Search results for: face skin cancer

Authors: Madhura Yadav

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Urban redevelopment planning initiatives in developing countries have been largely criticised due to top-down planning approach and lack of involvement of the targeted beneficiaries which have led to a challenging situation which is contrary to the perceived needs of beneficiaries. Urban renewal projects improve the lives of people and meaningful participation of community plays a pivotal role. Public perceptions on satisfaction and participation have been given less priority in the investigation, which hinders effective planning and implementation of urban renewal projects. Moreover, challenges of community participation in urban renewal projects are less documented, particularly in relation to public participation and satisfaction. There is a need for new paradigm shift focusing on community participatory approach in urban renewal projects. The over 125-year-old Bhendi Bazar in Mumbai, India is the country’s first ever cluster redevelopment project, popularly known as Bhendi Bazaar redevelopment and it will be one of the largest projects for urban rejuvenation of one of Mumbai’s oldest and dying inner city areas. The project is led by the community trust, inputs were taken from various stakeholders, including residents, commercial tenants and expert consultants to shape the master plan and design of the project. The project started in 2016 but there is a significant delay in implementing the project. The study aimed at studying and assessing public perceptions on satisfaction and the relationship between community participation and community satisfaction in Bhendi Bazaar of Mumbai, India. Furthermore, the study will outline the challenges and problems of community participation in urban renewal projects and it suggests recommendations for the future. The qualitative and quantitative methods such as reconnaissance survey, key informant interviews, focus group discussions, walking interviews, a narrative inquiry is used for analysis of data. Preliminary findings revealed that all tenants are satisfied for the redevelopment of an area but the willingness of residential tenants to move in transit accommodation has made the projects successful and reductant of some residential and commercial tenants, regulatory provisions rising to face challenges in implementation. Experiences from the case study can help to understand dynamics behind public participation and government. At the same time, they serve as an inspiration and learning opportunity for future projects to ensure that they are sustainable not only from an economic standpoint but also, a social perspective.

Keywords: urban renewal, Bhendi Bazaar, community participation, satisfaction, social perspective

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Authors: Jeremy Johnson, Craig Nitschke, Luke Kelly

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Fire regimes, climate and topographic gradients interact to influence ecosystem structure and function across fire-prone, montane landscapes worldwide. Biota have developed a range of adaptations to historic fire regime thresholds, which allow them to persist in these environments. In south-eastern Australia, a signal of fire regime changes is emerging across these landscapes, and anthropogenic climate change is likely to be one of the main drivers of an increase in burnt area and more frequent wildfire over the last 25 years. This shift has the potential to modify vegetation structure and composition at broad scales, which may lead to landscape patterns to which biota are not adapted, increasing the likelihood of local extirpation of some mammal species. This study aimed to address concerns related to the influence of abrupt changes in fire regimes on mammal populations in montane landscapes. It first examined the impact of climate, topography, and vegetation on fire patterns and then explored the consequences of these changes on mammal populations and their habitats. Field studies were undertaken across diverse vegetation, fire severity and fire frequency gradients, utilising camera trapping and passive acoustic monitoring methodologies and the collection of fine-scale vegetation data. Results show that drought is a primary contributor to fire regime shifts at the landscape scale, while topographic factors have a variable influence on wildfire occurrence at finer scales. Frequent, high severity wildfire influenced forest structure and composition at broad spatial scales, and at fine scales, it reduced occurrence of hollow-bearing trees and promoted coarse woody debris. Mammals responded differently to shifts in forest structure and composition depending on their habitat requirements. This study highlights the complex interplay between fire regimes, environmental gradients, and biotic adaptations across temporal and spatial scales. It emphasizes the importance of understanding complex interactions to effectively manage fire-prone ecosystems in the face of climate change.

Keywords: fire, ecology, biodiversity, landscape ecology

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Authors: B. Cilek Tatar, G. Sumnu, M. Oztop, E. Ayaz

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Encapsulation protects sensitive food ingredients against heat, oxygen, moisture and pH until they are released to the system. It can mask the unwanted taste of nutrients that are added to the foods for fortification purposes. Cherry laurels (Prunus laurocerasus) contain phenolic compounds which decrease the proneness to several chronic diseases such as types of cancer and cardiovascular diseases. The objective of this research was to study the effects of centrifugation, different coating materials and homogenization methods on microencapsulation of powders obtained from cherry laurels. In this study, maltodextrin and mixture of maltodextrin:whey protein with a ratio of 1:3 (w/w) were chosen as coating materials. Total solid content of coating materials was kept constant as 10% (w/w). Capsules were obtained from powders of freeze-dried cherry laurels through encapsulation process by silent crusher homogenizer or microfluidization. Freeze-dried cherry laurels were core materials and core to coating ratio was chosen as 1:10 by weight. To homogenize the mixture, high speed homogenizer was used at 4000 rpm for 5 min. Then, silent crusher or microfluidizer was used to complete encapsulation process. The mixtures were treated either by silent crusher for 1 min at 75000 rpm or microfluidizer at 50 MPa for 3 passes. Freeze drying for 48 hours was applied to emulsions to obtain capsules in powder form. After these steps, dry capsules were grounded manually into a fine powder. The microcapsules were analyzed for total antioxidant activity with DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging method. Prior to high speed homogenization, the samples were centrifuged (4000 rpm, 1 min). Centrifugation was found to have positive effect on total antioxidant activity of capsules. Microcapsules treated by microfluidizer were found to have higher total antioxidant activities than those treated by silent crusher. It was found that increasing whey protein concentration in coating material (using maltodextrin:whey protein 1:3 mixture) had positive effect on total antioxidant activity for both silent crusher and microfluidization methods. Therefore, capsules prepared by microfluidization of centrifuged mixtures can be selected as the best conditions for encapsulation of cherry laurel powder by considering their total antioxidant activity. In this study, it was shown that capsules prepared by these methods can be recommended to be incorporated into foods in order to enhance their functionality by increasing antioxidant activity.

Keywords: antioxidant activity, cherry laurel, microencapsulation, microfluidization

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Authors: Bilge Ozel

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Cities are high-complex living organisms and are subjects to continuous transformations produced by the stress that derives from changing conditions. Today the metropolises are seen like “development engines” of the countries and accordingly they become the centre of better living conditions that encourages demographic growth which constitutes the main reason of the changes. Indeed, the potential for economic advancement of the cities directly represents the economic status of their countries. The term of “resilience”, which sees the changes as natural processes and represents the flexibility and adaptability of the systems in the face of changing conditions, becomes a key concept for the development of urban transformation policies. The term of “resilience” derives from the Latin word ‘resilire’, which means ‘bounce’, ‘jump back’, refers to the ability of a system to withstand shocks and still maintain the basic characteristics. A resilient system does not only survive the potential risks and threats but also takes advantage of the positive outcomes of the perturbations and ensures adaptation to the new external conditions. When this understanding is taken into the urban context - or rather “urban resilience” - it delineates the capacity of cities to anticipate upcoming shocks and changes without undergoing major alterations in its functional, physical, socio-economic systems. Undoubtedly, the issue of coordinating the urban systems in a “resilient” form is a multidisciplinary and complex process as the cities are multi-layered and dynamic structures. The concept of “urban transformation” is first launched in Europe just after World War II. It has been applied through different methods such as renovation, revitalization, improvement and gentrification. These methods have been in continuous advancement by acquiring new meanings and trends over years. With the effects of neoliberal policies in the 1980s, the concept of urban transformation has been associated with economic objectives. Subsequently this understanding has been improved over time and had new orientations such as providing more social justice and environmental sustainability. The aim of this research is to identify the most applied urban transformation methods in Turkey and its main reasons of being selected. Moreover, investigating the lacking and limiting points of the urban transformation policies in the context of “urban resilience” in a comparative way with European interventions. The emblematic examples, which symbolize the breaking points of the recent evolution of urban transformation concepts in Europe and Turkey, are chosen and reviewed in a critical way.

