Search results for: face sketch image retrieval

Authors: Maria Sciammarella, Uttam M. Shrestha, Youngho Seo, Grant T. Gullberg, Elias H. Botvinick

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Background: Myocardial perfusion imaging (MPI) is typically performed with static imaging protocols and visually assessed for perfusion defects based on the relative intensity distribution. Dynamic cardiac SPECT, on the other hand, is a new imaging technique that is based on time varying information of radiotracer distribution, which permits quantification of myocardial blood flow (MBF). In this abstract, we report a progress and current status of dynamic cardiac SPECT using conventional gamma camera (Infinia Hawkeye 4, GE Healthcare) for estimation of myocardial blood flow and coronary flow reserve. Methods: A group of patients who had high risk of coronary artery disease was enrolled to evaluate our methodology. A low-dose/high-dose rest/pharmacologic-induced-stress protocol was implemented. A standard rest and a standard stress radionuclide dose of ⁹⁹ᵐTc-tetrofosmin (140 keV) was administered. The dynamic SPECT data for each patient were reconstructed using the standard 4-dimensional maximum likelihood expectation maximization (ML-EM) algorithm. Acquired data were used to estimate the myocardial blood flow (MBF). The correspondence between flow values in the main coronary vasculature with myocardial segments defined by the standardized myocardial segmentation and nomenclature were derived. The coronary flow reserve, CFR, was defined as the ratio of stress to rest MBF values. CFR values estimated with SPECT were also validated with dynamic PET. Results: The range of territorial MBF in LAD, RCA, and LCX was 0.44 ml/min/g to 3.81 ml/min/g. The MBF between estimated with PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (p < 0.001). But the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (p = 0.037). The mean stress MBF value was significantly lower for angiographically abnormal than that for the normal (Normal Mean MBF = 2.49 ± 0.61, Abnormal Mean MBF = 1.43 ± 0. 0.62, P < .001). Conclusions: The visually assessed image findings in clinical SPECT are subjective, and may not reflect direct physiologic measures of coronary lesion. The MBF and CFR measured with dynamic SPECT are fully objective and available only with the data generated from the dynamic SPECT method. A quantitative approach such as measuring CFR using dynamic SPECT imaging is a better mode of diagnosing CAD than visual assessment of stress and rest images from static SPECT images Coronary Flow Reserve.

Keywords: dynamic SPECT, clinical SPECT/CT, selective coronary angiograph, ⁹⁹ᵐTc-Tetrofosmin

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Authors: German Ricci

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The research aims to analyse the symbolic power of the International Monetary Fund (IMF) in its relationship with a borrowing country, drawing upon Pierre Bourdieu’s Field Theory. This theory of power, typical of constructivist structuralism, has been minor used in international relations. Thus, selecting this perspective offers a new understanding of how the IMF's power operates and is structured. The IMF makes periodic economic reviews in which the staff evaluates the Government's performance. It also offers “last instance” loans when private external credit is not accessible. This relationship generates great expectations in financial agents because the IMF’s statements indicate the capacity of the Nation-State to meet its payment obligations (or not). Therefore, it is argued that the IMF is a legitimate actor for financial agents concerned about a government facing an economic crisis both for the effects of its immediate economic contribution through loans and the promotion of adjustment programs, helpful to guarantee the payment of the external debt. This legitimacy implies a symbolic power relationship in addition to the already known economic power relationship. Obtaining the IMF's consent implies that the government partially puts its political-economic decisions into play since the monetary policy must be agreed upon with the Fund. This has consequences at the local level. First, it implies that the debtor state must establish a daily relationship with the Fund. This everyday interaction with the Fund influences how officials and policymakers internalize the meaning of political management. On the other hand, if the Government has access to the IMF's seal of approval, the State will be again in a position to re-enter the financial market and go back into debt to face external debt. This means that private creditors increase the chances of collecting the debt and, again, grant credits. Thus, it is argued that the borrowing country submits to the relationship with the IMF in search of the latter's economic and symbolic capital. Access to this symbolic capital has objective and subjective repercussions at the national level that might tend to reproduce the relevance of the financial market and legitimizes the IMF’s intervention during economic crises. The paper has Argentina as its case study, given its historical relationship with the IMF and the relevance of the current indebtedness period, which remains largely unexplored. Argentina’s economy is characterized by recurrent financial crises, and it is the country to which the Fund has lent the most in its entire history. It surpasses more than three times the second, Egypt. In addition, Argentina is currently the country that owes the most to the Fund after receiving the largest loan ever granted by the IMF in 2018, and a new agreement in 2022. While the historical strong association with the Fund culminated in the most acute economic and social crisis in the country’s contemporary history, producing an unprecedented political and institutional crisis in 2001, Argentina still recognized the IMF as the only way out during economic crises.

Keywords: IMF, fields theory, symbolic power, Argentina, Bourdieu

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Authors: F. L. Benu, I. W. Mudita, R. L. Natonis

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East Nusa Tenggara, together with part of East Java, West Nusa Tenggara, and Maluku, has been included as part of global drylands defined according to the ratio of annual precipitation (P) and annual potential evaporation (PET) and major vegetation types of grassland and savannah ecosystems. These tropical drylands are unique because, whereas drylands in other countries are mostly continental, here they are archipelagic. These archipelagic drylands are also unique in terms of being included because of more on their major vegetation types than of their P/PET ratio. Slash-and-burn cultivation and free roaming animal husbandry are two major livelihoods being widely practiced, along with alternative seasonal livelihood such as traditional fishing. Such livelihoods are vulnerable in various respects, especially because of drought, which becomes more unpredictable in the face of climate changes. To cope with such vulnerability, semi-intensive farming using drip irrigation is implemented as an appropriate technology with the goal of promoting a more sustainable alternative to the existing livelihoods. The implementation was started in 2016 with a pilot system at the university field laboratory in Kupang in which various designs of installation were tested. The modified system consisting of an uplifted water reservoir and solar-powered pump was tested in Papela, the District of Rote-Ndao, in 2017 to convince fishermen who had been involved in illegal fishing in Australia-Indonesia transboundary waters, to adopt small-scale farming as a more sustainable alternative to their existing livelihoods. The system was again tested in a larger coverage in Oesena, the District of Kupang, in 2018 to convince slash-and-burn cultivators to adopt an environmentally friendlier cultivation system. From the implementation of the modified system in both sites, the participating fishermen in Papela were able to manage the system under tight water supply to grow chili pepper, tomatoes, and watermelon and the slash-and-burn cultivators in Oesena to grow chili pepper in a more efficient water use than water use in a conventional irrigation system. The gross margin obtained from growing chili pepper, tomatoes, and watermelon in Papela and from growing chili pepper in Oesena showed that small-scale farming using drip irrigation system was a promising alternative to local people in generating cash income to support their livelihoods. However, before promoting this appropriate technology as a more sustainable alternative to the existing livelihoods elsewhere in the region, better understanding on social-related contexts of the implementation is needed.

