects, as sculptors of space, do not determine the exterior, what surrounds the volume and in which the forms live, but an interior underground space, perceptive and sensitive, able to generate new emotions each time. It is an intracorporeal architecture linked to the body, not in its external relationships, but rather with what happens inside. The proposed aims to reflect on the design of underground spaces in the Neapolitan city. The idea is to intend the underground as a spectacular museum of the city, an opportunity to learn in situ the history of the place along an unpredictable itinerary that crosses the caves and, in certain points, emerges, escaping from the world of shadows. Starting form the analysis and the study of the many overlapping elements, the archaeological one, the geological layer and the contemporary city above, it is possible to develop realistic alternatives for underground itineraries. The objective is to define minor paths to ensure the continuity between the touristic flows and entire underground segments already investigated but now disconnected: open-air paths, which abyss in the earth, retracing historical and preserved fragments. The visitor, in this way, passes from real spaces to sensitive spaces, in which the imaginary replaces the real experience, running towards exciting and secret knowledge. To safeguard the complex framework of the historical-artistic values, it is essential to use a multidisciplinary methodology based on a global approach. Moreover, it is essential to refer to similar design projects for the archaeological underground, capable of guide action strategies, looking at similar conditions in other cities, where the project has led to an enhancement of the heritage in the city. The research limits the field of investigation, by choosing the historic center of Naples, applying bibliographic and theoretical research to a real place. First of all, it’s necessary to deepen the places’ knowledge understanding the potentialities of the project as a link between what is below and what is above. Starting from a scientific approach, in which theory and practice are constantly intertwined through the architectural project, the major contribution is to provide possible alternative configurations for the underground space and its relationship with the city above, understanding how the condition of transition, as passage between the below and the above becomes structuring in the design process. Starting from the consideration of the underground as both a real physical place and a sensitive place, which engages the memory, imagination, and sensitivity of a man, the research aims at identifying possible configurations and actions useful for future urban programs to make the underground a central part of the lived city, again.

Keywords: underground paths, invisible ruins, imaginary, sculpted forms, sensitive spaces, Naples

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Authors: Mohammad Ali Tabibi, Farzad Nazemi, Nasrin Salimian

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Background: Peritoneal dialysis (PD) is a prevalent renal replacement therapy for patients with end-stage renal disease. Despite its benefits, PD patients often experience reduced physical activity and physical function, which can negatively impact dialysis adequacy and overall health outcomes. Despite the known benefits of maintaining physical activity in chronic disease management, the specific interplay between physical inactivity, physical function, and dialysis adequacy in PD patients remains underexplored. Understanding this relationship is essential for developing targeted interventions to enhance patient care and outcomes in this vulnerable population. This study aims to assess the impact of physical inactivity on dialysis adequacy and functional health in PD patients. Methods: This cross-sectional study included 135 peritoneal dialysis patients from multiple dialysis centers. Physical inactivity was measured using the International Physical Activity Questionnaire (IPAQ), while physical function was assessed using the Short Physical Performance Battery (SPPB). Dialysis adequacy was evaluated using the Kt/V ratio. Additional variables such as demographic data, comorbidities, and laboratory parameters were collected to control for potential confounders. Statistical analyses were performed to determine the relationships between physical inactivity, physical function, and dialysis adequacy. Results: The study cohort comprised 70 males and 65 females with a mean age of 55.4 ± 13.2 years. A significant proportion of the patients (65%) were categorized as physically inactive based on IPAQ scores. Inactive patients demonstrated significantly lower SPPB scores (mean 6.2 ± 2.1) compared to their more active counterparts (mean 8.5 ± 1.8, p < 0.001). Dialysis adequacy, as measured by Kt/V, was found to be suboptimal (Kt/V < 1.7) in 48% of the patients. There was a significant positive correlation between physical function scores and Kt/V values (r = 0.45, p < 0.01), indicating that better physical function is associated with higher dialysis adequacy. Also, there was a significant negative correlation between physical inactivity and physical function (r = -0.55, p < 0.01). Additionally, physically inactive patients had lower Kt/V ratios compared to their active counterparts (1.3 ± 0.3 vs. 1.8 ± 0.4, p < 0.05). Multivariate regression analysis revealed that physical inactivity was an independent predictor of reduced dialysis adequacy (β = -0.32, p < 0.01) and poorer physical function (β = -0.41, p < 0.01) after adjusting for age, sex, comorbidities, and dialysis vintage. Conclusion: This study underscores the critical role of physical activity and physical function in maintaining adequate dialysis in peritoneal dialysis patients. These findings highlight the need for targeted interventions to promote physical activity in this population to improve their overall health outcomes. Future research should focus on developing and evaluating exercise programs tailored for PD patients to enhance their physical function and dialysis adequacy. The findings suggest that interventions aimed at increasing physical activity and improving physical function may enhance dialysis adequacy and overall health outcomes in this population. Further research is warranted to explore the mechanisms underlying these associations and to develop targeted strategies for enhancing patient care.

Keywords: inactivity, physical function, peritoneal dialysis, dialysis adequacy

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Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

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Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

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Authors: José Manuel Palma, Paula Pereira, Margarida Tomás

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Foreseen the future: Human factors integration in European Horizon Projects The development of new technology as artificial intelligence, smart sensing, robotics, cobotics or intelligent machinery must integrate human factors to address the need to optimize systems and processes, thereby contributing to the creation of a safe and accident-free work environment. Human Factors Integration (HFI) consistently pose a challenge for organizations when applied to daily operations. AGILEHAND and FORTIS projects are grounded in the development of cutting-edge technology - industry 4.0 and 5.0. AGILEHAND aims to create advanced technologies for autonomously sort, handle, and package soft and deformable products, whereas FORTIS focuses on developing a comprehensive Human-Robot Interaction (HRI) solution. Both projects employ different approaches to explore HFI. AGILEHAND is mainly empirical, involving a comparison between the current and future work conditions reality, coupled with an understanding of best practices and the enhancement of safety aspects, primarily through management. FORTIS applies HFI throughout the project, developing a human-centric approach that includes understanding human behavior, perceiving activities, and facilitating contextual human-robot information exchange. it intervention is holistic, merging technology with the physical and social contexts, based on a total safety culture model. In AGILEHAND we will identify safety emergent risks, challenges, their causes and how to overcome them by resorting to interviews, questionnaires, literature review and case studies. Findings and results will be presented in “Strategies for Workers’ Skills Development, Health and Safety, Communication and Engagement” Handbook. The FORTIS project will implement continuous monitoring and guidance of activities, with a critical focus on early detection and elimination (or mitigation) of risks associated with the new technology, as well as guidance to adhere correctly with European Union safety and privacy regulations, ensuring HFI, thereby contributing to an optimized safe work environment. To achieve this, we will embed safety by design, and apply questionnaires, perform site visits, provide risk assessments, and closely track progress while suggesting and recommending best practices. The outcomes of these measures will be compiled in the project deliverable titled “Human Safety and Privacy Measures”. These projects received funding from European Union’s Horizon 2020/Horizon Europe research and innovation program under grant agreement No101092043 (AGILEHAND) and No 101135707 (FORTIS).

