Search results for: advanced care planning

Authors: Elmeida Effendy, Mustafa M. Amin, Nauli Aulia Lubis, P. J. Sirait

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Music therapy may have an effect on mental illnesses. This is a comparative, quasi-experimental study to examine the effect of music therapy added to standard care on Positive Negative Syndrome Scale, Cognitive Function and Quality of Life in female schizophrenic patients. 50 schizophrenic participants who were diagnosed with semistructured MINI ICD-X, were assigned into two groups received pharmacotherapy. Participants were assigned into each group of therapy by using matched allocation method. Music therapy added on to the first group. They received music therapy, using Mozart Sonata four times a week, over a period of six week. Positive and negative symptoms were measured by using Positive and Negative Syndrome Scale (PANSS). Cognitive function were measured by using Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA). All rating scale were administrated by certified skill residents every week after music therapy session. The participants who were received pharmaco-and-music therapy significantly showed greater response than who received pharmacotherapy only. The mean difference of response were -6,6164 (p=0,001) for PANNS, 2,911 (p=0,004) for MMSE, 3,618 (p=0,001) for MOCA, 4,599 (p=0,001) for SF-36. Music therapy have beneficial effects on PANSS, Cognitive Function and Quality of Life in schizophrenic patients.

Keywords: music therapy, rating scale, schizophrenia, symptoms

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Authors: Ummi Sholihah Pertiwi Abidin, Eva Fadhilah

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Social changes are more and more growing and having many different forms as the time passed and thought methods in the society. One of many forms of that social changes is the emancipation of women that is flourishing by the inception of gender equality perception between men and women in all aspects including education. It’s not anymore found the distinction between genders in learning and the education achieving right at this globalized era. But, it is still many perceptions which are against that equality of education achieving right, either come from the women’s selves or many external factors. They assumed that they are going to be a mother in the future, and a wife, someone with responsible for taking care of the household and everything inside, while the husband is the one who has the responsible for looking for the living. So comes from this kind of assumption, the perception against the education equality between genders, which means there is no need for them –women- to achieve the high education because they will still end up as housewives. Except those working or career women that need high education to support their works. These women are not aware that even a mother needs the high and capable education. Because, as the 'mother to be,' they surely need broad knowledge from the education to educate their children in the future. It is such a big fault to say the kind of thing, 'It is no matter that I am not educated, in case I’m just a housewife. The important thing is my children get a great education'. Unfortunately, it is still often found, saying 'A housewife job is not a big deal to do with high education.' This qualitative method paper raises a theme about the importance of education for women, no matter what will they be in the future. Because however, and whatever is the woman’s career outside the house, or even not working outside, she’s still a mother for her children, and 'educational provision' is a great need. And so forth, this educational provision is a big deal to do with future generation’s foredoom, regarding the first source of children’s knowledge and the first school for them is their mother.

Keywords: women education, mother to be, educational provision, first school, future generation’s foredoom

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Authors: Amber Zahid, Fatima Naseer, Maham Atta, Fareeha Zafar

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Corporate social authority (CSR) talk, scholarly scrutinize, open arrangement and media editorials, which have thrived in the previous not many decades according to the craving to characterize the nexus between business and social order had a tendency to center primarily on expansive corporate associations which are required to act mindfully. The enormous organizations have for a long time pulled in huge volume of expositive expression on CSR. Almost no expositive expression is presently accessible to upgrade our comprehension about the engagement of little and medium-measured endeavors (SMEs) in CSR. The SMEs, regularly characterized differently regarding turnover terrible stake quality, proprietorship structure and the amount of workers, is a noteworthy part worldwide as far as monetary ecological and the social effect they make. This paper endeavoured to extend this obvious research bay, characterized the way of SMEs the total commitments of the area to economies of both advanced and advancing countries and their part engagement in CSR. The study embraced qualitative literary works review strategy. An audit of the negligible expositive expression furnished knowledge and characterized the course of examination in this significant and underexplored region of study. SMEs were discovered to perform parts connected with group improvement, representative activities, consumerism, natural movements, and production network necessities. To defeat the imperatives going up against SMEs engagement in CSR activities the paper prescribed expanded assets, preparing programs advancement of SMEs arranged instruments and guidelines to guide appropriation and execution and government mediation systems to make the fundamental motivating forces and underpin administrations for adequate engagement.

Keywords: corporate social responsibility, small and medium-sized enterprises, responsible practices, corporate citizenship

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Authors: Ragy Raafat Gaber Attaalla

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health.

Keywords: low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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Authors: Shalini Rankawat, Mansi Rankawat, Rahul Dubey, Mazad Zaveri

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Physiological signals such as electrocardiogram (ECG) and arterial blood pressure (ABP) in the intensive care unit (ICU) are often seriously corrupted by noise, artifacts, and missing data, which lead to errors in the estimation of heart rate (HR) and incidences of false alarm from ICU monitors. Clinical support in ICU requires most reliable heart rate estimation. Cardiac activity, because of its relatively high electrical energy, may introduce artifacts in Electroencephalogram (EEG), Electrooculogram (EOG), and Electromyogram (EMG) recordings. This paper presents a robust heart rate estimation method by detection of R-peaks of ECG artifacts in EEG, EMG & EOG signals, using energy-based function and a novel Signal Quality Index (SQI) assessment technique. SQIs of physiological signals (EEG, EMG, & EOG) were obtained by correlation of nonlinear energy operator (teager energy) of these signals with either ECG or ABP signal. HR is estimated from ECG, ABP, EEG, EMG, and EOG signals from separate Kalman filter based upon individual SQIs. Data fusion of each HR estimate was then performed by weighing each estimate by the Kalman filters’ SQI modified innovations. The fused signal HR estimate is more accurate and robust than any of the individual HR estimate. This method was evaluated on MIMIC II data base of PhysioNet from bedside monitors of ICU patients. The method provides an accurate HR estimate even in the presence of noise and artifacts.