Keywords: archipelagic drylands, drip irrigation system, East Nusa Tenggara, sustainable livelihoods

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Authors: Athanasia Petropoulou

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While there is a common understanding that a person’s sex, gender, gender identity, and sexual orientation shape every stage of the migration experience, theories of international migration had until recently not been focused on exploring and incorporating a gender perspective in their analysis. In a similar vein, refugee law has long been the object of criticisms for failing to recognize and respond appropriately to women’s and sexual minorities’ experiences of persecution. The present analysis attempts to depict the challenges faced by the European Court of Human Rights (ECtHR) and U.S. courts when adjudicating in cases involving asylum claims with a gendered perspective. By providing a comparison between adjudicating strategies of international and national jurisdictions, the article aims to identify common or distinctive approaches in addressing gendered based claims. The paper argues that, despite the different nature of the judicial bodies and the different legal instruments applied respectively, judges face similar challenges in this context and often fail to qualify and address the gendered dimensions of asylum claims properly. The ECtHR plays a fundamental role in safeguarding human rights protection in Europe not only for European citizens but also for people fleeing violence, war, and dire living conditions. However, this role becomes more difficult to fulfill, not only because of the obvious institutional constraints but also because cases related to claims of asylum seekers concern a domain closely linked to State sovereignty. Amid the current “refugee crisis,” risk assessment performed by national authorities, like in the process of asylum determination, is shaped by wider geopolitical and economic considerations. The failure to recognize and duly address the gendered dimension of non - refoulement claims, one of the many shortcomings of these processes, is reflected in the decisions of the ECtHR. As regards U.S. case law, the study argues that U.S. courts either fail to apply any connection between asylum claims and their gendered dimension or tend to approach gendered based claims through the lens of the “political opinion” or “membership of a particular social group” reasons of fear of persecution. This exercise becomes even more difficult, taking into account that the U.S. asylum law inappropriately qualifies gendered-based claims. The paper calls for more sociologically informed decision-making practices and for a more contextualized and relational approach in the assessment of the risk of ill-treatment and persecution. Such an approach is essential for unearthing the gendered patterns of persecution and addressing effectively related claims, thus securing the human rights of asylum seekers.

Keywords: asylum, European court of human rights, gender, human rights, U.S. courts

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Authors: Rajesh Ranjan, Marimuthu Palaniswami, A. A. Hashmi

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With the changing lifestyle and environment around us, the prevalence of the critical and incurable disease has proliferated. One such condition is the neurological disorder which is rampant among the old age population and is increasing at an unstoppable rate. Most of the neurological disorder patients suffer from some movement disorder affecting the movement of their body parts. Tremor is the most common movement disorder which is prevalent in such patients that infect the upper or lower limbs or both extremities. The tremor symptoms are commonly visible in Parkinson’s disease patient, and it can also be a pure tremor (essential tremor). The patients suffering from tremor face enormous trouble in performing the daily activity, and they always need a caretaker for assistance. In the clinics, the assessment of tremor is done through a manual clinical rating task such as Unified Parkinson’s disease rating scale which is time taking and cumbersome. Neurologists have also affirmed a challenge in differentiating a Parkinsonian tremor with the pure tremor which is essential in providing an accurate diagnosis. Therefore, there is a need to develop a monitoring and assistive tool for the tremor patient that keep on checking their health condition by coordinating them with the clinicians and caretakers for early diagnosis and assistance in performing the daily activity. In our research, we focus on developing a system for automatic classification of tremor which can accurately differentiate the pure tremor from the Parkinsonian tremor using a wearable accelerometer-based device, so that adequate diagnosis can be provided to the correct patient. In this research, a study was conducted in the neuro-clinic to assess the upper wrist movement of the patient suffering from Pure (Essential) tremor and Parkinsonian tremor using a wearable accelerometer-based device. Four tasks were designed in accordance with Unified Parkinson’s disease motor rating scale which is used to assess the rest, postural, intentional and action tremor in such patient. Various features such as time-frequency domain, wavelet-based and fast-Fourier transform based cross-correlation were extracted from the tri-axial signal which was used as input feature vector space for the different supervised and unsupervised learning tools for quantification of severity of tremor. A minimum covariance maximum correlation energy comparison index was also developed which was used as the input feature for various classification tools for distinguishing the PT and ET tremor types. An automatic system for efficient classification of tremor was developed using feature extraction methods, and superior performance was achieved using K-nearest neighbors and Support Vector Machine classifiers respectively.

Keywords: machine learning approach for neurological disorder assessment, automatic classification of tremor types, feature extraction method for tremor classification, neurological movement disorder, parkinsonian tremor, essential tremor

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Authors: Shawn P. Daly

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Communities heavily engaged in the tourism industry discover their values intersect, meld, and conflict with those of visitors. Maintaining cultural integrity in the face of powerful external pressures causes stress among society members. This effect represents a less studied aspect of sustainable tourism. The present paper brings a perspective unique to the tourism literature: biculturalism. The grounded theories, coherent hypotheses, and validated constructs and indicators of biculturalism represent a sound base from which to consider sociocultural issues in sustainable tourism. Five models describe the psychological state of individuals operating at cultural crossroads: assimilation (joining the new culture), acculturation (grasping the new culture but remaining of the original culture), alternation (varying behavior to cultural context), multicultural (maintaining distinct cultures), and fusion (blending cultures). These five processes divide into two units of analysis (individual and society), permitting research questions at levels important for considering sociocultural sustainability. Acculturation modelling has morphed into dual processes of acculturation (new culture adaptation) and enculturation (original culture adaptation). This dichotomy divides sustainability research questions into human impacts from assimilation (acquiring new culture, throwing away original), separation (rejecting new culture, keeping original), integration (acquiring new culture, keeping original), and marginalization (rejecting new culture, throwing away original). Biculturalism is often cast in terms of its emotional, behavioral, and cognitive dimensions. Required cultural adjustments and varying levels of cultural competence lead to physical, psychological, and emotional outcomes, including depression, lowered life satisfaction and self-esteem, headaches, and back pain—or enhanced career success, social skills, and life styles. Numerous studies provide empirical scales and research hypotheses for sustainability research into tourism’s causality and effect on local well-being. One key issue in applying biculturalism to sustainability scholarship concerns identification and specification of the alternative new culture contacting local culture. Evidence exists for tourism industry, universal tourist, and location/event-specific tourist culture. The biculturalism paradigm holds promise for researchers examining evolving cultural identity and integrity in response to mass tourism. In particular, confirmed constructs and scales simplify operationalization of tourism sustainability studies in terms of human impact and adjustment.

