Search results for: children with special needs

Authors: Carmen J. Savelli, Romy Conzade

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Background: Access to sufficient amounts of safe and nutritious food is a basic human necessity, required to sustain life and promote good health. Food safety and food security are therefore inextricably linked, yet the importance of food safety in this relationship is often overlooked. Methodologies: A literature review and desk study were conducted to examine existing frameworks for discussing food security, especially from an international perspective, to determine the entry points for enhancing considerations for food safety in national and international policies. Major Findings: Food security is commonly understood as the state when all people at all times have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. Conceptually, food security is built upon four pillars including food availability, access, utilization and stability. Within this framework, the safety of food is often wrongly assumed as a given. However, in places where food supplies are insufficient, coping mechanisms for food insecurity are primarily focused on access to food without considerations for ensuring safety. Under such conditions, hygiene and nutrition are often ignored as people shift to less nutritious diets and consume more potentially unsafe foods, in which chemical, microbiological, zoonotic and other hazards can pose serious, acute and chronic health risks. While food supplies might be safe and nutritious, if consumed in quantities insufficient to support normal growth, health and activity, the result is hunger and famine. Recent estimates indicate that at least 842 million people, or roughly one in eight, still suffer from chronic hunger. Even if people eat enough food that is safe, they will become malnourished if the food does not provide the proper amounts of micronutrients and/or macronutrients to meet daily nutritional requirements, resulting in under- or over-nutrition. Two billion people suffer from one or more micronutrient deficiencies and over half a billion adults are obese. Access to sufficient amounts of nutritious food is not enough. If food is unsafe, whether arising from poor quality supplies or inadequate treatment and preparation, it increases the risk of foodborne infections such as diarrhoea. 70% of diarrhoea episodes occurring annually in children under five are due to biologically contaminated food. Conclusions: An integrated approach is needed where food safety and nutrition are systematically introduced into mainstream food system policies and interventions worldwide in order to achieve health and development goals. A new framework, “Food for Health” is proposed to guide policy development and requires all three aspects of food security to be addressed in balance: sufficiency, nutrition and safety.

Keywords: food safety, food security, nutrition, policy

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Authors: Xiaochen Mu

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Data rights confirmation, as a key legal issue in the development of the digital economy, is undergoing a transition from a traditional rights paradigm to a more complex private-economic paradigm. In this process, data rights confirmation has evolved from a simple claim of rights to a complex structure encompassing multiple dimensions of personality rights and property rights. Current data rights confirmation practices are primarily reflected in two models: holistic rights confirmation and process rights confirmation. The holistic rights confirmation model continues the traditional "one object, one right" theory, while the process rights confirmation model, through contractual relationships in the data processing process, recognizes rights that are more adaptable to the needs of data circulation and value release. In the design of the data property rights system, there is a hierarchical characteristic aimed at decoupling from raw data to data applications through horizontal stratification and vertical staging. This design not only respects the ownership rights of data originators but also, based on the usufructuary rights of enterprises, constructs a corresponding rights system for different stages of data processing activities. The subjects of data property rights include both data originators, such as users, and data producers, such as enterprises, who enjoy different rights at different stages of data processing. The intellectual property rights system, with the mission of incentivizing innovation and promoting the advancement of science, culture, and the arts, provides a complete set of mechanisms for protecting innovative results. However, unlike traditional private property rights, the granting of intellectual property rights is not an end in itself; the purpose of the intellectual property system is to balance the exclusive rights of the rights holders with the prosperity and long-term development of society's public learning and the entire field of science, culture, and the arts. Therefore, the intellectual property granting mechanism provides both protection and limitations for the rights holder. This perfectly aligns with the dual attributes of data. In terms of achieving the protection of data property rights, the granting of intellectual property rights is an important institutional choice that can enhance the effectiveness of the data property exchange mechanism. Although this is not the only path, the granting of data property rights within the framework of the intellectual property rights system helps to establish fundamental legal relationships and rights confirmation mechanisms and is more compatible with the classification and grading system of data. The modernity of the intellectual property rights system allows it to adapt to the needs of big data technology development through special clauses or industry guidelines, thus promoting the comprehensive advancement of data intellectual property rights legislation. This paper analyzes data protection under the virtual property layer theory and two-fold virtual property rights system. Based on the “bundle of right” theory, this paper establishes specific three-level data rights. This paper analyzes the cases: Google v. Vidal-Hall, Halliday v Creation Consumer Finance, Douglas v Hello Limited, Campbell v MGN and Imerman v Tchenquiz. This paper concluded that recognizing property rights over personal data and protecting data under the framework of intellectual property will be beneficial to establish the tort of misuse of personal information.

Keywords: data protection, property rights, intellectual property, Big data

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Authors: Mita Sirait

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Everyday Jakarta produces 7,000 tons of solid waste and only about 5,200 tons delivered to landfill out of the city by 720 trucks, the rest are left yet manageable, as reported by Government of Clean Sector. CLEAN Jakarta Project is aimed at empowering community to achieve healthy environment for children and families in urban slum in Semper Barat and Penjaringan sub-district of North Jakarta that consisted of 20,584 people. The project applies Community Based Total Sanitation, an approach to empowering community to achieve total hygiene and sanitation behaviour by triggering activities. As regulated by Ministry of Health, it has 5 pillars: (1) open defecation free, (2) hand-washing with soaps, (3) drinking-water treatment, (4) solid-waste management and (5) waste-water management; and 3 strategic components: 1) demand creation, 2) supply creation and 3) enabling environment. Demand creation is generated by triggering community’s reaction to their daily sanitation habits by exposing them to their surrounding where they can see faeces, waste and other environmental pollutant to stimulate disgusting, embarrassing and responsibility sense. Triggered people then challenged to commit to improving their hygiene practice such as to stop littering and start waste separation. In order to support this commitment, and for supply creation component, the project initiated waste bank with community working group. It facilitated capacity-building trainings, waste bank system formulation and meetings with local authorities to solicit land permit and waste bank decree. As it is of a general banking system, waste bank has customer service, teller, manager, legal paper and provides saving book and money transaction. In 8 months, two waste banks have established with 148 customers, 17 million rupiah cash, and about 9 million of stored recyclables. Approximately 2.5 tons of 15-35 types of recyclable are managed in both waste banks per week. On enabling environment, the project has initiated sanitation working group in community and multi sectors government level, and advocated both parties. The former is expected to promote behaviour change and monitoring in the community, while the latter is expected to support sanitation with regulations, strategies, appraisal and awards; to coordinate partnering and networking, and to replicate best practices to other areas.

Keywords: urban community, waste management, Jakarta, community based total sanitation (CBTS)

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Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton

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Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.

Keywords: adolescent, binge eating, mental illness, obesity

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Authors: M. Keršič, M. Lužnik, J. Lužnik

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Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.

Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage

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Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

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Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

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Authors: L. Abukova, O. Abramova, A. Goreva, Y. Yakovlev

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Important executive decisions on oil and gas production stimulation in Eastern Siberia have been recently taken. There are unique and large fields of oil, gas, and gas-condensate in Eastern Siberia. The Talakan, Koyumbinskoye, Yurubcheno-Tahomskoye, Kovykta, Chayadinskoye fields are supposed to be developed first. It will result in an abrupt increase in environmental load on the nature of Eastern Siberia. In Eastern Siberia, the introduction of ecological imperatives in hydrocarbon production is still realistic. Underground water movement is the one of the most important factors of the ecosystems condition management. Oil and gas production is associated with the forced displacement of huge water masses, mixing waters of different composition, and origin that determines the extent of anthropogenic impact on water drive systems and their protective reaction. An extensive hydrogeological system of the depression type is identified in the pre-salt deposits here. Pressure relieve here is steady up to the basement. The decrease of the hydrodynamic potential towards the basement with such a gradient resulted in reformation of the fields in process of historical (geological) development of the Nepsko-Botuobinskaya anteclise. The depression hydrodynamic systems are characterized by extremely high isolation and can only exist under such closed conditions. A steady nature of water movement due to a strictly negative gradient of reservoir pressure makes it quite possible to use environmentally-harmful liquid substances instead of water. Disposal of the most hazardous wastes is the most expedient in the deposits of the crystalline basement in certain structures distant from oil and gas fields. The time period for storage of environmentally-harmful liquid substances may be calculated by means of the geological time scales ensuring their complete prevention from releasing into environment or air even during strong earthquakes. Disposal of wastes of chemical and nuclear industries is a matter of special consideration. The existing methods of storage and disposal of wastes are very expensive. The methods applied at the moment for storage of nuclear wastes at the depth of several meters, even in the most durable containers, constitute a potential danger. The enormous size of the depression system of the Nepsko-Botuobinskaya anteclise makes it possible to easily identify such objects at the depth below 1500 m where nuclear wastes will be stored indefinitely without any environmental impact. Thus, the water drive system of the Nepsko-Botuobinskaya anteclise is the ideal object for large-volume injection of environmentally harmful liquid substances even if there are large oil and gas accumulations in the subsurface. Specific geological and hydrodynamic conditions of the system allow the production of hydrocarbons from the subsurface simultaneously with the disposal of industrial wastes of oil and gas, mining, chemical, and nuclear industries without any environmental impact.

Keywords: Eastern Siberia, formation pressure, underground water, waste burial

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Authors: Sree Sanyal

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Research in ageing often highlights the age-related health dimension more than the psycho-social characteristics of the elderly, which also influences and challenges the health outcomes. Multimorbidity is defined as the person having more than one chronic non-communicable diseases and their prevalence increases with ageing. The study aims to evaluate the influence of social ties on self-reported prevalence of multimorbidity (selected chronic non-communicable diseases) among the selected states of elderly population in India. The data is accessed from Building Knowledge Base on Population Ageing in India (BKPAI), collected in 2011 covering the self-reported chronic non-communicable diseases like arthritis, heart disease, diabetes, lung disease with asthma, hypertension, cataract, depression, dementia, Alzheimer’s disease, and cancer. The data of the above diseases were taken together and categorized as: ‘no disease’, ‘one disease’ and ‘multimorbidity’. The predicted variables were demographic, socio-economic, residential types, and the variable of social ties includes social support, social engagement, perceived support, connectedness, and importance of the elderly. Predicted probability for multiple logistic regression was used to determine the background characteristics of the old in association with chronic morbidities showing multimorbidity. The finding suggests that 24.35% of the elderly are suffering from multimorbidity. Research shows that with reference to ‘no disease’, according to the socio-economic characteristics of the old, the female oldest old (80+) from others in caste and religion, widowed, never had any formal education, ever worked in their life, coming from the second wealth quintile standard, from rural Maharashtra are more prone with ‘one disease’. From the social ties background, the elderly who perceives they are important to the family, after getting older their decision-making status has been changed, prefer to stay with son and spouse only, satisfied with the communication from their children are more likely to have less single morbidity and the results are significant. Again, with respect to ‘no disease’, the female oldest old (80+), who are others in caste, Christian in religion, widowed, having less than 5 years of education completed, ever worked, from highest wealth quintile, residing in urban Kerala are more associated with multimorbidity. The elderly population who are more socially connected through family visits, public gatherings, gets support in decision making, who prefers to spend their later years with son and spouse only but stays alone shows lesser prevalence of multimorbidity. In conclusion, received and perceived social integration and support from associated neighborhood in the older days, knowing about their own needs in life facilitates better health and wellbeing of the elderly population in selected states of India.

Keywords: morbidity, multi-morbidity, prevalence, social ties

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Authors: Maria V. Mishatkina

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The modelling of dialogical environment is an essential feature of modern education. The dialogue of cultures is a foundation and an important prerequisite for a formation of a human’s main moral qualities such as an ability to understand another person, which is manifested in such values as tolerance, respect, mutual assistance and mercy. A formation of a modern expert occurs in an educational environment that is significantly different from what we had several years ago. Nowadays university education has qualitatively new characteristics. They may be observed in Peoples’ Friendship University of Russia (RUDN University), a top Russian higher education institution which unites representatives of more than 150 countries. The content of its educational strategies is not an adapted cultural experience but material between science and innovation. Besides, RUDN University’s profiles and specialization are not equal to the professional structures. People study not a profession in a strict sense but a basic scientific foundation of an activity in different socio-cultural areas (science, business and education). RUDN University also provides a considerable unit of professional education components. They are foreign languages skills, economic, political, ethnic, communication and computer culture, theory of information and basic management skills. Moreover, there is a rich social life (festive multicultural events, theme parties, journeys) and prospects concerning the inclusive approach to education (for example, a special course ‘Social Pedagogy: Issues of Tolerance’). In our research, we use such methods as analysis of modern and contemporary scientific literature, opinion poll (involving students, teachers and research workers) and comparative data analysis. We came to the conclusion that knowledge transfer of RUDN student in the activity happens through making goals, problems, issues, tasks and situations which simulate future innovative ambiguous environment that potentially prepares him/her to dialogical way of life. However, all these factors may not take effect if there is no ‘personal inspiration’ of students by communicative and dialogic values, their participation in a system of meanings and tools of learning activity that is represented by cooperation within the framework of scientific and pedagogical schools dialogue. We also found out that dominating strategies of ensuring the quality of education are those that put students in the position of the subject of their own education. Today these strategies and approaches should involve such approaches and methods as task, contextual, modelling, specialized, game-imitating and dialogical approaches, the method of practical situations, etc. Therefore, University in the modern sense is not only an educational institution, but also a generator of innovation, cooperation among nations and cultural progress. RUDN University has been performing exactly this mission for many decades.

