Search results for: decisions making

Authors: Hai L. Tran

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Previous research on agenda setting effects has often focused on the top-down influence of the media at the aggregate level, while overlooking the capacity of audience members to select media and content to fit their individual dispositions. The decentralized characteristics of online communication and digital news create more choices and greater user control, thereby enabling each audience member to seek out a unique blend of media sources, issues, and elements of messages and to mix them into a coherent individual picture of the world. This study examines how audiences use media differently depending on their prior dispositions, thereby making sense of the world in ways that are congruent with their preferences and cognitions. The current undertaking is informed by theoretical frameworks from two distinct lines of scholarship. According to the ideological migration hypothesis, individuals choose to live in communities with ideologies like their own to satisfy their need to belong. One tends to move away from Zip codes that are incongruent and toward those that are more aligned with one’s ideological orientation. This geographical division along ideological lines has been documented in social psychology research. As an extension of agenda setting, the agendamelding hypothesis argues that audiences seek out information in attractive media and blend them into a coherent narrative that fits with a common agenda shared by others, who think as they do and communicate with them about issues of public. In other words, individuals, through their media use, identify themselves with a group/community that they want to join. Accordingly, the present study hypothesizes that because ideology plays a role in pushing people toward a physical community that fits their need to belong, it also leads individuals to receive an idiosyncratic blend of media and be influenced by such selective exposure in deciding what issues are more relevant. Consequently, the individualized focus of media choices impacts how audiences perceive political news coverage and what they know about political issues. The research project utilizes recent data from The American Trends Panel survey conducted by Pew Research Center to explore the nuanced nature of agenda setting at the individual level and amid heightened polarization. Hypothesis testing is performed with both nonparametric and parametric procedures, including regression and path analysis. This research attempts to explore the media-public relationship from a bottom-up approach, considering the ability of active audience members to select among media in a larger process that entails agenda setting. It helps encourage agenda-setting scholars to further examine effects at the individual, rather than aggregate, level. In addition to theoretical contributions, the study’s findings are useful for media professionals in building and maintaining relationships with the audience considering changes in market share due to the spread of digital and social media.

Keywords: agenda setting, agendamelding, audience fragmentation, ideological migration, partisanship, polarization

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Authors: Maria Thaemar Tana

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The paper examines the policy and practice of Japan’s human security. Specifically, it asks the question: How does Japan’s shift towards a more proactive defence posture affect the place of human security in its foreign policy agenda? Corollary to this, how is Japan sustaining its human security policy? The objective of this research is to understand how Japan, chiefly through the Ministry of Foreign Affairs (MOFA) and JICA (Japan International Cooperation Agency), sustains the concept of human security as a policy framework. In addition, the paper also aims to show how and why Japan continues to include the concept in its overall foreign policy agenda. In light of the recent developments in Japan’s security policy, which essentially result from the changing security environment, human security appears to be gradually losing relevance. The paper, however, argues that despite the strategic challenges Japan faced and is facing, as well as the apparent decline of its economic diplomacy, human security remains to be an area of critical importance for Japanese foreign policy. In fact, as Japan becomes more proactive in its international affairs, the strategic value of human security also increases. Human security was initially envisioned to help Japan compensate for its weaknesses in the areas of traditional security, but as Japan moves closer to a more activist foreign policy, the soft policy of human security complements its hard security policies. Using the framework of neoclassical realism (NCR), the paper recognizes that policy-making is essentially a convergence of incentives and constraints at the international and domestic levels. The theory posits that there is no perfect 'transmission belt' linking material power on the one hand, and actual foreign policy on the other. State behavior is influenced by both international- and domestic-level variables, but while systemic pressures and incentives determine the general direction of foreign policy, they are not strong enough to affect the exact details of state conduct. Internal factors such as leaders’ perceptions, domestic institutions, and domestic norms, serve as intervening variables between the international system and foreign policy. Thus, applied to this study, Japan’s sustained utilization of human security as a foreign policy instrument (dependent variable) is essentially a result of systemic pressures (indirectly) (independent variables) and domestic processes (directly) (intervening variables). Two cases of Japan’s human security practice in two regions are examined in two time periods: Iraq in the Middle East (2001-2010) and South Sudan in Africa (2011-2017). The cases show that despite the different motives behind Japan’s decision to participate in these international peacekeepings ad peace-building operations, human security continues to be incorporated in both rhetoric and practice, thus demonstrating that it was and remains to be an important diplomatic tool. Different variables at the international and domestic levels will be examined to understand how the interaction among them results in changes and continuities in Japan’s human security policy.

