Search results for: critically ill neonate

Authors: Lottie Lane

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It is habitually assumed and stated that the World Bank should engage and comply with international human rights standards. However, the basis for holding the Bank to such standards is unclear. Most advocates of the idea invoke aspects of international law to argue that the Bank has existing obligations to act in compliance with human rights standards. The Bank itself, however, does not appear to accept such arguments, despite having endorsed the importance of human rights for a considerable length of time. A substantial challenge is that under the current international human rights law framework, the World Bank is considered a non-state actor, and as such, has no direct human rights obligations. In the absence of clear legal duties for the Bank, it is necessary to look at the tools available beyond the international human rights framework to encourage the Bank to comply with human rights standards. This article critically examines several bases for arguing that the Bank should comply and engage with human rights through its policies and practices. Drawing on the Bank’s own ‘good governance’ approach as well as the United Nations’ ‘human rights-based-approach’ to development, a new basis is suggested. First, the relationship between the World Bank and human rights is examined. Three perspectives are considered: (1) the legal position – what the status of the World Bank is under international human rights law, and whether it can be said to have existing legal human rights obligations; (2) the Bank’s own official position – how the Bank envisages its relationship with and role in the protection of human rights; and (3) the relationship between the Bank’s policies and practices and human rights (including how its attitudes are reflected in its policies and how the Bank’s operations impact human rights enjoyment in practice). Here, the article focuses on two examples – the (revised) 2016 Environmental and Social Safeguard Policies and the 2012 case-study regarding Gambella, Ethiopia. Both examples are widely considered missed opportunities for the Bank to actively engage with human rights. The analysis shows that however much pressure is placed on the Bank to improve its human rights footprint, it is extremely reluctant to do so explicitly, and the legal bases available are insufficient for requiring concrete, ex ante action by the Bank. Instead, the Bank’s own ‘good governance’ approach to development – which it has been advocating since the 1990s – can be relied upon. ‘Good governance’ has been used and applied by many actors in many contexts, receiving numerous different definitions. This article argues that human rights protection can now be considered a crucial component of good governance, at least in the context of development. In doing so, the article explains the relationship and interdependence between the two concepts, and provides three rationales for the Bank to take a ‘human rights-based approach’ to good governance. Ultimately, this article seeks to look beyond international human rights law and take a governance approach to provide a convincing basis upon which to argue that the World Bank should comply with human rights standards.

Keywords: World Bank, international human rights law, good governance, human rights-based approach

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Authors: Ugo Rovigatti

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Neuroblastoma (NBL) has epitomized for at least 40 years our understanding of cancer cellular and molecular biology and its potential applications to novel therapeutic strategies. This includes the discovery of the very first oncogene aberrations and tumorigenesis suppression by differentiation in the 80s; the potential role of suppressor genes in the 90s; the relevance of immunotherapy in the millennium first, and the discovery of additional mutations by NGS technology in the millennium second decade. Similar discoveries were achieved in the majority of human cancers, and similar therapeutic interventions were obtained subsequently to NBL discoveries. Unfortunately, targeted therapies suggested by specific mutations (such as MYCN amplification –MNA- present in ¼ or 1/5 of cases) have not elicited therapeutic successes in aggressive NBL, where the prognosis is still dismal. The reasons appear to be linked to Tumor Heterogeneity, which is particularly evident in NBL but also a clear hallmark of aggressive human cancers generally. The new avenue of cancer immunotherapy (CIT) provided new hopes for cancer patients, but we still ignore the cellular or molecular targets. CIT is emblematic of high-risk disease (HR-NBL) since the mentioned GD2 passive immunotherapy is still providing better survival. We recently critically reviewed and evaluated the literature depicting the genomic landscapes of HR-NBL, coming to the qualified conclusion that among hundreds of affected genes, potential targets, or chromosomal sites, none correlated with anti-GD2 sensitivity. A better explanation is provided by the Micro-Foci inducing Virus (MFV) model, which predicts that neuroblasts infection with the MFV, an RNA virus isolated from a cancer-cluster (space-time association) of HR-NBL cases, elicits the appearance of MNA and additional genomic aberrations with mechanisms resembling chromothripsis. Neuroblasts infected with low titers of MFV amplified MYCN up to 100 folds and became highly transformed and malignant, thus causing neuroblastoma in young rat pups of strains SD and Fisher-344 and larger tumor masses in nu/nu mice. An association was discovered with GD2 since this glycosphingolipid is also the receptor for the family of MFV virus (dsRNA viruses). It is concluded that a dsRNA virus, MFV, appears to provide better explicatory mechanisms for the genesis of i) specific genomic aberrations such as MNA; ii) extensive tumor heterogeneity and chromothripsis; iii) the effects of passive immunotherapy with anti-GD2 monoclonals and that this and similar models should be further investigated in both pediatric and adult cancers.

Keywords: neuroblastoma, MYCN, amplification, viruses, GD2

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Authors: M. S. Sarkar, J. A. Johnson, S. Sen, G. K. Saha, K. Ramesh

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There is growing recognition of several important roles played by tigers for maintaining sustainable biodiversity at diverse ecosystems in South and South-East Asia. Only <3200 individuals are left in the wild because of poaching and habitat loss. Thus, restoring wild population is an emerging as well as important conservation initiative, but such efforts still remain challenging due to their elusive and solitary behavior. After careful translocation of few individuals, how reintroduced individuals colonize into suitable habitat and achieve stable stage population through reproduction is vital information for forest managers and policy makers of its 13 distribution range countries. Four wild and two captive radio collared tigers were reintroduced at Panna Tiger Reserve, Madhya-pradesh, India during 2009-2014. We critically examined their settlement behavior and population growth over the period. Results from long term telemetry data showed that male explored larger areas rapidly in short time span, while females explored small area in long time period and with significant high rate of movement in both sexes during exploratory period. Significant difference in home range sizes of tigers were observed in exploratory and settlement period. Though all reintroduced tigers preferred densely vegetated undisturbed forest patches within the core area of tiger reserve, a niche based k select analysis showed that individual variation in habitat selection was prominent among reintroduced tigers. Total 18 litter of >42 known cubs were born with low mortality rate, high maternity rate, high observed growth rate and short generation time in both the sexes. The population achieved its carrying capacity in a very short time span, marking success of this current tiger conservation programme. Our study information could provide significant insights on the tiger biology of translocated tigers with implication for future conservation strategies that consider translocation based recovery in their range countries.