Keywords: dialogical developing situation, dialogue of cultures, readiness for dialogue, university graduate

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Authors: Mirjana Dokmanovic

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The main topic of this paper is the analysis of the presence of gender stereotypes in the media content in the Republic of Serbia with respect to the state commitments to eliminate discrimination against women. The research methodology included the analysis of the media content of six daily newspapers and two magazines on the date of 28 December 2015 and the analysis of the reality TV show programs in 2015 from gender perspective. The methods of the research has also included a desk research and a qualitative analysis of the available data, statistics, policy papers, studies, and reports produced by the government, the Ministry of Culture and Information, the Regulatory Body for Electronic Media, the Press Council, the associations of media professionals, the independent human rights bodies, and civil society organizations (CSOs). As a State Signatory to the Convention on the Elimination of All Forms of Discrimination against Women, the Republic of Serbia has adopted numerous measures in this field, including the Law on Equality between Sexes and the national gender equality strategies. Special attention has been paid to eliminating gender stereotypes and prejudices in the media content and portraying of women. This practice has been forbidden by the Law on Electronic Media, the Law on Public Information and Media, the Law on Public Service Broadcasting and the Bylaw on the Protection of Human Rights in the Provision of Media Services. Despite these commitments, there has not been achieved progress regarding eliminating gender stereotypes in the media content. The research indicates that the media perpetuate traditional gender roles and patriarchal patterns. Female politicians, entrepreneurs, academics, scientists, and engineers have been very rarely portrayed in the media. On the other side, women are in their focus as celebrities, singers, and actresses. Women are underrepresented in the pages related to politics and economy, while they are mostly present in the cover stories related to show-business, health care, family and household matters. Women are three times more than men identified on the basis of their family status, as mothers, wives, daughters, etc. Hate speech, misogyny, and violence against women are often present in the reality TV shows. The abuse of women and their bodies in advertising is still widely present. The cases of domestic violence are still presented with sensationalism, although there has been achieved progress in portraying victims of domestic violence with respect and dignity. The issues related to gender equality and the position of the vulnerable groups of women, such as Roma women or rural women, are not visible in the media. This research, as well as warnings of women’s CSOs and independent human rights bodies, indicates the necessity to implement legal and policy measures in this field consistently and with due diligence. The aim of the paper is to contribute eliminating gender stereotypes in the media content and advancing gender equality.

Keywords: discrimination against women, gender roles, gender stereotypes, media, misogyny, portraying women in the media, prejudices against women, Republic of Serbia

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Authors: Panagiotis Svarnas, Polykarpos Papadopoulos

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Atmospheric-pressure cold plasmas continue to gain increasing interest for various applications due to their unique properties, like cost-efficient production, high chemical reactivity, low gas temperature, adaptability, etc. Numerous designs have been proposed for these plasmas production in terms of electrode configuration, driving voltage waveform and working gas(es). However, in order to exploit most of the advantages of these systems, the majority of the designs are based on dielectric-barrier discharges (DBDs) either in filamentary or glow regimes. A special category of the DBD-based atmospheric-pressure cold plasmas refers to the so-called plasma jets, where a carrier noble gas is guided by the dielectric barrier (usually a hollow cylinder) and left to flow up to the atmospheric air where a complicated hydrodynamic interplay takes place. Although it is now well established that these plasmas are generated due to ionizing waves reminding in many ways streamer propagation, they exhibit discrete characteristics which are better mirrored on the terms 'guided streamers' or 'plasma bullets'. These 'bullets' travel with supersonic velocities both inside the dielectric barrier and the channel formed by the noble gas during its penetration into the air. The present work is devoted to the interpretation of the electro-hydrodynamic effects that take place downstream of the dielectric barrier opening, i.e., in the noble gas-air mixing area where plasma bullet propagate under the influence of local electric fields in regions of variable noble gas concentration. Herein, we focus on the role of the local space charge and the residual ionic charge left behind after the bullet propagation in the gas flow field modification. The study communicates both experimental and numerical results, coupled in a comprehensive manner. The plasma bullets are here produced by a custom device having a quartz tube as a dielectric barrier and two external ring-type electrodes driven by sinusoidal high voltage at 10 kHz. Helium gas is fed to the tube and schlieren photography is employed for mapping the flow field downstream of the tube orifice. Mixture mass conservation equation, momentum conservation equation, energy conservation equation in terms of temperature and helium transfer equation are simultaneously solved, leading to the physical mechanisms that govern the experimental results. Namely, we deal with electro-hydrodynamic effects mainly due to momentum transfer from atomic ions to neutrals. The atomic ions are left behind as residual charge after the bullet propagation and gain energy from the locally created electric field. The electro-hydrodynamic force is eventually evaluated.

Keywords: atmospheric-pressure plasmas, dielectric-barrier discharges, schlieren photography, electro-hydrodynamic force

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Authors: Virany Diana, Martono Tri Utomo, Risa Etika

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Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.

Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock

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Authors: Stojan Kravanja, Andrej Ivanič, Tomaž Žula

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This contribution focuses on structural optimization in civil engineering using mixed integer non-linear programming (MINLP). MINLP is characterized as a versatile method that can handle both continuous and discrete optimization variables simultaneously. Continuous variables are used to optimize parameters such as dimensions, stresses, masses, or costs, while discrete variables represent binary decisions to determine the presence or absence of structural elements within a structure while also calculating discrete materials and standard sections. The optimization process is divided into three main steps. First, a mechanical superstructure with a variety of different topology-, material- and dimensional alternatives. Next, a MINLP model is formulated to encapsulate the optimization problem. Finally, an optimal solution is searched in the direction of the defined objective function while respecting the structural constraints. The economic or mass objective function of the material and labor costs of a structure is subjected to the constraints known from structural analysis. These constraints include equations for the calculation of internal forces and deflections, as well as equations for the dimensioning of structural components (in accordance with the Eurocode standards). Given the complex, non-convex and highly non-linear nature of optimization problems in civil engineering, the Modified Outer-Approximation/Equality-Relaxation (OA/ER) algorithm is applied. This algorithm alternately solves subproblems of non-linear programming (NLP) and main problems of mixed-integer linear programming (MILP), in this way gradually refines the solution space up to the optimal solution. The NLP corresponds to the continuous optimization of parameters (with fixed topology, discrete materials and standard dimensions, all determined in the previous MILP), while the MILP involves a global approximation to the superstructure of alternatives, where a new topology, materials, standard dimensions are determined. The optimization of a convex problem is stopped when the MILP solution becomes better than the best NLP solution. Otherwise, it is terminated when the NLP solution can no longer be improved. While the OA/ER algorithm, like all other algorithms, does not guarantee global optimality due to the presence of non-convex functions, various modifications, including convexity tests, are implemented in OA/ER to mitigate these difficulties. The effectiveness of the proposed MINLP approach is demonstrated by its application to various structural optimization tasks, such as mass optimization of steel buildings, cost optimization of timber halls, composite floor systems, etc. Special optimization models have been developed for the optimization of these structures. The MINLP optimizations, facilitated by the user-friendly software package MIPSYN, provide insights into a mass or cost-optimal solutions, optimal structural topologies, optimal material and standard cross-section choices, confirming MINLP as a valuable method for the optimization of structures in civil engineering.