Keywords: ECG, ABP, EEG, EMG, EOG, ECG artifacts, Teager-Kaiser energy, heart rate, signal quality index, Kalman filter, data fusion

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Authors: Sadia Suri Kashif, Raheeda Fatima, Maqsood Ahmed Khan

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Purpose of the study: The objective of this research was to determine the perception of Pakistani physicians (whether primary care, specialists or residents) in Karachi, being one of the largest and highly populated cities of Pakistan, regarding clinical approaches towards diet, exercise, and therapy in obese patients. This research determines their understanding of obesity and employability of obesity management in their daily practices. Research methodology: This is a questionnaire-based survey. A minimum of 300 questionnaires (N=300) were distributed and filled by practicing physicians in a random selection of medical setups in Karachi. Randomly 246 physicians responded to the survey. The survey tested their views regarding weight management, importance of general awareness and their strategies to control weight. Results: In the first part of survey the physicians responded to almost 66% regarding the seriousness of obesity management with advising diet modification, physical exercise and decreasing calorie intake; 57% failed to employ Body Mass Index and Waist Hip Ratio as weight measurement tools in their daily practice; 50% disagreed on using pharmacotherapy as an option; 67% were not sure about the proper dosage and indication of anti-obesity medication while almost same disagreed on using surgical options for management of obesity; 83.3% physicians agreed on the increased obesity pandemic in Pakistan. Conclusion: The findings indicate that there is a gap between awareness and knowledge among Pakistani practicing physicians regarding pharmacotherapy for obesity. There is a need to frequently update latest guidelines to help manage this condition, which is becoming more prevalent in our country day by day. Physicians should be obligated to use updated knowledge for managing obesity.

Keywords: obesity, physicians, BMI, weight management, obesity awareness

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Authors: Loes Nijskens

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The city of The Hague is coping with several social issues: high unemployment rates, segregation and environmental pollution. The amount of social enterprises in The Hague that want to tackle these issues is increasing, but no clear image exists of the stimulants and obstacles social entrepreneurs encounter. In this qualitative study 20 starting and established social entrepreneurs, investors and stimulators of social entrepreneurship have been interviewed. The findings indicate that the majority of entrepreneurs situated in The Hague focuses on creating jobs (the so called social nurturers) and diminishing food waste. Moreover, the study found smaller groups of social connectors, (who focus on stimulating the social cohesion in the city) and social traders (who create a market for products from developing countries). For the social nurturers, working together with local government to find people with a distance to the labour market is a challenge. The entrepreneurs are missing a governance approach within the local government, wherein space is provided to develop suitable legislation and projects in cooperation with several stakeholders in order to diminish social problems. All entrepreneurs in the sample face(d) the challenge of having a clear purpose of their business in the beginning. Starting social entrepreneurs tend to be idealistic without having defined a business model. Without a defined business model it is difficult to find proper funding for their business. The more advanced enterprises cope with the challenge of measuring social impact. The larger they grow, the more they have to ‘defend’ themselves towards the local government and their customers, of mainly being social. Hence, the more experienced social nurturers still find it difficult to work together with the local government. They tend to settle their business in other municipalities, where they find more effective public-private partnerships. Al this said, the eco-system for social enterprises in The Hague is on the rise. To stimulate the amount and growth of social enterprises the cooperation between entrepreneurs and local government, the developing of social business models and measuring of impact needs more attention.

Keywords: obstacles, social enterprises, stimulants, the Hague

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Authors: Aljohara M. Alquaiz, Tawfik A. M. Khoja, Abdullah Alsharif, Ambreen Kazi, Ashry Gad Mohamed, Hamad Al Mane, Abdullah Aldiris, Shaffi Ahamed Shaikh

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Objective: To determine the prevalence and correlates of anemia in male and female adolescents in Riyadh, Kingdom of Saudi Arabia. Design: A cross-sectional community based study setting: Five primary health care centers in Riyadh. Subjects: We invited 203 male and 292 female adolescents aged 13-18 years for interview, anthropometric measurements and complete blood count. Blood hemoglobin was measured with coulter cellular analysis system using light scatter method. Results: Using the WHO cut-off of Hb < 12gms/dl, 16.7%(34) males and 34%(100) females were suffering from anemia. The mean Hb (±SD) in males and females was 13.5(±1.4) and 12.3(±1.2) mg/dl, respectively. Mean(±SD) MCV, MCH, MCHC and RDW in male and female adolescents were 77.8(±6.2) vs76.4(±10.3)fL, 26.1(±2.7) vs25.5(±2.6)pg, 32.7(±2.4) vs32.2(±2.6)g/dL, 13.9(±1.4) vs13.6(±1.3)%, respectively. Multivariate logistic regression revealed that positive family history of iron deficiency anemia(IDA)(OR 4.7,95%CI 1.7–12.2), infrequent intake (OR 3.7,95%CI 1.3–10.0) and never intake of fresh juices(OR 3.5,95%CI 1.4–9.5), 13 to 14 years age (OR 3.1,95%CI 1.2–9.3) were significantly associated with anemia in male adolescents; whereas in females: family history of IDA (OR 3.4, 95%CI 1.5–7.6), being over-weight(OR 3.0,95%CI 1.4–6.1), no intake of fresh juice (OR 2.6,95%CI 1.4–5.1), living in an apartment (OR 2.0, 95%CI 1.1-3.8) or living in small house (OR 2.5, 95%CI 1.2-5.3) were significantly associated with anemia. Conclusion: Anemia is more prevalent among Saudi female adolescents as compared to males. Important factors like positive family history of IDA, overweight, lack of fresh juice intake and low socioeconomic status are significantly associated with anemia in adolescents.