Keywords: human security, foreign policy, neoclassical realism, peace-building

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Authors: Johan Anker

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The purpose of this paper is to discuss the nature of gender construction in modern dystopian fiction, the development of this genre in Young Adult Literature and reasons for the enormous appeal on the adolescent readers. A recent award winning South African text in this genre, The Mark by Edith Bullring (2014), will be used as example while also comparing this text to international bestsellers like Divergent (Roth:2011), The Hunger Games (Collins:2008) and others. Theoretical insights from critics and academics in the field of children’s literature, like Ames, Coats, Bradford, Booker, Basu, Green-Barteet, Hintz, McAlear, McCallum, Moylan, Ostry, Ryan, Stephens and Westerfield will be referred to and their insights used as part of the analysis of The Mark. The role of relevant and recurring themes in this genre, like global concerns, environmental destruction, liberty, self-determination, social and political critique, surveillance and repression by the state or other institutions will also be referred to. The paper will shortly refer to the history and emergence of dystopian literature as genre in adult and young adult literature as part of the long tradition since the publishing of Orwell’s 1984 and Huxley’s Brave New World. Different factors appeal to adolescent readers in the modern versions of this hybrid genre for young adults: teenage protagonists who are questioning the underlying values of a flawed society like an inhuman or tyrannical government, a growing understanding of the society around them, feelings of isolation and the dynamic of relationships. This unease leads to a growing sense of the potential to act against society (rebellion), and of their role as agents in a larger community and independent decision-making abilities. This awareness also leads to a growing sense of self (identity and agency) and the development of romantic relationships. The specific modern tendency of a female protagonist as leader in the rebellion against state and state apparatus, who gains in agency and independence in this rebellion, an important part of the identification with and construction of gender, while being part of the traditional coming-of-age young adult novel will be emphasized. A comparison between the traditional themes, structures and plots of young adult literature (YAL) with adult dystopian literature and those of recent dystopian YAL will be made while the hybrid nature of this genre and the 'sense of unease' but also of hope, as an essential part of youth literature, in the closure to these novels will be discussed. Important questions about the role of the didactic nature of these texts and the political issues and the importance of the formation of agency and identity for the young adult reader, as well as identification with the protagonists in this genre, are also part of this discussion of The Mark and other YAL novels.

Keywords: agency, dystopian literature, gender construction, young adult literature

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Authors: Noa Nelson, Orit Appel, Rachel Ben-ari

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Organizational Citizenship Behavior (OCB) is voluntary employee behavior that contributes to the organization beyond formal job requirements. It can take different forms, such as helping teammates (OCB toward individuals; hence, OCB-I), or staying after hours to attend a task force (OCB toward the organization; hence, OCB-O). Generally, OCB contributes substantially to organizational climate, goals, productivity, and resilience, so organizations need to understand what encourages it. This is particularly challenging in security organizations. Security work is characterized by high levels of stress and burnout, which is detrimental to OCB, and security organizational design emphasizes formal rules and clear hierarchies, leaving employees with less freedom for voluntary behavior. The current research explored the role of Perceived Procedural Justice (PPJ) in enhancing OCB in a security organization. PPJ refers to how fair decision-making processes are perceived to be. It involves the sense that decision makers are objective, attentive to everyone's interests, respectful in their communications and participatory - allowing individuals a voice in decision processes. Justice perceptions affect motivation, and it was specifically suggested that PPJ creates an attachment to one's organization and personal interest in its success. Accordingly, PPJ had been associated with OCB, but hardly any research tested their association with security organizations. The current research was conducted among prison guards in the Israel Prison Service, to test a correlational and a causal association between PPJ and OCB. It differentiated between perceptions of direct commander procedural justice (CPJ), and perceptions of organization procedural justice (OPJ), hypothesizing that CPJ would relate to OCB-I, while OPJ would relate to OCB-O. In the first study, 336 prison guards (305 male) from 10 different prisons responded to questionnaires measuring their own CPJ, OPJ, OCB-I, and OCB-O. Hierarchical linear regression analyses indicated the significance of commander procedural justice (CPJ): It associated with OCB-I and also associated with OPJ, which, in turn, associated with OCB-O. The second study tested CPJ's causal effects on prison guards' OCB-I and OCB-O; 311 prison guards (275 male) from 14 different prisons read scenarios that described either high or low CPJ, and then evaluated the likelihood of that commander's prison guards performing OCB-I and OCB-O. In this study, CPJ enhanced OCB-O directly. It also contributed to OCB-I, indirectly: CPJ enhanced the motivation for collaboration with the commander, which respondents also evaluated after reading scenarios. Collaboration, in turn, associated with OCB-I. The studies demonstrate that procedural justice, especially commander's PJ, promotes OCB in security work environments. This is important because extraordinary teamwork and motivation are needed to deal with emergency situations and with delicate security challenges. Following the studies, the Israel Prison Service implemented personal procedural justice training for commanders and unit level programs for procedurally just decision processes. From a theoretical perspective, the studies extend the knowledge on PPJ and OCB to security work environments and contribute evidence on PPJ's causal effects. They also call for further research, to understand the mechanisms through which different types of PPJ affect different types of OCB.