Keywords: MINLP, mixed-integer non-linear programming, optimization, structures

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Authors: Santhani M. Selveindran

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Background: Natural disasters are traumatic global events that are becoming increasing more common, with significant psychosocial impact on survivors. This impact results not only in psychosocial distress but, for many, can lead to psychosocial disorders and chronic psychopathology. While there are currently available interventions that seek to prevent and treat these psychosocial sequelae, their effectiveness is uncertain. The evidence-base is emerging with more primary studies evaluating the effectiveness of various psychosocial interventions for survivors of natural disasters, which remains to be synthesized. Aim of Review: To identify, critically appraise and synthesize the current evidence-base on the effectiveness of psychosocial interventions in preventing or treating Post-Traumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and/or Generalized Anxiety Disorder (GAD) in adults and children who are survivors of natural disasters. Methods: A protocol was developed as a guide to carry out this review. A systematic search was conducted in eight international electronic databases, three grey literature databases, one dissertation and thesis repository, websites of six humanitarian and non-governmental organizations renowned for their work on natural disasters, as well as bibliographic and citation searching for eligible articles. Papers meeting the specific inclusion criteria underwent quality assessment using the Downs and Black checklist. Data were extracted from the included papers and analysed by way of narrative synthesis. Results: Database and website searching returned 3777 papers where 31 met the criteria for inclusion. Additional 2 papers were obtained through bibliographic and citation searching. Methodological quality of most papers was fair. Twenty-five studies evaluated psychological interventions, five, social interventions whereas three studies evaluated ‘mixed’ psychological and social interventions. All studies, irrespective of methodological quality, reported post-intervention reductions in symptom scores for PTSD, depression and/or anxiety and where assessed, reduced diagnosis of PTSD and MDD, and produced improvements in self-efficacy and quality of life. Statistically significant results were seen in 27 studies. However, three studies demonstrated that the evaluated interventions may not have been very beneficial. Conclusions: The overall positive results suggest that any psychosocial interventions are favourable and should be delivered to all natural disaster survivors, irrespective of age, country, and phase of disaster. Yet, heterogeneity and methodological shortcomings of the current evidence-base makes it difficult to draw definite conclusions needed to formulate categorical guidance or frameworks. Further, rigorously conducted research is needed in this area, although the feasibility of such, given the context and nature of the problem, is also recognized.

Keywords: psychosocial interventions, natural disasters, survivors, effectiveness

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Authors: Willem J. A. Louw

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The wave of new advanced computing technology that has been developed during the recent past has significantly changed the way we communicate, collaborate and collect information. It has created a new technology environment and paradigm in which our children and students grow-up and this impacts on their learning. Research confirmed that Generation Y students have a preference for learning in the new technology environment. The challenge or question is: How do we adjust our teaching and learning to make the most of these changes. The complexity of effective and efficient teaching and learning must not be underestimated and changes must be preceded by proper objective research to prevent any haphazard developments that could do more harm than benefit. A blended learning approach has been used in the Forestry department for a few numbers of years including the use of electronic-peer assisted learning (e-pal) in a fixed-computer set-up within a learning management system environment. It was decided to extend the investigation and do some exploratory research by using a range of different Tablet devices. For this purpose, learning activities or assignments were designed to cover aspects of communication, collaboration and collection of information. The Moodle learning management system was used to present normal module information, to communicate with students and for feedback and data collection. Student feedback was collected by using an online questionnaire and informal discussions. The research project was implemented in 2013, 2014 and 2015 amongst first and third-year students doing a forestry three-year technical tertiary qualification in commercial plantation management. In general, more than 80% of the students alluded to that the device was very useful in their learning environment while the rest indicated that the devices were not very useful. More than ninety percent of the students acknowledged that they would like to continue using the devices for all of their modules whilst the rest alluded to functioning efficiently without the devices. Results indicated that information collection (access to resources) was rated the highest advantageous factor followed by communication and collaboration. The main general advantages of using Tablets were listed by the students as being mobility (portability), 24/7 access to learning material and information of any kind on a user friendly device in a Wi-Fi environment, fast computing process speeds, saving time, effort and airtime through skyping and e-mail, and use of various applications. Ownership of the device is a critical factor while the risk was identified as a major potential constraint. Significant differences were reported between the different types and quality of Tablets. The preferred types are those with a bigger screen and the ones with overall better functionality and quality features. Tablets significantly increase the collaboration, communication and information collection needs of the students. It does, however, not replace the need of a computer/laptop because of limited storage and computation capacity, small screen size and inefficient typing.

Keywords: tablets, teaching, blended learning, tablet quality

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Authors: Mahdi Farajzadeh Ajirlou

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Prior evidence of normal cardiac anatomy is desirable to relieve the anxiety of cases with a family history of congenital heart disease or to offer the option of early gestation termination or close follow-up should a cardiac anomaly be proved. Fetal heart discovery plays an important part in the opinion of the fetus, and it can reflect the fetal heart function of the fetus, which is regulated by the central nervous system. Acquisition of ventricular volume and inflow data would be useful to quantify more valve regurgitation and ventricular function to determine the degree of cardiovascular concession in fetal conditions at threat for hydrops fetalis. This study discusses imaging the fetal heart with transvaginal ultrasound, Doppler ultrasound, three-dimensional ultrasound (3DUS) and four-dimensional (4D) ultrasound, spatiotemporal image correlation (STIC), glamorous resonance imaging and cardiac catheterization. Doppler ultrasound (DUS) image is a kind of real- time image with a better imaging effect on blood vessels and soft tissues. DUS imaging can observe the shape of the fetus, but it cannot show whether the fetus is hypoxic or distressed. Spatiotemporal image correlation (STIC) enables the acquisition of a volume of data concomitant with the beating heart. The automated volume accession is made possible by the array in the transducer performing a slow single reach, recording a single 3D data set conforming to numerous 2D frames one behind the other. The volume accession can be done in a stationary 3D, either online 4D (direct volume scan, live 3D ultrasound or a so-called 4D (3D/ 4D)), or either spatiotemporal image correlation-STIC (off-line 4D, which is a circular volume check-up). Fetal cardiovascular MRI would appear to be an ideal approach to the noninvasive disquisition of the impact of abnormal cardiovascular hemodynamics on antenatal brain growth and development. Still, there are practical limitations to the use of conventional MRI for fetal cardiovascular assessment, including the small size and high heart rate of the mortal fetus, the lack of conventional cardiac gating styles to attend data accession, and the implicit corruption of MRI data due to motherly respiration and unpredictable fetal movements. Fetal cardiac MRI has the implicit to complement ultrasound in detecting cardiovascular deformations and extracardiac lesions. Fetal cardiac intervention (FCI), minimally invasive catheter interventions, is a new and evolving fashion that allows for in-utero treatment of a subset of severe forms of congenital heart deficiency. In special cases, it may be possible to modify the natural history of congenital heart disorders. It's entirely possible that future generations will ‘repair’ congenital heart deficiency in utero using nanotechnologies or remote computer-guided micro-robots that work in the cellular layer.