Keywords: adolescents, anemia, correlates, obesity

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Authors: Seyed-Ali Sadegh-Zadeh, Mahboobe Bahrami, Sahar Ahmadi, Seyed-Yaser Mousavi, Hamed Atashbar, Amir M. Hajiyavand

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This paper presents an investigation into the concept of neural reshaping, which is crucial for achieving strong artificial intelligence through the development of AI algorithms with very high plasticity. By examining the plasticity of both human and artificial neural networks, the study uncovers groundbreaking insights into how these systems adapt to new experiences and situations, ultimately highlighting the potential for creating advanced AI systems that closely mimic human intelligence. The uniqueness of this paper lies in its comprehensive analysis of the neural reshaping process in both human and artificial intelligence systems. This comparative approach enables a deeper understanding of the fundamental principles of neural plasticity, thus shedding light on the limitations and untapped potential of both human and AI learning capabilities. By emphasizing the importance of neural reshaping in the quest for strong AI, the study underscores the need for developing AI algorithms with exceptional adaptability and plasticity. The paper's findings have significant implications for the future of AI research and development. By identifying the core principles of neural reshaping, this research can guide the design of next-generation AI technologies that can enhance human and artificial intelligence alike. These advancements will be instrumental in creating a new era of AI systems with unparalleled capabilities, paving the way for improved decision-making, problem-solving, and overall cognitive performance. In conclusion, this paper makes a substantial contribution by investigating the concept of neural reshaping and its importance for achieving strong AI. Through its in-depth exploration of neural plasticity in both human and artificial neural networks, the study unveils vital insights that can inform the development of innovative AI technologies with high adaptability and potential for enhancing human and AI capabilities alike.

Keywords: neural plasticity, brain adaptation, artificial intelligence, learning, cognitive reshaping

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Authors: Mostafa Sefidgar, Kaamran Raahemifar, Hossein Bazmara, Madjid Soltani

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The computational methods provide condition for investigation related to the process of drug delivery, such as convection and diffusion of drug in extracellular matrices, and drug extravasation from microvascular. The information of this process clarifies the mechanisms of drug delivery from the injection site to absorption by a solid tumor. In this study, an advanced numerical method is used to solve fluid flow and solute transport equations simultaneously to show how capillary network structure induced by tumor affects drug delivery. The effect of heterogeneous capillary network induced by tumor on interstitial fluid flow and drug delivery is investigated by this multi scale method. The sprouting angiogenesis model is used for generating capillary network induced by tumor. Fluid flow governing equations are implemented to calculate blood flow through the tumor-induced capillary network and fluid flow in normal and tumor tissues. The Starling’s law is used for closing this system of equations and coupling the intravascular and extravascular flows. Finally, convection-diffusion-reaction equation is used to simulate drug delivery. The dynamic approach which changes the capillary network structure based on signals sent by hemodynamic and metabolic stimuli is used in this study for more realistic assumption. The study indicates that drug delivery to solid tumors depends on the tumor induced capillary network structure. The dynamic approach generates the irregular capillary network around the tumor and predicts a higher interstitial pressure in the tumor region. This elevated interstitial pressure with irregular capillary network leads to a heterogeneous distribution of drug in the tumor region similar to in vivo observations. The investigation indicates that the drug transport properties have a significant role against the physiological barrier of drug delivery to a solid tumor.

Keywords: solid tumor, physiological barriers to drug delivery, angiogenesis, microvascular network, solute transport

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Authors: Saba Atefyekta

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Aim: Control of bacterial bioburden in wounds is an important step for minimizing the risk of wound infection. An antimicrobial hydrogel wound dressing is developed out of soft polymeric hydrogels that contain antimicrobial peptides (AMPs). Such wound dressings can bind and kill all types of bacteria, even the resistance types at the wound site. Methods: AMPs are permanently bonded onto a soft nanostructured polymer via covalent attachment and physical entanglement. This improves stability, rapid antibacterial activity, and, most importantly, prevents the leaching of AMPs. Major Findings: Antimicrobial analysis of antimicrobial hydrogels using in-vitro wound models confirmed >99% killing efficiency against multiple bacterial trains, including MRSA, MDR, E. Coli. Furthermore, the hydrogel retained its antibacterial activity for up to 4 days when exposed to human serum. Tests confirmed no release of AMPs, and it was proven non-toxic to mammalian cells. An in-vivo study on human intact skin showed a significant reduction of bacteria for part of the subject’s skin treated with antibacterial hydrogels. A similar result was detected through a qualitative study in veterinary trials on different types of surgery wounds in cats, dogs, and horses. Conclusions: Antimicrobial hydrogels wound dressings developed by permanent attachment of AMPs can effectively and rapidly kill bacteria in contact. Such antibacterial hydrogel wound dressings are non-toxic and do not release any substances into the wound.