Keywords: reintroduction, tiger, home range, demography

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Authors: Abdulrahman Fahim M. Alsulami

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This paper is dedicated to a detailed investigation of the interaction between the agreement on trade-related aspects of intellectual property rights (TRIPS) and bilateral investment treaties (BITs) in the regulation of health-related intellectual property rights in Australia and the Kingdom of Saudi Arabia. The chosen research object is complex and requires a thorough examination of a set of factors influencing the problem under investigation. At the moment, to the author’s best knowledge’ there is no academic research that would conceptualize and critically compare the regulation of health-related intellectual property rights in these two countries. While there is a substantial amount of information in the literature on certain aspects of the problem, the existing knowledge about certain aspects of the health-related regulatory frameworks in Australia and Saudi Arabia barely explains in detail the specifics of the ways in which the TRIPS agreement interacts with (BITs) in the regulation of health-related intellectual property rights. Therefore, this paper will address an evident research gap by studying an intriguing yet under-researched problem. The paper comprises five subsections. The first subsection provides an overview of the investment climate in Saudi Arabia and Australia with an emphasis on the health care industry. It will cover political, economic, and social factors influencing the investment climate in these countries, the systems of intellectual property rights protection, recent patterns relevant to the investment climate’s development, and key characteristics of the investment climate in the health care industry. The second subsection analyses BITs in Saudi Arabia and Australia in light of the countries’ responsibilities under the TRIPS Agreement. The third subsection provides a critical examination of the interaction between the TRIPS Agreement and BITs in Saudi Arabia on the basis of data collected and analyzed in previous subsections. It will investigate key discrepancies concerning the regulation of health-related intellectual property rights in Saudi Arabia and Australia from the position of BITs’ interaction with the TRIPS Agreement and explore the existing procedures for clarifying priorities between them in regulating health-related intellectual property rights. The fourth subsection of the paper provides recommendations concerning the transformation of BITS into a TRIPS+ dimension in regulating health-related intellectual property rights in Saudi Arabia and Australia. The final subsection provides a summary of differences between the Australian and Saudi BITs from the perspective of the regulation of health-related intellectual property rights under the TRIPS agreement and bilateral investment treaties.

Keywords: Australia, bilateral investment treaties, IP law, public health sector, Saudi Arabia

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Authors: L. Gómez-Limia, I. Franco, T. Blanco, S. Martínez

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European eels (Anguilla anguilla) belong to Anguilliformes order and Anguillidae family. They are generally classified as warm-water fish. Eels have a great commercial value in Europe and Asian countries. Eels can reach high weights, although their commercial size is relatively low in some countries. The capture of larger eels would facilitate the recovery of the species, as well as having a greater number of either glass eels or elvers for aquaculture. In the last years, the demand and the price of eels have increased significantly. However, European eel is considered critically endangered by the International Union for the Conservation of Nature (IUCN) Red List. The biochemical composition of fishes is an important aspect of quality and affects the nutritional value and consumption quality of fish. In addition, knowing this composition can help predict an individual’s condition for their recovery. Fish is known to be important source of protein rich in essential amino acids. However, there is very little information about changes in amino acids composition of European eels with increase in size. The aim of this study was to evaluate the effect of two different weight categories on the amino acids content in muscle tissue of wild European eels. European eels were caught in River Ulla (Galicia, NW Spain), during winter. The eels were slaughtered in ice water immersion. Then, they were purchased and transferred to the laboratory. The eels were subdivided into two groups, according to the weight. The samples were kept frozen (-20 °C) until their analysis. Frozen eels were defrosted and the white muscle between the head and the anal hole. was extracted, in order to obtain amino acids composition. Thirty eels for each group were used. Liquid chromatography was used for separation and quantification of amino a cids. The results conclude that the eels are rich in glutamic acid, leucine, lysine, threonine, valine, isoleucine and phenylalanine. The analysis showed that there are significant differences (p < 0.05) among the eels with different sizes. Histidine, threonine, lysine, hydroxyproline, serine, glycine, arginine, alanine and proline were higher in small eels. European eels muscle presents between 45 and 46% of essential amino acids in the total amino acids. European eels have a well-balanced and high quality protein source in the respect of E/NE ratio. However, eels with higher weight showed a better ratio of essential and non-essential amino acid.

Keywords: European eels, amino acids, HPLC, body size

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Authors: Biljana Marković

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Social networks are an integral part of our everyday lives, becoming an indispensable medium for communication in personal and business environments. New forms and ways of communication change the general mindset and significantly affect the quality of life of individuals. Quality of life is perceived as an abstract term, but often people are not aware that they directly affect the quality of their own lives, making minor but significant everyday choices and decisions. Quality of life can be defined broadly, but in the widest sense, it involves a subjective sense of satisfaction with one's life. Scientific knowledge about the impact of social networks on self-assessment of the quality of life of individuals is only just beginning to be researched. Available research indicates potential benefits as well as a number of disadvantages. In the context of the previous claims, the focus of the study conducted by the authors of this paper focuses on analyzing the impact of social networks on individual’s self-assessment of quality of life and the correlation between time spent on social networks, and the choice of content that individuals choose to share to present themselves. Moreover, it is aimed to explain how much and in what ways they critically judge the lives of others online. The research aspires to show the positive as well as negative aspects that social networks, primarily Facebook and Instagram, have on creating a picture of individuals and how they compare themselves with others. The topic of this paper is based on quantitative research conducted on a representative sample. An analysis of the results of the survey conducted online has elaborated a hypothesis which claims that content shared by individuals on social networks influences the image they create about themselves. A comparative analysis of the results obtained with the results of similar research has led to the conclusion about the synergistic influence of social networks on the feeling of the quality of life of respondents. The originality of this work is reflected in the approach of conducting research by examining attitudes about an individual's life satisfaction, the way he or she creates a picture of himself/herself through social networks, the extent to which he/she compares herself/himself with others, and what social media applications he/she uses. At the cognitive level, scientific contributions were made through the development of information concepts on quality of life, and at the methodological level through the development of an original methodology for qualitative alignment of respondents' attitudes using statistical analysis. Furthermore, at the practical level through the application of concepts in assessing the creation of self-image and the image of others through social networks.

Keywords: quality of life, social media, self image, influence of social media

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Authors: Charles A. Khamala

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In 2003, constrained by an absent “rule of law culture” and negative economic growth, the new Kenyan government chose to pursue incremental judicial reforms rather than comprehensive constitutional reforms. President Mwai Kibaki’s first administration’s judicial reform strategy was two pronged. First, to implement unprecedented “radical surgery,” he appointed a new Chief Justice who instrumentally recommended that half the purportedly-corrupt judiciary should be removed by Presidential tribunals of inquiry. Second, the replacement High Court judges, initially, instrumentally-endorsed the “radical surgery’s” administrative decisions removing their corrupt predecessors. Meanwhile, retention of the welfare-reducing Constitution perpetuated declining public confidence in judicial institutions culminating in refusal by the dissatisfied opposition party to petition the disputed 2007 presidential election results, alleging biased and corrupt courts. Fatefully, widespread post-election violence ensued. Consequently, the international community prompted the second Kibaki administration to concede to a new Constitution. Suddenly, the High Court then adopted a non-instrumental interpretation to reject the 2003 “radical surgery.” This paper therefore critically analyzes whether the Kenyan court’s inconsistent interpretations–pertaining to the constitutionality of the 2003 “radical surgery” removing corruption from Kenya’s courts–was predicated on political expediency or human rights principles. If justice “must also seen to be done,” then pursuit of the CJ’s, Judicial Service Commission’s and president’s political or economic interests must be limited by respect for the suspected judges and magistrates’ due process rights. The separation of powers doctrine demands that the dismissed judges should have a right of appeal which entails impartial review by a special independent oversight mechanism. Instead, ignoring fundamental rights, Kenya’s new Supreme Court’s interpretation of another round of vetting under the new 2010 Constitution, ousts the High Court’s judicial review jurisdiction altogether, since removal of judicial corruption is “a constitutional imperative, akin to a national duty upon every judicial officer to pave way for judicial realignment and reformulation.”