Keywords: human factors integration, automation, digitalization, human robot interaction, industry 4.0 and 5.0

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Authors: Majed A. Alsalem

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In our contemporary world, literacy is an essential skill that enables students to increase their efficiency in managing the many assignments they receive that require understanding and knowledge of the world around them. In addition, literacy enhances student participation in society improving their ability to learn about the world and interact with others and facilitating the exchange of ideas and sharing of knowledge. Therefore, literacy needs to be studied and understood in its full range of contexts. It should be seen as social and cultural practices with historical, political, and economic implications. This study aims to rebuild and reorganize the instructional designs that have been used for deaf and hard-of-hearing (DHH) students to improve their literacy level. The most critical part of this process is the teachers; therefore, teachers will be the center focus of this study. Teachers’ main job is to increase students’ performance by fostering strategies through collaborative teamwork, higher-order thinking, and effective use of new information technologies. Teachers, as primary leaders in the learning process, should be aware of new strategies, approaches, methods, and frameworks of teaching in order to apply them to their instruction. Literacy from a wider view means acquisition of adequate and relevant reading skills that enable progression in one’s career and lifestyle while keeping up with current and emerging innovations and trends. Moreover, the nature of literacy is changing rapidly. The notion of new literacy changed the traditional meaning of literacy, which is the ability to read and write. New literacy refers to the ability to effectively and critically navigate, evaluate, and create information using a range of digital technologies. The term new literacy has received a lot of attention in the education field over the last few years. New literacy provides multiple ways of engagement, especially to those with disabilities and other diverse learning needs. For example, using a number of online tools in the classroom provides students with disabilities new ways to engage with the content, take in information, and express their understanding of this content. This study will provide teachers with the highest quality of training sessions to meet the needs of DHH students so as to increase their literacy levels. This study will build a platform between regular instructional designs and digital materials that students can interact with. The intervention that will be applied in this study will be to train teachers of DHH to base their instructional designs on the notion of Technology Acceptance Model (TAM) theory. Based on the power analysis that has been done for this study, 98 teachers are needed to be included in this study. This study will choose teachers randomly to increase internal and external validity and to provide a representative sample from the population that this study aims to measure and provide the base for future and further studies. This study is still in process and the initial results are promising by showing how students have engaged with digital books.

Keywords: deaf and hard of hearing, digital books, literacy, technology

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Authors: Tahmina Huq

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This paper presents the findings of an action research study that aimed to investigate the efficacy of a visual dialogue strategy in assisting autistic students with intellectual disabilities in managing their immediate emotions and improving their academic achievements. The research sought to explore the effectiveness of teaching self-regulation techniques as an alternative to traditional approaches involving segregation. The study identified visual dialogue as a valuable tool for promoting self-regulation in this specific student population. Action research was chosen as the methodology due to its suitability for immediate implementation of the findings in the classroom. Autistic students with intellectual disabilities often face challenges in controlling their emotions, which can disrupt their learning and academic progress. Conventional methods of intervention, such as isolation and psychologist-assisted approaches, may result in missed classes and hindered academic development. This study introduces the utilization of visual dialogue between students and teachers as an effective self-regulation strategy, addressing the limitations of traditional approaches. Action research was employed as the methodology for this study, allowing for the direct application of the findings in the classroom. The study observed two 15-year-old autistic students with intellectual disabilities who exhibited difficulties in emotional regulation and displayed aggressive behaviors. The research question focused on the effectiveness of visual dialogue in managing the emotions of these students and its impact on their learning outcomes. Data collection methods included personal observations, log sheets, personal reflections, and visual documentation. The study revealed that the implementation of visual dialogue as a self-regulation strategy enabled the students to regulate their emotions within a short timeframe (10 to 30 minutes). Through visual dialogue, they were able to express their feelings and needs in socially appropriate ways. This finding underscores the significance of visual dialogue as a tool for promoting emotional regulation and facilitating active participation in classroom activities. As a result, the students' learning outcomes and social interactions were positively impacted. The findings of this study hold significant implications for educators working with autistic students with intellectual disabilities. The use of visual dialogue as a self-regulation strategy can enhance emotional regulation skills and improve overall academic progress. The action research approach outlined in this paper provides practical guidance for educators in effectively implementing self-regulation strategies within classroom settings. In conclusion, the study demonstrates that visual dialogue is an effective strategy for enhancing emotional regulation in autistic students with intellectual disabilities. By employing visual communication, students can successfully regulate their emotions and actively engage in classroom activities, leading to improved learning outcomes and social interactions. This paper underscores the importance of implementing self-regulation strategies in educational settings to cater to the unique needs of autistic students.

Keywords: action research, self-regulation, autism, visual communication

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Authors: Lucas Derks, Christine Beenhakker, Michiel Brandt, Gert Arts, Ruud van Langeveld

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Background: The method Depression in Awareness Space (DAS) is a psychotherapeutic intervention technique based on the principles of spatial cognition and imagination therapy with spatial components. The basic assumptions are: mental space is the primary organizing principle in the mind, and all psychological issues can be treated by first locating and by next relocating the conceptualizations involved. The most clinical experience was gathered over the last 20 years in the area of social issues (with the social panorama model). The latter work led to the conclusion that a mental object (image) gains emotional impact when it is placed more central, closer and higher in the visual field – and vice versa. Changing the locations of mental objects in space thus alters the (socio-) emotional meaning of the relationships. The experience of depression seems always associated with darkness. Psychologists tend to see the link between depression and darkness as a metaphor. However, clinical practice hints to the existence of more literal forms of darkness. Aims: The aim of the method Depression in Awareness Space is to reduce the distress of clients with depression in the clinical counseling practice, as a reliable alternative method of psychological therapy for the treatment of depression. The method Depression in Awareness Space aims at making dark areas smaller, lighter and more transparent in order to identify the problem or the cause of the depression which lies behind the darkness. It was hypothesized that the darkness is a subjective side-effect of the neurological process of repression. After reducing the dark clouds the real problem behind the depression becomes more visible, allowing the client to work on it and in that way reduce their feelings of depression. This makes repression of the issue obsolete. Results: Clients could easily get into their 'sadness' when asked to do so and finding the location of the dark zones proved pretty easy as well. In a recent pilot study with five participants with mild depressive symptoms (measured on two different scales and tested against an untreated control group with similar symptoms), the first results were also very promising. If the mental spatial approach to depression can be proven to be really effective, this would be very good news. The Society of Mental Space Psychology is now looking for sponsoring of an up scaled experiment. Conclusions: For spatial cognition and the research into spatial psychological phenomena, the discovery of dark areas can be a step forward. Beside out of pure scientific interest, it is great to know that this discovery has a clinical implication: when darkness can be connected to depression. Also, darkness seems to be more than metaphorical expression. Progress can be monitored over measurement tools that quantify the level of depressive symptoms and by reviewing the areas of darkness.

Keywords: depression, spatial cognition, spatial imagery, social panorama

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Authors: Gary Peach, Furqan Hameed

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Musaimeer outfall tunnel is one of the longest storm water tunnels in the world, with a total length of 10.15 km. The tunnel will accommodate surface and rain water received from the drainage networks from 270 km of urban areas in southern Doha with a pumping capacity of 19.7m³/sec. The tunnel is excavated by Tunnel Boring Machine (TBM) through Rus Formation, Midra Shales, and Simsima Limestone. Water inflows at high pressure, complex mixed ground, and weaker ground strata prone to karstification with the presence of vertical and lateral fractures connected to the sea bed were also encountered during mining. In addition to pre-tender geotechnical investigations, the Contractor carried out a supplementary offshore geophysical investigation in order to fine-tune the existing results of geophysical and geotechnical investigations. Electric resistivity tomography (ERT) and Seismic Reflection survey was carried out. Offshore geophysical survey was performed, and interpretations of rock mass conditions were made to provide an overall picture of underground conditions along the tunnel alignment. This allowed the critical tunnelling area and cutter head intervention to be planned accordingly. Karstification was monitored with a non-intrusive radar system facility installed on the TBM. The Boring Electric Ahead Monitoring(BEAM) was installed at the cutter head and was able to predict the rock mass up to 3 tunnel diameters ahead of the cutter head. BEAM system was provided with an online system for real time monitoring of rock mass condition and then correlated with the rock mass conditions predicted during the interpretation phase of offshore geophysical surveys. The further correlation was carried by Samples of the rock mass taken from tunnel face inspections and excavated material produced by the TBM. The BEAM data was continuously monitored to check the variations in resistivity and percentage frequency effect (PFE) of the ground. This system provided information about rock mass condition, potential karst risk, and potential of water inflow. BEAM system was found to be more than 50% accurate in picking up the difficult ground conditions and faults as predicted in the geotechnical interpretative report before the start of tunnelling operations. Upon completion of the project, it was concluded that the combined use of different geophysical investigation results can make the execution stage be carried out in a more confident way with the less geotechnical risk involved. The approach used for the prediction of rock mass condition in Geotechnical Interpretative Report (GIR) and Geophysical Reflection and electric resistivity tomography survey (ERT) Geophysical Reflection surveys were concluded to be reliable as the same rock mass conditions were encountered during tunnelling operations.