Keywords: resilience, urban dynamics, urban resilience, urban transformation

Procedia PDF Downloads 265

Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

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The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

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Authors: Cengiz Akyildiz, Ismail Ekmekci

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In the past 15 years, many people have sought refuge and emigrated to developed countries due to the civil war in Syria, terrorism and turmoil in Iraq, Iran and Afghanistan, hunger problems in Africa and the purpose of work. Many of these people came to Turkey. By the end of the 2019, in Turkey, regular and irregular migrants, asylum seekers and foreigners under international protection are about 6 million people. The majority of these people are Syrians. Approximately 2 800 000 immigrants and refugees are in the workforce. Migrant workers in our country constitute the largest proportion among all countries in the world according to the local labor force. 2.5 million of these employees, with a high rate of about 90%, work informally and do not have legal records and valid employment contracts as a workforce; They cannot benefit from Occupational Health and Safety (OHS) services. Migrant workers generally receive less wages than local workers, working longer hours and worse conditions; they are often subjected to human rights violations, harassment, human trafficking and violence. Migrant workers face problems such as OHS practices, environmental and occupational exposures, language / cultural barriers, access to health services, and lack of documentation. Therefore, the OHS problems of these employees are becoming an increasingly problematic area. However, there is not enough research, analysis and academic studies in this field. The order of importance should be known for the radical solution of the problems, because of the problems with high severity are also at high risk. In this study, for the first time, a Search Conference was held with the participation of 45 stakeholders to reveal the OHS problems of regular and irregular migrant workers in our country. The problems arising from this workshop were compared with the problems in the literature and the problems in this field were determined and weighted for our country. Later, to determine the significance levels of these problems, AHP study, which is a Multi Criteria Decision Making Method in which 15 experts participated, was conducted and the significance levels of these problems were determined. When the data obtained are evaluated, it has been seen that the OSH risks of migrant workers arise from 58% laws and government policies, 29% from employers, 13% from personal faults of employees. An academic study has been carried out for the first time in this field regarding the OHS problems of migrant workers, and an academic study has been created to guide which of the problems should be prioritized.

Keywords: environmental conditions, migrant workers, OHS issues, workplace conditions

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Authors: Ahmad Saad, Shuja Abbas, Breanna Marine

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Introduction: This study explores the potential applications of autologous pedal fat pad grafting as a minimally invasive therapeutic strategy for addressing pedal fat pad loss. Without adequate shock absorbing tissue, a patient can experience functional deficits, ulcerations, loss of quality of life, and significant limitations with ambulation. This study details a novel technique involving autologous adipose grafting from the abdomen to enhance plantar fat pad thickness in a patient involved in a severe motor vehicle accident which resulted in total fat pad loss of the heel. Autologous adipose grafting (AAG) was used following adipose allografting in an effort to recreate a normal shock absorbing surface to allow return to activities of daily living and painless ambulation. Methods: A 46-year-old male sustained multiple open pedal fractures and necrosis to the heel fat pad after a motorcycle accident, which resulted in complete loss of the calcaneal fat pad. The patient underwent serial debridement’s, utilization of wound vac therapy and split thickness skin grafting to accomplish complete closure, despite complete loss of adipose to area. Patient presented with complaints of pain on ambulation, inability to bear weight on the heel, recurrent ulcerations, admitted had not been ambulating for two years. Clinical exam demonstrated complete loss of the plantar fat pad with a thin layer of epithelial tissue overlying the calcaneal bone, allowing visibility of the osseous contour of the calcaneus. Scar tissue had formed in place of the fat pad, with thickened epithelial tissue extending from the midfoot to the calcaneus. After conservative measures were exhausted, the patient opted for initial management by adipose allograft matrix (AAM) injections. Post operative X-ray imaging revealed noticeable improvement in calcaneal fat pad thickness. At 1 year follow up, the patient was able to ambulate without assistive devices. The fat pad at this point was significantly thicker than it was pre-operatively, but the thickness did not restore to pre-accident thickness. In order to compare the take of allograft versus autografting of adipose tissue, the decision to use adipose autograft through abdominal liposuction harvesting was deemed suitable. A general surgeon completed harvesting of adipose cells from the patient’s abdomen via liposuction, and a podiatric surgeon performed the AAG injection into the heel. Total of 15 cc’s of autologous adipose tissue injected to the calcaneus. Results: There was a visual increase in the calcaneal fat pad thickness both clinically and radiographically. At the 6-week follow up, imaging revealed retention of the calcaneal fat pad thickness. Three months postop, patient returned to activities of daily living and increased quality of life due to their increased ability to ambulate. Discussion: AAG is a novel treatment for pedal fat pad loss. These treatments may be viable and reproducible therapeutic choices for patients suffering from fat pad atrophy, fat pad loss, and/or plantar ulcerations. Both treatments of AAM and AAG exhibited similar therapeutic results by providing pain relief for ambulation and allowing for patients to return to their quality of life.

Keywords: podiatry, wound, adipose, allograft, autograft, wound care, limb reconstruction, injection, limb salvage

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Authors: Iman Jabbar

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Within the scope of professionalism and in order to compete with the modern world, teachers, are expected to develop their teaching skills and activities in addition to their professional knowledge. At the college level, the teacher should be able to face classroom challenges through his engagement with the learning situation to understand the students and their needs. In our field of TESOL, the role of the English teacher is no longer restricted to teaching English texts, but rather he should endeavor to enhance the students’ skills such as communication and critical analysis. Within the literature of professionalism, there are certain strategies and tools that an English teacher should adopt to develop his competence and performance. Reflective practice, which is an exploratory process, is one of these strategies. Another strategy contributing to classroom development is motivation. It is crucial in students’ learning as it affects the quality of learning English in the classroom in addition to determining success or failure as well as language achievement. This is a qualitative study grounded on interpretive perspectives of teachers and students regarding the process of professional development. This study aims at (a) understanding how teachers at the college level conceptualize reflective practice and motivation inside EFL classroom, and (b) exploring the methods and strategies that they implement to practice reflection and motivation. This study and is based on two questions: 1. How do EFL teachers perceive and view reflection and motivation in relation to their teaching and professional development? 2. How can reflective practice and motivation be developed into practical strategies and actions in EFL teachers’ professional context? The study is organized into two parts, theoretical and practical. The theoretical part reviews the literature on the concept of reflective practice and motivation in relation to professional development through providing certain definitions, theoretical models, and strategies. The practical part draws on the theoretical one, however; it is the core of the study since it deals with two issues. It involves the research design, methodology, and methods of data collection, sampling, and data analysis. It ends up with an overall discussion of findings and the researcher's reflections on the investigated topic. In terms of significance, the study is intended to contribute to the field of TESOL at the academic level through the selection of the topic and investigating it from theoretical and practical perspectives. Professional development is the path that leads to enhancing the quality of teaching English as a foreign or second language in a way that suits the modern trends of globalization and advanced technology.