Keywords: fetal, cardiac MRI, ultrasound, 3D, 4D, heart disease, invasive, noninvasive, catheter

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Authors: Diana Kwok

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Introduction: There is a rising concern on the educational needs of school guidance teachers, counselors, and sex educators to work effectively with students from multicultural groups, such as racial minorities, gender minorities, sexual minorities, and disability groups etc., and to respect cultural diversities. A specialized training model, the multicultural framework based on contact theory is recognized as necessary training model for professional training programs. Methodology: While the major focus of this project is on improving teaching and learning in teacher training courses within the department of Special Education and Counselling, it specifically aims to enhance the cultural competence of 102 participants enrolled in counseling and sexuality education courses by integrating the following teaching and learning strategies: 1) Panel presentation; 2) Case studies; 3) Experiential learning. Data sources from the participants consisted of the following: (a) questionnaires (MCKAS and ATLG) administered in classes; (b) weekly reflective journals, and c) focus group interviews with panel members. The focus group interviews with panel members were documented. Qualitatively, the weekly reflections were content analyzed. The presentation in this specific conference put focus on themes we found from qualitative content analysis of weekly reflective journals from 102 participants. Findings: Content analysis had found the following preliminary emergent themes: Theme I) Cultural knowledge and challenges to personal limitation. Students had gained a new perspective that specific cultural knowledge involved unique values and worldview. Awareness of limitation of counsellors is very important after actively acquiring the cultural knowledge. Theme 2 - Observation, engagement and active learning. Through the sharing and case studies, as well as visits to the communities, students recognized that observation and listening to the needs of cultural group members were the essential steps before taking any intervention steps. Theme 3 - Curiosity and desire for further inter-group dialogue. All students expressed their desire, curiosity, and motivation to have further inter-group dialogue in their future work settings. Theme 4: Experience with teaching and learning strategies. Students shared their perspectives on how teaching and learning strategies had facilitated their acquisition of cultural competence. Results of this analysis suggests that diverse teaching and learning strategies based on contact perspective had stimulated their curiosity to re-examine their values and motivated them to acquire cultural knowledge relevant to the cultural groups. Acknowledgment: The teaching and learning project was funded by the Teaching and Development Grant, Hong Kong Institute of Education (Project Number T0142).

Keywords: cultural competence, Chinese teacher students, teaching and learning, contacts

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Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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Authors: Ahlam Ali, Katrina Lappin, Jaine Blayney, Ken Mills

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Leukaemia is the most frequently (30%) occurring type of paediatric cancer. Of these, approximately 80% are acute lymphoblastic leukaemia (ALL) with acute myeloid leukaemia (AML) cases making up the remaining 20% alongside other leukaemias. Unfortunately, children with AML do not have promising prognosis with only 60% surviving 5 years or longer. It has been highlighted recently the need for age-specific therapies for AML patients, with paediatric AML cases having a different mutational landscape compared with AML diagnosed in adult patients. Drug Repurposing is a recognized strategy in drug discovery and development where an already approved drug is used for diseases other than originally indicated. We aim to identify novel combination therapies with the promise of providing alternative more effective and less toxic induction therapy options. Our in-silico analysis highlighted ‘cell death and survival’ as an aberrant, potentially targetable pathway in paediatric AML patients. On this basis, 83 apoptotic inducing compounds were screened. A preliminary single agent screen was also performed to eliminate potentially toxic chemicals, then drugs were constructed into a pooled library with 10 drugs per well over 160 wells, with 45 possible pairs and 120 triples in each well. Seven cell lines were used during this study to represent the clonality of AML in paediatric patients (Kasumi-1, CMK, CMS, MV11-14, PL21, THP1, MOLM-13). Cytotoxicity was assessed up to 72 hours using CellTox™ Green reagent. Fluorescence readings were normalized to a DMSO control. Z-Score was assigned to each well based on the mean and standard deviation of all the data. Combinations with a Z-Score <2 were eliminated and the remaining wells were taken forward for further analysis. A well was considered ‘successful’ if each drug individually demonstrated a Z-Score <2, while the combination exhibited a Z-Score >2. Each of the ten compounds in one well (155) had minimal or no effect as single agents on cell viability however, a combination of two or more of the compounds resulted in a substantial increase in cell death, therefore the ten compounds were de-convoluted to identify a possible synergistic pair/triple combinations. The screen identified two possible ‘novel’ drug pairing, with BCL2 inhibitor ABT-737, combined with either a CDK inhibitor Purvalanol A, or AKT/ PI3K inhibitor LY294002. (ABT-737- 100 nM+ Purvalanol A- 1 µM) (ABT-737- 100 nM+ LY294002- 2 µM). Three possible triple combinations were identified (LY2409881+Akti-1/2+Purvalanol A, SU9516+Akti-1/2+Purvalanol A, and ABT-737+LY2409881+Purvalanol A), which will be taken forward for examining their efficacy at varying concentrations and dosing schedules, across multiple paediatric AML cell lines for optimisation of maximum synergy. We believe that our combination screening approach has potential for future use with a larger cohort of drugs including FDA approved compounds and patient material.

Keywords: AML, drug repurposing, ABT-737, apoptosis

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Authors: Torsten Hermanns, You Wang, Stefan Janssen, Markus Niessen, Christoph Schoeler, Ulrich Thombansen, Wolfgang Schulz

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In long pulse laser drilling of metals, it can be demonstrated that the ablation shape approaches a so-called asymptotic shape such that it changes only slightly or not at all with further irradiation. These findings are already known from ultra short pulse (USP) ablation of dielectric and semiconducting materials. The explanation for the occurrence of an asymptotic shape in long pulse drilling of metals is identified, a model for the description of the asymptotic hole shape numerically implemented, tested and clearly confirmed by comparison with experimental data. The model assumes a robust process in that way that the characteristics of the melt flow inside the arising melt film does not change qualitatively by changing the laser or processing parameters. Only robust processes are technically controllable and thus of industrial interest. The condition for a robust process is identified by a threshold for the mass flow density of the assist gas at the hole entrance which has to be exceeded. Within a robust process regime the melt flow characteristics can be captured by only one model parameter, namely the intensity threshold. In analogy to USP ablation (where it is already known for a long time that the resulting hole shape results from a threshold for the absorbed laser fluency) it is demonstrated that in the case of robust long pulse ablation the asymptotic shape forms in that way that along the whole contour the absorbed heat flux density is equal to the intensity threshold. The intensity threshold depends on the special material and radiation properties and has to be calibrated be one reference experiment. The model is implemented in a numerical simulation which is called AsymptoticDrill and requires such a few amount of resources that it can run on common desktop PCs, laptops or even smart devices. Resulting hole shapes can be calculated within seconds what depicts a clear advantage over other simulations presented in literature in the context of industrial every day usage. Against this background the software additionally is equipped with a user-friendly GUI which allows an intuitive usage. Individual parameters can be adjusted using sliders while the simulation result appears immediately in an adjacent window. A platform independent development allow a flexible usage: the operator can use the tool to adjust the process in a very convenient manner on a tablet during the developer can execute the tool in his office in order to design new processes. Furthermore, at the best knowledge of the authors AsymptoticDrill is the first simulation which allows the import of measured real beam distributions and thus calculates the asymptotic hole shape on the basis of the real state of the specific manufacturing system. In this paper the emphasis is placed on the investigation of the effect of multiple reflections on the asymptotic hole shape which gain in importance when drilling holes with large aspect ratios.