Keywords: administrative decisions, corruption, fair hearing, judicial review, (non) instrumental

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Authors: Amy L. Smith

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This study investigates the impact of student authenticity while engaging in academic exploration of students' sense of belonging, autonomy, and persistence. Research questions include: How does incorporating authenticity in first-year academic exploration courses impact; 1) first-year students’ sense of belonging, autonomy, and persistence? 2) first-year students’ sense of belonging, autonomy, and persistence during the first and last halves of the fall semester? 3) first-year students’ sense of belonging, autonomy, and persistence among various student demographics? First-year students completed a Likert-like survey at the conclusion of eight weeks (first and last eight weeks/fall semester) academic exploration courses. Course redesign included grounding the curriculum and instruction with student authenticity and creating opportunities for students to explore, define, and reflect upon their authenticity during academic exploration. Surveys were administered at the conclusion of these eight week courses (first and last eight weeks/fall semester). Data analysis included an entropy balancing matching method and t-tests. Research findings indicate integrating authenticity into academic exploration courses for first-year students has a positive impact on students' autonomy and persistence. There is a significant difference between authenticity and first-year students' autonomy (p = 0.00) and persistence (p = 0.01). Academic exploration courses with the underpinnings of authenticity are more effective in the second half of the fall semester. There is a significant difference between an academic exploration course grounding the curriculum and instruction in authenticity offered M8A (first half, fall semester) and M8B (second half, fall semester) (p = 0); M8B courses illustrate an increase of students' sense of belonging, autonomy, and persistence. Integrating authenticity into academic exploration courses for first-year students has a positive impact on varying student demographics (p = 0.00). There is a significant difference between authenticity and low-income (p = 0.04), first-generation (p = 0.00), Caucasian (p = 0.02), and American Indian/Alaskan Native (p = 0.05) first-year students' sense of belonging, autonomy, and persistence. Academic exploration courses embedded in authenticity helps develop first-year students’ sense of belonging, autonomy, and persistence, which are effective traits of college students. As first-year students engage in content courses, professors can empower students to have greater engagement in their learning process by relating content to students' authenticity and helping students think critically about how content is authentic to them — how students' authenticity relates to the content, how students can take their content expertise into the future in ways that, to the student, authentically contribute to the greater good. A broader conversation within higher education needs to include 1) designing courses that allow students to develop and reflect upon their authenticity/to formulate answers to the questions: who am I, who am I becoming, and how will I move my authentic self forward; and 2) a discussion of how to shift from the university shaping students to the university facilitating the process of students shaping themselves.

Keywords: authenticity, first-year experience, sense of belonging, autonomy, persistence

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Authors: Robert Ab Butarbutar, Sutan Musa Buyana

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Purpose: The purpose of this study is to empirically test the correlation between several variables: perceived quality, overall customer satisfaction and brand attitude to brand loyalty on Maxim magazine in Indonesia. Since the room of adult magazine in Indonesia is restricted, the study of this category has became so interesting to reveal how those variables occur. Design/ methodology/ approach: The combination of exploratory, descriptive and causal research design used in this study. Non-probability sampling, specifically purposive sampling used to determine 160 respondents. Path analysis used to examine the contribution of antecedents variables, perceived quality, overall satisfaction and brand attitude in contribution to brand loyalty. Additional respondents serve for in-depth interview to enrich findings from questionnaire that directly distributed. Findings: The research shows that perceived quality positively contribute to overall satisfaction and brand attitude. Overall satisfaction also positively influence brand attitude and brand loyalty. Finally, brand attitude directly impact to brand loyalty. Despite the hypothesis testing, qualitative research also shows specific behavior of Indonesian customer in consuming adult magazine. Research limitation/implication: This research limited to adult male (18 years at minimum) and who live in big city as Jakarta. Broader geographical coverage is advisable for further research. This study also serves a call for additional empirical research into different product category that targeted to adult male, Since the research of this segment is quite scarce. Managerial Implications: Since findings show perceived quality positively impact and strong contribute to overall satisfaction and brand attitude, it implies for adult magazine to be driven by quality of content. The selection of model, information of current lifestyle of urban male became prioritizes in developing perceived quality. Differentiation also emerges as critical issues since consumer difficult to differentiate significantly one magazine to another. The way magazine deliver its content toward distinctive communication is highly recommended. Furthermore, brand loyalty faces big challenge. Interactivity toward events and social media become critically important. Originality/ value: perceived quality plays as prerequisite to develop overall satisfaction and brand attitude. Finding shows customer difficult to differentiate among adult magazines. Therefore, brand loyalty become a big challenge for company.

Keywords: perceived quality, overall satisfaction, brand attitude, adult magazine

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Authors: Fatema Akram, Mohammad G. Rasul, M. Masud K. Khan, M. Sharif I. I. Amir

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Australia is a country of some 7,700 million square kilometres with a population of about 22.6 million. At present water security is a major challenge for Australia. In some areas the use of water resources is approaching and in some parts it is exceeding the limits of sustainability. A focal point of proposed national water conservation programs is the recycling of both urban storm-water and treated wastewater. But till now it is not widely practiced in Australia, and particularly storm-water is neglected. In Australia, only 4% of storm-water and rainwater is recycled, whereas less than 1% of reclaimed wastewater is reused within urban areas. Therefore, accurately monitoring, assessing and predicting the availability, quality and use of this precious resource are required for better management. As storm-water is usually of better quality than untreated sewage or industrial discharge, it has better public acceptance for recycling and reuse, particularly for non-potable use such as irrigation, watering lawns, gardens, etc. Existing storm-water recycling practice is far behind of research and no robust technologies developed for this purpose. Therefore, there is a clear need for using modern technologies for assessing feasibility of storm-water harvesting and reuse. Numerical modelling has, in recent times, become a popular tool for doing this job. It includes complex hydrological and hydraulic processes of the study area. The hydrologic model computes storm-water quantity to design the system components, and the hydraulic model helps to route the flow through storm-water infrastructures. Nowadays water quality module is incorporated with these models. Integration of Geographic Information System (GIS) with these models provides extra advantage of managing spatial information. However for the overall management of a storm-water harvesting project, Decision Support System (DSS) plays an important role incorporating database with model and GIS for the proper management of temporal information. Additionally DSS includes evaluation tools and Graphical user interface. This research aims to critically review and discuss all the aspects of storm-water harvesting and reuse such as available guidelines of storm-water harvesting and reuse, public acceptance of water reuse, the scopes and recommendation for future studies. In addition to these, this paper identifies, understand and address the importance of modern technologies capable of proper management of storm-water harvesting and reuse.

Keywords: storm-water management, storm-water harvesting and reuse, numerical modelling, geographic information system, decision support system, database

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Authors: Waheed Anwar, Kiran Nawaz, Muhammad Saleem Haider, Ahmad Ali Shahid, Sehrish Iftikhar