Keywords: biculturalism, cultural integrity, psychological and sociocultural adjustment, tourist culture

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Authors: Ana Julia Acevedo Urquiaga, Jose A. Acevedo Suarez, Ana Julia Urquiaga Rodriguez, Neyfe Sablon Cossio

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Despite the progress made in logistics and supply chains fields, it is unavoidable the development of business models that use efficiently information to facilitate the integrated logistics flows management between partners. Collaborative management is an important tool for materializing the cooperation between companies, as a way to achieve the supply chain efficiency and effectiveness. The first face of this research was a comprehensive analysis of the collaborative planning on the Cuban companies. It is evident that they have difficulties in supply chains planning where production, supplies and replenishment planning are independent tasks, as well as logistics and distribution operations. Large inventories generate serious financial and organizational problems for entities, demanding increasing levels of working capital that cannot be financed. Problems were found in the efficient application of Information and Communication Technology on business management. The general objective of this work is to develop a methodology that allows the deployment of a planning and control system in a coordinated way on the medicine’s logistics system in Cuba. To achieve these objectives, several mechanisms of supply chain coordination, mathematical programming models, and other management techniques were analyzed to meet the requirements of collaborative logistics management in Cuba. One of the findings is the practical and theoretical inadequacies of the studied models to solve the current situation of the Cuban logistics systems management. To contribute to the tactical-operative management of logistics, the Collaborative Logistics Flow Management Model (CLFMM) is proposed as a tool for the balance of cycles, capacities, and inventories, always to meet the final customers’ demands in correspondence with the service level expected by these. The CLFMM has as center the supply chain planning and control system as a unique information system, which acts on the processes network. The development of the model is based on the empirical methods of analysis-synthesis and the study cases. Other finding is the demonstration of the use of a single information system to support the supply chain logistics management, allows determining the deadlines and quantities required in each process. This ensures that medications are always available to patients and there are no faults that put the population's health at risk. The simulation of planning and control with the CLFMM in medicines such as dipyrone and chlordiazepoxide, during 5 months of 2017, permitted to take measures to adjust the logistic flow, eliminate delayed processes and avoid shortages of the medicines studied. As a result, the logistics cycle efficiency can be increased to 91%, the inventory rotation would increase, and this results in a release of financial resources.

Keywords: collaborative management, medicine logistic system, supply chain planning, tactical-operative planning

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Authors: Sergio A. Navarro Tuch, Martin Rogelio Bustamante Bello, Leopoldo Julian Lechuga Lopez

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In recent years, Mexico’s population has seen a rise of different physiological and mental negative states. Two main consequences of this problematic are deficient work performance and high levels of stress generating and important impact on a person’s physical, mental and emotional health. Several approaches, such as the use of audiovisual stimulus to induce emotions and modify a person’s emotional state, can be applied in an effort to decreases these negative effects. With the use of different non-invasive physiological sensors such as EEG, luminosity and face recognition we gather information of the subject’s current emotional state. In a controlled environment, a subject is shown a series of selected images from the International Affective Picture System (IAPS) in order to induce a specific set of emotions and obtain information from the sensors. The raw data obtained is statistically analyzed in order to filter only the specific groups of information that relate to a subject’s emotions and current values of the physical variables in the controlled environment such as, luminosity, RGB light color, temperature, oxygen level and noise. Finally, a neural network based control algorithm is given the data obtained in order to feedback the system and automate the modification of the environment variables and audiovisual content shown in an effort that these changes can positively alter the subject’s emotional state. During the research, it was found that the light color was directly related to the type of impact generated by the audiovisual content on the subject’s emotional state. Red illumination increased the impact of violent images and green illumination along with relaxing images decreased the subject’s levels of anxiety. Specific differences between men and women were found as to which type of images generated a greater impact in either gender. The population sample was mainly constituted by college students whose data analysis showed a decreased sensibility to violence towards humans. Despite the early stage of the control algorithm, the results obtained from the population sample give us a better insight into the possibilities of emotional domotics and the applications that can be created towards the improvement of performance in people’s lives. The objective of this research is to create a positive impact with the application of technology to everyday activities; nonetheless, an ethical problem arises since this can also be applied to control a person’s emotions and shift their decision making.

Keywords: data analysis, emotional domotics, performance improvement, neural network

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Authors: Liliana Gomez Cardona, Echo Parent-Racine, Joy Outerbridge, Arlene Laliberté, Outi Linnaranta

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Suicide rates among Inuit in Nunavik are six to eleven times larger than the Canadian average. The colonization, religious missions, residential schools as well as economic and political marginalization are factors that have challenged the well-being and mental health of these populations. In psychiatry, screening for mental illness is often done using questionnaires with which the patient is expected to respond how often he/she has certain symptoms. However, the Indigenous view of mental wellbeing may not fit well with this approach. Moreover, biomedical treatments do not always meet the needs of Indigenous peoples because they do not understand the culture and traditional healing methods that persist in many communities. Assess whether the questionnaires used to measure symptoms, commonly used in psychiatry are appropriate and culturally safe for the Inuit in Quebec. Identify the most appropriate tool to assess and promote wellbeing and follow the process necessary to improve its cultural sensitivity and safety for the Inuit population. Qualitative, collaborative, and participatory action research project which respects First Nations and Inuit protocols and the principles of ownership, control, access, and possession (OCAP). Data collection based on five focus groups with stakeholders working with these populations and members of Indigenous communities. Thematic analysis of the data collected and emerging through an advisory group that led a revision of the content, use, and cultural and conceptual relevance of the instruments. The questionnaires measuring psychiatric symptoms face significant limitations in the local indigenous context. We present the factors that make these tools not relevant among Inuit. Although the scale called Growth and Empowerment Measure (GEM) was originally developed among Indigenous in Australia, the Inuit in Quebec found that this tool comprehends critical aspects of their mental health and wellbeing more respectfully and accurately than questionnaires focused on measuring symptoms. We document the process of cultural adaptation of this tool which was supported by community members to create a culturally safe tool that helps in resilience and empowerment. The cultural adaptation of the GEM provides valuable information about the factors affecting wellbeing and contributes to mental health promotion. This process improves mental health services by giving health care providers useful information about the Inuit population and their clients. We believe that integrating this tool in interventions can help create a bridge to improve communication between the Indigenous cultural perspective of the patient and the biomedical view of health care providers. Further work is needed to confirm the clinical utility of this tool in psychological and psychiatric intervention along with social and community services.

Keywords: cultural adaptation, cultural safety, empowerment, Inuit, mental health, Nunavik, resiliency

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Authors: Anthony Credoz, Nathalie Nief, Remy Hedacq, Salvador Jordana, Laurent Cazes

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Groundwater monitoring is classically performed in a network of piezometers in industrial sites. Groundwater flow parameters, such as direction, sense and velocity, are deduced from indirect measurements between two or more piezometers. Groundwater sampling is generally done on the whole column of water inside each borehole to provide concentration values for each piezometer location. These flow and concentration values give a global ‘static’ image of potential plume of contaminants evolution in the shallow aquifer with huge uncertainties in time and space scales and mass discharge dynamic. TOTAL R&D Subsurface Environmental team is challenging this classical approach with an innovative dynamic way of characterization of shallow aquifer groundwater. The current study aims at optimizing the tools and methodologies for (i) a direct and multilevel measurement of groundwater velocities in each piezometer and, (ii) a calculation of potential flux of dissolved contaminant in the shallow aquifer. Lab-scale experiments have been designed to test commercial and R&D tools in a controlled sandbox. Multiphysics modeling were performed and took into account Darcy equation in porous media and Navier-Stockes equation in the borehole. The first step of the current study focused on groundwater flow at porous media/piezometer interface. Huge uncertainties from direct flow rate measurements in the borehole versus Darcy flow rate in the porous media were characterized during experiments and modeling. The structure and location of the tools in the borehole also impacted the results and uncertainties of velocity measurement. In parallel, direct-push tool was tested and presented more accurate results. The second step of the study focused on mass flux of dissolved contaminant in groundwater. Several active and passive commercial and R&D tools have been tested in sandbox and reactive transport modeling has been performed to validate the experiments at the lab-scale. Some tools will be selected and deployed in field assays to better assess the mass discharge of dissolved contaminants in an industrial site. The long-term subsurface environmental strategy is targeting an in-situ, real-time, remote and cost-effective monitoring of groundwater.