Keywords: professional development, motivation, reflection, learning

Procedia PDF Downloads 451

Authors: Krupali Mehta, Sandip Bhatt, Umesh Trivedi, Bhavesh Bharatiya, Mukesh Ranjan, Atindra D. Shukla

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Owing to the dominating surface forces and large-scale surface interactions, the nano-scale particles face difficulties in getting suspended in various media. Magnetic nanoparticles of iron oxide offer a great deal of promise due to their ease of preparation, reasonable magnetic properties, low cost and environmental compatibility. We intend to modify the surface of magnetic Fe₂O₃ nanoparticles with selected surface modifying agents using simple and effective single-step chemical reactions in order to enhance dispersibility of magnetic nanoparticles in non-polar media. Magnetic particles were prepared by hydrolysis of Fe²⁺/Fe³⁺ chlorides and their subsequent oxidation in aqueous medium. The dried particles were then treated with Octadecyl quaternary ammonium silane (Terrasil™), stearic acid and gallic acid ester of stearyl alcohol in ethanol separately to yield S-2 to S-4 respectively. The untreated Fe₂O₃ was designated as S-1. The surface modified nanoparticles were then analysed with Dynamic Light Scattering (DLS), Fourier Transform Infrared spectroscopy (FTIR), X-Ray Diffraction (XRD), Thermogravimetric Gravimetric Analysis (TGA) and Scanning Electron Microscopy and Energy dispersive X-Ray analysis (SEM-EDAX). Characterization reveals the particle size averaging 20-50 nm with and without modification. However, the crystallite size in all cases remained ~7.0 nm with the diffractogram matching to Fe₂O₃ crystal structure. FT-IR suggested the presence of surfactants on nanoparticles’ surface, also confirmed by SEM-EDAX where mapping of elements proved their presence. TGA indicated the weight losses in S-2 to S-4 at 300°C onwards suggesting the presence of organic moiety. Hydrophobic character of modified surfaces was confirmed with contact angle analysis, all modified nanoparticles showed super hydrophobic behaviour with average contact angles ~129° for S-2, ~139.5° for S-3 and ~151° for S-4. This indicated that surface modified particles are super hydrophobic and they are easily dispersible in non-polar media. These modified particles could be ideal candidates to be suspended in oil-based fluids, polymer matrices, etc. We are pursuing elaborate suspension/sedimentation studies of these particles in various oils to establish this conjecture.

Keywords: iron nanoparticles, modification, hydrophobic, dispersion

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Authors: Md. Rashel Sheikh

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The shipbuilding industry in Bangladesh had become a fast-growing industry in recent years when it began to export newly built ships. The various activities of shipbuilding industries in their limited, confined spaces added occupational worker exposures to chemicals, dusts, and metal fumes. The aim of this literature search is to identify the potential sources of occupational health hazards in shipyards and to promote the regulation of appropriate personal protective equipment (PPE) for the workers. In shipyards, occupational workers are involved in various activities, such as the manufacture, repair, maintenance, dismantling of boats and ships, building small ocean-going vessels and ferries. The occupational workers in the shipbuilding industry suffer from a number of hazardous issues, such as asthma, dermatitis, hearing deficits, and musculoskeletal disorders. The use of modern technologies, such as underwater plasma welding, electron beam welding, and friction stir welding and laser cutting and welding, and appropriate PPE (i.e., long-sleeved shirt and long pants, shoes plus socks, safety masks, chemical resistant gloves, eyewear, face shield, and respirators) can help reduce the occupational exposure to environmental hazards created by different activities in the shipyards. However, most shipyards in Bangladesh use traditional methods, e.g., flame cutting and arc, that add hazardous waste and pollutants to the environment in and around the shipyard. The safety and security of occupational workers in the shipyard workplace are very important. It is the primary responsibility of employers to ensure the safety and security of occupational workers in the shipyards. Employers must use advanced technologies and supply adequate and appropriate PPE for the workers. There are a number of accidents and illnesses that happen daily in the shipyard industries in Bangladesh due to the negligence and lack of adequate technologies and appropriate PPE. In addition, there are no specific regulations and implementations available to use the PPE. It is essential to have PPE regulations and strict enforcement for the adoption of PPE in the shipbuilding industries in Bangladesh. Along with the adoption of PPE with regular health examinations, health education to the workers regarding occupational hazards and lifestyle diseases are also important and require reinforcement. Monitoring health and safety hazards in shipyards are essential to enhance worker protection, and ensure worker safety, and mitigate workplace injuries and illnesses.

Keywords: shipbuilding Industries, health education, occupational health hazards, personal protective equipment, shipyard workers, occupational workers, shipyards

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Authors: Humaira Saeed Malik, Salma Saad

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Introduction: Fowler's syndrome, first described by Clare Fowler in 1985, is a rare urological condition characterized by difficulty in urination due to the abnormal function of the urethral sphincter. It predominantly affects young women and leads to chronic urinary retention. The main concern in managing this condition is ensuring regular bladder emptying. Clam cystoplasty is a bladder augmentation surgery in which the bladder is clam-shelled open, and a segment of the intestine is used to increase the bladder's capacity and reduce bladder pressure. The Mitrofanoff procedure, a surgical creation of a continent urinary diversion, is often performed in patients with Fowler's syndrome who require long-term catheterization. This procedure involves creating a conduit (from the appendix or a segment of the small intestine) between the bladder and the skin, allowing for intermittent self-catheterization to manage urinary retention. Study: This case study examines a 39-year-old gravida 3, para 0+2 woman with a BMI of 40, Fowler's syndrome, type I diabetes, and post-traumatic stress disorder (PTSD), presenting at Dumfries and Galloway Royal Infirmary at 8 weeks of gestation. Diagnosed with Fowler's syndrome at 23, . A sacral nerve stimulator (SNS) device was initially placed but was subsequently removed after one year due to malfunction caused by trauma, subsequently she had undergone clam cystoplasty and the Mitrofanoff procedure for bladder management. Her pregnancy was complicated by vaginal bleeding at 10 weeks, treated with progesterone pessaries, and a urinary tract infection at 14 weeks, managed with antibiotics. Despite these challenges, she continued self-catheterization through the Mitrofanoff stoma and was placed on prophylactic antibiotics. Her diabetes was well-controlled on insulin, and a 20-week fetal anomaly scan was normal. The multidisciplinary team, including an obstetrician and a urologist, planned for serial growth scans and the initiation of low molecular weight heparin (LMWH) from 28 weeks due to the intermediate risk of venous thromboembolism (VTE) and to continue six weeks after delivery. A planned cesarean delivery at 37 weeks was arranged, with an MRI scan scheduled later in the pregnancy to assist in surgical planning, ensuring the preservation of the Mitrofanoff stoma's function. The surgery will occur in an elective setting and include a consultant urologist. Conclusion: Pregnancy in women with Fowler's syndrome who have undergone Clam cystoplasty and the Mitrofanoff procedure is rare, and management requires careful planning and a multidisciplinary approach. This case highlights the importance of individualized care plans and close monitoring of both mother and fetus. The patient's risk of recurrent UTIs, coupled with her diabetes and high BMI, necessitated coordinated care across specialties to ensure the best possible outcomes. The Mitrofanoff procedure proved effective in managing her urinary retention, allowing her to maintain self-catheterization during pregnancy. The multidisciplinary team approach was crucial in addressing her complex medical needs, involving obstetrics, urology, and endocrinology. This case adds valuable information to the limited literature on pregnancy management in patients with Fowler's syndrome who have undergone the Mitrofanoff procedure, highlighting the need for comprehensive, individualized care and the involvement of a multidisciplinary team to achieve the best results.