Keywords: asymptotic hole shape, intensity threshold, long pulse laser drilling, robust process

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Authors: Muhammad Aji Fajari, Ririt Aprilin Sumarsono

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Particular instability of structural building under lateral load (e.g earthquake) will rise due to irregularity in vertical and horizontal direction as stated in SNI 03-1762-2012. The conventional slab has been considered for its less contribution in increasing the stability of the structure, except special slab system such as flat slab turned into account. In this paper, the analysis of flat slab system at Sequis Tower located in South Jakarta will be assessed its performance under earthquake. It consists of 6 floors of the basement where the flat slab system is applied. The flat slab system will be the main focus in this paper to be compared for its performance with conventional slab system under earthquake. Regarding the floor plan of Sequis Tower basement, re-entrant corner signed for this building is 43.21% which exceeded the allowable re-entrant corner is 15% as stated in ASCE 7-05 Based on that, the horizontal irregularity will be another concern for analysis, otherwise vertical irregularity does not exist for this building. Flat slab system is a system where the slabs use drop panel with shear head as their support instead of using beams. Major advantages of flat slab application are decreasing dead load of structure, removing beams so that the clear height can be maximized, and providing lateral resistance due to lateral load. Whilst, deflection at middle strip and punching shear are problems to be detail considered. Torsion usually appears when the structural member under flexure such as beam or column dimension is improper in ratio. Considering flat slab as alternative slab system will keep the collapse due to torsion down. Common seismic load resisting system applied in the building is a shear wall. Installation of shear wall will keep the structural system stronger and stiffer affecting in reduced displacement under earthquake. Eccentricity of shear wall location of this building resolved the instability due to horizontal irregularity so that the earthquake load can be absorbed. Performing linear dynamic analysis such as response spectrum and time history analysis due to earthquake load is suitable as the irregularity arise so that the performance of structure can be significantly observed. Utilization of response spectrum data for South Jakarta which PGA 0.389g is basic for the earthquake load idealization to be involved in several load combinations stated on SNI 03-1726-2012. The analysis will result in some basic seismic parameters such as period, displacement, and base shear of the system; besides the internal forces of the critical member will be presented. Predicted period of a structure under earthquake load is 0.45 second, but as different slab system applied in the analysis then the period will show a different value. Flat slab system will probably result in better performance for the displacement parameter compare to conventional slab system due to higher contribution of stiffness to the whole system of the building. In line with displacement, the deflection of the slab will result smaller for flat slab than a conventional slab. Henceforth, shear wall will be effective to strengthen the conventional slab system than flat slab system.

Keywords: conventional slab, flat slab, horizontal irregularity, response spectrum, shear wall

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Authors: Edna Negron-Martinez

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

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

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Authors: Caitlin Bailey, Marian Frattarola Saulino, Beth Steinberg

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Today, virtually all programs offered to people with intellectual and developmental disabilities tout themselves as person-centered, community-based and inclusive, yet there is a vast range in type and quality of services that use these similar descriptors. The issue is exacerbated by the fields’ measurement practices around quality, inclusion, independent living, choice and person-centered outcomes. For instance, community inclusion for people with disabilities is often measured by the number of times person steps into his or her community. These measurement approaches set standards for quality too low so that agencies supporting group home residents to go bowling every week can report the same outcomes as an agency that supports one person to join a book club that includes people based on their literary interests rather than disability labels. Ultimately, lack of delineation in measurement contributes to the confusion between face value “quality” and true quality services and supports for many people with disabilities and their families. This exploratory study adopts alternative approaches to quality measurement including co-production methods and systems theoretical framework in order to identify the factors that 1) lead to high-quality supports and, 2) differentiate high-quality services. Project researchers have partnered with community practitioners who are all committed to providing quality services and supports but vary in the degree to which they are actually able to provide them. The study includes two parts; first, an online survey distributed to more than 500 agencies that have demonstrated commitment to providing high-quality services; and second, four in-depth case studies with agencies in three United States and Israel providing a variety of supports to children and adults with disabilities. Results from both the survey and in-depth case studies were thematically analyzed and coded. Results show that there are specific factors that differentiate service quality; however meaningful quality measurement practices also require that researchers explore the contextual factors that contribute to quality. These not only include direct services and interactions, but also characteristics of service users, their environments as well as organizations providing services, such as management and funding structures, culture and leadership. Findings from this study challenge researchers, policy makers and practitioners to examine existing quality service standards and measurements and to adopt alternate methodologies and solutions to differentiate and scale up evidence-based quality practices so that all people with disabilities have access to services that support them to live, work, and enjoy where and with whom they choose.

Keywords: co-production, inclusion, independent living, quality measurement, quality supports

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Authors: Selin Top, Raul Marcos, M. Sinan Bilgili

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Although there have been several studies related to collection, temporary storage, handling and disposal of solid wastes generated by hospitals, there are only a few studies related to liquid wastes generated by hospitals or hospital wastewaters. There is an important amount of water consumptions in hospitals. While minimum domestic water consumption per person is 100 L/day, water consumption per bed in hospitals is generally ranged between 400-1200 L. This high amount of consumption causes high amount of wastewater. The quantity of wastewater produced in a hospital depends on different factors: bed numbers, hospital age, accessibility to water, general services present inside the structure (kitchen, laundry, laboratory, diagnosis, radiology, and air conditioning), number and type of wards and units, institution management policies and awareness in managing the structure in safeguarding the environment, climate and cultural and geographic factors. In our country, characterization of hospital wastewaters conducted by classical parameters in a very few studies. However, as mentioned above, this type of wastewaters may contain different compounds than domestic wastewaters. Hospital Wastewater (HWW) is wastewater generated from all activities of the hospital, medical and non medical. Nowadays, hospitals are considered as one of the biggest sources of wastewater along with urban sources, agricultural effluents and industrial sources. As a health-care waste, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components due to using disinfectants, pharmaceuticals, radionuclides and solvents making not suitable the connection of hospital wastewater to the municipal sewage network. These characteristics may represent a serious health hazard and children, adults and animals all have the potential to come into contact with this water. Therefore, the treatment of hospital wastewater is an important current interest point to focus on. This paper aims to approach on the investigation of hospital wastewater treatment by membrane systems. This study aim is to determined hospital wastewater’s characterization and also evaluates the efficiency of hospital wastewater treatment by high pressure filtration systems such as ultrafiltration (UF). Hospital wastewater samples were taken directly from sewage system from Şişli Etfal Training and Research Hospital, located in the district of Şişli, in the European part of Istanbul. The hospital is a 784 bed tertiary care center with a daily outpatient department of 3850 patients. Ultrafiltration membrane is used as an experimental treatment and the influence of the pressure exerted on the membranes was examined, ranging from 1 to 3 bar. The permeate flux across the membrane was observed to define the flooding membrane points. The global COD and BOD5 removal efficiencies were 54% and 75% respectively for ultrafiltration, all the SST removal efficiencies were above 90% and a successful removal of the pathological bacteria measured was achieved.