Keywords: dynamic characterization, groundwater flow, lab-scale, mass flux

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Authors: Lacheheb Dhia Eddine Zakaria, Ballout Amor

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Today, it is necessary to be thrifty for its planet, on one hand the space being a rare, nonrenewable resource, and on the other hand the ecological, economic and social cost of the urban sprawl. It is commonly asserted that the promotion of a more compact and dense city has a positive effect in terms of public costs of investment, functioning and costs for the citizens and the users of the city. It is clear that the modes urban development management have to evolve profoundly, in particular towards a densification favourable to the raising of the urban quality through an ideal urban density on the scale of the individual housing estate. The lot as an individual housing estate was adopted as an alternative development model to the collective housing, thought in an anthropocentric perspective to emerge as a quality model where the density plays an important role, by being included in operations of a global coherence, in an optimal organization without forgetting the main importance of the deadlines of construction and the finalization of the works. The image of eternal construction site inflicted to our cities explains the renewed interest for the application of the regulatory framework and the completion of these limited operations without global coherence, which are summed up in our case to a ground cut in plots of land, sold then built independently without being finished, and support the relevance of the essential question of the improvement of the outside aspect bound to the appearance which can be revealed as a so important factor for a better use and a better acceptance of its housing environment, that the ratio of a number of houses on a plot of land or the number of square meters by house. To demonstrate the impact of the completion degree of the subdivision dwellings, roads system and urban public utilities on the density or the densification and therefore on the urban quality, we studied two residential subdivisions, the private subdivision Sellam and the subdivision El Imane with a common situation, and a different land surface, density and cutting, being occupied by various social classes, with different needs and different household average size. The approach of this work is based on the typo morphological analysis to reveal the differences in the degrees of completions of the subdivision’s built environment and on the investigation, by a household’s survey, to demonstrate importance of the degree of completion and to reveal the conditions of qualitative densification favourable and convenient to a better subdivision’s appropriation.

Keywords: subdivision, degree of completion, densification, urban quality

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Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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Authors: Brittany Richardson, Ying Wang

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For physical therapy, exercise prescription, athlete training, and regular fitness training, it is crucial to perform health assessments or fitness assessments periodically. An accurate assessment is propitious for tracking recovery progress, preventing potential injury and making long-range training plans. Assessments include necessary measurements, height, weight, blood pressure, heart rate, body fat, etc. and advanced evaluation, muscle group strength, stability-mobility, and movement evaluation, etc. In the current standard assessment procedures, the accuracy of assessments, especially advanced evaluations, largely depends on the experience of physicians, coaches, and personal trainers. And it is challenging to track clients’ progress in the current assessment. Unlike the tradition assessment, in this paper, we present a deep learning based face recognition algorithm for accurate, comprehensive and trackable assessment. Based on the result from our assessment, physicians, coaches, and personal trainers are able to adjust the training targets and methods. The system categorizes the difficulty levels of the current activity for the client or user, furthermore make more comprehensive assessments based on tracking muscle group over time using a designed landmark detection method. The system also includes the function of grading and correcting the form of the clients during exercise. Experienced coaches and personal trainer can tell the clients' limit based on their facial expression and muscle group movements, even during the first several sessions. Similar to this, using a convolution neural network, the system is trained with people’s facial expression to differentiate challenge levels for clients. It uses landmark detection for subtle changes in muscle groups movements. It measures the proximal mobility of the hips and thoracic spine, the proximal stability of the scapulothoracic region and distal mobility of the glenohumeral joint, as well as distal mobility, and its effect on the kinetic chain. This system integrates data from other fitness assistant devices, including but not limited to Apple Watch, Fitbit, etc. for a improved training and testing performance. The system itself doesn’t require history data for an individual client, but the history data of a client can be used to create a more effective exercise plan. In order to validate the performance of the proposed work, an experimental design is presented. The results show that the proposed work contributes towards improving the quality of exercise plan, execution, progress tracking, and performance.

Keywords: exercise prescription, facial recognition, landmark detection, fitness assessments

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

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

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

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Authors: Thel Phyu Phyu Soe

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Myanmar started its new political movement in 2011, opening up to trade, encouraging foreign investment, deepening its financial sectors. The tourism is one of the key sectors to make reform process from the perspective of green economy and green growth. The Inle Lake, second largest lake, famous for broad diversity of cultural and natural assets, become one of the country’s main tourism destination. In the study area, local livelihoods are based on a combination of farming (mainly floating garden) wage labor, tourism, and small business. But the Inle lake water body or water surface area decreased by 96.44 km² within 20 years, from 67.98 km² in 1990 to 56.63 km² in 2010. Floating garden cultivation (hydro phonic farm) is a distinguished characteristic of Inle Lake. Two adjacent villages (A and B) were selected to compare the relationship between tourism access and agricultural production. Ground truthing, focus group discussion, and in-depth questionnaires with floating gardeners were carried out. In A village, 57% of the respondents relied tourism as their major income sources, while almost all the households in B village relied floating gardens as major livelihood. Both satellite image interpretation and community studies highlighted that around 80% of the floating garden become fallow after severe drought in 2010 and easy income access to tourism related activities. The villagers can get 20-30 US$ for round trip guiding to major tourist attraction places.Even though tourism is the major livelihood options for the A village, the poorest households (less than 1500 US$ per year) are those who didn’t own transportation property for tourism related activities. In B village, more than 70% of the households relied floating gardens as their major income sources and less participated in tourism related activities because they don’t have motorboat stand connected to the major tourist attraction areas. Access to tourism related activities (having boat stand where they can guide tourists by boat and sell local products and souvenirs) have much impacted on changes in local people livelihood options. However, tourism may have impacts that are beneficial for one group of a society, but which are negative for another. Income inequality and negative impacts can only be managed effectively if they have been identified, measured and evaluated. The severe drought in 2010, instability of lake water level, high expenses for agriculture assisted the local people to participate in easy access tourism related activities.