Keywords: fowler's syndrome, clam cystoplasty, mitrofanoff procedure, pregnancy

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Authors: Mai Alharthy, Agnes Shiel, Hynes Sinead

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Objectives: The objectives of the study are to translate and culturally adapt the RBMT-3 to be appropriate for use within an Arabic-speaking population and to achieve maximum equivalency between the translated and original versions and to evaluate the psychometric properties of the Arabic version of the RBMT-3. Participants' numbers are 16 (10 females and 6 males). All participants are bilingual speakers of Arabic and English, above 18 years old and with no current nor past memory impairment. Methods: The study was conducted in two stages: Translation and cultural adaptation stage: Forward and backward translations were completed by professional translators. Five out of the 14 RBMT-3 subtests required cultural adaptations. Half of the faces in the face recognition subtests were replaced with Arabic faces by a professional photographer. Pictures that are irrelevant to the Arabic culture in the picture recognition subtests were replaced. Names, story and orientations subtests were also adapted to suit the Arabic culture. An expert committee was formed to compare the translated and original versions and to advise on further changes required for test materials. Validation of the Arabic RBMT-3- pilot: 16 Participants were tested on version 1 of the English version and the two versions of the Arabic RBMT-3 ( counterbalanced ). The assessment period was 6 weeks long, with two weeks gap between tests. All assessments took place in a quiet room in the National University of Ireland Galway. Two qualified occupational therapists completed the assessments. Results: Wilcox signed-rank test was used to compare between subtest scores. Significant differences were found in the story, orientation and names subtests between the English and Arabic versions. No significant differences were found in subtests from both Arabic versions except for the story subtest. Conclusion: The story and orientation subtests should be revised by the expert committee members to make further adaptations. The rest of the Arabic RBMT-3 subtests are equivalent to the subtests of the English version. The psychometric properties of the Arabic RBMT-3 will be investigated in a larger Arabic-speaking sample in Saudi Arabia. The outcome of this research is to provide clinicians and researchers with a reliable tool to assess memory problems in Arabic speaking population.

Keywords: memory impairment, neuropsychological assessment, cultural adaptation, cognitive assessment

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Authors: Divyansh Goel, Varun Jain

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Classical economics works on the principle that people are rational and analytical in their decision making and their choices fall in line with the most suitable option according to the dominant strategy in a standard game theory model. This model has failed at many occasions in estimating the behavior and dealings of rational people, giving proof of some other underlying heuristics and cognitive biases at work. This paper probes into the study of these factors, which fall under the umbrella of behavioral economics and through their medium explore the solution to a problem which a lot of nations presently face. There has long been a wide disparity in the number of people holding favorable views on organ donation and the actual number of people signing up for the same. This paper, in its entirety, is an attempt to shape the public policy which leads to an increase the number of organ donations that take place and close the gap in the statistics of the people who believe in signing up for organ donation and the ones who actually do. The key assumption here is that in cases of cognitive dissonance, where people have an inconsistency due to conflicting views, people have a tendency to go with the default choice. This tendency is a well-documented cognitive bias known as the status quo bias. The research in this project involves an assay of mandated choice models of organ donation with two case studies. The first of an opt-in system of Germany (where people have to explicitly sign up for organ donation) and the second of an opt-out system of Austria (every citizen at the time of their birth is an organ donor and has to explicitly sign up for refusal). Additionally, there has also been presented a detailed analysis of the experiment performed by Eric J. Johnson and Daniel G. Goldstein. Their research as well as many other independent experiments such as that by Tsvetelina Yordanova of the University of Sofia, both of which yield similar results. The conclusion being that the general population has by and large no rigid stand on organ donation and are gullible to status quo bias, which in turn can determine whether a large majority of people will consent to organ donation or not. Thus, in our paper, we throw light on how governments can use status quo bias to drive positive social change by making policies in which everyone by default is marked an organ donor, which will, in turn, save the lives of people who succumb on organ transplantation waitlists and save the economy countless hours of economic productivity.

Keywords: behavioral economics, game theory, organ donation, status quo bias

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Authors: Merertu Wakuma Rundassa

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Global competition and rapidly changing customer requirements are forcing major changes in the production styles and configuration of manufacturing organizations. Increasingly, traditional centralized and sequential manufacturing planning, scheduling, and control mechanisms are being found insufficiently flexible to respond to changing production styles and highly dynamic variations in product requirements. The traditional approaches limit the expandability and reconfiguration capabilities of the manufacturing systems. Thus many business houses face increasing pressure to lower production cost, improve production quality and increase responsiveness to customers. In a textile and apparel manufacturing, globalization has led to increase in competition and quality awareness and these industries have changed tremendously in the last few years. So, to sustain competitive advantage, companies must re-examine and fine-tune their business processes to deliver high quality goods at very low costs and it has become very important for the textile and apparel industries to integrate themselves with information technology to survive. IT can create competitive advantages for companies to improve coordination and communication among trading partners, increase the availability of information for intermediaries and customers and provide added value at various stages along the entire chain. Ethiopia is in the process of realizing its potential as the future sourcing location for the global textile and garments industry. With a population of over 90 million people and the fastest growing non-oil economy in Africa, Ethiopia today represents limitless opportunities for international investors. For the textile and garments industry Ethiopia promises a low cost production location with natural resources such as cotton to enable the setup of vertically integrated textile and garment operation. However; due to lack of integration of their business activities textile and apparel industry of Ethiopia faced a problem in that it can‘t be competent in the global market. On the other hand the textile and apparel industries of other countries have changed tremendously in the last few years and globalization has led to increase in competition and quality awareness. So the aim of this paper is to study the trend of Ethiopian Textile and Apparel Industry on the application of different IT system to integrate them in the global market.

Keywords: information technology, business integrity, textile and apparel industries, Ethiopia

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Authors: Aleksandra Chałupnik, Zuzanna Chilimoniuk, Joanna Borowik, Aleksandra Borkowska, Anna Torres