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The whitefly, Bemisia tabaci (Gennadius), is a complex insect species, including many cryptic species or biotypes. Whitefly causes damage to many ornamental and horticultural crops through directly feeding on phloem sap, resulting in sooty mould and critically decreases the rate of photosynthesis of many host plants. Biological control has emerged as one of the most important methods for the management of soil-borne plant pathogens. Among the natural enemies of insects different entomopathogenic fungi are mostly used as biological control of the pest. The purpose of this research was to find indigenous insect-associated fungi and their virulence against Bemisia tabaci. A detailed survey of cotton fields in sample collection was conducted during July and August 2013 from the central mixed zone of Punjab, Pakistan. For the isolation of T. longibrachiatum, sabouraud dextrose peptone yeast extract agar (SDAY) media was used and morphological characterization of isolated T. longibrachiatum was studied using different dichotomous keys. Molecular Identification of the pathogen was confirmed by amplifying the internal transcribed spacer region. Blastn analysis showed 100% homology with already reported sequences on the database. For these bioassays, two conidial concentrations 4 × 108/mL & 4 × 104/mL of T. longibrachiatum was sprayed in clip cages for nymph and adult B. tabaci respectively under controlled environmental conditions. The pathogenicity of T. longibrachiatum was tested on nymph and adult whitefly to check mortality. Mortality of B. tabaci at nymphal and adult stages were observed after 24-hour intervals. Percentage mortality of nymphs treated with 4 x 104/mL conidia of T. longibrachiatum was 20, 24, 36 and 40% after 48, 72, 96, 72, 96, 120 and 144 hours respectively. However, no considerable difference was recorded in percentage mortality of whitefly after 120 and 144 hours. There were great variations after 24, 48, 72 and 96 hours in the rate of mortality. The efficacy of T. longibrachiatum as entomopathogenic fungi was evaluated in adult and nymphal stages of whitefly. Trichoderma longibrachiatum showed maximum activity on nymphal stages of whitefly as compared to adult stages. The percentage of conidial germination was also recorded on the outer surface of adult and nymphal stages of B. tabaci. The present findings indicated that T. longibrachiatum is an entomopathogenic fungus against B. tabaci and many species of Trichoderma were already reported as an antagonistc organism against a wide range of bacterial and fungal pathogens.

Keywords: efficacy, Trichoderma, virulence, bioassay

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Authors: Roger M. Wall, David G. Proverbs, Yamina Silva, Danny Scipion

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This paper critically reviews the outcomes of a 4 day workshop focused on building resilience to El Niño related Flood Events in northern Perú. The workshop was run jointly by Birmingham City University (BCU) in partnership with Instituto Geofísico del Perú (IGP) and was hosted by the Universidad de Piura (UDEP). The event took place in August 2018 and was funded by the Newton-Paulet fund administered by the British Council. The workshop was a response to the severe flooding experienced in Piura during the El Niño event of March 2017 which damaged over 100,000 homes and destroyed much local infrastructure including around 100 bridges. El Niño is a recurrent event and there is concern that its frequency and intensity may change in the future as a consequence of climate change. A group of 40 early career researchers and practitioners from the UK and Perú were challenged with working together across disciplines to identify key cross-cutting themes and make recommendations for building resilience to similar future events. Key themes identified on day 1 of the workshop were governance; communities; risk information; river management; urban planning; health; and infrastructure. A field study visit took place on day 2 so that attendees could gain first-hand experience of affected and displaced communities. Each of the themes was then investigated in depth on day 3 by small interdisciplinary teams drawing on their own expertise, local knowledge and the experiences of the previous day’s field trip. Teams were responsible for developing frameworks for analysis of their chosen theme and presenting their findings to the whole group. At this point, teams worked together to develop links between the different themes so that an integrated approach could be developed and presented on day 4. This paper describes the approaches taken by each team and the way in which these were integrated to form an holistic picture of the whole system. The findings highlighted the importance of risk-related information and the need for strong governance structures to enforce planning regulations and development. The structured facilitation approach proved to be very effective and it is recommended that the process be repeated with a broader group of stakeholders from across the region.

Keywords: El Niño, integrated flood risk management, Perú, structured facilitation, systems approach, resilience

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Authors: Taus Muganda

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This research explores the intricate relationship between e-procurement adoption and effective service delivery in the Uganda Coffee Industry, focusing on the processes involved, key actors, and the impact of digital transformation. The study is guided by three prominent theories, Actor-Network Theory, Resource-Based View Theory, and Institutional Theory to comprehensively explore the dynamics of e-procurement in the context of the coffee sector. The primary aim of this project is to examine the e-procurement adoption process and its role in enhancing service delivery within the Uganda Coffee Industry. The research questions guiding this inquiry are: firstly, whether e-procurement adoption and implementation contribute to achieving quality service delivery; and secondly, how e-procurement adoption can be effectively realized within the Uganda Coffee Industry. To address these questions, the study has laid out specific objectives. Firstly, it seeks to investigate the impact of e-procurement on effective service delivery, analysing how the integration of digital processes influences the overall quality of services provided in the coffee industry. Secondly, it aims to critically analyse the measures required to achieve effective delivery outcomes through the adoption and implementation of e-procurement, assessing the strategies that can maximize the benefits of digital transformation. Furthermore, the research endeavours to identify and examine the key actor’s instrumental in achieving effective service delivery within the Uganda Coffee Industry. By utilizing Actor-Network Theory, the study will elucidate the network of relationships and collaborations among actors involved in the e-procurement process. The research contributes to addressing a critical gap in the sector. Despite coffee being the leading export crop in Uganda, constituting 16% of total exports, there is a recognized need for digital transformation, specifically in the realm of e-procurement, to enhance the productivity of producers and contribute to the economic growth of the country. The study aims to provide insights into transforming the Uganda Coffee Industry by focusing on improving the e-procurement services delivered to actors in the coffee sector. The three forms of e-procurement investigated in this research—E-Sourcing, E-Payment, and E-Invoicing—serve as focal points in understanding the multifaceted dimensions of digital integration within the Uganda Coffee Industry. This research endeavours to offer practical recommendations for policymakers, industry stakeholders, and the UCDA to strategically leverage e-procurement for the benefit of the entire coffee value chain.

Keywords: e-procurement, effective service delivery, actors, actor-network theory, resource-based view theory, institutional theory, e-invocing, e-payment, e-sourcing

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Authors: Mandy Tao Benec

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Propaganda, understood as a ‘deliberate attempt to persuade people to think and behave in a desired way’, contributes to the fabric of mass media discourse as an important component, albeit often under various alternative expressions except ‘propaganda’. When the word ‘propaganda’ does appear in the mainstream media of the West, it is often selectively applied upon undesiring parties such as China, the North Korea, Russia’s Putin, or terrorists, etc.. This attitude reveals an ‘us verse them’ mentality; and a presupposition that propaganda is something only ‘they’ do whilst ‘we’ do not. This phenomenon not only runs in danger of generating political naivety, but also calls for the necessity of re-examining propaganda which will benefit from analysing it in contrasting social and political environments. Therefore, this paper aims to compare how propaganda has been understood and put in practice both in the Anglo-American context and by the Chinese Communist Party (CCP). By revealing the convergence and divergence of the propaganda discourses between China and the West, it will help clarify the misconception and misunderstanding of the term. Historical narrative analysis and critical discourse analysis are the main methodologies. By carefully examining data from academic research on propaganda in both English and Chinese, the landscape of how propaganda is defined throughout different eras is mapped, with special attention paid to analysing the parallelism and/or correspondence between China and the West when applicable. Meanwhile, critically analysing the official documents such as speeches and guidelines for propaganda administration given by top-rank CCP leaders will help reveal that in contrast to the West’s ‘us-them’ mentality, China sees oneself in no difference with the Western democracies when propaganda is concerned. Major findings of this study will identify a series of convergence and divergence between Chinese and Western propaganda discourses, and the relationship between propaganda the ‘signified’ (its essence) and propaganda the ‘signifier’ (the term itself), including (yet not limited to): 1) convergence in China catching up with the West, acknowledging the perceived pejorative connotation of the term 2) divergence in propaganda activities disassociated from the term in the West; and convergence in adopting such practice when China following suit in its external propaganda towards the West 3) convergence in utilising alternative notions to replace ‘propaganda’, first by the West, then imported and incorporated enthusiastically by China into its propaganda discourse 4) divergence between China’s internal and external propaganda and the subsequent differentiation between in which contexts the CCP sees fit to utilise the concept 5) convergence between China and the West in their English language propaganda discourses, whilst simultaneous divergence in their presuppositions: ‘usthem’ by the West and ‘we are the same’ by China. To conclude, this paper will contribute to the study of propaganda and its discourse by analysing how propaganda is understood and utilised in both worlds, and hence to uncover the discourse power struggle between the two, which contributes to the propaganda discourse itself. Hence, to untie the misconception of propaganda.