Keywords: diminishing, floating garden, livelihood, tourism-related income

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Authors: Sudipta Garai

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Films as a cultural, social practice remains a dominant space for creation and destruction of ideologies and practices which make the sociological viewing, analysis, and interpretation of the same a complex affair. It remains the doorway between the interpretations and understanding of the writer/director and the reader/viewer. India, being a multi-linguistic culture, the media plays a much intriguing role than that of newspaper, books, stories, novels or any other medium of expression. Known to be the largest democracy, the State seem to guarantee and safeguard people’s choices and life of dignity through its Fundamental Rights and Directives. However, the laws contradict themselves when it comes to IPC 377 criminalizing anything except penovaginal sexual intercourse restricting alternative sexual preferences and practices questioning its sense of ‘democracy.' In this context, the issue of homosexuality came up in bits and pieces through various representations in ‘popular’ cinema mostly with sudden references of mockery and laughter where the explicit narratives of ‘queer’ seemed missing. Rituparno Ghosh, an eminent film maker of Bengal, came up as the ‘queer’ face in Kolkata specifically through his ‘queer’ trilogy (Memories in March, 2010; Arekti Premer Golpo, 2010; Chitrangada: A Crowning Wish, 2012) coming out of his own closet and speaking about his own sexual choices not only through the explicit narratives in films but also in person which made these films an important point of departure in Bengali film history. A sociological reading of these films through a discourse analysis is being done with the critical questions of ‘choice,' ’freedom,' ‘love and marriage’ and most importantly the ‘change.' This study not only focuses on the films and its analysis of content but also to engage with its audience, queer and not in order to extend beyond the art form into the actual vulnerabilities of life and experiences through informal interviews, focused group discussions and engaging with the real life narratives. A research of this kind is always looked upon as a medium of change hoping for a better world wiping away the discrimination and ‘shame’ the ‘queer’ faces in their everyday life, but a social science research is limited but its ‘time’ and academic boundary where the hope of change might be initiated but not fulfilled. The experiences and reflections of the ‘queer’ not only redefined the narratives of the films but also me as a researcher. The perspectives of the ‘hetero-normative’ informants gave a broader picture of the study and the socio-cultural complications that are intrigued with the ideas of resistance and change. The issues on subjectivity, power, and position couldn’t be wiped out in a study of this kind as both politics and aesthetics become integrated with each other in the creation of any art form be it films or a study of research.

Keywords: cinema, alternative sexualities, narratives, sexual choices, state and society

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Authors: Maria Angela Bedini, Fabio Bronzini

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The Italian experiences, positive and negative, of the post-earthquake are conditioned by long times and structural bureaucratic constraints, also motivated by the attempt to contain mafia infiltration and corruption. The transition from the operational phase of the emergency to the planning phase of the reconstruction project is thus hampered by a series of inefficiencies and delays, incompatible with the need for rapid recovery of the territories in crisis. In fact, intervening in areas affected by seismic events means at the same time associating the reconstruction plan with an urban and territorial rehabilitation project based on strategies and tools in which prevention and safety play a leading role in the regeneration of territories in crisis and the return of the population. On the contrary, the earthquakes that took place in Italy have instead further deprived the territories affected of the minimum requirements for habitability, in terms of accessibility and services, accentuating the depopulation process, already underway before the earthquake. The objective of this work is to address with implementing and programmatic tools the procedures and strategies to be put in place, today and in the future, in Italy and abroad, to face the challenge of the reconstruction of activities, sociality, services, risk mitigation: a protocol of operational intentions and firm points, open to a continuous updating and implementation. The methodology followed is that of the comparison in a synthetic form between the different Italian experiences of the post-earthquake, based on facts and not on intentions, to highlight elements of excellence or, on the contrary, damage. The main results obtained can be summarized in technical comparison cards on good and bad practices. With this comparison, we intend to make a concrete contribution to the reconstruction process, certainly not only related to the reconstruction of buildings but privileging the primary social and economic needs. In this context, the recent instrument applied in Italy of the strategic urban and territorial SUM (Minimal Urban Structure) and the strategic monitoring process become dynamic tools for supporting reconstruction. The conclusions establish, by points, a protocol of interventions, the priorities for integrated socio-economic strategies, multisectoral and multicultural, and highlight the innovative aspects of 'inversion' of priorities in the reconstruction process, favoring the take-off of 'accelerator' interventions social and economic and a more updated system of coexistence with risks. In this perspective, reconstruction as a necessary response to the calamitous event can and must become a unique opportunity to raise the level of protection from risks and rehabilitation and development of the most fragile places in Italy and abroad.

Keywords: an operational protocol for reconstruction, operational priorities for coexistence with seismic risk, social and economic interventions accelerators of building reconstruction, the difficult post-earthquake reconstruction in Italy

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Authors: Claudia Rodriguez-Espinosa, Erika Elizabeth Pérez Múzquiz

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Since the creation of the “Pueblos Mágicos” program in 2001, a series of social and cultural events had directly affected the heritage conservation of the 121 registered localities until 2018, when the federal government terminated the program. Many studies have been carried out that seek to analyze from different perspectives and disciplines the consequences that these appointments have generated in the “Pueblos Mágicos.” Multidisciplinary groups such as the one headed by Carmen Valverde and Liliana López Levi, have brought together specialists from all over the Mexican Republic to create a set of diagnoses of most of these settlements, and although each one has unique specificities, there is a constant in most of them that has to do with the loss of cultural heritage and that is related to transculturality. There are several factors identified that have fostered a cultural loss, as a direct reflection of the economic crisis that prevails in Mexico. It is important to remember that the origin of this program had as its main objective to promote the growth and development of local economies since one of the conditions for entering the program is that they have less than 20,000 inhabitants. With this goal in mind, one of the first actions that many “Pueblos Mágicos” carried out was to improve or create an infrastructure to receive both national and foreign tourists since this was practically non-existent. Creating hotels, restaurants, cafes, training certified tour guides, among other actions, have led to one of the great problems they face: globalization. Although by itself it is not bad, its impact in many cases has been negative for heritage conservation. The entry into and contact with new cultures has led to the undervaluation of cultural traditions, their transformation and even their total loss. This work seeks to present specific cases of transformation and loss of cultural heritage, as well as to reflect on the problem and propose scenarios in which the negative effects can be reversed. For this text, 36 “Pueblos Mágicos” have been selected for study, based on those settlements that are cited in volumes I and IV (the first and last of the collection) of the series produced by the multidisciplinary group led by Carmen Valverde and Liliana López Levi (researchers from UNAM and UAM Xochimilco respectively) in the project supported by CONACyT entitled “Pueblos Mágicos. An interdisciplinary vision”, of which we are part. This sample is considered representative since it forms 30% of the total of 121 “Pueblos Mágicos” existing at that moment. With this information, the elements of its intangible heritage loss or transformation have been identified in every chapter based on the texts written by the participants of that project. Finally, this text shows an analysis of the effects that this federal program, as a public policy applied to 132 populations, has had on the conservation or transformation of the intangible cultural heritage of the “Pueblos Mágicos.” Transculturality, globalization, the creation of identities and the desire to increase the flow of tourists have impacted the changes that traditions (main intangible cultural heritage) have had in the 18 years that the federal program lasted.