Keywords: tunnel boring machine (TBM), subsea, karstification, seismic reflection survey

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Authors: E. Steen, B. Dewulf, N. Müller, C. Vandycke, Y. Vandekerckhove

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Introduction: The care for a ST-elevation myocardial infarction (STEMI) patient is time-critical. Reperfusion therapy within 90 minutes of initial medical contact is mandatory in the improvement of the outcome. Primary percutaneous coronary intervention (PCI) without previous fibrinolytic treatment, is the preferred reperfusion strategy in patients with STEMI, provided it can be performed within guideline-mandated times. Aim of the study: During a one year period (January 2013 to December 2013) the files of all consecutive STEMI patients with urgent referral from non-PCI facilities for primary PCI were reviewed. Special attention was given to a subgroup of patients with prior out-of-hospital medical contact generated by the 112-system. In an effort to reduce out-of-hospital system delay to definitive care a change in pre-hospital 112 dispatch strategies is proposed for these time-critical patients. Actual time recordings were compared with travel time simulations for two suggested scenarios. A first scenario (SC1) involves the decision by the on scene ground EMS (GEMS) team to transport the out-of-hospital diagnosed STEMI patient straight forward to a PCI centre bypassing the nearest non-PCI hospital. Another strategy (SC2) explored the potential role of helicopter EMS (HEMS) where the on scene GEMS team requests a PCI-centre based HEMS team for immediate medical transfer to the PCI centre. Methods and Results: 49 (29,1% of all) STEMI patients were referred to our hospital for emergency PCI by a non-PCI facility. 1 file was excluded because of insufficient data collection. Within this analysed group of 48 secondary referrals 21 patients had an out-of-hospital medical contact generated by the 112-system. The other 27 patients presented at the referring emergency department without prior contact with the 112-system. The table below shows the actual time data from first medical contact to definitive care as well as the simulated possible gain of time for both suggested strategies. The PCI-team was always alarmed upon departure from the referring centre excluding further in-hospital delay. Time simulation tools were similar to those used by the 112-dispatch centre. Conclusion: Our data analysis confirms prolonged reperfusion times in case of secondary emergency referrals for STEMI patients even with the use of HEMS. In our setting there was no statistical difference in gain of time between the two suggested strategies, both reducing the secondary referral generated delay with about one hour and by this offering all patients PCI within the guidelines mandated time. However, immediate HEMS activation by the on scene ground EMS team for transport purposes is preferred. This ensures a faster availability of the local GEMS-team for its community. In case these options are not available and the guideline-mandated times for primary PCI are expected to be exceeded, primary fibrinolysis should be considered in a non-PCI centre.

Keywords: STEMI, system delay, HEMS, emergency medicine

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Authors: Ombir Singh

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In spite of the religious and cultural pre-dominance of the river Ganga in the Indian ethos, fragmentation and degradation of the river continued down the ages. Recognizing the national concern on environmental degradation of the river and its basin, Ministry of Water Resources, River Development & Ganga Rejuvenation (MoWR,RD&GR), Government of India has initiated a number of pilot schemes for the rejuvenation of river Ganga under the ‘Namami Gange’ Programme. Considering the diversity, complexity, and intricacies of forest ecosystems and pivotal multiple functions performed by them and their inter-connectedness with highly dynamic river ecosystems, forestry interventions all along the river Ganga from its origin at Gaumukh, Uttarakhand to its mouth at Ganga Sagar, West Bengal has been planned by the ministry. For that Forest Research Institute (FRI) in collaboration with National Mission for Clean Ganga (NMCG) has prepared a Detailed Project Report (DPR) on Forestry Interventions for Ganga. The Institute has adopted an extensive consultative process at the national and state levels involving various stakeholders relevant in the context of river Ganga and employed a science-based methodology including use of remote sensing and GIS technologies for geo-spatial analysis, modeling and prioritization of sites for proposed forestation and conservation interventions. Four sets of field data formats were designed to obtain the field based information for forestry interventions, mainly plantations and conservation measures along the river course. In response, five stakeholder State Forest Departments had submitted more than 8,000 data sheets to the Institute. In order to analyze a voluminous field data received from five participating states, the Institute also developed a software to collate, analyze and generation of reports on proposed sites in Ganga basin. FRI has developed potential plantation and treatment models for the proposed forestry and other conservation measures in major three types of landscape components visualized in the Ganga riverscape. These are: (i) Natural, (ii) Agriculture, and (iii) Urban Landscapes. Suggested plantation models broadly varied for the Uttarakhand Himalayas and the Ganga Plains in five participating states. Besides extensive plantations in three type of landscapes within the riverscape, various conservation measures such as soil and water conservation, riparian wildlife management, wetland management, bioremediation and bio-filtration and supporting activities such as policy and law intervention, concurrent research, monitoring and evaluation, and mass awareness campaigns have been envisioned in the DPR. The DPR also incorporates the details of the implementation mechanism, budget provisioned for different components of the project besides allocation of budget state-wise to five implementing agencies, national partner organizations and the Nodal Ministry.

Keywords: conservation, Ganga, river, water, forestry interventions

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Authors: Glauberto S. Quirino, Emanuelly V. Pereira, Amana S. Figueiredo, Antonia T. F. Santos, Paulo R. A. Firmino, Denise F. F. Barbosa, Caroline B. Q. Aquino, Eveliny S. Martins, Cinthia G. P. Calou, Ana K. B. Pinheiro

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Introduction: During pregnancy there are adjustments in the physical, emotional, existential and sexual areas, which may contribute to changes in sexual behavior. The objective was to analyze the sexual behavior of pregnant women. Methods: Quantitative, exploratory-descriptive study, approved by the Ethics and Research Committee of the Regional University of Cariri. For data collection, it was used the Sexuality Questionnaire in Gestation and Sexual Quotient - Female Version. It was carried out in public institutions in the urban and rural areas of three municipalities of the Metropolitan Region of Cariri, south of Ceará, Brazil from February to September 2016. The sampling was proportional stratified by convenience. A total of 815 pregnant women who were literate and aged 20 years or over were broached. 461 pregnant women were excluded because of high risk, adolescence, saturation of the extract, incomplete filling of the instrument, mental and physical handicap, without sexual partner, and the sample was 354 pregnant. The data were grouped, organized and analyzed in the statistical program R Studio (version 386 3.2.4). Descriptive frequency statistics and non-parametric tests were used to analyze the variables, and the results were shown in graphs and tables. Results: The women presented a minimum age of 20, maximum 35 and average of 26.9 years, predominantly urban area residents, with a monthly income of up to one minimum wage (US$ 275,00), high school, catholic, with fixed partner, heterosexuals, multiparous, multiple sexual partners throughout life and with the beginning of sexual life in adolescence (median age 17 years). There was a reduction in sexual practices (67%) and when they were performed, they were more frequent in the first trimester (79.7%) and less frequent in the third trimester (30.5%). Preliminary sexual practices did not change and were more frequent in the second trimester (46.6%). Throughout the gestational trimesters, the partner was referred as the main responsible for the sexual initiative. The women performed vaginal sex (97.7%) and provided greater pleasure (42.8%) compared to non-penetrative sex (53.9%) (oral sex and masturbation). There was also a reduction in the sexual disposition of pregnant women (90.7%) and partner (72.9%), mainly in the first trimester (78.8%), and sexual positions. Sexual performance ranged from regular to good (49.7%). Level of schooling, marital status, sexual orientation of the pregnant woman and the partner, sexual practices and positions, preliminaries, frequency of sexual practices and importance attributed to them were variables that influenced negatively sexual performance and satisfaction. It is concluded that pregnancy negatively changes the sexual behavior of the women and it is suggested to further investigations and approach of the partner, in order to clarify the influence of these variables on the sexual function and subsidize intervention strategies, with a view to the integrality of sexual and reproductive health.