Keywords: China, discourse, power, propaganda

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Authors: Zheng Yuxun

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This review critically assesses the advancements and prospective developments in defect detection methodologies within the semiconductor industry, an essential domain that significantly affects the operational efficiency and reliability of electronic components. As semiconductor devices continue to decrease in size and increase in complexity, the precision and efficacy of defect detection strategies become increasingly critical. Tracing the evolution from traditional manual inspections to the adoption of advanced technologies employing automated vision systems, artificial intelligence (AI), and machine learning (ML), the paper highlights the significance of precise defect detection in semiconductor manufacturing by discussing various defect types, such as crystallographic errors, surface anomalies, and chemical impurities, which profoundly influence the functionality and durability of semiconductor devices, underscoring the necessity for their precise identification. The narrative transitions to the technological evolution in defect detection, depicting a shift from rudimentary methods like optical microscopy and basic electronic tests to more sophisticated techniques including electron microscopy, X-ray imaging, and infrared spectroscopy. The incorporation of AI and ML marks a pivotal advancement towards more adaptive, accurate, and expedited defect detection mechanisms. The paper addresses current challenges, particularly the constraints imposed by the diminutive scale of contemporary semiconductor devices, the elevated costs associated with advanced imaging technologies, and the demand for rapid processing that aligns with mass production standards. A critical gap is identified between the capabilities of existing technologies and the industry's requirements, especially concerning scalability and processing velocities. Future research directions are proposed to bridge these gaps, suggesting enhancements in the computational efficiency of AI algorithms, the development of novel materials to improve imaging contrast in defect detection, and the seamless integration of these systems into semiconductor production lines. By offering a synthesis of existing technologies and forecasting upcoming trends, this review aims to foster the dialogue and development of more effective defect detection methods, thereby facilitating the production of more dependable and robust semiconductor devices. This thorough analysis not only elucidates the current technological landscape but also paves the way for forthcoming innovations in semiconductor defect detection.

Keywords: semiconductor defect detection, artificial intelligence in semiconductor manufacturing, machine learning applications, technological evolution in defect analysis

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Authors: Sara Gallo, Margherita Pasini, Margherita Brondino, Daniela Raccanello, Roberto Burro, Elisa Menardo

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Most of the studies on the ability of environments to recover people’s cognitive resources have been conducted in laboratory using simulated environments (e.g., photographs, videos, or virtual reality), based on the implicit assumption that exposure to simulated environments has the same effects of exposure to real environments. However, the technical characteristics of simulated environments, such as the dynamic or static characteristics of the stimulus, critically affect their perception. Measuring perceived restorativeness in situ rather than in laboratory could increase the validity of the obtained measurements. Personal mobile devices could be useful because they allow accessing immediately online surveys when people are directly exposed to an environment. At the same time, it becomes important to develop short and reliable measuring instruments that allow a quick assessment of the restorative qualities of the environments. One of the frequently used self-report measures to assess perceived restorativeness is the “Perceived Restorativeness Scale” (PRS) based on Attention Restoration Theory. A lot of different versions have been proposed and used according to different research purposes and needs, without studying their validity. This longitudinal study reported some preliminary validation analyses on a short version of original scale, the PRS-6, developed to be quick and mobile-friendly. It is composed of 6 items assessing fascination and being-away. 102 Italian university students participated to the study, 84% female with age ranging from 18 to 47 (M = 20.7; SD = 2.9). Data were obtained through a survey online that asked them to report their perceived restorativeness of the environment they were in (and the kind of environment) and their positive emotion (Positive and Negative Affective Schedule, PANAS) once a day for seven days. Cronbach alpha and item-total correlations were used to assess reliability and internal consistency. Confirmatory Factor Analyses (CFA) models were run to study the factorial structure (construct validity). Correlation analyses between PRS and PANAS scores were used to check discriminant validity. In the end, multigroup CFA models were used to study measurement invariance (configural, metric, scalar, strict) between different mobile devices and between day of assessment. On the whole, the PRS-6 showed good psychometric proprieties, similar to those of the original scale, and invariance across devices and days. These results suggested that the PRS-6 could be a valid alternative to assess perceived restorativeness when researchers need a brief and immediate evaluation of the recovery quality of an environment.

Keywords: restorativeness, validation, short scale development, psychometrics proprieties

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Authors: Cetin Balanuye

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The present study aims to accomplish two tasks: First, it critically reinterprets the actual relationship between democracy and the modern state in order to show that it is responsible for most of our current political problems and dilemmas. Second, it is argued that this relationship can be reimagined for better, and Spinozistic notions such as ‘conatus’, ‘power’ and ‘virtue’ are crucial in this pursuit. The significance of the present study lies in several interrelated observations: The world has never been a more heterogeneous place than today. People from different religious, cultural and historical backgrounds do equally have 'good reasons' to hold that their world views are the best ones. We have almost no authority to be respected equally by all these different world views. We no longer have gods at once we had in our ancient times. We have three big monotheistic religions, yet the God of which is significantly different from each other. The worse is that the believers of these religions do not seem eager to perform a duet, but rather tend to fight a duel with each other. Thanks to post-modernism, neither reason nor science is any longer seen as universally value-neutral guide to be employed in our search for a common ground. In sum, the question 'how should I live?' has never generated this much diversity before in terms of answers and the answers have never been this much away from a fairly objective evaluation. Our so-called liberal democracies are supposed to perform against this heterogenous, antagonistic and self-sustained web of discursive background. It is argued that our conception of 'State' with a weak emphasis on democracy is not a solution, if not itself the source of this topsy-turvy. Weak emphasis on democracy should be understood here as a kind of liberal democracy which operates in a partisan State, one which takes sides among rivals either for this or against that world view. This conception of State rests on a misleading understanding of the concept of power, and it is argued that it can only be corrected by means of a Spinoza-informed ontology of politics. The role of State in such an ontology is no longer a partisanship of any kind, nor is it representative of all-encompassing authority to favor any world view. State in this Spinozistic ontology equally encourages world views and their discursive practices to let them increase the power of acting and have more power to affect rules and regulations. World views can enhance every medium -in the sense of nonviolence ethology- to increase their power of acting. The more active a world view is, the more powerful and the more virtuous it is in terms of its effective power on the State. Though Spinoza has provided us with a limited guideline to understand what kind of democracy, he actually had in his mind, his ontology developed in Ethics is rich enough to imagine and inspire a better democratic practice to help us sustain the modern State in our extremely pluralistic contemporary societies.