Keywords: public policies, cultural tourism, heritage preservation, pueblos mágicos program

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Authors: Ian Kingsbury

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The rapid expansion of charter schools (public schools that receive government but do not face the same regulations as traditional public schools) over the preceding two decades has raised concerns over the potential for graft and fraud. These concerns are largely justified: Incidents of financial crime and mismanagement are not unheard of, and the charter sector has become a darling of hedge fund managers. In response, several states have strengthened their charter school regulatory regimes. Imposing regulations and attempting to increase accountability seem like sensible measures, and perhaps they are necessary. However, increased regulation may come at the cost of imposing barriers to entry. Specifically, increased regulation often entails evidence for a high likelihood of fiscal solvency. That should theoretically entail access to capital in the short-term, which may systematically preclude Black or Hispanic applicants from opening charter schools. Moreover, increased regulation necessarily entails more red tape. The institutional wherewithal and the number of hours required to complete an application to open a charter school might favor those who have partnered with an education service provider, specifically a charter management organization (CMO) or education management organization (EMO). These potential barriers to entry pose a significant policy concern. Just as policymakers hope to increase the share of minority teachers and principals, they should sensibly care whether individuals who open charter schools look like the students in that school. Moreover, they might be concerned if successful applications in states with stringent regulations are overwhelmingly affiliated with education service providers. One of the original missions of charter schools was to serve as a laboratory of innovation. Approving only those applications affiliated with education service providers (and in effect establishing a parallel network of schools rather than a diverse marketplace of schools) undermines that mission. Data and methods: The analysis examines more than 2,000 charter school applications from 15 states. It compares the outcomes of applications from states with a strong regulatory environment (those with high scores) from NACSA-the National Association of Charter School Authorizers- to applications from states with a weak regulatory environment (those with a low NACSA score). If the hypothesis is correct, applicants not affiliated with an ESP are more likely to be rejected in high-regulation states compared to those affiliated with an ESP, and minority candidates not affiliated with an education service provider (ESP) are particularly likely to be rejected. Initial returns indicate that the hypothesis holds. More applications in low NASCA-scoring Arizona come from individuals not associated with an ESP, and those individuals are as likely to be accepted as those affiliated with an ESP. On the other hand, applicants in high-NACSA scoring Indiana and Ohio are more than 20 percentage points more likely to be accepted if they are affiliated with an ESP, and the effect is particularly pronounced for minority candidates. These findings should spur policymakers to consider the drawbacks of charter school accountability and consider accountability regimes that do not impose barriers to entry.

Keywords: accountability, barriers to entry, charter schools, choice

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Authors: Rameshwar Dahal, S. Ping Ho

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Although the demand for infrastructure development forms a promising market opportunity for international firms, the dominance of informal institutions over formal ones, investors are facing extraordinary institutional challenges when investing in emerging Least Developed Countries (LDCs). We believe that, in emerging LDCs, the project performance heavily depends on how well the entrants respond to the challenges exerted by the host institutional environments. Which primarily depends on how much they learn about the host institution and what strategy they apply in response. In Nepal, almost all international or global infrastructure projects are financed by international financers, so the procurement process of the infrastructure projects financed by foreign agencies is guided by the policies and regulations of the financer. Because of limited resources and the financers’ demand, contractors and consults are procured internationally. Moreover, the resources, including but not limited to construction material, manpower, and equipment, also need to be imported. Therefore, the involvement of international companies as an entrant in global infrastructure projects of LDCs is obvious. In a global project (GP), participants from different geographical and institutional environments hold different beliefs and have disparate interests. Therefore, the entrants face the challenges exerted by the host institutional environments. The entrants must either adapt to the institutions prevailing in the environment or resist the institutional pressures. It is hypothesized that, in emerging LDCs, the project performance heavily depends on how much the entrants learn about the host institutional knowledge and how well they respond to the institutional environments. While it is impossible to generalize the phenomenon and contextual conditions because of their vast diversity, this study has answered why and how participants’ level of institutional knowledge impacts the project's implementation performance. To draw that conclusion, firstly, we explored two typical GPs from Nepal. For this study, the data were collected by conducting interviews and examining the secondary data, such as the project reports published by the financers, project data provided by interviewees, and news reports. In an event analysis, firstly, we identify the sources, causes, or nature of the institutional challenges; secondly, we analyze the entrant’s responses to the exerted challenges and evaluate the impacts of the responses on the overall project performance. In this study, at first, the events occurred during the project implementation process have a causal link with the local institutions that demand the entrants’ response are extracted. Secondly, each event is scrutinized as the critical success factor of the case project. Finally, it is crucially examined whether and what institutional knowledge in these events played a critical role in project success or failure. The results also provide insights into the crucial institutional knowledge in LDCs and the subsequent strategy implications for undertaking projects in LDCs.

Keywords: emerging countries, LDC, project management, project performance, institutional knowledge, institutional theory

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Authors: Nikou Javadi, Uğur Dağlı

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The importance of culture and tourism in the attractiveness and competitiveness of the countries is central, and many regions are evidencing their cultural assets, tangible and intangible, as a means to create comparative advantages in tourism and produce a distinctive place in response to the pressures of globalization. Culture and tourism are interlinked because of their obvious combination and growth potential. Cultural tourism is a crucial global tourism market with fast growing. Regions can develop significant relations between culture and tourism to increase their attractiveness as places to visit, live and invest, increasing their competitiveness. Accordingly, having new and creative approach to historical areas as cultural value-based destinations can improve their conditions to promote tourism. Furthermore, in 21st century, media become the most important factor affecting the development of urban cities, including public places. As a result of the digital revolution, re-imaging and re-linkage public places by media are essential to create more interactions between public spaces and users, interaction media display, and urban screens, one of the most important defined media. This interaction can transform the urban space from being neglected to be more interactive space with users, especially the pedestrians. The paper focuses on The Walled City of Famagusta. As many other historic quarters elsewhere in the world, is in a process, of decay and deterioration, and its functionally distinctive areas are severely threatened by physical, functional, locational, and image obsolescence at varying degrees. So the focus on the future development of this area through tourism promotion can be an appropriate decision for the monument enhancement of the spatial quality in Walled City of Famagusta. In this paper, it is aimed to identify the effects of these new digital factors to transform public spaces especially in historic urban areas to promote creative tourism. Accordingly, two different analysis methods are used as well as a theoretical review. The first is case study on site and the second is Close ended questionnaire, test many concepts raised in this paper. The physical analysis on site carried out in order to evaluate the walled city restoration for touristic purpose. Besides, theoretical review is done in order to provide background to the subject and cleared Factors to attract tourists.

Keywords: historical areas, media façade, sustainable tourism, Walled city of Famagusta

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Authors: Wandera Stephen Ojumbo

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People living with hearing impairment in Uganda are one of the most excluded minority groups in the country. The Uganda National Association of the Deaf estimates that deaf people make up 3.4% of Uganda’s 43 million people. Deaf Children and youth often appear withdrawn because they face social stigma. In 2009, photojournalist Stephen Wandera Ojumbo conducted an exhibition in Kampala titled “Silent Voices with colourful Hearts” showcasing the life of deaf children at Uganda School for the Deaf, Ntinda, in order to create awareness of their plight, raising funds for the construction of a vocational centre for the deaf that didn’t continue their education due to: lack of funds, non-inclusive educational institutions, and for those who cannot read and write. These children, whose lives were exhibited in 2009, are currently youths. In Uganda, there are just five primary schools for the deaf (three of these are located in Kampala, the capital city), and barely five secondary schools for the deaf. At the moment, some deaf children only receive special needs training equivalent to primary seven levels and the majority don’t make it to secondary school education level due to the fact that English is a second language to them. There is a communication gap between speaking parents and deaf children, which leads to the breakage of family bonds. The deaf youth run away from their homes to form a community where they can communicate freely. Likewise, employment opportunities for the deaf are equally very limited. It’s for this reason that a follow-up photo exhibition was conducted to expose more about what the youthful deaf people and their guardians go through in Uganda to get jobs, live and fit in the community, how they communicate and get understood, bonding with families instead of running away to bond with fellow deaf persons. The photo exhibition under the theme “Loud Silence” was significant in showcasing the ability of deaf youths in Uganda and eliciting solutions to make a more inclusive society for the deaf. It is hoped that partners in development will join in for intervention. The methodology used included individual interviews with the deaf youth and their parents and caretakers; photography at household and community levels; document review at organizations working with the deaf; observations; and key informant interviews with relevant personnel working with the deaf. Some of the major findings include: i) Effective sign language communication is key in deaf education, family bonding, and developing a sense of belonging; ii) Love and intimacy can keep the deaf bound together; iii) Education is important; everybody should struggle even if alone; iv) Games and sports are a unifying factor and most loved among the deaf; and v) better communication skills build confidence in deaf youth. In conclusion, concerted efforts are still needed to make Uganda schools more inclusive for deaf persons. This will enable a secure future for deaf youths.