Keywords: hospital wastewater, membrane, ultrafiltration, treatment

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Authors: Ribeiro Tiago Magalhães

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Objective: The objective of this study was to evaluate the influence of a hydroelectric power plant in the state of Amapá, and to present the results obtained by dimensioning the diversity of the main mosquito vectors involved in the transmission of pathogens that cause diseases such as malaria, dengue and leishmaniasis. Methodology: The present study was conducted on the banks of the Araguari River, in the municipalities of Porto Grande and Ferreira Gomes in the southern region of Amapá State. Nine monitoring campaigns were conducted, the first in April 2014 and the last in March 2016. The selection of the catch sites was done in order to prioritize areas with possible occurrence of the species considered of greater importance for public health and areas of contact between the wild environment and humans. Sampling efforts aimed to identify the local vector fauna and to relate it to the transmission of diseases. In this way, three phases of collection were established, covering the schedules of greater hematophageal activity. Sampling was carried out using Shannon Shack and CDC types of light traps and by means of specimen collection with the hold method. This procedure was carried out during the morning (between 08:00 and 11:00), afternoon-twilight (between 15:30 and 18:30) and night (between 18:30 and 22:00). In the specific methodology of capture with the use of the CDC equipment, the delimited times were from 18:00 until 06:00 the following day. Results: A total of 32 species of mosquitoes was identified, and a total of 2,962 specimens was taxonomically subdivided into three genera (Culicidae, Psychodidae and Simuliidae) Psorophora, Sabethes, Simulium, Uranotaenia and Wyeomyia), besides those represented by the family Psychodidae that due to the morphological complexities, allows the safe identification (without the method of diaphanization and assembly of slides for microscopy), only at the taxonomic level of subfamily (Phlebotominae). Conclusion: The nine monitoring campaigns carried out provided the basis for the design of the possible epidemiological structure in the areas of influence of the Cachoeira Caldeirão HPP, in order to point out among the points established for sampling, which would represent greater possibilities, according to the group of identified mosquitoes, of disease acquisition. However, what should be mainly considered, are the future events arising from reservoir filling. This argument is based on the fact that the reproductive success of Culicidae is intrinsically related to the aquatic environment for the development of its larvae until adulthood. From the moment that the water mirror is expanded in new environments for the formation of the reservoir, a modification in the process of development and hatching of the eggs deposited in the substrate can occur, causing a sudden explosion in the abundance of some genera, in special Anopheles, which holds preferences for denser forest environments, close to the water portions.

Keywords: Amazon, hydroelectric, power, plants

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Authors: Naziema Jappie

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South Africa is a diverse nation but with many challenges. The fundamental changes in the political, economic and educational domains in South Africa in the late 1990s affected the South African community profoundly. In higher education, experiences of discrimination and bias are detrimental to the sense of belonging of staff and students. It is therefore important to cultivate an appreciation of diversity and inclusion. To bridge common understandings with the reality of racial inequality, we must understand the ways in which senior and executive leadership at universities think about social justice issues relating to diversity and inclusion and contextualize these within the current post-democracy landscape. The position and status of social justice issues and initiatives in South African higher education is a slow process. The focus is to highlight how and to what extent initiatives or practices around campus diversity and inclusion have been considered and made part of the mainstream intellectual and academic conversations in South Africa. This involves an examination of the social and epistemological conditions of possibility for meaningful research and curriculum practices, staff and student recruitment, and student access and success in addressing the challenges posed by social diversity on campuses. Methodology: In this study, university senior and executive leadership were interviewed about their perceptions and advancement of social justice and examine the buffering effects of diverse and inclusive peer interactions and institutional commitment on the relationship between discrimination–bias and sense of belonging for staff and students at the institutions. The paper further explores diversity and inclusion initiatives at the three institutions using a Critical Race Theory approach in conjunction with a literature review on social justice with a special focus on diversity and inclusion. Findings: This paper draws on research findings that demonstrate the need to address social justice issues of diversity and inclusion in the SA higher education context. The reason for this is so that university leaders can live out their experiences and values as they work to transform students into being accountable and responsible. Documents were selected for review with the intent of illustrating how diversity and inclusion work being done across an institution can shape the experiences of previously disadvantaged persons at these institutions. The research has highlighted the need for institutional leaders to embody their own mission and vision as they frame social justice issues for the campus community. Finally, the paper provides recommendations to institutions for strengthening high-level diversity and inclusion programs/initiatives among staff, students and administrators. The conclusion stresses the importance of addressing the historical and current policies and practices that either facilitate or negate the goals of social justice, encouraging these privileged institutions to create internal committees or task forces that focus on racial and ethnic disparities in the institution.

Keywords: diversity, higher education, inclusion, social justice

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Authors: Laura M. F. Bertens

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The houses we inhabit are important containers of memory. As homes, they take on meaning for those who live inside, and memories of family life become intimately tied up with rooms, windows, and gardens. Each new family creates a new layer of meaning, resulting in a palimpsest of family memory. These houses function quite literally as memory palaces, as a walk through a childhood home will show; each room conjures up images of past events. Over time, these personal memories become woven together with the cultural memory of countries and generations. The importance of the home is a central theme in art, and several contemporary artists have a special interest in the relationship between memory and the home. This paper analyses three case studies in order to get a deeper understanding of the ways in which the home functions and feels like a memory palace, both on an individual and on a collective, cultural level. Close reading of the artworks is performed on the theoretical intersection between Art History and Cultural Memory Studies. The first case study concerns works from the exhibition Mnemosyne by the artist duo Anne and Patrick Poirier. These works combine interests in architecture, archaeology, and psychology. Models of cities and fantastical architectural designs resemble physical structures (such as the brain), architectural metaphors used in representing the concept of memory (such as the memory palace), and archaeological remains, essential to our shared cultural memories. Secondly, works by Do Ho Suh will help us understand the relationship between the home and memory on a far more personal level; outlines of rooms from his former homes, made of colourful, transparent fabric and combined into new structures, provide an insight into the way these spaces retain individual memories. The spaces have been emptied out, and only the husks remain. Although the remnants of walls, light switches, doors, electricity outlets, etc. are standard, mass-produced elements found in many homes and devoid of inherent meaning, together they remind us of the emotional significance attached to the muscle memory of spaces we once inhabited. The third case study concerns an exhibition in a house put up for sale on the Dutch real estate website Funda. The house was built in 1933 by a Jewish family fleeing from Germany, and the father and son were later deported and killed. The artists Anne van As and CA Wertheim have used the history and memories of the house as a starting point for an exhibition called (T)huis, a combination of the Dutch words for home and house. This case study illustrates the way houses become containers of memories; each new family ‘resets’ the meaning of a house, but traces of earlier memories remain. The exhibition allows us to explore the transition of individual memories into shared cultural memory, in this case of WWII. Taken together, the analyses provide a deeper understanding of different facets of the relationship between the home and memory, both individual and collective, and the ways in which art can represent these.