Keywords: democracy, Islam, power, Spinoza

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Authors: Havva Tutar Kahraman, Erol Pehlivan

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In recent years, environmental pollution by wastewater rises very critically. Effluents discharged from various industries cause this challenge. Different type of pollutants such as organic compounds, oxyanions, and heavy metal ions create this threat for human bodies and all other living things. However, heavy metals are considered one of the main pollutant groups of wastewater. Therefore, this case creates a great need to apply and enhance the water treatment technologies. Among adopted treatment technologies, adsorption process is one of the methods, which is gaining more and more attention because of its easy operations, the simplicity of design and versatility. Ion exchange process is one of the preferred methods for removal of heavy metal ions from aqueous solutions. It has found widespread application in water remediation technologies, during the past several decades. Therefore, the purpose of this study is to the removal of hexavalent chromium, Cr(VI), from aqueous solutions. Cr(VI) is considered as a well-known highly toxic metal which modifies the DNA transcription process and causes important chromosomic aberrations. The treatment and removal of this heavy metal have received great attention to maintaining its allowed legal standards. The purpose of the present paper is an attempt to investigate some aspects of the use of three anion exchange resins: Eichrom 1-X4, Lewatit Monoplus M800 and Lewatit A8071. Batch adsorption experiments were carried out to evaluate the adsorption capacity of these three commercial resins in the removal of Cr(VI) from aqueous solutions. The chromium solutions used in the experiments were synthetic solutions. The parameters that affect the adsorption, solution pH, adsorbent concentration, contact time, and initial Cr(VI) concentration, were performed at room temperature. High adsorption rates of metal ions for the three resins were reported at the onset, and then plateau values were gradually reached within 60 min. The optimum pH for Cr(VI) adsorption was found as 3.0 for these three resins. The adsorption decreases with the increase in pH for three anion exchangers. The suitability of Freundlich, Langmuir and Scatchard models were investigated for Cr(VI)-resin equilibrium. Results, obtained in this study, demonstrate excellent comparability between three anion exchange resins indicating that Eichrom 1-X4 is more effective and showing highest adsorption capacity for the removal of Cr(VI) ions. Investigated anion exchange resins in this study can be used for the efficient removal of chromium from water and wastewater.

Keywords: adsorption, anion exchange resin, chromium, kinetics

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Authors: Zeite Shumneiyang Koireng

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Liberation is the act of liberating or the state of being liberated. Indian philosophy, in general, understands liberation as moksa, which etymological is derived from the Sanskrit root muc+ktin meaning to loose, set free, to let go, discharge, release, liberate, deliver, etc. According to Indian schools of thought, moksa is the highest value on realizing which nothing remains to be realized. It is the cessation of birth and death, all kinds of pain and at the same time, it is the realization of one’s own self. Sankara’s Advaita philosophy is based on the following propositions: Brahman is the only Reality; the world has apparent reality, and the soul is not different from Brahman. According to Sankara, Brahman is the basis on which the world form appears; it is the sustaining ground of all various modification. It is the highest self and the self of all reveals himself by dividing himself [ as it was in the form of various objects] in multiple ways. The whole world is the manifestation of the Supreme Being. Brahman modifying itself into the Atman or internal self of all things is the world. Since Brahman is the Upadhana karana of the world, the sruti speaks of the world as the modification of Brahman into the Atman of the effect. Contemplation as the fulfillment of man finds a radical foundation in Aquinas teaching concerning the natural end or as he also referred to it, natural desire. The third book of the Summa Contra Gentiles begins the study of happiness with a consideration of natural desire. According to him, all creatures, even those devoid of understanding are ordered to God as an ultimate end. Intrinsically, a part of every nature is a tendency or inclination, originating in the natural form and tendency toward the end for which the possessor of nature exists. It is the study of the nature and finality of inclination that Aquinas establishes through an argument of induction man’s Contemplation of God as the fulfillment of his nature. The present paper is attempted to critically approach two important, seminal and originated thought, representing Indian and Western traditions which mark on the thinking of their respective times. Both these thoughts- Advaitic concept of Liberation in the Indian tradition and the concept of Contemplation in Thomas Aquinas’ Summa Contra Gentiles’- confront directly the question of the ultimate meaning of human existence. According to Sankara, it is knowledge and knowledge alone which is the means of moksa and the highest knowledge is moksa itself. Liberation in Sankara Vedanta is attained as a process of purification of self, which gradually and increasingly turns into purer and purer intentional construction. Man’s inner natural tendency for Aquinas is towards knowledge. The human subject is driven to know more and more about reality and in particular about the highest reality. Contemplation of this highest reality is fulfillment in the philosophy of Aquinas. Rather, Contemplation is the perfect activity in man’s present state of existence.

Keywords: liberation, Brahman, contemplation, fulfillment

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Authors: T. Nguyen, H. Rennie, S. Vallance, M. Mackay

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Municipal Associations, also called Unions, Leagues or Federations of municipalities have been established worldwide to represent the interests and needs of urban governments in the face of increasing urban issues. In 2008, the Association of Cities of Vietnam (ACVN) joined the Asian Coalition of Community Action Program (ACCA program) and introduced the community-based upgrading approach to help Vietnamese cities to address urban upgrading issues. While this community-based upgrading approach has only been implemented in a small number of Vietnamese cities and its replication has faced certain challenges, it is worthy to explore insights on how the Association of cities of Vietnam played its role in implementing some reportedly successful projects. This paper responds to this inquiry and presents results extracted from the author’s PhD study that sets out with a general objective to critically examine how social capital dimensions (i.e., bonding, bridging and linking) were formed, mobilized and maintained in a local collective and community-based upgrading process. Methodologically, the study utilized the given general categorization of bonding, bridging and linking capitals to explore and confirm how social capital operated in the real context of a community-based upgrading process, particularly in the context of Vietnam. To do this, the study conducted two exploratory and qualitative case studies of housing projects in Friendship neighbourhood (Vinh city) and Binh Dong neighbourhood (Tan An city). This paper presents the findings of the Friendship neighbourhood case study, focusing on the role of the Vietnamese municipal association in forming, mobilizing and maintaining bonding, bridging and linking capital for a community-based upgrading process. The findings highlight the essential but uncertain role of ACVN - the organization that has a hybrid legitimacy status - in such a process. The results improve our understanding both practically and theoretically. Practically, the results offer insights into the performance of a municipal association operating in a transitioning socio-political context of Vietnam. Theoretically, the paper questions the necessity of categorizing social capital dimensions (i.e., bonding, bridging and linking) by suggesting a holistic approach of looking at social capital for urban governance issues within the Vietnamese context and perhaps elsewhere.