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Background: Precocious puberty is the occurrence of secondary sexual characteristics in girls before the age of 8. The diverse etiology of premature puberty is crucial to determine whether it is true precocious puberty, depending on the activation of the hypothalamic-pituitary-gonadal axis, or pseudo-precocious, which is independent of the activation of this axis. Whatever the cause, premature action of the sex hormones leads to the common symptoms of various forms of puberty. These include the development of sexual characteristics, acne, acceleration of growth rate and acceleration of skeletal maturation. Due to the possible genetic basis of the disorders, an interdisciplinary search for the cause is needed. Case report: The case report concerns a patient of a pediatric gynecology clinic who, at the age of two years, developed advanced thelarhe (M3) and started recurrent vaginal bleeding. In August 2019, gonadotropin suppression initially and after LHRH stimulation and high estradiol levels were reported at the Endocrinology Department. Imaging examinations showed a cyst in the right ovary projection. The bone age was six years. The entire clinical picture indicated pseudo- (peripheral) precocious in the course of ovarian autonomic cyst. In the follow-up ultrasound performed in September, the image of the cyst was stationary and normalization of estradiol levels and clinical symptoms was noted. In December 2019, cyst regression and normal gonadotropin and estradiol concentrations were found. In June 2020, white mucus tinged with blood on the underwear, without any other disturbing symptoms, was observed for several days. Two consecutive USG examinations carried out in the same month confirmed the change in the right ovary, the diameter of which was 25 mm with a very high level of estradiol. Germinal tumor markers were normal. On the Tanner scale, the patient scored M2P1. The labia and hymen had puberty features. The correct vaginal entrance was visible. Another active vaginal bleeding occurred in the first week of July 2020. The considered laparoscopic treatment was abandoned due to the lack of oncological indications. Treatment with Tamoxifen was recommended in July 2020. In the initiating period of treatment, no maturation progression, and even reduction of symptoms, no acceleration of growth and a marked reduction in the size of the cysts were noted. There was no bleeding. After the size of the cyst and hormonal activity increased again, the treatment was changed to Anastrozole, the effect of which led to a reduction in the size of the cyst. Conclusions: The entire clinical picture indicates alleged (peripheral) puberty. Premature puberty in girls, which is manifested as enlarged mammary glands with high levels of estrogens secreted by autonomic ovarian cysts and prepubertal levels of gonadotropins, may indicate McCune-Albright syndrome. Vaginal bleeding may also occur in this syndrome. Cancellation of surgical treatment of the cyst made it impossible to perform a molecular test that would allow to confirm the diagnosis. Taking into account the fact that cysts are often one of the first symptoms of McCune-Albrigt syndrome, it is important to remember about multidisciplinary care for the patient and careful search for skin and bone changes or other hormonal disorders.

Keywords: McCune Albrigth's syndrome, ovarian cyst, pediatric gynaecology, precocious puberty

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Authors: Djehich Mohamed Yousri

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The national sovereignty of states is now facing a dangerous situation that has witnessed a clear exacerbation of the restrictions that this sovereignty has known for quite some time, if not since the establishment of the sovereign national state in the first place, and things have reached this way to the extent that a group of analysts and commentators are talking about the demise or disappearance of the phenomenon of sovereignty Patriotism, a judgment that some consider exaggerated, although there is agreement on the seriousness of what has afflicted the national sovereignty of medium and small states in particular. In fact, the phenomenon of national sovereignty has not completely ended, as there is still a category of countries that are able to disagree with the American will without disappearing from the world map, as happened with the Soviet Union. China, some European countries, and some countries with leading regional roles are still able to deal with This administration, with rational and complex calculations, makes the restrictions on its sovereignty minimal, or at least draws a red line in front of the vital interests of those countries that the restrictions on sovereignty cannot cross, and it is certain that strengthening internal democratic development in countries will increase their ability to challenge external restrictions. On its sovereignty to the extent that this development creates a cohesive society in the face of external hegemony attempts, as well as to the extent that it eliminates some pretexts for interference in the internal affairs of states, including the claim of a lack of democracy or lack of respect for human rights in it. What led to transformations in the international arena in the wake of globalization and its effects on international aspects, including national sovereignty and the principle of state independence. Which was marred by several currents, which led to affecting it in a negative way, and this is what poor countries suffer from at the expense of rich countries, which led us to research the extent of the presence of national sovereignty on the international arena, and the extent to which the principle of non-interference in affairs is applied or existed. The internal affairs of states, which are stipulated in the Charter of the United Nations in the modern era, the theory of sovereignty has been subjected to substantial criticism and abandonment by many on the grounds that it is inconsistent with the current conditions of the international community. In fact, the theory of sovereignty has been misused to justify internal tyranny and international chaos. This theory has hindered the development of international law, the work of international organizations and the dominance of strong states over weak ones. At the present time, the concept of sovereignty has moved towards direction, as the transformations of the international system in the economic, political and military fields have led to the decline and erosion of the idea of the sovereignty of the national state.

Keywords: sovereignty, intervention, non-interference, globalization, humanitarian intervention

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Authors: Piyush Hajela

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The significance of public spaces is on a rise in Indian cities as a strong interaction space across cultures and community. It is a pertinent gathering space for people across age and gender, where the face keeps changing with time. A public space is directly related to the social dimension, people, comfort, safety, and security, that, it proposes to provide, as inherent qualities. The presence of these and other dimensions of space, together with related equitable environments, impart certain quality to a public space. The higher the optimum contents of these dimensions, the better the quality of public space. Public is represented by PEOPLE through society and community, and space is created by dimensions. Society contains children, women and the elderly, community is composed of social, and religious groups. These behave differently in a different setting and call for varied quality of spaces, created and generated. Public spaces are spread across a city and have more or less established their existence and prominence in a social set up. While few of them are created others are discovered by the people themselves in their constant search for desirable interactive public spaces. These are the most sought after gathering spaces that have the quality of promoting social interaction, providing free accessibility, provide desirable scale etc. The emergence of public space dates back to the times when people started forming communities, display cultures and traditions publicly, gathered for religious observations and celebrations, and address the society. Traditional cities and societies in India were feudal and orthodox in their nature and yet had public spaces. When the gathering of people at one point in a city became more frequent the point became more accessible and occupied. Baras (large courts, Chowks (public squares) and Maidans (large grounds) became well-known gathering spaces in the towns and cities. As the population grew such points grew in number, each becoming a public space in itself and with a different and definite social character. The author aims at studying the various dimensions of public spaces with which a public space has power to hold people for a significant period of time. The human senses here are note referred to as taste, sight, hearing, touch or smell, but how human senses collectively respond to when stationed in a given public space. The collectives may reflect in dimensions like comfort, safety, environment, freedom etc. Various levels of similar other responses would be studied through interviews, observations and other scientific methods for both qualitative and quantitative analysis.

Keywords: society, interaction, people, accessibility, comfort, enclosure

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Authors: Paule Olivia Akotto

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The recent literature suggests spending between 50%-85% of oil rents. However, there are not yet clear guidelines for allocating this windfall in the public investment system, while most of the resource-rich countries fail to improve their intergenerational mobility. We study a design of the optimal spending system in Senegal, a low-income developing country featuring newly discovered oil fields and low intergenerational mobility. We build a dynamic general equilibrium model in which rural and urban (Dakar and other urban centers henceforth OUC) households face different health, education, and employment opportunities based on their location, affecting their intergenerational mobility. The model captures the relationship between oil rents, public investment, and multidimensional inequality of opportunity. The government invests oil rents in three broad sectors: health and education, road and industries, and agriculture. Through endogenous productivity externality and human capital accumulation, our model generates the predominant position of Dakar and OUC households in terms of access to health, education, and employment in line with Senegal data. Rural households are worse off in all dimensions. We compute the optimal spending policy under two sets of simulation scenarios. Under the current Senegal public investment strategy, which weighs more health and education investments, we find that the reform maximizing the decline in inequality of opportunity between households, frontloads investment during the first eight years of the oil exploitation and spends the perpetual value of oil wealth thereafter. We will then identify the marginal winners and losers associated with this policy and its redistributive implications. Under our second set of scenarios, we will test whether the Senegalese economy can reach better equality of opportunity outcomes under this frontloading reform, by allowing the sectoral shares of investment to vary. The trade-off will be between cutting human capital investment in favor of agricultural and productive infrastructure or increasing the former. We will characterize the optimal policy by specifying where the higher weight should be. We expect that the optimal policy of the second set strictly dominates in terms of equality of opportunity, the optimal policy computed under the current investment strategy. Finally, we will quantify this optimal policy's aggregate and distributional effects on poverty, well-being, and gender earning gaps.