Keywords: organizational citizenship behavior, perceived procedural justice, prison guards, security organizations

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Authors: Shenlun Chen, Leonard Wee

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Tumor grading is an essential reference for colorectal cancer (CRC) staging and survival prognostication. The widely used World Health Organization (WHO) grading system defines histological grade of CRC adenocarcinoma based on the density of glandular formation on whole slide images (WSI). Tumors are classified as well-, moderately-, poorly- or un-differentiated depending on the percentage of the tumor that is gland forming; >95%, 50-95%, 5-50% and <5%, respectively. However, manually grading WSIs is a time-consuming process and can cause observer error due to subjective judgment and unnoticed regions. Furthermore, pathologists’ grading is usually coarse while a finer and continuous differentiation grade may help to stratifying CRC patients better. In this study, a deep learning based automatic differentiation grading algorithm was developed and evaluated by survival analysis. Firstly, a gland segmentation model was developed for segmenting gland structures. Gland regions of WSIs were delineated and used for differentiation annotating. Tumor regions were annotated by experienced pathologists into high-, medium-, low-differentiation and normal tissue, which correspond to tumor with clear-, unclear-, no-gland structure and non-tumor, respectively. Then a differentiation prediction model was developed on these human annotations. Finally, all enrolled WSIs were processed by gland segmentation model and differentiation prediction model. The differentiation grade can be calculated by deep learning models’ prediction of tumor regions and tumor differentiation status according to WHO’s defines. If multiple WSIs were possessed by a patient, the highest differentiation grade was chosen. Additionally, the differentiation grade was normalized into scale between 0 to 1. The Cancer Genome Atlas, project COAD (TCGA-COAD) project was enrolled into this study. For the gland segmentation model, receiver operating characteristic (ROC) reached 0.981 and accuracy reached 0.932 in validation set. For the differentiation prediction model, ROC reached 0.983, 0.963, 0.963, 0.981 and accuracy reached 0.880, 0.923, 0.668, 0.881 for groups of low-, medium-, high-differentiation and normal tissue in validation set. Four hundred and one patients were selected after removing WSIs without gland regions and patients without follow up data. The concordance index reached to 0.609. Optimized cut off point of 51% was found by “Maxstat” method which was almost the same as WHO system’s cut off point of 50%. Both WHO system’s cut off point and optimized cut off point performed impressively in Kaplan-Meier curves and both p value of logrank test were below 0.005. In this study, gland structure of WSIs and differentiation status of tumor regions were proven to be predictable through deep leaning method. A finer and continuous differentiation grade can also be automatically calculated through above models. The differentiation grade was proven to stratify CAC patients well in survival analysis, whose optimized cut off point was almost the same as WHO tumor grading system. The tool of automatically calculating differentiation grade may show potential in field of therapy decision making and personalized treatment.

Keywords: colorectal cancer, differentiation, survival analysis, tumor grading

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Authors: Adinew Gebremeskel Tizazu

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The effect of soil-structure interaction on the dynamic response of reinforced concrete buildings of regular and symmetrical geometry are considered in this study. The structures are presumed to be generally embedded in a homogenous soil formation underlain by very stiff material or bedrock. The structure-foundation–soil system is excited at the base by an earthquake ground motion. The superstructure is idealized as a system with lumped masses concentrated at the floor levels, and coupled with the substructure. The substructure system, which comprises of the foundation and soil, is represented, and replaced by springs and dashpots. Frequency-dependent impedances of the foundation system are incorporated in the discrete model in terms of the springs and dashpots coefficients. The excitation applied to the model is field ground motions of actual earthquake records. Modal superposition principle is employed to transform the equations of motion in geometrical coordinates to modal coordinates. However, the modal equations remain coupled with respect to damping terms due to the difference in damping mechanisms of the superstructure and the soil. Hence, proportional damping for the coupled structural system may not be assumed. An iterative approach is adopted and programmed to solve the system of coupled equations of motion in modal coordinates to obtain the displacement responses of the system. Parametric studies for responses of building structures with regular and symmetric plans of different structural properties and heights are made for fixed and flexible base conditions, for different soil conditions encountered in Addis Ababa. The displacement, base shear and base overturning moments are used in the comparison of different types of structures for various foundation embedment depths, site conditions and height of structures. These values are compared against those of fixed base structure. The study shows that the flexible base structures, generally exhibit different responses from those structures with fixed base. Basically, the natural circular frequencies, the base shears and the inter-story displacements for the flexible base are less than those of the fixed base structures. This trend is particularly evident when the flexible soil has large thickness. In contrast, the trend becomes less predictable, when the thickness of the flexible soil decreases. Moreover, in the latter case, the iteration undulates significantly making the prediction difficult. This is attributed to the highly jagged nature of the impedance functions of frequencies for such formations. In this case, it is difficult to conclude whether the conventional fixed-base approach yields conservative design forces, as is the case for soil formations of large thickness.