Keywords: antibacterial wound dressing, antimicrobial peptides, post-surgical wounds, infection

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Authors: Hadjer Didouh, Mohammed Hadj Melliani, Izzeddine Sameut Bouhaik

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Corrosion is a serious problem in industrial installations or metallic transport pipes. Corrosion is an interfacial process controlled by several parameters. The presence of microorganisms affects the kinetics of corrosion. This type of corrosion is often referred to as bio-corrosion or corrosion influenced by microorganisms (MIC). The action of a microorganism or a bacterium is carried out by the formation of biofilm following its attachment to the metal surface. The formation of biofilm isolates the metal surface from its environment and allows the bacteria to control the parameters of the metal/bacteria interface. Biofilm formation by sulfate-reducing bacteria (SRB) X52 steel poses substantial challenges in the oil and gas industry SONATRACH of Algeria. This research delves into the complex attachment mechanisms employed by SRB biofilm on X52 carbon steel and investigates innovative strategies for effective mitigation using biocides. The exploration commences by elucidating the underlying mechanisms facilitating SRB biofilm adhesion to X52 carbon steel, considering factors such as surface morphology, electrostatic interactions, and microbial extracellular substances. Advanced microscopy and spectroscopic techniques provide support to the attachment processes, laying the foundation for targeted mitigation strategies. The use of 100 ppm of Moringa Oleifera extract biocide as a promising approach to control and prevent SRB biofilm formation on X52 carbon steel surfaces. Green extracts undergo evaluation for their effectiveness in disrupting biofilm development while ensuring the integrity of the steel substrate. Systematic analysis is conducted on the biocide's impact on the biofilm's structural integrity, microbial viability, and overall attachment strength. This two-pronged investigation aims to deepen our comprehension of SRB biofilm dynamics and contribute to the development of effective strategies for mitigating its impact on X52 carbon steel.

Keywords: attachment, bio-corrosion, biofilm, metal/bacteria interface

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Authors: S. Schröder, P. Ennen, T. Langer, S. Müller, M. Shehadeh, M. Haberstroh, F. Hees

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Since a bit over a year ago, Festo AG and Co. KG, Festo Didactic SE, robomotion GmbH, the researchers of the Cybernetics-Lab IMA/ZLW and IfU, as well as the Human-Computer Interaction Center at the RWTH Aachen University, have been working together in the focal point of assembly competences to realize different scenarios in the field of human-machine interaction (HMI). In the framework of project ARIZ, questions concerning the future of production within the fourth industrial revolution are dealt with. There are many perspectives of human-robot collaboration that consist Industry 4.0 on an individual, organization and enterprise level, and these will be addressed in ARIZ. The aim of the ARIZ projects is to link AI-Approaches to assembly problems and to implement them as prototypes in demonstrators. To do so, island and flow based production scenarios will be simulated and realized as prototypes. These prototypes will serve as applications of flexible robotics as well as AI-based planning and control of production process. Using the demonstrators, human interaction strategies will be examined with an information system on one hand, and a robotic system on the other. During the tests, prototypes of workspaces that illustrate prospective production work forms will be represented. The human being will remain a central element in future productions and will increasingly be in charge of managerial tasks. Questions thus arise within the overall perspective, primarily concerning the role of humans within these technological revolutions, as well as their ability to act and design respectively to the acceptance of such systems. Roles, such as the 'Trainer' of intelligent systems may become a possibility in such assembly scenarios.

Keywords: human-machine interaction, information technology, island based production, assembly competences

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Authors: Rani Silvia

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English has surpassed other languages to become the most widely taught and studied foreign language in Indonesia. This reflects the tendency of the Indonesian public to participate in global mainstream culture, which is longstanding but has been greatly facilitated by the widespread availability of television, the traditional media, and more recently the Internet and social media. However, despite increasing exposure and a history of teaching and study, mastery of English remains low, even as interest and perceived importance continue to increase. This along with Indonesia’s extremely complex linguistic environment has increased the status and value associated with the use of English and is changing the dynamic of language use nationwide. This study investigates the use of English in public settings in Indonesia as well as the attitudes of Indonesian speakers towards English. A case study was developed to explicate this phenomenon in a major Indonesian city. Fifty individuals, including both professionals and lay people, were interviewed about their language preferences as well as their perceptions about English as compared to other languages, such as the local language, Indonesian as the national language, and other foreign languages. Observations on the use of language in the public environment in advertising, signs, and other forms of public expression were analyzed to identify language preferences at this level and their relationship to current language policy. This study has three major findings. First, Indonesian speakers have more positive attitudes towards English than other languages; second, English has encroached on domains in which Indonesian should be used; and third, perceived awareness of the importance of Indonesian as an introduced national language seems to be declining to suggest a failure of policy. The study includes several recommendations for the future development of language planning in determining and directing language use in a public context in Indonesia.

Keywords: English, Indonesia, language attitudes, language policy

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Authors: Mara Balestrieri

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Climate change has long been the focus of attention for the growing impact of extreme weather events and global warming in many areas of the planet and the evidence of economic, social, and environmental damage caused by global warming. Nowadays, climate change is recognized as a critical global problem. Several initiatives have been undertaken over time to enhance the long theoretical debate and field experience in order to reduce Co2 emissions and contain climate alteration. However, the awareness that climate change is already taking place has led to a growing demand for adaptation. It is certainly a matter of anticipating the negative effects of climate change but, at the same time, implementing appropriate actions to prevent climate change-related damage, minimize the problems that may result, and also seize any opportunities that may arise. Consequently, adaptation has become a core element of climate policy and research. However, the attention to this issue has not developed in a uniform manner across countries. Some countries are further ahead than others. This paper examines the literature on climate change adaptation developed until 2018 in Italy, considering the urban dimension, to provide a framework for it, and to identify main topics and features. The papers were selected from Scopus and were analyzed through a matrix that we propose. Results demonstrate that adaptation to climate change studies attracted increasing attention from Italian scientific communities in the last years, although Italian scientific production is still quantitatively lower than in other countries and describes strengths and weaknesses in line with international panorama with respect to objectives, sectors, and problems.