Keywords: obstetric nursing, pregnant women, sexual behavior, women's health

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Authors: Zeleke Ayalew Alemu

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This study aims to investigate tax administration constraints in Addis Ababa with a focus on small and medium-sized enterprises by identifying issues and constraints in tax administration and assessment. The study identifies problems associated with taxpayers and tax-collecting authorities in the city. The research used qualitative and quantitative research designs and employed questionnaires, focus group discussion and key informant interviews for primary data collection and also used secondary data from different sources. The study identified many constraints that taxpayers are facing. Among others, tax administration offices’ inefficiency, reluctance to respond to taxpayers’ questions, limited tax assessment and administration knowledge and skills, and corruption and unethical practices are the major ones. Besides, the tax laws and regulations are complex and not enforced equally and fully on all taxpayers, causing a prevalence of business entities not paying taxes. This apparently results in an uneven playing field. Consequently, the tax system at present is neither fair nor transparent and increases compliance costs. In case of dispute, the appeal process is excessively long and the tax authority’s decision is irreversible. The Value Added Tax (VAT) administration and compliance system is not well designed, and VAT has created economic distortion among VAT-registered and non-registered taxpayers. Cash registration machine administration and the reporting system are big headaches for taxpayers. With regard to taxpayers, there is a lack of awareness of tax laws and documentation. Based on the above and other findings, the study forwarded recommendations, such as, ensuring fairness and transparency in tax collection and administration, enhancing the efficiency of tax authorities by use of modern technologies and upgrading human resources, conducting extensive awareness creation programs, and enforcing tax laws in a fair and equitable manner. The objective of this study is to assess problems, weaknesses and limitations of small and medium-sized enterprise taxpayers, tax authority administrations, and laws as sources of inefficiency and dissatisfaction to forward recommendations that bring about efficient, fair and transparent tax administration. The entire study has been conducted in a participatory and process-oriented manner by involving all partners and stakeholders at all levels. Accordingly, the researcher used participatory assessment methods in generating both secondary and primary data as well as both qualitative and quantitative data on the field. The research team held FGDs with 21 people from Addis Ababa City Administration tax offices and selected medium and small taxpayers. The study team also interviewed 10 KIIs selected from the various segments of stakeholders. The lead, along with research assistants, handled the KIIs using a predesigned semi-structured questionnaire.

Keywords: taxation, tax system, tax administration, small and medium enterprises

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Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

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Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

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Authors: Heather Warfield, Brad Genereux

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Military personnel encounter a number of challenges when separating from military service to include career uncertainty, relational/family dynamics, trauma as a result of military experiences, reconceptualization of identity, and existential issues related to purpose, meaning making and framing of the military experience(s). Embedded within military culture are well-defined rites of passage and a significant sense of belonging. Consequently, transition out of the military can result in the loss of such rites of passage and belongingness. However, a pilgrimage journey can provide the time and space to engage in a new rite of passage, to construct a new pilgrim identity, and a to develop deep social relationships that lead to a sense of belongingness to a particular pilgrim community as well as to the global community of pilgrims across numerous types of pilgrimage journeys. The aims of the current paper are to demonstrate the rationale for why pilgrimage journeys are particularly significant for military veterans, provide an overview of an innovative program that facilitates the Camino de Santiago pilgrimage for military veterans, and discusses the lessons learned from the initial pilot project of a recently established program. Veterans on the Camino (VOC) is an emerging nongovernmental organization in the USA. Founded by a military veteran, after leaving his military career, the primary objective of the organization is to facilitate healing for veterans via the Camino de Santiago pilgrimage journey. As part of the program, participants complete a semi-structured interview at three time points – pre, during, and post journey. The interview items are based on ongoing research by the principal investigator and address such constructs as meaning-making, wellbeing, therapeutic benefits and transformation. In addition, program participants complete The Sources of Meaning and Meaning in Life Questionnaire (SoMe). The pilot program occurred in the spring of 2017. Five participants were selected after an extensive application process and review by a three-person selection board. The selection criteria included demonstrated compatibility with the program objectives (i.e., prior military experience, availability for a 40 day journey, and awareness of the need for a transformational intervention). The participants were connected as a group through a private Facebook site and interacted with one another for several months prior to the pilgrimage. Additionally, the participants were interviewed prior to beginning the pilgrimage, at one point during the pilgrimage and immediately following the conclusion of the pilgrimage journey. The interviews yielded themes related to loss, meaning construction, renewed hope in humanity, and a commitment to future goals. The lessons learned from this pilot project included a confirmation of the need for such a program, a need for greater focus on logistical details, and the recognition that the pilgrimage experience needs to continue in some manner once the veterans return home.

Keywords: pilgrimage, healing, military veterans, Camino de Santiago

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Authors: Alexander Otchere Fianko, Clement Yeboah, Evans Oteng

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Prior research concludes that Green Procurement Practices positively drive Organisational Performance. Nonetheless, the nexus and conditions under which Green Procurement Practices contribute to a Firm’s Performance are less understood. The purpose of this quantitative relational study was to examine the relationship between Green Procurement Practices and 500 Firms’ Performances in Ghana. The researchers further seek to draw insights from the resource-based view to conceptualize Green Procurement Practices and Environmental Commitment as resource capabilities to enhance Firm Performance. The researchers used insights from the contingent resource-based view to examine Green Leadership Orientation conditions under which Green Procurement Practices contribute to Firm Performance through Environmental Commitment Capabilities. The study’s conceptual framework was tested on primary data from some firms in the Ghanaian market. PROCESS Macro was used to test the study’s hypotheses. Beyond that, Environmental Commitment Capabilities mediated the association between Green Procurement Practices and the Firm’s Performance. The study further seeks to find out whether Green Leadership Orientation positively moderates the indirect relationship between Green Procurement Practices and Firm Performance through Environmental Commitment Capabilities. While conventional wisdom suggests that improved Green Procurement Practices help improve a Firm’s Performance, this study tested this presumed relationship between Green Procurement Practices and Firm Performance and provides theoretical arguments and empirical evidence to justify how Environmental Commitment Capabilities uniquely and in synergy with Green Leadership Orientation transform this relationship. The study results indicated a positive correlation between Green Procurement Practices and Firm Performance. This result suggests that firms that prioritize environmental sustainability and demonstrate a strong commitment to environmentally responsible practices tend to experience better overall performance. This includes financial gains, operational efficiency, enhanced reputation, and improved relationships with stakeholders. The study's findings inform policy formulation in Ghana related to environmental regulations, incentives, and support mechanisms. Policymakers can use the insights to design policies that encourage and reward firms for their Green Procurement Practices, thereby fostering a more sustainable and environmentally responsible business environment. The findings from such research can influence the design and development of educational programs in Ghana, specifically in fields related to sustainability, environmental management, and corporate social responsibility (CSR). Institutions may consider integrating environmental and sustainability topics into their business and management courses to create awareness and promote responsible practices among future business professionals. Also, the study results can also promote the adoption of environmental accounting practices in Ghana. By recognizing and measuring the environmental impacts and costs associated with business activities, firms can better understand the financial implications of their Green Procurement Practices and develop strategies for improved performance.