Keywords: effect of soil structure, dynamic response corroborated, the modal superposition principle, parametric studies

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Authors: Rohini Sharma, Chandan Kumar Sahoo, Rama Krishna Gupta Potnuru

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Strong competitive forces and requirements to achieve efficiency are forcing the organizations to realize the necessity and inevitability of change. What's more, the trend does not appear to be abating. Researchers have estimated that about two thirds of change project fails. Empirical evidences further shows that organizations invest significantly in the planned change but people side is accounted for in a token or instrumental way, which is identified as one of the important reason, why change endeavours fail. However, whatever be the reason for change, organizational change readiness must be gauged prior to the institutionalization of organizational change. Hence, in this study the influence of employee voice and employee involvement on organizational change readiness via commitment-to-change is examined, as it is an area yet to be extensively studied. Also, though a recent study has investigated the interrelationship between leadership, organizational change readiness and commitment to change, our study further examined these constructs in relation with employee voice and employee involvement that plays a consequential role for organizational change readiness. Further, integrated conceptual model weaving varied concepts relating to organizational readiness with focus on commitment to change as mediator was found to be an area, which required more theorizing and empirical validation, and this study rooted in an Indian public sector organization is a step in this direction. Data for the study were collected through a survey among employees of Rourkela Steel Plant (RSP), a unit of Steel Authority of India Limited (SAIL); the first integrated Steel Plant in the public sector in India, for which stratified random sampling method was adopted. The schedule was distributed to around 700 employees, out of which 516 complete responses were obtained. The pre-validated scales were used for the study. All the variables in the study were measured on a five-point Likert scale ranging from “strongly disagree (1)” to “strongly agree (5)”. Structural equation modeling (SEM) using AMOS 22 was used to examine the hypothesized model, which offers a simultaneous test of an entire system of variables in a model. The study results shows that inter-relationship between employee voice and commitment-to-change, employee involvement and commitment-to-change and commitment-to-change and organizational change readiness were significant. To test the mediation hypotheses, Baron and Kenny’s technique was used. Examination of direct and mediated effect of mediators confirmed that commitment-to-change partially mediated the relation between employee involvement and organizational change readiness. Furthermore, study results also affirmed that commitment-to-change does not mediate the relation between employee involvement and organizational change readiness. The empirical exploration therefore establishes that it is important to harness employee’s valuable suggestions regarding change for building organizational change readiness. Regarding employee involvement, it was found that sharing information and involving people in decision-making, leads to a creation of participative climate, which educes employee commitment during change and commitment-to-change further, fosters organizational change readiness.

Keywords: commitment-to-change, change management, employee voice, employee involvement, organizational change readiness

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Authors: Fatin Mansour Daas

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Language education responds to and is reflective of emerging social and political trends. Language policies and practices are shaped by political, economic, social and cultural considerations. Following this, Israeli language education policy as implemented in Arab schools in Israel is influenced by the particular political and social situation of Arab-Palestinian citizens of Israel. This national group remained in their homeland following the war in 1948 between Israel and its Arab neighbors and became Israeli citizens following the establishment of the State of Israel. This study examines language policy in Arab schools in Israel from 1948 until the present time in light of the unique experience of the Palestinian Arab homeland minority in Israel with a particular focus on questions of politics and identity. The establishment of the State of Israel triggered far-reaching political, social and educational transformations within Arab Palestinian society in Israel, including in the area of language and language studies. Since 1948, the linguistic repertoire of Palestinian Arabs in Israel has become more complex and diverse, while the place and status of different languages have changed. Following the establishment of the State of Israel, only Hebrew and Arabic were retained as the official languages, and Israeli policy reflected this in schools as well: with the advent of the Jewish state, Hebrew language education among Palestinians in Israel has increased. Similarly, in Arab Palestinian schools in Israel, English is taught as a third language, Hebrew as a second language, and Arabic as a first language – even though it has become less important to native Arabic speakers. This research focuses on language studies and language policy in the Arab school system in Israel from 1948 onwards. It will analyze the relative focus of language education between the different languages, the rationale of various language education policies, and the pedagogic approach used to teach each language and student achievements vis-à-vis language skills. This study seeks to understand the extent to which Arab schools in Israel are multi-lingual by examining successes, challenges and difficulties in acquiring the respective languages. This qualitative study will analyze five different components of language education policy: (1) curriculum, (2) learning materials; (3) assessment; (4) interviews and (5) archives. Firstly, it consists of an analysis examining language education curricula, learning materials and assessments used in Arab schools in Israel from 1948-2018 including a selection of language textbooks for the compulsory years of study and the final matriculation (Bagrut) examinations. The findings will also be based on archival material which traces the evolution of language education policy in Arabic schools in Israel from the years 1948-2018. This archival research, furthermore, will reveal power relations and general decision-making in the field of the Arabic education system in Israel. The research will also include interviews with Ministry of Education staff who provide instructional oversight in the instruction of the three languages in the Arabic education system in Israel. These interviews will shed light on the goals of language education as understood by those who are in charge of implementing policy.