Keywords: developing countries, general equilibrium, inequality of opportunity, oil rents

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Authors: Marisol Warthon-Medina, Jenny Plumb, Ayoub Aljawaldeh, Mark Roe, Ailsa Welch, Maria Glibetic, Paul M. Finglas

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Similar to Western Countries, the Eastern Mediterranean Region (EMR) also presents major public health issues associated with the increased consumption of sugar, fat, and salt. Therefore, one of the policies of the World Health Organization’s (WHO) EMR is to reduce the intake of salt, sugar, and fat (Saturated fatty acids, trans fatty acids) to address the risk of non-communicable diseases (i.e. diabetes, cardiovascular disease, cancer) and obesity. The project objective is to assess status and provide training and capacity development in the use of improved standardized methodologies for updated food composition data, dietary intake methods, use of suitable biomarkers of nutritional value and determine health outcomes in low and middle-income countries (LMIC). Training exchanges have been developed with clusters of countries created resulting from regional needs including Sudan, Egypt and Jordan; Tunisia, Morocco, and Mauritania; and other Middle Eastern countries. This capacity building will lead to the development and sustainability of up-to-date national and regional food composition databases in LMIC for use in dietary monitoring assessment in food and nutrient intakes. Workshops were organized to provide training and capacity development in the use of improved standardized methodologies for food composition and food intake. Training needs identified and short-term scientific missions organized for LMIC researchers including (1) training and knowledge exchange workshops, (2) short-term exchange of researchers, (3) development and application of protocols and (4) development of strategies to reduce sugar and fat intake. An initial training workshop, Morocco 2018 was attended by 25 participants from 10 EMR countries to review status and support development of regional food composition. 4 training exchanges are in progress. The use of improved standardized methodologies for food composition and dietary intake will produce robust measurements that will reinforce dietary monitoring and policy in LMIC. The capacity building from this project will lead to the development and sustainability of up-to-date national and regional food composition databases in EMR countries. Supported by the UK Medical Research Council, Global Challenges Research Fund, (MR/R019576/1), and the World Health Organization’s Eastern Mediterranean Region.

Keywords: dietary intake, food composition, low and middle-income countries, status.

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Authors: Xiaoli Tian

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The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.

Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine

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Authors: James P. Takona

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In a world that is experiencing sharp digital transformations guided by digital technologies, the potential of technology to drive transformation and evolution in the higher is apparent. Higher education is facing a paradigm shift that exposes susceptibilities and threats to fully online programs in the face of post-Covid-19 trends of commodification. This historical moment is likely to be remembered as a critical turning point from analog to digital degree-focused learning modalities, where the default became the pivot point of competition between higher education institutions. Fall 2020 marks a significant inflection point in higher education as students, educators, and government leaders scrutinize higher education's price and value propositions through the new lens of traditional lecture halls versus multiple digitized delivery modes. Online education has since tiled the way for a pedagogical shift in how teachers teach and students learn. The incremental growth of online education in the west can now be attributed to the increasing patronage among students, faculty, and institution administrators. More often than not, college instructors assume paraclete roles in this learning mode, while students become active collaborators and no longer passive learners. This paper offers valuable discernments into the threats, challenges, and opportunities of a massive digital revolution in servicing degree programs. To view digital instruction and learning demands for instructional practices that revolve around collaborative work, engaging students in learning activities, and an engagement that promotes active efforts to solicit strong connections between course activities and expected learning pace for all students. Appropriate digital technologies demand instructors and students need prior solid skills. Need for the use of digital technology to support instruction and learning, intelligent tutoring offers great promise, and failures at implementing digital learning may not improve outcomes for specific student populations. Digital learning benefits students differently depending on their circumstances and background and those of the institution and/or program. Students have alternative options, access to the convenience of learning anytime and anywhere, and the possibility of acquiring and developing new skills leading to lifelong learning.

Keywords: digi̇tized learning, digital education, collaborative work, high education, online education, digitize delivery

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Authors: Zhang Tao, Si Tang, Zhang Yufeng, Jin Jiahua

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Work pressure is an emerging research of organizational behavior. Many factors associated with this study also attracted the interest of scholars. Macao is surrounding by open micro-capitalist economy which has a high internationalization level and Mature operation system. And there is no doubt that tourism and hotel service industry is the pillar of the Macao economy with the developing of the mainland individual tourist visa. More and more cities are willing to inclusive culture diversity which lead to the amount of inbound tourists present high-speed up trend cause the hotel industry has a strong customer base and development space. At the same time, the hotel staff is an important role in the service. However, affected by some adverse factors, the hotel staff face a variety of pressures. This study combs the concept and theory of pressures relevant influencing factors and puts forward the purpose of this research. The focus of this study will be organizational supported by work efficiency and work pressure, using qualitative and quantitative research methods. Through questionnaires and interviews, 10 hotels in Macao were selected and 500 questionnaires were distributed to the employees. Statistical analysis software SPSS was used for descriptive statistics. By exploratory factor analysis and confirmatory factor analysis, effect. And the relevant practitioners on behalf of the interview content analysis. The innovation of this research lies in the empirical study of the relationship between the working pressure, organizational support and working efficiency of Macau hotel practitioners, and constructs and validates the structural model of the relationship among them. This model will be helpful for people to use more research methods to study hotel practitioners pressure in the future. At the same time, we can draw the following conclusions: 1. There is a significant negative correlation between salary level and job stress; 2. There is a significant negative correlation between job stress and performance; 3. Different organizational support can interfere the relationship between job stress and performance; 4. Put forward the strategy of relevance adjustment, which provides a reference value for the hotel industry in human resource management. It would be helpful to improve their service standard by training their practitioners more scientifically and rationally.

Keywords: Macau, perceived organizational support, work stress, work efficiency

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Authors: Robin Devillers, Chantal van Dijk

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Children face ambiguities in everyday language use. Particularly ambiguity in pronoun resolution can be challenging, whereas adults can rapidly identify the antecedent of the mentioned pronoun. Two main factors underlie this process, namely the accessibility of the referent and the syntactic cues of the pronoun. After 200ms, adults have converged the accessibility and the syntactic constraints, while relieving cognitive effort by considering contextual cues. As children are still developing their cognitive capacity, they are not able yet to simultaneously assess and integrate accessibility, contextual cues and syntactic information. As such, they fail to identify the correct referent and possibly fixate more on the competitor in comparison to adults. In this study, Dutch while-clauses were used to investigate the interpretation of pronouns by children. The aim is to a) examine the extent to which 7-10 year old children are able to utilise discourse and syntactic information during online and offline sentence processing and b) analyse the contribution of individual factors, including age, working memory, condition and vocabulary. Adult and child participants are presented with filler-items and while-clauses, and the latter follows a particular structure: ‘Anna and Sophie are sitting in the library. While Anna is reading a book, she is taking a sip of water.’ This sentence illustrates the ambiguous situation, as it is unclear whether ‘she’ refers to Anna or Sophie. In the unambiguous situation, either Anna or Sophie would be substituted by a boy, such as ‘Peter’. The pronoun in the second sentence will unambiguously refer to one of the characters due to the syntactic constraints of the pronoun. Children’s and adults’ responses were measured by means of a visual world paradigm. This paradigm consisted of two characters, of which one was the referent (the target) and the other was the competitor. A sentence was presented and followed by a question, which required the participant to choose which character was the referent. Subsequently, this paradigm yields an online (fixations) and offline (accuracy) score. These findings will be analysed using Generalised Additive Mixed Models, which allow for a thorough estimation of the individual variables. These findings will contribute to the scientific literature in several ways; firstly, the use of while-clauses has not been studied much and it’s processing has not yet been identified. Moreover, online pronoun resolution has not been investigated much in both children and adults, and therefore, this study will contribute to adults and child’s pronoun resolution literature. Lastly, pronoun resolution has not been studied yet in Dutch and as such, this study adds to the languages