Keywords: environmental commitment, firm’s performance, green procurement practice, green leadership orientation

Procedia PDF Downloads 63

Authors: Mandayachepa C. Nyando, Lauren Suchman, Innocencia Mtalimanja, Address Malata, Tamanda Jumbe, Martha Kamanga, Peter Waiswa

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Background: Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is a new innovation in contraceptive methods that allow users to inject themselves with a hormonal contraceptive in their own homes. Self-injection (SI) of DMPA-SC has the potential to improve the accessibility of family planning to women who want it and who are capable of injecting themselves. Malawi started implementing this new innovation in 2018. SI was incorporated into the DMPA-SC delivery strategy from its outset. Methodology: This study involved two districts in Malawi where DMPA-SC SI was rolled out: Mulanje and Ntchisi. We used a qualitative cross-sectional study design where 60 in-depth interviews were conducted with women of reproductive age group stratified as 15-45 age band. These included women who were SI users, non-users, and any woman who was on any contraceptive methods. The women participants were tape-recorded, and data were transcribed and then analysed using Dedoose software, where themes were categorised into mother and child themes. Results: Women perceived DMPA SC SI as uniquely private, convenient, and less painful when self-injected. In terms of privacy, women in Mulanje and Ntchisi especially appreciated that self-injecting allowed them to use covertly from partners. Some men do not allow their spouses to use modern contraceptive methods; hence women prefer to use them covertly. “… but I first reach out to men because the strongest power is answered by men (MJ015).” In addition, women reported that SI offers privacy from family/community and less contact with healthcare providers. These aspects of privacy were especially valued in areas where there is a high degree of mistrust around family planning and among those who feel judged or antagonized purchasing contraception, such as young unmarried women. Women also valued the convenience SI provided in terms of their ability to save time by injecting themselves at home rather than visiting a healthcare provider and having more reliable access to contraception, particularly in the face of stockouts. SI allows for stocking up on doses to accommodate shifting work schedules in case of future stockouts or hard times, such as the period of COVID-19, where there was a limitation in the movement of the people. Conclusion: Our findings suggest that SI may meet the needs of many women in Malawi as long as the barriers are eliminated. The barriers women mentioned include fear of self-inject and proper storage of the DMPA SC SI, and these barriers can be eliminated by proper training. The findings also set the scene for policy revision and direction at a national level and integrate the approach with national family planning strategies in Malawi. Findings provide insights that may guide future implementation strategies, strengthen non-clinic family planning access programs and stimulate continued research.

Keywords: family planning, Malawi, Sayana press, self-injection

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Authors: Thomas J. Bell III

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This paper explores the value of assimilating certification training within a traditional course curriculum. This innovative approach is believed to increase stakeholder value within the Computer Information System program at Texas Wesleyan University. Stakeholder value is obtained from increased job marketability and critical thinking skills that create employment-ready graduates. This paper views value as first developing the capability to earn an industry-recognized certification, which provides the student with more job placement compatibility while allowing the use of critical thinking skills in a liberal arts business program. Graduates with industry-based credentials are often given preference in the hiring process, particularly in the information technology sector. And without a pioneering curriculum that better prepares students for an ever-changing employment market, its educational value is dubiously questioned. Since certifications are trending in the hiring process, academic programs should explore the viability of incorporating certification training into teaching pedagogy and courses curriculum. This study will examine the use of the balanced scorecard across four performance dimensions (financial, customer, internal process, and innovation) to measure the stakeholder value of certification training within a traditional course curriculum. The balanced scorecard as a strategic management tool may provide insight for leveraging resource prioritization and decisions needed to achieve various curriculum objectives and long-term value while meeting multiple stakeholders' needs, such as students, universities, faculty, and administrators. The research methodology will consist of quantitative analysis that includes (1) surveying over one-hundred students in the CIS program to learn what factor(s) contributed to their certification exam success or failure, (2) interviewing representatives from the Texas Workforce Commission to identify the employment needs and trends in the North Texas (Dallas/Fort Worth) area, (3) reviewing notable Workforce Innovation and Opportunity Act publications on training trends across several local business sectors, and (4) analyzing control variables to identify specific correlations between industry alignment and job placement to determine if a correlation exists. These findings may provide helpful insight into impactful pedagogical teaching techniques and curriculum that positively contribute to certification credentialing success. And should these industry-certified students land industry-related jobs that correlate with their certification credential value, arguably, stakeholder value has been realized.

Keywords: certification exam teaching pedagogy, exam preparation, testing techniques, exam study tips, passing certification exams, embedding industry certification and curriculum alignment, balanced scorecard performance evaluation

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Authors: Elena Maria Scalisi

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Currently, photodegradation by nanoparticles (NPs) is a common solution for wastewater treatment. Nanoparticles are efficient for removing organic and inorganic pollutants, heavy metals from wastewater and killing microorganisms through environmentally friendly. In this context, the major representative of photocatalytic technology for industrial wastewater treatment are TiO₂ nanoparticles (TiO₂-NPs). TiO₂-NPs have a strong catalytic activity that depends to their physicochemical properties. Thanks to their small size (between 1-100 nm), nanoparticles occupy less volume, then their surface area increases. The increase in the surface-to-volume ratio results in the increase of the particle surface energy, which improve their reactivity potential. However, these unique properties represent risks to the ecosystems and organisms when unintentionally TiO₂-NPs are release into the environment and absorbed by living organisms. Several studies confirm that there is a high level of interest concerning the safety of TiO₂-NPs in the aquatic environment, furthermore, ecotoxicological tools are useful to correctly evaluate their toxicity. In the current study, we aimed to characterize potential toxic effects of TiO₂-NP suspension to zebrafish during embryo-larval stages to evaluate parameters such as survival rates, malformation, hatching, the overall length of the larvae heartbeat, and biochemical biomarkers that reflect the acute toxicity and sublethal effects of TiO₂-NPs. Zebrafish embryos were exposed to titanium dioxide nanoparticles (TiO₂-NPs at 1mg/L, 2mg/L, and 4mg/L) from fertilization to the free swimming stage (144hpf). Every day, we recorded the toxicological endpoints, moreover, immunohistochemical analysis has been performed at the end of the exposure. In particular, we have evaluate the expression of the following biomarkers: Heat Shock Protein 70 (HSP70), Poly ADP-Ribose Polymerase-1 (PARP-1), Metallothioneins (MTs). Our results have shown that hatch ability, survival, and malformation rate were not affected by TiO₂ NPs at these exposure levels. However, TiO₂-NPs caused an increase of heartbeat and reduction of body length; at the same time, TiO₂-NPs have inducted the production of ROS and the expression of oxidative stress biomarkers HSP70 and PARP-1. Hight positivity for PARP-1 at all concentration tested was observed. As regards MT, positivity was found in the expression of this biomarker in the whole body of the embryo, with the exception of the end of the tail. Metallothioneins (MT) are biomarkers widely used in environmental monitoring programs for aquatic creatures. At the light of our results i.e. no death until the end of the experiment (144hpf), no malformation and expression of the biomarkers mentioned, it is evident that zebrafish larvae with their natural detoxification pathways are able to resist the presence of toxic substances and then they can tolerate the presence of metal concentrations. However, an excessive oxidative state can compromise cell function, therefore the uncontrolled release of nanoparticles into the environment is severe and must be constantly monitored.