Keywords: Anne and Patrick Poirier, cultural memory, Do Ho Suh, home, memory palace

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Authors: Khaled Alabduljabbar

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Background: Benign, isolated, recurrent sixth nerve palsy is very rare in children. Here we report a case of recurrent abducens nerve palsy with no obvious etiology. It is a diagnosis of exclusion. A recurrent benign form of 6th nerve palsy, a rarer still palsy, has been described in the literature, and it is of most likely secondary to inflammatory causes, e.g, following viral and bacterial infections. Purpose: To present a case of 14 months old girl with recurrent attacks of isolated left sixth cranial nerve palsy following upper respiratory tract infection. Observation: The patient presented to opthalmology clinic with sudden onset of inward deviation (esotropia) of the left eye with a compensatory left face turn one week following signs of upper respiratory tract infection. Ophthalmological examination revealed large angle esotropia of the left eye in primary position, with complete limitation of abduction of the left eye, no palpebral fissure changes, and abnormal position of the head (left face turn). Visual acuity was normal, and no significant refractive error on cycloplegic refraction for her age. Fundus examination was normal with no evidence of papilledema. There was no relative afferent pupillary defect (RAPD) and no anisocoria. Past medical history and family history were unremarkable, with no history of convulsion attacks or head trauma. Additional workout include CBC. Erythrocyte sedimentation rate, Urgent magnetic resonance imaging (MRI), and angiography of the brain were performed and demonstrated the absence of intracranial and orbital lesions. Referral to pediatric neurologist was also done and concluded no significant finding. The patient showed improvement of the left sixth cranial nerve palsy and left face turn over a period of two months. Seven months since the first attack, she experienced a recurrent attack of left eye esotropia with left face turn concurrent with URTI. The rest of eye examination was again unremarkable. CT scan and MRI scan of brain and orbit were performed and showed only signs of sinusitis with no intracranial pathology. The palsy resolved spontaneously within two months. A third episode of left 6th nerve palsy occurred 6 months later, whichrecovered over one month. Examination and neuroimagingwere unremarkable. A diagnosis of benign recurrent left 6th cranial nerve palsy was made. Conclusion: Benign sixth cranial nerve palsy is always a diagnosis of exclusion given the more serious and life-threatening alternative causes. It seems to have a good prognosis with only supportive measures. The likelihood of benign 6th cranial nerve palsy to resolve completely and spontaneously is high. Observation for at least 6 months without intervention is advisable.

Keywords: 6th nerve pasy, abducens nerve pasy, recurrent nerve palsy, cranial nerve palsy

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Authors: Sonia Kudlacik-Kramarczyk, Anna Drabczyk, Dagmara Malina, Bozena Tyliszczak, Agnieszka Sobczak-Kupiec

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Introduction: In the preparation of polymer materials, compounds of natural origin are currently gaining more and more interest. This is particularly noticeable in the case of synthesis of materials considered for biomedical use. Then, selected material has to meet many requirements. It should be characterized by non-toxicity, biodegradability and biocompatibility. Therefore special attention is directed to substances such as polysaccharides, proteins or substances that are the basic building components of proteins, i.e. amino acids. These compounds may be crosslinked with other reagents that leads to the preparation of polymer matrices. Such amino acids as e.g. cysteine or histidine. On the other hand, previously mentioned requirements may be met by polymers obtained as a result of biosynthesis, e.g. polyhydroxybutyrate. This polymer belongs to the group of aliphatic polyesters that is synthesized by microorganisms (selected strain of bacteria) under specific conditions. It is possible to modify matrices based on given polymer with substances of various origin. Such a modification may result in the change of their properties or/and in providing the material with new features desirable in viewpoint of specific application. Described materials are synthesized using UV radiation. Process of photopolymerization is fast, waste-free and enables to obtain final products with favorable properties. Methodology: Polymer matrices have been prepared by means of photopolymerization. First step involved the preparation of solutions of particular reagents and mixing them in the appropriate ratio. Next, crosslinking agent and photoinitiator have been added to the reaction mixture and the whole was poured into the Petri dish and treated with UV radiation. After the synthesis, polymer samples were dried at room temperature and subjected to the numerous analyses aimed at the determining their physicochemical properties. Firstly, sorption properties of obtained polymer matrices have been determined. Next, mechanical properties have been characterized, i.e. tensile strength. The ability to deformation under applied stress of all prepared polymer matrices has been checked. Such a property is important in viewpoint of the application of analyzed materials e.g. as wound dressings. Wound dressings have to be elastic because depending on the location of the wound and its mobility, such a dressing has to adhere properly to the wound. Furthermore, considering the use of the materials for biomedical purposes it is essential to determine its behavior in environments simulating these ones occurring in human body. Therefore incubation studies using selected liquids have also been conducted. Conclusions: As a result of photopolymerization process, polymer matrices based on natural compounds have been prepared. These exhibited favorable mechanical properties and swelling ability. Moreover, biocompatibility in relation to simulated body fluids has been stated. Therefore it can be concluded that analyzed polymer matrices constitute an interesting materials that may be considered for biomedical use and may be subjected to the further more advanced analyses using specific cell lines.

Keywords: photopolymerization, polymer matrices, simulated body fluids, swelling properties

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Authors: Delaram Hosseinioun

Abstract:

In their collections, Shirin Neshat, Mitra Tabrizian, Gohar Dashti and Newsha Tavakolian adopt a hybrid form of narrative to confront the restrictions imposed on women in hegemonic public and private spaces. Focusing on motives such as social marginalisation, crisis of belonging, as well as lack of agency for women, the artists depict the regression of women’s rights in their respective generations. Based on the ideas of Michael Bakhtin, namely his concept of polyphony or the plurality of contradictory voices, the views of Judith Butler on giving an account to oneself and Henri Leverbre’s theories on social space, this study illustrates the artists’ concept of identity in crisis through time and space. The research explores how the artists took their art as a novel dimension to depict and confront the hardships imposed on Iranian women. Henri Lefebvre makes a distinction between complex social structures through which individuals situate, perceive and represent themselves. By adding Bakhtin’s polyphonic view to Lefebvre’s concepts of perceived and lived spaces, the study explores the sense of social fragmentation in the works of Dashti and Tavakolian. One argument is that as the representatives of the contemporary generation of female artists who spend their lives in Iran and faced a higher degree of restrictions, their hyperbolic and theatrical styles stand as a symbolic act of confrontation against restrictive socio-cultural norms imposed on women. Further, the research explores the possibility of reclaiming one's voice and sense of agency through art, corresponding with the Bakhtinian sense of polyphony and Butler’s concept of giving an account to oneself. Works of Neshat and Tabrizian as the representatives of the previous generation who faced exile and diaspora, encompass a higher degree of misplacement, violence and decay of women’s presence. In Their works, the women’s body encompasses Lefebvre’s dismantled temporal and special setting. Notably, the ongoing social conviction and gender-based dogma imposed on women frame some of the concurrent motives among the selected collections of the four artists. By applying an interdisciplinary lens and integrating the conducted interviews with the artists, the study illustrates how the artists seek a transcultural account for themselves and women in their generations. Further, the selected collections manifest the urgency for an authentic and liberal voice and setting for women, resonating with the concurrent Women, Life, Freedom movement in Iran.

Keywords: persian modern female photographers, transcultural studies, shirin neshat, mitra tabrizian, gohar dashti, newsha tavakolian, butler, bakhtin, lefebvre

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