Keywords: pronouns, online language processing, Dutch, eye-tracking, first language acquisition, language development

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Authors: Adel S. Alanazi

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The transition of a student with a disability from school to work is the most crucial phase while moving from the stage of adolescence into early adulthood. In this process, young individuals face various difficulties and challenges in order to accomplish the next venture of life successfully. In this respect, this paper aims to examine the challenges encountered by the individuals with intellectual disabilities in transition to work in Saudi Arabia. For this purpose, this study has undertaken a qualitative research-based methodology; wherein interpretivist philosophy has been followed along with inductive approach and exploratory research design. The data for the research has been gathered with the help of semi-structured interviews, whose findings are analysed with the help of thematic analysis. Semi-structured interviews were conducted with parents of persons with intellectual disabilities, officials, supervisors and specialists of two vocational rehabilitation centres providing training to intellectually disabled students, in addition to that, directors of companies and websites in hiring those individuals. The total number of respondents for the interview was 15. The purposive sampling method was used to select the respondents for the interview. This sampling method is a non-probability sampling method which draws respondents from a known population and allows flexibility and suitability in selecting the participants for the study. The findings gathered from the interview revealed that the lack of awareness among their parents regarding the rights of their children who are intellectually disabled; the lack of adequate communication and coordination between various entities; concerns regarding their training and subsequent employment are the key difficulties experienced by the individuals with intellectual disabilities. Training in programmes such as bookbinding, carpentry, computing, agriculture, electricity and telephone exchange operations were involved as key training programmes. The findings of this study also revealed that information technology and media were playing a significant role in smoothing the transition to employment of individuals with intellectual disabilities. Furthermore, religious and cultural attitudes have been identified to be restricted for people with such disabilities in seeking advantages from job opportunities. On the basis of these findings, it can be implied that the information gathered through this study will serve to be highly beneficial for Saudi Arabian schools/ rehabilitation centres for individuals with intellectual disability to facilitate them in overcoming the problems they encounter during the transition to work.

Keywords: intellectual disability, transition services, rehabilitation centre, employment

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Authors: Diana K. Kwok

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Despite the fact that Hong Kong government aims to develop an inclusive society, sexual minority students continue to encounter sexual prejudice without legal protection. They also have difficulties accessing relevant services from mental health and educational professionals, who do not receive systematic training to work with sexual minority students. Informed by the literature on sexual prejudice, heterosexual hegemony, genderism, as well as code of practice for frontline practitioners, the authors explored self-perceived knowledge of teachers and sexual minorities on sexuality and sexual prejudice, and how they perceive prejudice towards sexual minorities in Chinese cultural context. Semi-structure qualitative interviews were carried out with 31 school personnel informants (school teachers and counseling team members) and 25 sexual minority informants on their understanding of sexuality knowledge, their perception of sexual prejudice within school context in Hong Kong, as well as their suggested themes on teachers training on sexual prejudice reduction. This presentation specifically focuses on transcripts from sexual minority informants. Data analysis was carried out through NVivo, and followed the procedures spelt out in the qualitative research literature. Trustworthiness of the study was addressed through various strategies. Preliminary themes emerged from transcript content analysis: 1) A gap of knowledge between sexual minority informants and teachers; 2) Perception on sexual prejudice within cultural context; 3) Heterosexual hegemony and genderism within school system; 4) Needs for mandatory training: contents and strategies. The sexual minority informants found that teachers they encountered were predominantly adopted concepts of binary sex and dichotomous gender. Informants also indicated that the teachings of Confucianism cultural values, religiosity in Hong Kong might well be important cultural forces contributing to sexual prejudice manifested in school context. Although human rights and social justice concepts were embedded in professional code of practice of teachers and school helping professionals, informants found that teachers they encountered may face a dilemma when supporting sexual minority students navigating heterosexual hegemony and genderism in, as a consequence of their personal, institutional, cultural and religious backgrounds. Acknowledgments: The sexual prejudice project was funded by the Hong Kong Research Grant Council (ECS28401614), 2015 to 2017.

Keywords: sexual prejudice, Chinese teachers, Chinese sexual minorities, teacher training

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Authors: Elizabeth Grier, Meg Gemmill, Mary Martin, Leora Reiter, Herman Tang, Alexandra Donaldson, Isis Lunsky, Mia Wu

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Background: Individuals with Cerebral Palsy (CP) and/or IDD face numerous physical and mental health challenges, including difficulty accessing effective palliative care. The aim of this study is to assess the knowledge and comfort of healthcare providers in providing community-based palliative care for patients with Cerebral Palsy (CP) and severe to profound Intellectual and Developmental Disabilities (IDD). Methods: This study includes a mixed methods approach obtaining both quantitative and qualitative data. Quantitative data from palliative care practitioners was obtained through an online survey assessing comfort in symptom management, grief assessment, and goals of care discussion. This survey was distributed to physicians and allied health practitioners across Canada through the College of Family Physicians of Canada Member Interest Groups for Palliative Care and for IDD. Survey results guided the development of a semi-structured interview template, which was used to conduct a focus group on the same topic. Participants were four palliative care providers (3 physicians and one spiritual care practitioner). The focus group transcript is currently undergoing thematic analysis using NVivo 12 software. Results: 57 palliative care practitioners completed the survey. 87% of participants indicated they have provided palliative care services for persons with CP and/or IDD. Findings suggest practitioners are somewhat confident in identifying specific physical symptoms (dyspnea, pressure ulcers) but less confident in identifying physical/emotional pain, addressing grief, and prognosticating life expectancy in this population. 54% of responses indicated they had little/no training on palliating those with CP or IDD, and 45% somewhat or strongly disagree members of their profession can manage symptoms for this population. Focus group analysis is underway, and results will be available at the time of the poster presentation. Conclusion: Persons with CP and IDD are more likely to experience severe health inequities when accessing palliative care. Results of this study suggest further education is needed for palliative care professionals to address the barriers and challenges in providing palliative care to this patient population.