Keywords: nanoparticles, embryo zebrafish, HSP70, PARP-1

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Authors: Maria C. Almario, Pam Remer, Jeff Resse, Kathy Moran, Linda Theander Adam

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The identification of victims of human trafficking and consequential service provision is characterized by a significant disconnection between the estimated prevalence of this issue and the number of cases identified. This poses as tremendous problem for human rights advocates as it prevents data collection, information sharing, allocation of resources and opportunities for international dialogues. The current paper introduces the Inclusive Human Trafficking Checklist (IHTC) as a measurement methodology with theoretical underpinnings derived from dialectic theory. The presence of human trafficking in a person’s life is conceptualized as a dynamic and dialectic interaction between vulnerability and exploitation. The current papers explores the operationalization of exploitation and vulnerability, evaluates the metric qualities of the instrument, evaluates whether there are differences in assessment based on the participant’s profession, level of knowledge, and training, and assesses if users of the instrument perceive it as useful. A total of 201 participants were asked to rate three vignettes predetermined by experts to qualify as a either human trafficking case or not. The participants were placed in three conditions: business as usual, utilization of the IHTC with and without training. The results revealed a statistically significant level of agreement between the expert’s diagnostic and the application of the IHTC with an improvement of 40% on identification when compared with the business as usual condition While there was an improvement in identification in the group with training, the difference was found to have a small effect size. Participants who utilized the IHTC showed an increased ability to identify elements of identity-based vulnerabilities as well as elements of fraud, which according to the results, are distinctive variables in cases of human trafficking. In terms of the perceived utility, the results revealed higher mean scores for the groups utilizing the IHTC when compared to the business as usual condition. These findings suggest that the IHTC improves appropriate identification of cases and that it is perceived as a useful instrument. The application of the IHTC as a multidisciplinary instrumentation that can be utilized in legal and human services settings is discussed as a pivotal piece of helping victims restore their sense of dignity, and advocate for legal, physical and psychological reparations. It is noteworthy that this study was conducted with a sample in the United States and later re-tested in Colombia. The implications of the instrument for treatment conceptualization and intervention in human trafficking cases are discussed as opportunities for enhancement of victim well-being, restoration engagement and activism. With the idea that what is personal is also political, we believe that the careful observation and data collection in specific cases can inform new areas of human rights activism.

Keywords: exploitation, human trafficking, measurement, vulnerability, screening

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Authors: Yuki Matsumoto, Yuma Ishimoto

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Cognitive Behavior Therapy (CBT) with children has shown effective application to various problems such as anxiety and depression. Although there are barriers to access to mental health services including lack of professional services in communities and parental concerns about stigma, school has a significant role to address children’s health problems. Schools are regarded as a suitable arena for prevention and early intervention of mental health problems. In this line, CBT can be adaptable to school education and useful to enhance students’ social and emotional skills. However, Japanese school curriculum is rigorous so as to limit available time for implementation of CBT in schools. This paper describes Brief Cognitive Behavior Therapy (BCBT) with children in a Japanese school setting. The program has been developed in order to facilitate acceptability of CBT in schools and aimed to enhance students’ skills to manage anxiety and difficult behaviors. The present research used a single arm design in which 30 students aged 9-10 years old participated. The authors provided teachers a CBT training workshop (two hours) at two primary schools in Tokyo metropolitan area and recruited participants in the research. A homeroom teacher voluntarily delivered a 6-session BCBT program (15 minutes each) in classroom periods which is called as Kaerinokai, a meeting before leaving school. Students completed a questionnaire sheet at pre- and post-periods under the supervision of the teacher. The sheet included the Spence Child Anxiety Scale (SCAS), the Depression Self-Rating Scale for Children (DSRS), and the Strengths and Difficulties Questionnaire (SDQ). The teacher was asked for feedback after the completion. Significant positive changes were found in the total and five of six sub-scales of the SCAS and the total difficulty scale of the SDQ. However, no significant changes were seen in Physical Injury Fear sub-scale of the SCAS, in the DSRS or the Prosocial sub-scale of the SDQ. The effect sizes are mostly between small and medium. The teacher commented that the program was easy to use and found positive changes in classroom activities and personal relationships. This preliminary research showed the feasibility of the BCBT in a school setting. The results suggest that the BCBT offers effective treatment for reduction in anxiety and in difficult behaviors. There is a good prospect of the BCBT suggesting that BCBT may be easier to be delivered than CBT by Japanese teachers to promote child mental health. The study has limitations including no control group, small sample size, or a short teacher training. Future research should address these limitations.

Keywords: brief cognitive behavior therapy, cognitive behavior therapy, mental health services in schools, teacher training workshop

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Authors: Regina Rekuviene, Vykintas Samaitis, Liudas Mažeika, Audrius Jankauskas, Virginija Jankauskaitė, Laura Gegeckienė, Abdolali Sadaghiani, Shaghayegh Saeidiharzand

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Icing brings significant damage to aviation and renewable energy installations. Air-conditioning, refrigeration, wind turbine blades, airplane and helicopter blades often suffer from icing phenomena, which cause severe energy losses and impair aerodynamic performance. The icing process is a complex phenomenon with many different causes and types. Icing mechanisms, distributions, and patterns are still relevant to research topics. The adhesion strength between ice and surfaces differs in different icing environments. This makes the task of anti-icing very challenging. The techniques for various icing environments must satisfy different demands and requirements (e.g., efficient, lightweight, low power consumption, low maintenance and manufacturing costs, reliable operation). It is noticeable that most methods are oriented toward a particular sector and adapting them to or suggesting them for other areas is quite problematic. These methods often use various technologies and have different specifications, sometimes with no clear indication of their efficiency. There are two major groups of anti-icing methods: passive and active. Active techniques have high efficiency but, at the same time, quite high energy consumption and require intervention in the structure’s design. It’s noticeable that vast majority of these methods require specific knowledge and personnel skills. The main effect of passive methods (ice-phobic, superhydrophobic surfaces) is to delay ice formation and growth or reduce the adhesion strength between the ice and the surface. These methods are time-consuming and depend on forecasting. They can be applied on small surfaces only for specific targets, and most are non-biodegradable (except for anti-freezing proteins). There is some quite promising information on ultrasonic ice mitigation methods that employ UGW (Ultrasonic Guided Wave). These methods are have the characteristics of low energy consumption, low cost, lightweight, and easy replacement and maintenance. However, fundamental knowledge of ultrasonic de-icing methodology is still limited. The objective of this work was to identify the ice formation processes and its progress by employing ultrasonic guided wave technique. Throughout this research, the universal set-up for acoustic measurement of ice formation in a real condition (temperature range from +240 C to -230 C) was developed. Ultrasonic measurements were performed by using high frequency 5 MHz transducers in a pitch-catch configuration. The selection of wave modes suitable for detection of ice formation phenomenon on copper metal surface was performed. Interaction between the selected wave modes and ice formation processes was investigated. It was found that selected wave modes are sensitive to temperature changes. It was demonstrated that proposed ultrasonic technique could be successfully used for the detection of ice layer formation on a metal surface.

Keywords: ice formation processes, ultrasonic GW, detection of ice formation, ultrasonic testing

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Authors: Julia Gontar, Natalia Buderatskaya, Igor Ilyin, Olga Parnitskaya, Sergey Lavrynenko, Eduard Kapustin, Ekaterina Ilyina, Yana Lakhno