Keywords: bonding capital, bridging capital, municipal association, linking capital, social capital, housing upgrading

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Authors: Neringa Bagdonaite

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Study Aims: The current study aimed to systematically analyse various research done in the area of female post-traumatic stress disorder (PTSD) and alcohol abuse, and to critically review these results on the basis of theoretical models as well as answer following questions: (I) What is the reciprocal relationship between PTSD and problem alcohol use among females; (II) What are the moderating/mediating factors of this relationship? Methods: The computer bibliographic databases Ebsco, Scopus, Springer, Web of Science, Medline, Science Direct were used to search for scientific articles. Systematic analyses sample consisted of peer-reviewed, English written articles addressing mixed gender and female PTSD and alcohol abuse issues from Jan 2012 to May 2017. Results: Total of 1011 articles were found in scientific databases related to searched keywords of which 29 met the selection criteria and were analysed. The results of longitudinal studies indicate that (I) various trauma, especially interpersonal trauma exposure in childhood is linked with increased risk of revictimization in later life and problem alcohol use; (II) revictimization in adolescence or adulthood, rather than victimization in childhood has a greater impact on the onset and progression of problematic alcohol use in adulthood. Cross-sectional and epidemiological studies also support significant relationships between female PTSD and problem alcohol use. Regards to the negative impact of alcohol use on PTSD symptoms results are yet controversial; some evidence suggests that alcohol does not exacerbate symptoms of PTSD over time, while others argue that problem alcohol use worsens PTSD symptoms and is linked to chronicity of both disorders, especially among women with previous alcohol use problems. Analysis of moderating/mediating factors of PTSD and problem alcohol use revealed, that higher motives/expectancies, specifically distress coping motives for alcohol use significantly moderates the relationship between PTSD and problematic alcohol use. Whereas negative affective states mediate relationship between symptoms of PTSD and alcohol use, but only among woman with alcohol use problems already developed. Conclusions: Interpersonal trauma experience, especially in childhood and its reappearance in lifetime is linked with PTSD symptoms and problem drinking among women. Moreover, problem alcohol use can be both a cause and a consequence of trauma and PTSD, and if used for coping it, increases the likelihood of chronicity of both disorders. In order to effectively treat both disorders, it’s worthwhile taking into account this dynamic interplay of women's PTSD symptoms and problem drinking.

Keywords: female, trauma, post-traumatic stress disorder, problem alcohol use, systemic analysis

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Authors: Till Gramberg, Max Kellner, Erwin Gross

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This paper presents a comprehensive investigation into the topic of smart services and IIoT-Platforms, focusing on their selection and prioritization in manufacturing organizations. First, a literature review is conducted to provide a basic understanding of the current state of research in the area of smart services. Based on discussed and established definitions, a definition approach for this paper is developed. In addition, value propositions for smart services are identified based on the literature and expert interviews. Furthermore, the general requirements for the provision of smart services are presented. Subsequently, existing approaches for the selection and development of smart services are identified and described. In order to determine the requirements for the selection of smart services, expert opinions from successful companies that have already implemented smart services are collected through semi-structured interviews. Based on the results, criteria for the evaluation of existing methods are derived. The existing methods are then evaluated according to the identified criteria. Furthermore, a novel method for the selection of smart services in manufacturing companies is developed, taking into account the identified criteria and the existing approaches. The developed concept for the method is verified in expert interviews. The method includes a collection of relevant smart services identified in the literature. The actual relevance of the use cases in the industrial environment was validated in an online survey. The required data and sensors are assigned to the smart service use cases. The value proposition of the use cases is evaluated in an expert workshop using different indicators. Based on this, a comparison is made between the identified value proposition and the required data, leading to a prioritization process. The prioritization process follows an established procedure for evaluating technical decision-making processes. In addition to the technical requirements, the prioritization process includes other evaluation criteria such as the economic benefit, the conformity of the new service offering with the company strategy, or the customer retention enabled by the smart service. Finally, the method is applied and validated in an industrial environment. The results of these experiments are critically reflected upon and an outlook on future developments in the area of smart services is given. This research contributes to a deeper understanding of the selection and prioritization process as well as the technical considerations associated with smart service implementation in manufacturing organizations. The proposed method serves as a valuable guide for decision makers, helping them to effectively select the most appropriate smart services for their specific organizational needs.

Keywords: smart services, IIoT, industrie 4.0, IIoT-platform, big data

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Authors: Somya Sharma

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Ahalya, the critically acclaimed short film, is known to demolish the gender constructs of the age old myth of Ahalya. The paper tries to crack the overt meaning of the short film by reading between the dialogues and deconstructing the idea of the pseudo feminism in the short film Ahalya by Sujoy Ghosh. The film, by subverting the role of male character by making it seem submissive as compared to the female character's role seems to be just a surface level reading of the text. It seems that Sujoy Ghosh has played not just with changing the paradigm, but also trying to alter the history by doing so. The age old myth of putting Ahalya as a part of the five virgins (panchkanya) of Hindu mythology is explored in the paper. God's manoeuvre cannot be questioned and the two male characters tend to again shape the deed and the life of the female character, Ahalya. It is of importance to note that even in the 21st century, progressive actors like Radhika Apte fail to acknowledge the politics of altering history, not in a progressive way. The film blinds the viewer in the first watch to fall for the female strength and ownership of her sexuality, which is reflected in the opening scene itself where she opens the gate for the police man Indra Sen (representing God Indra who seduced her) who is charmed by her white dress. White, in Hindu mythology, stands for mourning, and this can be a hint towards the prophecy of what is about to come. Ahalya, bold, strong, and confident in this scene seems to be in total ownership of her sexual identity. Further, as the film progresses, control of Ahalya over her acts becomes even more dominant. In the myth of Ahalya, Gautama Maharishi, her husband, who wins her by Brahma's courtesy, curses her for her infidelity. She is then turned into a stone because of the curse and is redeemed when Lord Rama's foot brushes the stone. In the film, it is with the help of Ahalya that Goutam Sadhu turns Indra Sen into a stone doll. Ahalya is seen as a seductress who bewitches Indra Sen, and because the latter falls for the trap laid by the husband wife duo, he is turned into a doll. The attempt made by the paper is to read Ahalya as a character of the stand in wife who is yet again a pawn in the play of Goutama's revenge from Indra (who in the myth is able to escape from any curse or punishment for the act). The paper, therefore, reverts the idea which has till now been signified by the film and attempts to study the feminism this film appropriates. It is essential to break down the structure formed by such overt transgressing films in order to provide a real outlook of how feminism is twisted and moulded according to a man’s wishes.

Keywords: deconstructing, Hindu mythology, Panchkanya, predominant feminism, seductress, stone doll

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Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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Authors: Suneet Jagdev

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The development of the original Bauhaus occurred at a time in the beginning of the 20th century when the industrialization of Germany had reached a climax. The cities were a reflection of the new living conditions of an industrialized society. The Bauhaus can be interpreted as an ambitious attempt to find appropriate answers to the challenges by using architecture-urban development and design. The core elements of the conviction of the day were the belief in the necessary crossing of boundaries between the various disciplines and courage to experiment for a better solution. Even after 100 years, the situation in our cities is shaped by similar complexity. The urban consequences of developments are difficult to estimate and to predict. The paper critically reflected on the central aspects of the history of the Bauhaus and its role in bringing the modernism in India by comparative studies of the methodology adopted by the artists and designer in both the countries. The paper talked in detail about how the Bauhaus Exhibition in 1922 offered Indian artists a new weapon of anti-colonial resistance. The original Bauhaus fought its aesthetic and political battles in the context of economic instability and the rise of German fascism. The Indians had access to dominant global languages and in a particular English. The availability of print media and a vibrant indigenous intellectual culture provided Indian people a tool to accept technology while denying both its dominant role in culture and the inevitability of only one form of modernism. The indigenous was thus less an engagement with their culture as in the West than a tool of anti-colonial struggle. We have shown how the Indian people used Bauhaus as a critique of colonialism itself through an undermining of its typical modes of representation and as a means of incorporating the Indian desire for spirituality into art and as providing the cultural basis for a non-materialistic and anti-industrial form of what we might now term development. The paper reflected how through painting the Bauhaus entered the artistic consciousness of the sub-continent not only for its stylistic and technical innovations but as a tool for a critical and even utopian modernism that could challenge both the hegemony of academic and orientalist art and as the bearer of a transnational avant-garde as much political as it was artistic, and as such the basis of a non-Eurocentric but genuinely cosmopolitan alternative to the hierarchies of oppression and domination that had long bound India and were at that moment rising once again to a tragic crescendo in Europe. We have talked about how the Bauhaus of today can offer an innovative orientation towards discourse around architecture and design.