Keywords: adaptation, bibliometric literature, climate change, urban studies

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Authors: Dwarika P. Shrestha, Dipendra Gurung, Rushma Shrestha, Inger Rosdahl

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Introduction: Skin diseases are one of the most common health problems in Nepal. The objectives of this study are to determine the prevalence of skin diseases and impact on quality of life in rural areas in Nepal. Materials and methods: A house-to-house survey was conducted, to obtain socio-demographic data and identify individuals with skin diseases, followed by health camps, where the villagers were examined. A pilot study was conducted in one village, which was then extended to 10 villages in 4 districts. To assess the impact on quality of life, the villagers were interviewed with Skin Disease Disability Index. This is a questionnaire developed and validated by the authors for use in Nepal. Results: In the pilot study, the overall prevalence of skin diseases was 20.1% (645/3207). In the additional 10 villages with 7348 (3651/3787 m/f) inhabitants, 1862 (721/1141 m/f, mean age 31.4 years) had one or more skin diseases. The overall prevalence of skin diseases was 25%. The most common skin disease categories were eczemas (13.7%, percentage among all inhabitants) pigment disorders (6.8%), fungal infections (4.9%), nevi (3.7%) and urticaria (2.9%). These five most common skin disease categories comprise 71% of all skin diseases seen in the study. The mean skin disease disability index score was 13.7, indicating very large impact on the quality of life. Conclusions: This population-based study shows that skin diseases are very common in the rural areas of Nepal and have significant impact on quality of life. Targeted intervention at the primary health care level should help to reduce the health burden due to skin diseases.

Keywords: prevalence and pattern of skin diseases, impact on quality of life, rural Nepal, interventions

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Authors: Dinamarie Fonzone

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Employer-sponsored health insurance (ESI) strategic decision-making processes rely on financial analysis to guide leadership in choosing plans that will produce optimal organizational spending outcomes. These financial decision-making methods have not abated ESI costs. Previously unrecognized external social determinants, the impact on ESI plan spending, and other organizational strategies are emerging and are important considerations for organizational decision-makers and change management practitioners. The purpose of thisstudy is to examine the relationship between the social determinants of health (SDoH), employer-sponsored health insurance (ESI) plans, andthe unintended consequence of health inequity. A quantitative research design using selectemployee records from an existing employer human capital management database will be analyzed. Statistical regressionmethods will be used to study the relationships between certainSDoH (employee income, neighborhood geographic living area, and health care access) and health plan utilization, cost, and chronic disease prevalence. The discussion will include an application of the social gradient of health theory to the study findings, organizational transformation through changes in ESI decision-making mental models, and the connection of ESI health inequity to organizational development and changediversity, equity, and inclusion strategies.

Keywords: employer-sponsored health insurance, social determinants of health, health inequity, mental models, organizational development, organizational change, social gradient of health theory

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Authors: Mohammed Muzafar, Darshan Ruikar

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BIM, an acronym for Building Information Modelling relates to the practice of creating a computer generated model which is capable of displaying the planning, design, construction and operation of a structure. The resulting simulation is a data-rich, object-oriented, intelligent and parametric digital representation of the facility, from which views and data, appropriate to various users needs can be extracted and analysed to generate information that can be used to make decisions and to improve the process of delivering the facility. BIM also refers to a shift in culture that will influence the way the built environment and infrastructure operates and how it is delivered. One of the main issues of concern in the construction industry at present in the UK is its record on Health & Safety (H&S). It is, therefore, important that new technologies such as BIM are developed to help improve the quality of health and safety. Historically the H&S record of the construction industry in the UK is relatively poor as compared to the manufacturing industries. BIM and the digital environment it operates within now allow us to use design and construction data in a more intelligent way. It allows data generated by the design process to be re-purposed and contribute to improving efficiencies in other areas of a project. This evolutionary step in design is not only creating exciting opportunities for the designers themselves but it is also creating opportunity for every stakeholder in any given project. From designers, engineers, contractors through to H&S managers, BIM is accelerating a cultural change. The paper introduces the concept behind a research project that mitigates the H&S risks associated with the construction, operation and maintenance of assets through the adoption of BIM.

Keywords: building information modeling, BIM levels, health, safety, integration

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Authors: Haruna Maama

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Environmental, social and governance (ESG) reporting is gaining considerable attention despite being voluntary. Meanwhile, it consumes resources to provide ESG reporting, raising a question of its value relevance. The study examined the impact of ESG reporting on the market value of listed firms in SSA. The annual and integrated reports of 276 listed sub-Sahara Africa (SSA) firms. The integrated reporting scores of the firm were analysed using a content analysis method. A multiple regression estimation technique using a GMM approach was employed for the analysis. The results revealed that ESG has a positive relationship with firms’ market value, suggesting that investors are interested in the ESG information disclosure of firms in SSA. This suggests that extensive ESG disclosures are attempts by firms to obtain the approval of powerful social, political and environmental stakeholders, especially institutional investors. Furthermore, the market value analysis evidence is consistent with signalling theory, which postulates that firms provide integrated reports as a signal to influence the behaviour of stakeholders. This finding reflects the value placed on investors' social, environmental and governance disclosures, which affirms the views that conventional investors would care about the social, environmental and governance issues of their potential or existing investee firms. Overall, the evidence is consistent with the prediction of signalling theory. In the context of this theory, integrated reporting is seen as part of firms' overall competitive strategy to influence investors' behaviour. The findings of this study make unique contributions to knowledge and practice in corporate reporting.