Keywords: deaf, education, excluded, photo exhibition

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Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries

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Background: Commonly, womanhood is defined as the qualities considered to be natural to or characteristic of a woman. However, womanhood is not a static concept; it is contextual and negotiable. For women with disabilities, gender roles or ‘qualities’ of womanhood are often overstated or contradicted because of assumptions of weakness, passivity, asexuality and infertility. Currently, little is known about how disability stigma intersects with notions of womanhood to make women with disabilities vulnerable to violence, or how women navigate this intersection to prevent or protect themselves from violence. Objective: To describe how the stigmatized constructions of womanhood and disability promote women with physical disabilities’ exposure to or protection from violence. Methods: Qualitative data for this paper comes from a doctoral study involving women with disabilities living in Cape Town, South Africa. It presents data from repeat in-depth interviews with 30 women with a range of physical impairments. Women attending protective workshops, rehabilitative centers and residential care facilities for people living with disabilities were invited to participate. Consent procedures and interviews were conducted by the first author (who is herself a woman living with a physical disability), and a female research assistant/translator who is a qualified occupational therapist. Reasonable accommodation is central to the methodology and the study as a whole. Findings: Descriptive and thematic analyses reveal how stigma and local constructions around womanhood, as well as women’s self-image and physical limitations, promotes women’s exposure to psychological, physical and sexual violence. It reveals how disabled women feel they are presumed incapable of living up to expectations of a ‘proper’ woman. This plays out as psychological violence, with women reporting that they feel ‘devalued,' ‘rejected’ and deprived of lasting intimate relationships. Furthermore, forms of psychological violence perpetuate physical and sexual violence. Women also discuss using strategies to prevent violence; by refusing to date, avoiding certain places or avoiding isolation, creating awareness, hiding their physical impairments, and exaggerating their ‘femininity.' Implications: Service providers need to be made aware of women’s violence experiences, and provide a range of accessible psychological and mental health services to women living with disabilities, as well as raising awareness around disability, and violence prevention, among caregivers, men, and women. Violence awareness and prevention interventions need to involve disability experts, researchers and people with disabilities.

Keywords: disability, gender, stigma, violence awareness and prevention interventions

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Authors: Annie Singh, Ishaan Singh

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Background: Transgenders are people who have a gender identity different from their sex assigned at birth. Their gender behaviour doesn’t match their body anatomy. The community faces discrimination due to their gender identity all across the world. The term transgender is an umbrella term for many people non-conformal to their biological identity; note that the term transgender is different from gender dysphoria, which is a DSM-5 disorder defined as problems faced by an individual due to their non-conforming gender identity. Transgender people have been a part of Indian culture for ages yet have continued to face exclusion and discrimination in society. This has led to the low socio-economic status of the community. Various studies done across the world have established the role of discrimination, harassment and exclusion in the development of psychological disorders. The study is aimed to assess the frequency of stress and anxiety in the transgender population and understand the various factors affecting the same. Methodology: A cross-sectional survey of self consenting transgender individuals above the age of 18 residing in Delhi was done to assess their socioeconomic status and experiential ecology. Recruitment of participants was done with the help of NGOs. The survey was constructed GAD-7 and PSS-10, two well-known scales were used to assess the stress and anxiety levels. Medians, means and ranges are used for reporting continuous data wherever required, while frequencies and percentages are used for categorical data. For associations and comparison between groups in categorical data, the Chi-square test was used, while the Kruskal-Wallis H test was employed for associations involving multiple ordinal groups. SPSS v28.0 was used to perform the statistical analysis for this study. Results: The survey showed that the frequency of stress and anxiety is high in the transgender population. A demographic survey indicates a low socio-economic background. 44% of participants reported facing discrimination on a daily basis; the frequency of discrimination is higher in transwomen than in transmen. Stress and anxiety levels are similar among both transmen and transwomen. Only 34.5% of participants said they had receptive family or friends. The majority of participants (72.7%) reported a positive or neutral experience with healthcare workers. The prevalence of discrimination is significantly lower in the higher educated groups. Analysis of data shows a positive impact of acceptance and reception on mental health, while discrimination is correlated with higher levels of stress and anxiety. Conclusion: The prevalence of widespread transphobia and discrimination faced by the transgender community has culminated in high levels of stress and anxiety in the transgender population and shows variance according to multiple socio-demographic factors. Educating people about the LGBT community formation of support groups, policies and laws are required to establish trust and promote integration.

Keywords: transgender, gender, stress, anxiety, mental health, discrimination, exclusion

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Authors: Yu Zhang, Mingxue Lang, Li Dong

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The hundreds of years of slow succession of living environment in rural area is a crucial carrier of China’s long history of culture and national wisdom. In recent years, the space evolution of traditional rural settlements has been promoted by the intervention of tourism development, among which the public architecture and outdoor activity areas together served as the major places for villagers, and tourists’ social activities are an important characterization for settlement spatial evolution. Traditional public space upgrade and layout study of new public space can effectively promote the tourism industry development of traditional rural settlements. This article takes Qi County, one China Traditional Culture Village as the exemplification and uses the technology of Remote Sensing (RS), Geographic Information System (GIS) and Space Syntax, studies the evolution features of public space of tourism-oriented traditional rural settlements in four steps. First, acquire the 2003 and 2016 image data of Qi County, using the remote sensing application EDRAS8.6. Second, vectorize the basic maps of Qi County including its land use map with the application of ArcGIS 9.3 meanwhile, associating with architectural and site information concluded from field research. Third, analyze the accessibility and connectivity of the inner space of settlements using space syntax; run cross-correlation with the public space data of 2003 and 2016. Finally, summarize the evolution law of the public space of settlements; study the upgrade pattern of traditional public space and location plan for new public space. Major findings of this paper including: first, location layout of traditional public space has a larger association with the calculation results of space syntax and further confirmed the objective value of space syntax in expressing the space and social relations. Second, the intervention of tourism development generates remarkable impact on public space location of tradition rural settlements. Third, traditional public space produces the symbols of both strengthening and decline and forms a diversified upgrade pattern for the purpose of meeting the different tourism functional needs. Finally, space syntax provides an objective basis for location plan of new public space that meets the needs of tourism service. Tourism development has a significant impact on the evolution of public space of traditional rural settlements. Two types of public space, architecture, and site are both with changes seen from the perspective of quantity, location, dimension and function after the intervention of tourism development. Function upgrade of traditional public space and scientific layout of new public space are two important ways in achieving the goal of sustainable development of tourism-oriented traditional rural settlements.