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Introduction: It is well known that oocytes obtained from older reproductive women have accumulated mitochondrial DNA mutations, which negatively affects the morphology of a developing embryo and may lead to the birth of a child with mitochondrial disease. Special techniques have been developed to allow a donor oocyte cytoplasmic transfer with the parents’ biological nuclear DNA retention. At the same time, it is important to understand whether the procedure affects the future embryonic chromosome sets as the nuclear DNA is the transfer subject in this new complex procedure. Material and Methods: From July 2015 to July 2016, the investigation was carried out in the Medical Centre IGR. 34 donor oocytes (group A) were used for the manipulation with the aim of donating cytoplasm: 21 oocytes were used for zygotes pronuclear transfer and oocytes 13 – for the spindle transfer. The mean age of the oocyte donors was 28.4±2.9 years. The procedure was performed using Nikon Ti Eclipse inverted microscope equipped with the micromanipulators Narishige system (Japan), Saturn 3 laser console (UK), Oosight imaging systems (USA). For the preimplantation genetic screening (PGS) blastocyst biopsy was performed, trophectoderm samples were diagnosed using fluorescent in situ hybridization on chromosomes 9, 13, 15, 16, 17, 18, 21, 22, X, Y. For comparison of morphological characteristics and euploidy, was chosen a group of embryos (group B) with the amount of 121 blastocysts obtained from 213 oocytes, which were gotten from the donor programs of assisted reproductive technologies (ART). Group B was not subjected to donor oocyte cytoplasmic transfer procedure and studied on the above mentioned chromosomes. Statistical analysis was carried out using the criteria t, x^2 at a significance levels p<0.05, p<0.01, p<0.001. Results: After the donor cytoplasm transfer process the amount of the third day developing embryos was 27 (79.4%). In this stage, the group B consisted of 189 (88.7%) developing embryos, and there was no statistically significant difference (SSD) between the two groups (p>0.05). After a comparative analysis of the morphological characteristics of the embryos on the fifth day, we also found no SSD among the studied groups (p>0.05): from 34 oocytes exposed to manipulation, 14 (41.2%) blastocysts was obtained, while the group B blastocyst yield was 56.8% (n=121) from 213 oocytes. The following results were obtained after PGS performing: in group A euploidy in studied chromosomes were 28.6%(n=4) blastocysts, whereas in group B this rate was 40.5%(n=49), 28.6%(n=4) and 21.5%(n=26) of mosaic embryos and 42.8%(n=6) and 38.0%(n=46) aneuploid blastocysts respectively were identified. None of these specified parameters had an SSD (p>0.05). But attention was drawn by the blastocysts in group A with identified mosaicism, which was chaotic without any cell having euploid chromosomal set, in contrast to the mosaic embryos in group B where identified chaotic mosaicism was only 2.5%(n=3). Conclusions: According to the obtained results, there is no direct procedural effect on the chromosome in embryos obtained following donor oocyte cytoplasmic transfer. Thus, the technology introduction will enhance the infertility treating effectiveness as well as avoiding having a child with mitochondrial disease.

Keywords: donor oocyte cytoplasmic transfer, embryos’ chromosome set, oocyte spindle transfer, pronuclear transfer

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Authors: Alexis Polanco Jr, Tsai Lu Liu

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Research on digital assessment for deaf and hard of hearing (DHH) students is negligible. Part of this stems from the DHH assessment design existing at the intersection of the emergent disciplines of usability, accessibility, and child-computer interaction (CCI). While these disciplines have some prevailing guidelines —e.g. in user experience design (UXD), there is Jacob Nielsen’s 10 Usability Heuristics (Nielsen-10); for accessibility, there are the Web Content Accessibility Guidelines (WCAG) & the Principles of Universal Design (PUD)— this research was unable to uncover a unified set of guidelines. Given that digital assessments have lasting implications for the funding and shaping of U.S. school districts, it is vital that cross-disciplinary guidelines emerge. As a result, this research seeks to provide a framework by which these disciplines can share knowledge. The framework entails a process of asking subject-matter experts (SMEs) and design & development professionals to self-describe their fields of expertise, how their work might serve DHH students, and to expose any incongruence between their ideal process and what is permissible at their workplace. This research used two rounds of mixed methods. The first round consisted of structured interviews with SMEs in usability, accessibility, CCI, and DHH education. These practitioners were not designers by trade but were revealed to use designerly work processes. In addition to asking these SMEs about their field of expertise, work process, etc., these SMEs were asked to comment about whether they believed Nielsen-10 and/or PUD were sufficient for designing products for middle-school DHH students. This first round of interviews revealed that Nielsen-10 and PUD were, at best, a starting point for creating middle-school DHH design guidelines or, at worst insufficient. The second round of interviews followed a semi-structured interview methodology. The SMEs who were interviewed in the first round were asked open-ended follow-up questions about their semantic understanding of guidelines— going from the most general sense down to the level of design guidelines for DHH middle school students. Designers and developers who were never interviewed previously were asked the same questions that the SMEs had been asked across both rounds of interviews. In terms of the research goals: it was confirmed that the design of digital assessments for DHH students is inherently cross-disciplinary. Unexpectedly, 1) guidelines did not emerge from the interviews conducted in this study, and 2) the principles of Nielsen-10 and PUD were deemed to be less relevant than expected. Given the prevalence of Nielsen-10 in UXD curricula across academia and certificate programs, this poses a risk to the efficacy of DHH assessments designed by UX designers. Furthermore, the following findings emerged: A) deep collaboration between the disciplines of usability, accessibility, and CCI is low to non-existent; B) there are no universally agreed-upon guidelines for designing digital assessments for DHH middle school students; C) these disciplines are structured academically and professionally in such a way that practitioners may not know to reach out to other disciplines. For example, accessibility teams at large organizations do not have designers and accessibility specialists on the same team.

Keywords: deaf, hard of hearing, design, guidelines, education, assessment

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Authors: Jesus Rodriguez Viejo

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The aim of this paper is to study cross-cultural interactions between the West and Byzantium, in the fields of art and religion, by analyzing the decoration of one luxury manuscript. The Spanish National Library is home to one of the most extraordinary examples of illuminated manuscript production of Norman Sicily – the Messina Missal. Dating from the late twelfth century, this liturgical book was the result of the intense activity of artistic patronage of an Englishman, Richard Palmer. Appointed bishop of the Sicilian city in the second half of the century, Palmer set a painting workshop attached to his cathedral. The illuminated manuscripts produced there combine a clear Byzantine iconographic language with a myriad of elements imported from France, such as a large number of decorated initials. The most remarkable depiction contained in the Missal is that of the Theotokos (fol. 80r). Its appearance immediately recalls portative Byzantine icons of the Mother of God in South Italy and Byzantium and implies the intervention of an artist familiar with icon painting. The richness of this image is a clear proof of the prestige that Byzantine art enjoyed in the island after the Norman takeover. The production of the school of Messina under Richard Palmer could be considered a counterpart in the field of manuscript illumination of the court art of the Sicilian kings in Palermo and the impressive commissions for the cathedrals of Monreale and Cefalù. However, the ethnic composition of Palmer’s workshop has never been analyzed and therefore, we intend to shed light on the permanent presence of Greek-speaking artists in Norman Messina. The east of the island was the last stronghold of the Greeks and soon after the Norman conquest, the previous exchanges between the cities of this territory and Byzantium restarted again, mainly by way of trade. Palmer was not a Norman statesman, but a churchman and his love for religion and culture prevailed over the wars and struggles for power of the Sicilian kingdom in the central Mediterranean. On the other hand, the representation of the Theotokos can prove that Eastern devotional approaches to images were still common in the east of the island more than a century after the collapse of Byzantine rule. Local Norman lords repeatedly founded churches devoted to Greek saints and medieval Greek-speaking authors were widely copied in Sicilian scriptoria. The Madrid Missal and its Theotokos are doubtless the product of Western initiative but in a land culturally dominated by Byzantium. Westerners, such as Palmer and his circle, could have been immersed in this Hellenophile culture and therefore, naturally predisposed to perform prayers and rituals, in both public and private contexts, linked to ideas and practices of Greek origin, such as the concept of icon.

Keywords: history of art, byzantine art, manuscripts, norman sicily, messina, patronage, devotion, iconography

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Authors: Rafał Szmajser, Katarzyna Świetla, Mariusz Andrzejewski

Abstract:

Robotic process automation (RPA) is a technology of repeatable business processes performed using computer programs, robots that simulate the work of a human being. This approach assumes replacing an existing employee with the use of dedicated software (software robots) to support activities, primarily repeated and uncomplicated, characterized by a low number of exceptions. RPA application is widespread in modern business services, particularly in the areas of Finance, Accounting and Human Resources Management. By utilizing this technology, the effectiveness of operations increases while reducing workload, minimizing possible errors in the process, and as a result, bringing measurable decrease in the cost of providing services. Regardless of how the use of modern information technology is assessed, there are also some doubts as to whether we should replace human activities in the implementation of the automation in business processes. After the initial awe for the new technological concept, a reflection arises: to what extent does the implementation of RPA increase the efficiency of operations or is there a Business Case for implementing it? If the business case is beneficial, in which business processes is the greatest potential for RPA? A closer look at these issues was provided by in this research during which the respondents’ view of the perceived advantages resulting from the use of robotization and automation in financial and accounting processes was verified. As a result of an online survey addressed to over 500 respondents from international companies, 162 complete answers were returned from the most important types of organizations in the modern business services industry, i.e. Business or IT Process Outsourcing (BPO/ITO), Shared Service Centers (SSC), Consulting/Advisory and their customers. Answers were provided by representatives of the positions in their organizations: Members of the Board, Directors, Managers and Experts/Specialists. The structure of the survey allowed the respondents to supplement the survey with additional comments and observations. The results formed the basis for the creation of a business case calculating tangible benefits associated with the implementation of automation in the selected financial processes. The results of the statistical analyses carried out with regard to revenue growth confirmed the correctness of the hypothesis that there is a correlation between job position and the perception of the impact of RPA implementation on individual benefits. Second hypothesis (H2) that: There is a relationship between the kind of company in the business services industry and the reception of the impact of RPA on individual benefits was thus not confirmed. Based results of survey authors performed simulation of business case for implementation of RPA in selected Finance and Accounting Processes. Calculated payback period was diametrically different ranging from 2 months for the Account Payables process with 75% savings and in the extreme case for the process Taxes implementation and maintenance costs exceed the savings resulting from the use of the robot.