Keywords: environmental accounting, ESG accounting, signalling theory, sustainability reporting, sub-saharan Africa

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Authors: Maya Saade, Rafic Younes, Pascal Lafon

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This paper explores the transformative impact of smartphones on pedagogy and presents a smartphone application developed specifically for engineering problem-solving and educational purposes. The widespread availability and advanced capabilities of smartphones have revolutionized the way we interact with technology, including in education. The ubiquity of smartphones allows learners to access educational resources anytime and anywhere, promoting personalized and self-directed learning. The first part of this paper discusses the overall influence of smartphones on pedagogy, emphasizing their potential to improve learning experiences through mobile technology. In the context of engineering education, this paper focuses on the development of a dedicated smartphone application that serves as a powerful tool for both engineering problem-solving and education. The application features an intuitive and user-friendly interface, allowing engineering students and professionals to perform complex calculations and analyses on their smartphones. The smartphone application primarily focuses on beam calculations and serves as a comprehensive beam calculator tailored to engineering education. It caters to various engineering disciplines by offering interactive modules that allow students to learn key concepts through hands-on activities and simulations. With a primary emphasis on beam analysis, this application empowers users to perform calculations for statically determinate beams, statically indeterminate beams, and beam buckling phenomena. Furthermore, the app includes a comprehensive library of engineering formulas and reference materials, facilitating a deeper understanding and practical application of the fundamental principles in beam analysis. By offering a wide range of features specifically tailored for beam calculation, this application provides an invaluable tool for engineering students and professionals looking to enhance their understanding and proficiency in this crucial aspect of a structural engineer.

Keywords: mobile devices in education, solving engineering problems, smartphone application, engineering education

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Authors: Mir Mohammad Reza Hosseini

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In new years immune checkpoint inhibitors have gathered care as being one of the greatest talented kinds of immunotherapy on the prospect. There has been a specific emphasis on the immune checkpoint molecules, cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1). In 2011, ipilimumab, the primary antibody obstructive an immune checkpoint (CTLA4) was authorized. It is now documented that recognized tumors have many devices of overpowering the antitumor immune response, counting manufacture of repressive cytokines, staffing of immunosuppressive immune cells, and upregulation of coinhibitory receptors recognized as immune checkpoints. This was fast followed by the growth of monoclonal antibodies directing PD1 (pembrolizumab and nivolumab) and PDL1 (atezolizumab and durvalumab). Anti-PD1/PDL1 antibodies have developed some of the greatest extensively set anticancer therapies. We also compare and difference their present place in cancer therapy and designs of immune-related toxicities and deliberate the role of dual immune checkpoint inhibition and plans for the organization of immune-related opposing proceedings. In this review, the employed code and present growth of numerous immune checkpoint inhibitors are abridged, while the communicating device and new development of Immune checkpoint inhibitors in cancer therapy-based synergistic therapies with additional immunotherapy, chemotherapy, phototherapy, and radiotherapy in important and clinical educations in the historical 5 years are portrayed and tinted. Lastly, we disapprovingly measure these methods and effort to find their fortes and faintness based on pre-clinical and clinical information.

Keywords: checkpoint, cancer therapy, PD-1, PDL-1, CTLA4, immunosuppressive

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Authors: A. Myrzabekova, D. Nurmukhamed, K. Nurumov, A. Zhulbarissova

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It is widely believed that stress can affect teachers’ intention to change the workplace. While existing research primarily focuses on the intrinsic sources of stress stemming from the school climate, the current attempt analyzes educational policies as one of the determinants of teacher’s intention to leave schools. In this respect, Kazakhstan presents a unique case since the country endorsed several educational policies which directly impacted teaching and administrative practices within schools. Using Teaching and Learning International Survey 2018 (TALIS) data with the country specific questionnaire, we construct a statistical measure of stress caused by the implementation of educational policies and test its impact on teacher’s intention to leave through the logistic regression. In addition, we control for sociodemographic, professional, and students related covariates while considering the intrinsic dimension of stress stemming from the school climate. Overall, our results suggest that stress caused by the educational policies has a statistically significant positive effect on teachers’ intentions to transfer between schools. Both policy makers and educational scholars could find these results beneficial. For the former careful planning and addressing the negative effects of the educational policies is critical for the sustainability of the educational process. For the latter, accounting for exogenous sources of stress can lead to a more complete understanding of why teachers decide to change their schools.

Keywords: educational policies, Kazakhstani teachers, logistic regression factor analysis, sustainability education TALIS, teacher turnover intention, work stress

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Authors: Oluwagbemiga Paul Agboola, Cornelius Olatunji Omojola, Dayo Martins Oyeshomo

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The role of a recreational park in human and environmental development has attracted much interest in the recent time. Recreation parks' development could act as an effective planning strategy to enhance environmental sustainability, social cohesiveness, and users' quality of life. Similarly, parks enhance neighbourhood's aesthetics, refresh the air and enhance humans' contact with nature. In this connection, recreation parks create natural surroundings of rural areas for leisure, relaxation, recreation, psychological and physical comfort of the people. The purpose of this paper is to investigate the effectiveness of the two recreational parks' development as a strategy for neighbourhood's environmental improvement, sustainability and the recreationists' cohesiveness. A total number of 158 survey questionnaires were distributed to the tourists at Ikogosi cold and warm spring in Ekiti state as well as Olumirin waterfalls, Erin-Ijesa, Osun State, in South-West, Nigeria. The quantitative results of the analyzed data with Relative Importance Index (RII) revealed that recreation parks provide optimum opportunities for users' social cohesiveness and well-being while parks' sustainable environment could be enhanced base on the provision of essential facilities, services, and future developmental plans. It is recommended that for recreation parks to realize their full potential in environmental sustainability, adequate maintenance and provision of essential facilities becomes imperative.