Keywords: public space evolution, Qi county, space syntax, tourism oriented, traditional rural settlements

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Authors: G. P. Gunasinghe, Lilani Ruhunage, N. P. Ratnayake, G. V. I. Samaradivakara, H. M. R. Premasiri, A. S. Ratnayake, Nimila Dushantha, W. A. P. Weerakoon, K. B. A. Silva

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Sri Lanka is affected by different natural disasters such as tsunami, landslides, lightning, and riverine flood. Out of them, riverine floods act as a major disaster in the country. Different strategies are applied to control the impacts of flood hazards, and the expansion of river mouth is considered as one of the main activities for flood mitigation and disaster reduction. However, due to this expansion process, natural sand barriers including sand spits, barrier islands, and tidal planes are destroyed or subjected to change. This, in turn, can change the hydrodynamics and sediment dynamics of the area leading to other damages to the natural coastal features. The removal of a considerable portion of naturally formed sand barrier at Kaluganga River outlet (Calido Beach), Sri Lanka to control flooding event at Kaluthara urban area on May 2017, has become a serious issue in the area causing complete collapse of river mouth barrier spit bar system leading to rapid coastal erosion Kaluganga river outlet area and saltwater intrusion into the Kaluganga River. The present investigation is focused on assessing effects due to the removal of a considerable portion of naturally formed sand barrier at Kaluganga river mouth. For this study, the beach profiles, the bathymetric surveys, and Google Earth historical satellite images, before and after the flood event were collected and analyzed. Furthermore, a beach boundary survey was also carried out in October 2018 to support the satellite image data. The results of Google Earth satellite images and beach boundary survey data analyzed show a chronological breakdown of the sand barrier at the river outlet. The comparisons of pre and post-disaster bathymetric maps and beach profiles analysis revealed a noticeable deepening of the sea bed at the nearshore zone as well. Such deepening in the nearshore zone can cause the sea waves to break very near to the coastline. This might also lead to generate new diffraction patterns resulting in differential coastal accretion and erosion scenarios. Unless immediate mitigatory measures were not taken, the impacts may cause severe problems to the sensitive Kaluganag river mouth system.

Keywords: bathymetry, beach profiles, coastal features, river outlet, sand barrier, Sri Lanka

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Authors: Marta Kaprzyk

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The cinema of Alejandro González Iñárritu hasn’t been subjected to a lot of detailed analysis yet, what makes it an exceptionally interesting research material. The purpose of this presentation is to discuss the significance of urban space in three films of this Mexican director, that forms Death Trilogy: ‘Amores Perros’ (2000), ‘21 Grams’ (2003) and ‘Babel’ (2006). The fact that in the aforementioned movies the urban space itself becomes an additional protagonist with its own identity, psychology and the ability to transform and affect other characters, in itself warrants for independent research and analysis. Independently, such mode of presenting urban space has another function; it enables the director to complement the rest of characters. The basis for methodology of this description of cinematographic space is to treat its visual layer as a point of departure for a detailed analysis. At the same time, the analysis itself will be supported by recognised academic theories concerning special issues, which are transformed here into essential tools necessary to describe the world (mise-en-scène) created by González Iñárritu. In ‘Amores perros’ the Mexico City serves as a scenery – a place full of contradictions- in the movie depicted as a modern conglomerate and an urban jungle, as well as a labyrinth of poverty and violence. In this work stylistic tropes can be found in an intertextual dialogue of the director with photographies of Nan Goldin and Mary Ellen Mark. The story recounted in ‘21 Grams’, the most tragic piece in the trilogy, is characterised by almost hyperrealistic sadism. It takes place in Memphis, which on the screen turns into an impersonal formation full of heterotopias described by Michel Foucault and non-places, as defined by Marc Augé in his essay. By contrast, the main urban space in ‘Babel’ is Tokio, which seems to perfectly correspond with the image of places discussed by Juhani Pallasmaa in his works concerning the reception of the architecture by ‘pathological senses’ in the modern (or, even more adequately, postmodern) world. It’s portrayed as a city full of buildings that look so surreal, that they seem to be completely unsuitable for the humans to move between them. Ultimately, the aim of this paper is to demonstrate the coherence of the manner in which González Iñárritu designs urban spaces in his Death Trilogy. In particular, the author attempts to examine the imperative role of the cities that form three specific microcosms in which the protagonists of the Mexican director live their overwhelming tragedies.

Keywords: cinematographic space, Death Trilogy, film Studies, González Iñárritu Alejandro, urban space

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Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

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Authors: Tahmina Huq

Abstract:

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

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

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Authors: Sherine S. Aly, Fahd A. Hemeida, Mohamed A. Elshamy

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In the face of rapid urbanization and the myriad challenges posed by climate change, population growth, and socio-economic disparities, fostering urban resilience has become paramount. This abstract offers a comprehensive overview of the study on "Urban Resilience Challenges," exploring the background, methodologies, major findings, and concluding insights. The paper unveils a spectrum of challenges encompassing environmental stressors and deep-seated socio-economic issues, such as unequal access to resources and opportunities. Emphasizing their interconnected nature, the study underscores the imperative for holistic and integrated approaches to urban resilience, recognizing the intricate web of factors shaping the urban landscape. Urbanization has witnessed an unprecedented surge, transforming cities into dynamic and complex entities. With this growth, however, comes an array of challenges that threaten the sustainability and resilience of urban environments. This study seeks to unravel the multifaceted urban resilience challenges, exploring their origins and implications for contemporary cities. Cities serve as hubs of economic, social, and cultural activities, attracting diverse populations seeking opportunities and a higher quality of life. However, the urban fabric is increasingly strained by climate-related events, infrastructure vulnerabilities, and social inequalities. Understanding the nuances of these challenges is crucial for developing strategies that enhance urban resilience and ensure the longevity of cities as vibrant and adaptive entities. This paper endeavors to discern strategic guidelines for enhancing urban resilience amidst the dynamic challenges posed by rapid urbanization. The study aims to distill actionable insights that can inform strategic approaches. Guiding the formulation of effective strategies to fortify cities against multifaceted pressures. The study employs a multifaceted approach to dissect urban resilience challenges. A qualitative method will be employed, including comprehensive literature reviews and data analysis of urban vulnerabilities that provided valuable insights into the lived experiences of resilience challenges in diverse urban settings. In conclusion, this study underscores the urgency of addressing urban resilience challenges to ensure the sustained vitality of cities worldwide. The interconnected nature of these challenges necessitates a paradigm shift in urban planning and governance. By adopting holistic strategies that integrate environmental, social, and economic considerations, cities can navigate the complexities of the 21st century. The findings provide a roadmap for policymakers, planners, and communities to collaboratively forge resilient urban futures that withstand the challenges of an ever-evolving urban landscape.

Keywords: resilient principles, risk management, sustainable cities, urban resilience

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