Keywords: palliative care, symptom management, health equity, community healthcare, intellectual and developmental disabilities

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Authors: Bander Mohayya Alotaibi

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The valuable partnerships between parents and teachers may develop positive and effective interactions between home and school. This will help these stakeholders share information and resources regarding student academics during ongoing interactions. Thus, partnerships will build a solid foundation for both families and schools to help children succeed in school. Parental involvement can be seen as an effective tool that can change homes and communities and not just schools’ systems. Seeking parents and stakeholders’ attitudes toward learning and learners can help schools design a curriculum. Subsequently, this information can be used to find ways to help improve the academic performance of students, especially in low performing schools. There may be some conflicts when designing curriculum. In addition, designing curriculum might bring more educational expectations to all the sides. There is a lack of research that targets the specific attitude of parents toward specific concepts on curriculum contents. More research is needed to study the perspective that parents of children with learning disabilities (LD) have regarding early reading curriculum. Parents and stakeholders’ perspectives on early reading intervention implemented as a curriculum for children with LD was studied through an advanced quantitative research. The purpose of this study seeks to understand stakeholders and parents’ perspectives of key concepts and essential early reading skills that impact the design of curriculum that will serve as an intervention for early struggler readers who have LD. Those concepts or stages include phonics, phonological awareness, and reading fluency as well as strategies used in house by parents. A survey instrument was used to gather the data. Participants were recruited through 29 schools and districts of the metropolitan area of the northern part of Saudi Arabia. Participants were stakeholders including parents of children with learning disability. Data were collected using distribution of paper and pen survey to schools. Psychometric properties of the instrument were evaluated for the validity and reliability of the survey; face validity, content validity, and construct validity including an Exploratory Factor Analysis were used to shape and reevaluate the structure of the instrument. Multivariate analysis of variance (MANOVA) used to find differences between the variables. The study reported the results of the perspectives of stakeholders toward reading strategies, phonics, phonological awareness, and reading fluency. Also, suggestions and limitations are discussed.

Keywords: stakeholders, learning disability, early reading, perspectives, parents, intervention, curriculum

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Authors: Xinchao Liu

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Regulating environmental and human rights damages caused by transnational corporations in host States is a core issue in the business and human rights discourse. In current regulatory practices, host States, which are territorially based and should bear primary regulation responsibility, face dual challenges at both domestic and international levels, leading to their continued marginalization. Specifically, host States as TNC damage regulators are constrained domestically by territorial jurisdiction limitations and internationally by the neoliberal international economic order exemplified by investment protection mechanisms. Taking China as a sample, it currently lacks a comprehensive regulation system to address TNC damages; while domestic constraints manifest as the marginalization of judicial regulation, the absence of corporate duty of care, and inadequate extraterritorial regulation effectiveness, international constraints are reflected in the absence of foreign investor obligations in investment agreements and the asymmetry of dispute resolution clauses, challenging regulatory sovereignty. As China continues to advance its policy of high-quality opening up, the risks of negative externalities from transnational capital will continue to increase, necessitating a focus on building and perfecting a regulation mechanism for TNC damages within the framework of international law. To address domestic constraints, it is essential to clarify the division of regulation responsibilities between judicial and administrative bodies, promote the normalization of judicial regulation, and enhance judicial oversight of governmental settlements. Improving the choice of law rules for cross-border torts and the standards for parent company liability for omissions, and enhancing extraterritorial judicial effectiveness through transnational judicial dialogue and cooperation mechanisms are also crucial. To counteract international constraints, specifying investor obligations in investment treaties and designing symmetrical dispute resolution clauses are indispensable to eliminate regulatory chill. Additionally, actively advancing the implementation of TNC obligations in business and human rights treaty negotiations will lay an international legal foundation for the regulation sovereignty of host States.

Keywords: transnational corporate damages, home state litigation, optimization limit, investor-state dispute settlement

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Authors: Man-Yu Wong, Siyu Zhou, Zhiqiang Cao

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In quality of life, health service utilization is an important determinant of medical resource expenditures on Colorectal cancer (CRC) care, a better understanding of the increased utilization of health services is essential for optimizing the allocation of healthcare resources to services and thus for enhancing the service quality, especially for high expenditure on CRC care like Hong Kong region. In assessing the association between the health-related quality of life (HRQOL) and health service utilization in patients with colorectal neoplasm, count data models can be used, which account for over dispersion or extra zero counts. In our data, the HRQOL evaluation is a self-reported measure obtained from a questionnaire completed by the patients, misreports and variations in the data are inevitable. Besides, there are more zero counts from the observed number of clinical consultations (observed frequency of zero counts = 206) than those from a Poisson distribution with mean equal to 1.33 (expected frequency of zero counts = 156). This suggests that excess of zero counts may exist. Therefore, we study tests for detecting zero-inflation in models with measurement error in covariates. Method: Under classical measurement error model, the approximate likelihood function for zero-inflation Poisson regression model can be obtained, then Approximate Maximum Likelihood Estimation(AMLE) can be derived accordingly, which is consistent and asymptotically normally distributed. By calculating score function and Fisher information based on AMLE, a score test is proposed to detect zero-inflation effect in ZIP model with measurement error. The proposed test follows asymptotically standard normal distribution under H0, and it is consistent with the test proposed for zero-inflation effect when there is no measurement error. Results: Simulation results show that empirical power of our proposed test is the highest among existing tests for zero-inflation in ZIP model with measurement error. In real data analysis, with or without considering measurement error in covariates, existing tests, and our proposed test all imply H0 should be rejected with P-value less than 0.001, i.e., zero-inflation effect is very significant, ZIP model is superior to Poisson model for analyzing this data. However, if measurement error in covariates is not considered, only one covariate is significant; if measurement error in covariates is considered, only another covariate is significant. Moreover, the direction of coefficient estimations for these two covariates is different in ZIP regression model with or without considering measurement error. Conclusion: In our study, compared to Poisson model, ZIP model should be chosen when assessing the association between condition-specific HRQOL and health service utilization in patients with colorectal neoplasm. and models taking measurement error into account will result in statistically more reliable and precise information.

Keywords: count data, measurement error, score test, zero inflation

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Authors: William Luke Hamel

Abstract:

Existing conceptions of urban flooding caused by tidal fluctuations and sea-level rise have been inadequately conceptualized by metrics of resilience and methods of flow modeling. While a great deal of research has been devoted to the effects of urbanization on pluvial flooding, the kind of tidal flooding experienced by locations like Hampton Roads, Virginia, has not been adequately conceptualized as being a result of human factors such as urbanization and gray infrastructure. Resilience from sea level rise and its associated flooding has been pioneered in the region with the 2015 Norfolk Resilience Plan from 100 Resilient Cities as well as the 2016 Norfolk Vision 2100 plan, which envisions different patterns of land use for the city. Urban resilience still conceptualizes the city as having the ability to maintain an equilibrium in the face of disruptions. This economic and social equilibrium relies on the Elizabeth River, narrowly conceptualized. Intentionally or accidentally, the river was made to be a piece of infrastructure. Its development was meant to serve the docks, shipyards, naval yards, and port infrastructure that gives the region so much of its economic life. Inasmuch as it functions to permit the movement of cargo; the raising and lowering of ships to be repaired, commissioned, or decommissioned; or the provisioning of military vessels, the river as infrastructure is functioning properly. The idea that the infrastructure is malfunctioning when high tides and sea-level rise create flooding is predicated on the idea that the infrastructure is truly a human creation and can be controlled. The natural flooding cycles of an urban river, combined with the action of climate change and sea-level rise, are only abnormal so much as they encroach on the development that first encroached on the river. The urban political ecology of water provides the ability to view the river as an infrastructural extension of urban networks while also calling for its emancipation from stationarity and human control. Understanding the river and city as a hydrosocial territory or as a socio-natural system liberates both actors from the duality of the natural and the social while repositioning river flooding as a normal part of coexistence on a floodplain. This paper argues for the adoption of an urban political ecology lens in the analysis and governance of urban rivers like the Elizabeth River as a departure from the equilibrium-seeking and stability metrics of urban resilience.

Keywords: urban flooding, political ecology, Elizabeth river, Hampton roads

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