Keywords: environmental sustainability, neighbourhood development, recreational park, Nigeria

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Authors: Yi-Fung Lin, Yuan-Mei Liao

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Background: Pain is common among patients with cancer and is also one of the most disturbing symptoms. As this suffering is subjective, if patients proactively participate in their pain self-management, pain could be alleviated effectively. However, not everyone can carry out self-management very well because human behavior is a product of the cognition process. In this process, we can see that "self-efficacy" plays an essential role in affecting human behaviors. Methods: We used the eight steps of concept analysis proposed by Walker and Avant to clarify the concept of “self-efficacy for cancer pain management.” A comprehensive literature review was conducted for relevant publications that were published during the period of 1977 to 2021. We used several keywords, including self-efficacy, self-management, concept analysis, conceptual framework, and cancer pain, to search the following databases: PubMed, CINAHL, Web of Science, and Embase. Results: We identified three defining attributes for the concept of self-efficacy for cancer pain management, including pain management abilities, confidence, and continuous pain monitoring, and recognized six skills related to pain management abilities: problem-solving, decision-making, resource utilization, forming partnerships between medical professionals and patients, planning actions, and self-regulation. Five antecedents for the concept of self-efficacy for cancer pain management were identified: pain experience, existing cancer pain, pain-related knowledge, a belief in pain management, and physical/mental state. Consequences related to self-efficacy for cancer pain management were achievement of pain self-management, well pain control, satisfying quality of life, and containing motivation. Conclusions: This analysis provides researchers with a clearer understanding of the concept of “self-efficacy for cancer pain management.” The findings presented here provide a foundation for future research and nursing interventions to enhance self-efficacy for cancer pain management.

Keywords: cancer pain, concept analysis, self-efficacy, self-management

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Authors: S Eli, DGB Kalio, BOA Altraide, P Kua, DA MacPepple, FE Okonofua

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Background: Anaemia in pregnancy is worrisome morbidity encountered by obstetricians and gynaecologist in the developing countries of the world. It is an indirect cause of maternal mortality and also a cause of perinatal mortality. Aim: The study aimed to ascertain the prevalence of anaemia amongst antenatal clinic (ANC) attendees at booking at The Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Rivers State, Nigeria. Method: The method was a cross-sectional study of ANC attendees at booking at RSUTH. The cut-off for anaemia by the WHO used for this study was packed cell volume (PCV) less than 33%. Simple randomized sampling method was used. Information was analyzed using SPSS version 25. Result: A total of 500 questionnaires were distributed, and 488 questionnaires retrieved. The mean age was of the ANC attendees was 31.44 years, and the modal parity was 0. Three hundred and fifty-seven (73.2%) of the respondents had a tertiary level of education, 126(25.8%) had a secondary level of education while 5 (1%) of the respondents had a primary level of education. Five (1%) of the respondents did not volunteer their educational status. The modal packed cell volume was 32%. Three hundred and eighty-two (78.3%) of the ANC attendees had PCV level less than 33% compared to 106 (21.7%) who had PCV equal or greater than 33%. Conclusion: The study revealed that the prevalence of anaemia in pregnancy amongst ANC attendees at the RSUTH was high, representing 73.3% of the subjects. Anaemia was common amongst multiparas (38.5%). Malaria prophylaxis, as well as encouraging pregnant women to be compliant with their routine antenatal drugs as well as counseling on the right diet, cannot be overemphasized during pregnancy. In addition, women should use family planning for child spacing for them to recover from previous pregnancies.

Keywords: anaemia, ANC attendees, Nigeria, prevalence

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Authors: Liu Szu Yin

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The center of urban development lies in commercial transactions and folk religious activities. In Taipei City, temples serve as crucial urban spaces and centers for civic activities and religious beliefs. The appearance of local temples can be influenced by the prosperity of the surrounding communities. Apart from being centers of religious worship, Taipei's temples also host festival celebrations, allowing people to gather in front of the temples and form collective urban memories. The spatial attributes for hosting festival activities include streets, squares, parks, and buildings. In Taipei, many traditional festivals take place on the streets, either as round-trip routes or linear routes with a single starting and ending point. Given the processions and parades involving palanquins and other ceremonial objects during traditional festival activities, street spaces are frequently utilized. Therefore, this study analyzes the historical context and street spaces of three traditional festivals in Taipei City, including Qingshan Temple in Monga, Xiahai City God Temple in Dadaocheng, and Baoan Temple in Dalongdong, through on-site research. Most urban festival planners need to understand the characteristics of the city's streets in order to effectively utilize street spaces for festival planning. Taipei's traditional festivals not only preserve Chinese traditional culture but also incorporate modern elements, ensuring the transmission of culture and faith and allowing the city to become characterized by sustainable culture and unique urban memories.