Keywords: automation, outsourcing, business process automation, process automation, robotic process automation, RPA, RPA business case, RPA benefits

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Authors: Amarachukwu B. Isiaka, Vivian N. Anakwenze, Chinyere C. Ezemba, Chiamaka R. Ilodinso, Chikodili G. Anaukwu, Chukwuebuka M. Ezeokoli, Ugonna H. Uzoka

Abstract:

Infectious diseases continue to pose significant threats to global public health, necessitating advanced and timely detection methods for effective outbreak management. This study explores the integration of artificial intelligence (AI) in the early detection and management of infectious disease outbreaks. Leveraging vast datasets from diverse sources, including electronic health records, social media, and environmental monitoring, AI-driven algorithms are employed to analyze patterns and anomalies indicative of potential outbreaks. Machine learning models, trained on historical data and continuously updated with real-time information, contribute to the identification of emerging threats. The implementation of AI extends beyond detection, encompassing predictive analytics for disease spread and severity assessment. Furthermore, the paper discusses the role of AI in predictive modeling, enabling public health officials to anticipate the spread of infectious diseases and allocate resources proactively. Machine learning algorithms can analyze historical data, climatic conditions, and human mobility patterns to predict potential hotspots and optimize intervention strategies. The study evaluates the current landscape of AI applications in infectious disease surveillance and proposes a comprehensive framework for their integration into existing public health infrastructures. The implementation of an AI-driven early detection system requires collaboration between public health agencies, healthcare providers, and technology experts. Ethical considerations, privacy protection, and data security are paramount in developing a framework that balances the benefits of AI with the protection of individual rights. The synergistic collaboration between AI technologies and traditional epidemiological methods is emphasized, highlighting the potential to enhance a nation's ability to detect, respond to, and manage infectious disease outbreaks in a proactive and data-driven manner. The findings of this research underscore the transformative impact of harnessing AI for early detection and management, offering a promising avenue for strengthening the resilience of public health systems in the face of evolving infectious disease challenges. This paper advocates for the integration of artificial intelligence into the existing public health infrastructure for early detection and management of infectious disease outbreaks. The proposed AI-driven system has the potential to revolutionize the way we approach infectious disease surveillance, providing a more proactive and effective response to safeguard public health.

Keywords: artificial intelligence, early detection, disease surveillance, infectious diseases, outbreak management

Procedia PDF Downloads 47

Authors: Leonardo Coloma

Abstract:

The world changes constantly, every second its properties vary due either natural factors or human intervention. As the most intelligent creatures on the planet, human beings have transformed the environment and paradoxically –have allowed ‘mother nature’ to lose species, accelerate the processes of climate change, the deterioration of the ozone layer, among others. The rapid population growth, the procurement, administration and distribution of resources, waste management, and technological advances are some of the factors that boost urban sprawl whose gray stain extends over the territory, facing challenges such as pollution, overpopulation and scarcity of resources. In Ecuador, these problems are added to the social, cultural, economic and political anomalies that have historically affected it. This fact can represent a greater delay when trying to solve global problems, without having paid attention to local inconveniences –smaller ones, but ones that could be the key to project smart solutions on bigger ones. This research aims to highlight the main characteristics of the development models adopted by two Amazonian cities, and analyze the impact of such urban growth on society; to finally define the parameters that would allow the development of an intelligent city in Ecuador, prepared for the challenges of the XXI Century. Contrasts in the climate, temperature, and landscape of Ecuadorian cities are fused with the cultural diversity of its people, generating a multiplicity of nuances of an indecipherable wealth. However, we strive to apply development models that do not recognize that wealth, not understanding them and ignoring that their proposals will vary according to where they are applied. Urban plans seem to take a bit of each of the new theories and proposals of development, which, in the encounter with the informal growth of cities, with those excluded and ‘isolated’ societies, generate absurd morphologies - where the uncertain becomes tangible. The desire to project smart cities is ever growing, but it is important to consider that this concept does not only have to do with the use of information and communication technologies. Its success is achieved when advances in science and technology allow the establishment of a better relationship between people and their context (natural and built). As a research methodology, urban analysis through mappings, diagrams and geographical studies, as well as the identification of sensorial elements when living the city, will make evident the shortcomings of the urban models adopted by certain populations of the Ecuadorian Amazon. Following the vision of previous investigations started since 2014 as part of ‘Centro de Acciones Urbanas,’ the results of this study will encourage the dialogue between the city (as a physical fact) and those who ‘make the city’ (people as its main actors). This research will allow the development of workshops and meetings with different professionals, organizations and individuals in general.

Keywords: Latin American cities, smart cities, urban development, urban morphology, urban sprawl

Procedia PDF Downloads 142

Authors: A. Maghoul, A. Rostampouryasouri, MR. Maghami

Abstract:

The development of an urban design and power network planning has been gaining momentum in recent years. The integration of renewable energy with urban design has been widely regarded as an increasingly important solution leading to climate change and energy security. Through the use of passive strategies and solar integration with Urban Building Energy Modeling (UBEM) tools, architects and designers can create high-quality designs that meet the needs of clients and stakeholders. To determine the most effective ways of combining renewable energy with urban development, we analyze the relationship between urban form and renewable energy production. The procedure involved in this practice include passive solar gain (in building design and urban design), solar integration, location strategy, and 3D models with a case study conducted in Tehran, Iran. The study emphasizes the importance of spatial and temporal considerations in the development of sector coupling strategies for solar power establishment in arid and semi-arid regions. The substation considered in the research consists of two parallel transformers, 13 lines, and 38 connection points. Each urban load connection point is equipped with 500 kW of solar PV capacity and 1 kWh of battery Energy Storage (BES) to store excess power generated from solar, injecting it into the urban network during peak periods. The simulations and analyses have occurred in EnergyPlus software. Passive solar gain involves maximizing the amount of sunlight that enters a building to reduce the need for artificial lighting and heating. Solar integration involves integrating solar photovoltaic (PV) power into smart grids to reduce emissions and increase energy efficiency. Location strategy is crucial to maximize the utilization of solar PV in an urban distribution feeder. Additionally, 3D models are made in Revit, and they are keys component of decision-making in areas including climate change mitigation, urban planning, and infrastructure. we applied these strategies in this research, and the results show that it is possible to create sustainable and energy-efficient urban environments. Furthermore, demand response programs can be used in conjunction with solar integration to optimize energy usage and reduce the strain on the power grid. This study highlights the influence of ancient Persian architecture on Iran's urban planning system, as well as the potential for reducing pollutants in building construction. Additionally, the paper explores the advances in eco-city planning and development and the emerging practices and strategies for integrating sustainability goals.

Keywords: energy-efficient urban planning, sustainable architecture, solar energy, sustainable urban design

Procedia PDF Downloads 61