Keywords: language education policy, languages, multilingualism, language education, educational policy, identity, Palestinian-Arabs, Arabs in Israel, educational school system

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Authors: Shahril Anuar Bahari, Mohd Azrie Mohd Kepli, Mohd Ariff Jamaludin, Kamarulzaman Nordin, Mohamad Jani Saad

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Formaldehyde release from wood-based panel composites can be very toxicity and may increase the risk of human health as well as environmental problems. A new bio-composites product without synthetic adhesive or resin is possible to be developed in order to reduce these problems. Apart from formaldehyde release, adhesive is also considered to be expensive, especially in the manufacturing of composite products. Natural bonded composites can be termed as a panel product composed with any type of cellulosic materials without the addition of synthetic resins. It is composed with chemical content activation in the cellulosic materials. Pulp and paper making method (chemical pulping) was used as a general guide in the composites manufacturing. This method will also generally reduce the manufacturing cost and the risk of formaldehyde emission and has potential to be used as an alternative technology in fiber composites industries. In this study, the natural bonded bamboo fiber composite was produced from virgin Malaysian bamboo fiber (Bambusa vulgaris). The bamboo culms were chipped and digested into fiber using this pulping method. The black liquor collected from the pulping process was used as a natural binding agent in the composition. Then the fibers were mixed and blended with black liquor without any resin addition. The amount of black liquor used per composite board was 20%, with approximately 37% solid content. The composites were fabricated using a hot press machine at two different board densities, 850 and 950 kg/m³, with two sets of hot pressing time, 25 and 35 minutes. Samples of the composites from different densities and hot pressing times were tested in flexural strength and internal bonding (IB) for strength performance according to British Standard. Modulus of elasticity (MOE) and modulus of rupture (MOR) was determined in flexural test, while tensile force perpendicular to the surface was recorded in IB test. Results show that the strength performance of the composites with 850 kg/m³ density were significantly higher than 950 kg/m³ density, especially for samples from 25 minutes hot pressing time. Strength performance of composites from 25 minutes hot pressing time were generally greater than 35 minutes. Results show that the maximum mean values of strength performance were recorded from composites with 850 kg/m³ density and 25 minutes pressing time. The maximum mean values for MOE, MOR and IB were 3251.84, 16.88 and 0.27 MPa, respectively. Only MOE result has conformed to high density fiberboard (HDF) standard (2700 MPa) in British Standard for Fiberboard Specification, BS EN 622-5: 2006. Microstructure characteristics of composites can also be related to the strength performance of the composites, in which, the observed fiber damage in composites from 950 kg/m³ density and overheat of black liquor led to the low strength properties, especially in IB test.

Keywords: bamboo fiber, natural bonded, black liquor, mechanical tests, microstructure observations

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Authors: Muhammad Nouman, Salim Gul, Karim Ullah