Keywords: festival space, urban festival, taipei, urban memory

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Authors: Yuan Zhao, Phimsupha Kokchang

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As a responsible nation, China has outlined its Nationally Determined Contributions (NDCs) of reaching peak carbon by 2030 and carbon neutrality by 2060. Peak and carbon neutrality are tough goals to achieve, and China must undertake a shift to green energy. In contrast, China's existing energy consumption structure is unsustainable and heavily dependent on coal supplies. China must revise its energy mix planning in order to strengthen energy security and satisfy the requirement for low-carbon energy generation to mitigate climate change. Shanxi Province is one of China's most important coal-producing regions, and Linfen is one of the province's key economic towns. However, Shanxi Province's economic development is severely hampered by the region's high levels of pollution and energy consumption. The purpose of this study is to investigate Linfen citizens' perceptions and attitudes toward China's NDC's energy restructuring plan through questionnaires. The majority of respondents were aware of China's NDCs, as indicated by 402 valid responses to an online questionnaire. Furthermore, respondents' perceptions and attitudes toward renewable energy initiatives are growing. To ensure that the results were dependable and consistent, reliability and validity were examined. According to the findings, the majority of Linfen's citizens believe that renewable energy projects such as solar and wind, which are consistent with China's NDCs, may improve their quality of life, public health, and the nation's economy.

Keywords: China’s NDC, perceptions, attitudes, Linfen, energy restructuring

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Authors: S. M. Amin Hosseini, Oriol Pons, Albert de la Fuente

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After natural disasters, displaced people (DP) require important numbers of housing units, which have to be erected quickly due to emergency pressures. These tight timeframes can cause the multiplication of the environmental construction impacts. These negative impacts worsen the already high energy consumption and pollution caused by the building sector. Indeed, post-disaster housing, which is often carried out without pre-planning, usually causes high negative environmental impacts, besides other economic and social impacts. Therefore, it is necessary to establish a suitable strategy to deal with this problem which also takes into account the instability of its causes, like changing ratio between rural and urban population. To this end, this study aims to present a model that assists decision-makers to choose the most suitable building technology for post-disaster housing units. This model focuses on the alternatives sustainability and fulfillment of the stakeholders’ satisfactions. Four building technologies have been analyzed to determine the most sustainability technology and to validate the presented model. In 2003, Bam earthquake DP had their temporary housing units (THUs) built using these four technologies: autoclaved aerated concrete blocks (AAC), concrete masonry unit (CMU), pressed reeds panel (PR), and 3D sandwich panel (3D). The results of this analysis confirm that PR and CMU obtain the highest sustainability indexes. However, the second life scenario of THUs could have considerable impacts on the results.

Keywords: sustainability, post-disaster temporary housing, integrated value model for sustainability assessment, life cycle assessment

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Authors: Asma Ammar, Nabiha Bouafia , Asma BenCheikh, Mohamed Mahjoub, Olfa Ezzi, Wadiaa Bannour, Radhia Helali, Mansour Njah

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Background: The objective of the present study was to identify factors associated with vaccination against Hepatitis B virus (HBV) among healthcare workers (HWs) in the University Hospital Center (UHC) Farhat Hached Sousse, Tunisia. Methods: We conducted a descriptive cross-sectional study all licensed physicians (n= 206) and a representative sample of paramedical staff (n= 372) exercising at UHC Hached Sousse (Tunisia) during two months (January and February 2014). Data were collected using a self-administered and pre-tested questionnaire, which composed by 21 questions. In order to determinate factors associated with vaccination against hepatitis B among HWs, this questionnaire was based on the Health Belief Model, one of the most classical behavior theories. Logistic regression with the stepwise method of Hosmer and Lemeshow was used to identify the determinants of the use of vaccination against HBV. Results: The response rates were 79.8%. Fifty two percent believe that HBV is frequent in our healthcare units and 60.6% consider it a severe infection. The prevalence of HWs vaccination was 39%, 95% CI [34.49%; 43.5%]. In multivariate analysis, determinants of the use of vaccination against HBV among HWs were young age (p=10-4), male gender (p = 0. 006), high or very high importance accorded to health (p = 0.035), perception membership in a risk group for HBV infection (p = 0.038) and very favorable or favorable opinion about vaccination against HVB (p=10-4). Conclusion: The results of our study should be considered in any strategy for preventing VHB infection in HWs. In the mean time, coverage with standard vaccines should be improved also by supplying complete information on the risks of VHB infection and on the safety and efficacy of vaccination.

Keywords: Hepatitis B virus, healthcare workers, prevalence, vaccination

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Authors: Getachew Adugna

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Background: Chronic energy malnutrition and human immune deficiency virus among pregnant women are highly prevalent in Sub-Saharan Africa, and they are interrelated in a vicious cycle. However, the prevalence of chronic energy malnutrition and its determinant factors among human immune deficiency virus-positive pregnant women is not well studied in Ethiopia and Addis Ababa in particular. Objective: To determine the prevalence & associated factors of chronic energy malnutrition among human immune deficiency virus-positive pregnant women in health centres of Addis Ababa Ethiopia. Methods: An institution-based cross-sectional study was conducted and a systematic random sampling technique was used to select study subjects. A total of 253 study subjects were enrolled in the study—a structured and pre-tested questionnaire collected sociodemographic, maternal health-related, and nutritional-related variables. MUAC measurements were taken and medical charts were reviewed. Bi-variable and multi-variable logistic regression analyses were used to assess the effect of different factors on chronic energy malnutrition. Result: The overall prevalence of chronic energy malnutrition was 32.0%. It was significantly associated with dietary counselling (AOR: 0.062; 95%CI: 0.007, 0.549), CD4 level (AOR: 0.219; 95%CI: 0.025, 1.908), and clinical stage (AOR: 0.127; 95%CI: 0.053, 0.305). Conclusions: The prevalence of chronic energy malnutrition among Human Immune deficiency virus-infected pregnant women in Addis Ababa was high and Nutritional Intervention should be an integral part of the HIV care program.

Keywords: chronic energy malnutrition, HIV, MUAC, Addis Ababa

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