Keywords: anti-colonial struggle, art over architecture, Bauhaus exhibition of 1922, industrialization

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Authors: Jessica A. Hellings, Piyushkumar Jani

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Background: Systemic autoimmune disorders are increasingly implicated in neuropsychiatric illness, especially in the setting of treatment resistance in individuals of all ages. Gluten allergy in fullest extent results in celiac disease, affecting multiple organs including central nervous system (CNS). Clinicians often lack awareness of the association between neuropsychiatric illness and gluten allergy, partly since many such research studies are published in immunology and gastroenterology journals. Methods: Following a Pubmed literature search and online searches on celiac disease websites, 40 articles are critically reviewed in detail. This work reviews celiac disease, gluten intolerance and current evidence of their relationship to neuropsychiatric and systemic illnesses. The review also covers current work-up and diagnosis, as well as dietary interventions, gluten restriction outcomes, and future research directions. Results: Gluten allergy in susceptible individuals damages the small intestine, producing a leaky gut and malabsorption state, as well as allowing antibodies into the bloodstream, which attack major organs. Lack of amino acid precursors for neurotransmitter synthesis together with antibody-associated brain changes and hypoperfusion may result in neuropsychiatric illness. This is well documented; however, studies in neuropsychiatry are often small. In the large CATIE trial, subjects with schizophrenia had significantly increased antibodies to tissue transglutaminase (TTG), and antigliadin antibodies, both significantly greater gluten antibodies than in control subjects. On later follow up, TTG-6 antibodies were identified in these subjects’ brains but not in their intestines. Significant evidence mostly from small studies also exists for gluten allergy and celiac-related depression, anxiety disorders, attention-deficit/hyperactivity disorder, autism spectrum disorders, ataxia, and epilepsy. Dietary restriction of gluten resulted in remission in several published cases, including for treatment-resistant schizophrenia. Conclusions: Ongoing and larger studies are needed of the diagnosis and treatment efficacy of the gluten-free diet in neuropsychiatric illness. Clinicians should ask about the patient history of anemia, hypothyroidism, irritable bowel syndrome and family history of benefit from the gluten-free diet, not limited to but especially in cases of treatment resistance. Obtaining gluten antibodies by a simple blood test, and referral for gastrointestinal work-up in positive cases should be considered.

Keywords: celiac, gluten, neuropsychiatric, translational

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Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospital Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre- EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors that are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality, and the data were analyzed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system that can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analyzed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospital staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: emergency medical teams, communication, information and communication technologies, disaster

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Authors: Fernando Araujo, Sandra Cardoso, Fátima Fonseca, Sandra Cavaca

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A debureaucratization strategy for the Portuguese Health Service was assumed by the Executive Board of the SNS, in deep articulation with the Shared Services of the Ministry of Health. Two of the main dimensions were focused on sick leaves (SL), that transform primary health care (PHC) in administrative institutions, limiting access to patients. The self-declaration of illness (SDI) project, through the National Health Service Contact Centre (SNS24), began on May 1, 2023, and has already resulted in the issuance of more than 300,000 SDI without the need to allocate resources from the National Health Service (NHS). This political decision allows each citizen, in a maximum 2 times/year, and 3 days each time, if ill, through their own responsibility, report their health condition in a dematerialized way, and by this way justified the absence to work, although by Portuguese law in these first three days, there is no payment of salary. Using a digital approach, it is now feasible without the need to go to the PHC and occupy the time of the PHC only to obtain an SL. Through this measure, bureaucracy has been reduced, and the system has been focused on users, improving the lives of citizens and reducing the administrative burden on PHC, which now has more consultation times for users who need it. The second initiative, which began on March 1, 2024, allows the SL to be issued in emergency departments (ED) of public hospitals and in the health institutions of the social and private sectors. This project is intended to allow the user who has suffered a situation of acute urgent illness and who has been observed in an ED of a public hospital or in a private or social entity no longer need to go to PHC only to apply for the respective SL. Since March 1, 54,453 SLs have been issued, 242 in private or social sector institutions and 6,918 in public hospitals, of which 134 were in ED and 47,292 in PHC. This approach has proven to be technically robust, allows immediate resolution of problems and differentiates the performance of doctors. However, it is important to continue to qualify the proper functioning of the ED, preventing non-urgent users from going there only to obtain SL. Thus, in order to make better use of existing resources, it was operationalizing this extension of its issuance in a balanced way, allowing SL to be issued in the ED of hospitals only to critically ill patients or patients referred by INEM, SNS24, or PHC. In both cases, an intense public campaign was implemented to explain the way it works and the benefits for patients. In satisfaction surveys, more than 95% of patients and doctors were satisfied with the solutions, asking for extensions to other areas. The administrative simplification agenda of the NHS continues its effective development. For the success of this debureaucratization agenda, the key factors are effective communication and the ability to reach patients and health professionals in order to increase health literacy and the correct use of NHS.

Keywords: debureaucratization strategy, self-declaration of illness, sick leaves, SNS24

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Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon

Abstract:

Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.

Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida

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Authors: Ankita Singh

Abstract:

Sex trafficking and child pornography are those kinds of borderless crimes which can not be effectively prevented only through the laws and efforts of one country because it requires a proper and smooth collaboration among countries. Eradication of international human trafficking syndicates, criminalisation of international cyber offenders, and effective ban on child pornography is not possible without applying effective universal laws; hence, continuous collaboration of all countries is much needed to adopt and routinely update these universal laws. Congregation of countries on an international platform is very necessary from time to time, where they can simultaneously adopt international agendas and create powerful universal laws to prevent sex trafficking and child pornography in this modern digital era. In the past, some international steps have been taken through The Convention on the Rights of the Child (CRC) and through The Optional Protocol to the Convention on the Rights of the Child on the Sale of Children, Child Prostitution, and Child Pornography, but in reality, these measures are quite weak and are not capable in effectively protecting children from sexual abuse in this modern & highly advanced digital era. The uncontrolled growth of artificial intelligence (AI) and its misuse, lack of proper legal jurisdiction over foreign child abusers and difficulties in their extradition, improper control over international trade of digital child pornographic content, etc., are some prominent issues which can only be controlled through some new, effective and powerful universal laws. Due to a lack of effective international standards and a lack of improper collaboration among countries, Indian laws are also not capable of taking effective actions against child abusers. This research will be conducted through both doctrinal as well as empirical methods. Various literary sources will be examined, and a questionnaire survey will be conducted to analyse the effectiveness of international standards and Indian laws against child pornography. Participants in this survey will be Indian University students. In this work, the existing international norms made for protecting children from sexual abuse will be critically analysed. It will explore why effective and strong collaboration between countries is required in modern times. It will be analysed whether existing international steps are enough to protect children from getting trafficked or being subjected to pornography, and if these steps are not found to be sufficient enough, then suggestions will be given on how international standards and protections can be made more effective and powerful in this digital era. The approach of India towards the existing international standards, the Indian laws to protect children from being subjected to pornography, and the contributions & capabilities of India in strengthening the international standards will also be analysed.

Keywords: child pornography, prevention of children from sexual offences act, the optional protocol to the convention on the rights of the child on the sale of children, child prostitution and child pornography, the convention on the rights of the child

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