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Partnership has been understood as the essence of Islamic banking. However, in practice, the non-partnership paradigm dominates the operations of Islamic banks. Islamic banks adopt partnership contracts for the scheme of deposits, especially for term deposit accounts. However, they do not adopt partnership contracts (i.e., Musharakah and Mudarabah) as the main financing scheme. In practice, non-partnership contracts including Murabahah and Ijara are widely used for financing. Many authors have provided different explanations for the less utilization of the partnership contracts as a scheme of financing. However, the typology of constraints remains missing. The extant literature remains scattered, with diverse studies focused on different dimensions of the issue. Therefore, there is no unified understanding of the constraints in the application of the partnership contracts. This paper aims to highlight the major factors hindering the application of partnership contracts, and produce a coherent view by synthesizing different explanations provided in several studies conducted around the globe. The present study employs insights form the extant literature using a systematic review and provides academia, practitioners, and policy makers with a holistic framework to name and make sense of what is making partnership contracts a less attractive option for Islamic banks. A total of 84 relevant publications including 11 books, 14 chapters of edited books, 48 journal articles, 8 conference papers and 3 IMF working papers were selected using a systematic procedure. Analysis of these selected publications followed three steps: i) In the first step of analysis the constraints explicitly appearing in the literature set of 84 articles were extracted, ii) In the second step 27 factors hindering the application of partnership contracts were identified from the constraints extracted in the first step with the overlapping items either eliminated or combined, iii) In the last step the factors identified in the second step were classified into three distinct categories. Our intention was to develop the typology of constraints by connecting the rather abstract concepts into the broader sets of constraints for better conceptualization and policy implications. Our framework highlights that there are mainly three facets of lower preference for partnership contracts of financing. First, there are several factors in the contemporary business settings, prevailing social setting, and the bank’s internal environment that underpin uncertainty in the success of partnership contracts of financing. Second, partnership contracts have lower demand i.e., entrepreneurs prefer to use non-partnership contracts for financing their ventures due to the inherent restraining characteristics of the partnership contracts. Finally, there are certain factors in the regulatory framework that restraint the extensive utilization of partnership contracts of financing by Islamic banks. The present study contributes to the Islamic banking literature in many ways. It provides clarification to the heavily criticized operations of Islamic banks, integrates the scattered literature, and provides a holistic framework for better conceptualization of the key constraints in the application of the partnership contracts and policy implications. Moreover, it demonstrates an application of systematic review in Islamic banking research.

Keywords: Islamic banking, Islamic finance, Mudarabah, Musharakah, partnership, systematic review

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Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel

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Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.

Keywords: functional performance, predictors, stroke, recovery

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Authors: J. Waita, S. Wamuhu, J. Makoyo, M. Rachel, T. Ngangari, W. Christine, M. Zipporah

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Contraceptive use is one of the key global strategies to alleviate maternal mortality. Global efforts through advocating for contraceptive uptake and service provision has led improved contraceptive prevalence. In Kenya maternal mortality rate has remained a challenged despites efforts by government and non-governmental organizations. Objective: To describe the uptake of contraceptives among women in Tunza Clinics, Kenya. Design and Methods: Ps Kenya through health care marketing fund is implementing a family planning program among its 350 Tunza fractional franchise facilities. Through private partnership, private owned facilities in low socio-economic areas are recruited and trained on contraceptive technology update. The providers are supported through facilitative supervision through a mobile based application Health Network Quality Improvement System (HNQIS) and interpersonal communication through 150 community based volunteers. The data analyzed in this paper was collected between January to July 2017 to show the uptake of modern Contraceptives among women in the Tunza franchise, method mix, age and distribution among the age bracket. Further analysis compares two different service delivery strategies; outreach and walk ins. Supportive supervision HNQIS scores was analyzed. Results: During the time period, a total of 132121 family planning clients were attended in 350 facilities. The average age of clients was 29.6 years. The average number of clients attended in the facilities per month was 18874. 73.7 %( n=132121) of the clients attended in the Tunza facilities were aged above 25 years while 22.1% 20-24 years and 4.2% 15-19 years. On contraceptive method mix, intra uterine device insertions clients contributed to 7.5%, implant insertions 15.3%, pills 11.2%, injections 62.7% while condoms and emergency pills had 2.7% and 0.6% respectively. Analysis of service delivery strategy indicated more than 79% of the clients were walk ins while 21% were attended to during outreaches. Uptake of long term contraceptive methods during outreaches was 73% of the clients while short term modern methods were 27%. Health Network Quality Improvement system assessment scores indicated 51% of the facilities scored over 90%, 25% scoring 80-89% while 21% scored below 80%. Conclusion: Preference for short term methods by women is possibly associated to cost as they are cheaper and easy to administer. When the cost of intra uterine device Implants is meant affordable during outreaches, the uptake is observed to increase. Making intra uterine device and implants affordable to women is a key strategy in increasing contraceptive prevalence hence averting maternal mortality.

Keywords: contraceptives, contraceptive uptake, low socio economic, supportive supervision

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Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu

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Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).

Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions

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Authors: Danny Barash

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Riboswitches are RNA genetic control elements that were originally discovered in bacteria and provide a unique mechanism of gene regulation. They work without the participation of proteins and are believed to represent ancient regulatory systems in the evolutionary timescale. One of the biggest challenges in riboswitch research is that many are found in prokaryotes but only a small percentage of known riboswitches have been found in certain eukaryotic organisms. The few examples of eukaryotic riboswitches were identified using sequence-based bioinformatics search methods that include some slight structural considerations. These pattern-matching methods were the first ones to be applied for the purpose of riboswitch detection and they can also be programmed very efficiently using a data structure called affix arrays, making them suitable for genome-wide searches of riboswitch patterns. However, they are limited by their ability to detect harder to find riboswitches that deviate from the known patterns. Several methods have been developed since then to tackle this problem. The most commonly used by practitioners is Infernal that relies on Hidden Markov Models (HMMs) and Covariance Models (CMs). Profile Hidden Markov Models were also carried out in the pHMM Riboswitch Scanner web application, independently from Infernal. Other computational approaches that have been developed include RMDetect by the use of 3D structural modules and RNAbor that utilizes Boltzmann probability of structural neighbors. We have tried to incorporate more sophisticated secondary structure considerations based on RNA folding prediction using several strategies. The first idea was to utilize window-based methods in conjunction with folding predictions by energy minimization. The moving window approach is heavily geared towards secondary structure consideration relative to sequence that is treated as a constraint. However, the method cannot be used genome-wide due to its high cost because each folding prediction by energy minimization in the moving window is computationally expensive, enabling to scan only at the vicinity of genes of interest. The second idea was to remedy the inefficiency of the previous approach by constructing a pipeline that consists of inverse RNA folding considering RNA secondary structure, followed by a BLAST search that is sequence-based and highly efficient. This approach, which relies on inverse RNA folding in general and our own in-house fragment-based inverse RNA folding program called RNAfbinv in particular, shows capability to find attractive candidates that are missed by Infernal and other standard methods being used for riboswitch detection. We demonstrate attractive candidates found by both the moving-window approach and the inverse RNA folding approach performed together with BLAST. We conclude that structure-based methods like the two strategies outlined above hold considerable promise in detecting riboswitches and other conserved RNAs of functional importance in a variety of organisms.

Keywords: riboswitches, RNA folding prediction, RNA structure, structure-based methods

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Authors: Mehrnaz Mostafavi

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The assessment and categorization of incidental lung nodules present a considerable challenge in healthcare, often necessitating resource-intensive multiple computed tomography (CT) scans for growth confirmation. This research addresses this issue by introducing a distinct computational approach leveraging radiomics and deep-learning methods. However, understanding local services is essential before implementing these advancements. With diverse tracking methods in place, there is a need for efficient and accurate identification approaches, especially in the context of managing lung nodules alongside pre-existing cancer scenarios. This study explores the integration of text-based algorithms in medical data curation, indicating their efficacy in conjunction with machine learning and deep-learning models for identifying lung nodules. Combining medical images with text data has demonstrated superior data retrieval compared to using each modality independently. While deep learning and text analysis show potential in detecting previously missed nodules, challenges persist, such as increased false positives. The presented research introduces a Structured-Query-Language (SQL) algorithm designed for identifying pulmonary nodules in a tertiary cancer center, externally validated at another hospital. Leveraging natural language processing (NLP) and machine learning, the algorithm categorizes lung nodule reports based on sentence features, aiming to facilitate research and assess clinical pathways. The hypothesis posits that the algorithm can accurately identify lung nodule CT scans and predict concerning nodule features using machine-learning classifiers. Through a retrospective observational study spanning a decade, CT scan reports were collected, and an algorithm was developed to extract and classify data. Results underscore the complexity of lung nodule cohorts in cancer centers, emphasizing the importance of careful evaluation before assuming a metastatic origin. The SQL and NLP algorithms demonstrated high accuracy in identifying lung nodule sentences, indicating potential for local service evaluation and research dataset creation. Machine-learning models exhibited strong accuracy in predicting concerning changes in lung nodule scan reports. While limitations include variability in disease group attribution, the potential for correlation rather than causality in clinical findings, and the need for further external validation, the algorithm's accuracy and potential to support clinical decision-making and healthcare automation represent a significant stride in lung nodule management and research.

Keywords: lung cancer diagnosis, structured-query-language (SQL), natural language processing (NLP), machine learning, CT scans

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Authors: Milu T. Cherian, Sergio C. Chai, Morgan A. Casal, Taosheng Chen

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This study aims to use CINPA1, a recently discovered small-molecule inhibitor of the xenobiotic receptor CAR (constitutive androstane receptor) for understanding the binding modes of CAR and to guide CAR-mediated gene expression profiling studies in human primary hepatocytes. CAR and PXR are xenobiotic sensors that respond to drugs and endobiotics by modulating the expression of metabolic genes that enhance detoxification and elimination. Elevated levels of drug metabolizing enzymes and efflux transporters resulting from CAR activation promote the elimination of chemotherapeutic agents leading to reduced therapeutic effectiveness. Multidrug resistance in tumors after chemotherapy could be associated with errant CAR activity, as shown in the case of neuroblastoma. CAR inhibitors used in combination with existing chemotherapeutics could be utilized to attenuate multidrug resistance and resensitize chemo-resistant cancer cells. CAR and PXR have many overlapping modulating ligands as well as many overlapping target genes which confounded attempts to understand and regulate receptor-specific activity. Through a directed screening approach we previously identified a new CAR inhibitor, CINPA1, which is novel in its ability to inhibit CAR function without activating PXR. The cellular mechanisms by which CINPA1 inhibits CAR function were also extensively examined along with its pharmacokinetic properties. CINPA1 binding was shown to change CAR-coregulator interactions as well as modify CAR recruitment at DNA response elements of regulated genes. CINPA1 was shown to be broken down in the liver to form two, mostly inactive, metabolites. The structure-activity differences of CINPA1 and its metabolites were used to guide computational modeling using the CAR-LBD structure. To rationalize how ligand binding may lead to different CAR pharmacology, an analysis of the docked poses of human CAR bound to CITCO (a CAR activator) vs. CINPA1 or the metabolites was conducted. From our modeling, strong hydrogen bonding of CINPA1 with N165 and H203 in the CAR-LBD was predicted. These residues were validated to be important for CINPA1 binding using single amino-acid CAR mutants in a CAR-mediated functional reporter assay. Also predicted were residues making key hydrophobic interactions with CINPA1 but not the inactive metabolites. Some of these hydrophobic amino acids were also identified and additionally, the differential coregulator interactions of these mutants were determined in mammalian two-hybrid systems. CINPA1 represents an excellent starting point for future optimization into highly relevant probe molecules to study the function of the CAR receptor in normal- and pathophysiology, and possible development of therapeutics (for e.g. use for resensitizing chemoresistant neuroblastoma cells).

Keywords: antagonist, chemoresistance, constitutive androstane receptor (CAR), multi-drug resistance, structure activity relationship (SAR), xenobiotic resistance

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Authors: Elena Kokkoni, Prasanna Kannappan, Ashkan Zehfroosh, Effrosyni Mavroudi, Kristina Strother-Garcia, James C. Galloway, Jeffrey Heinz, Rene Vidal, Herbert G. Tanner

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Early immobility affects the motor, cognitive, and social development. Current pediatric rehabilitation lacks the technology that will provide the dosage needed to promote mobility for young children at risk. The addition of socially assistive robots in early interventions may help increase the mobility dosage. The aim of this study is to examine the feasibility of an early intervention paradigm where non-walking infants experience independent mobility while socially interacting with robots. A dynamic environment is developed where both the child and the robot interact and learn from each other. The environment involves: 1) a range of physical activities that are goal-oriented, age-appropriate, and ability-matched for the child to perform, 2) the automatic functions that perceive the child’s actions through novel activity recognition algorithms, and decide appropriate actions for the robot, and 3) a networked visual data acquisition system that enables real-time assessment and provides the means to connect child behavior with robot decision-making in real-time. The environment was tested by bringing a two-year old boy with Down syndrome for eight sessions. The child presented delays throughout his motor development with the current being on the acquisition of walking. During the sessions, the child performed physical activities that required complex motor actions (e.g. climbing an inclined platform and/or staircase). During these activities, a (wheeled or humanoid) robot was either performing the action or was at its end point 'signaling' for interaction. From these sessions, information was gathered to develop algorithms to automate the perception of activities which the robot bases its actions on. A Markov Decision Process (MDP) is used to model the intentions of the child. A 'smoothing' technique is used to help identify the model’s parameters which are a critical step when dealing with small data sets such in this paradigm. The child engaged in all activities and socially interacted with the robot across sessions. With time, the child’s mobility was increased, and the frequency and duration of complex and independent motor actions were also increased (e.g. taking independent steps). Simulation results on the combination of the MDP and smoothing support the use of this model in human-robot interaction. Smoothing facilitates learning MDP parameters from small data sets. This paradigm is feasible and provides an insight on how social interaction may elicit mobility actions suggesting a new early intervention paradigm for very young children with motor disabilities. Acknowledgment: This work has been supported by NIH under grant #5R01HD87133.

Keywords: activity recognition, human-robot interaction, machine learning, pediatric rehabilitation

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Authors: Michael Amankwaa Adu

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Effective communication in the classroom plays a vital role in ensuring successful teaching and learning. In particular, the types of language and speech acts teachers use shape classroom interactions and influence student engagement. This study aims to analyze the speech acts employed by a Career Technology teacher in a junior high school. While much research has focused on speech acts in language classrooms, less attention has been given to how these acts operate in non-language subject areas like technical education. The study explores how different types of speech acts—directives, assertives, expressives, and commissives—are used during three classroom encounters: lesson introduction, content delivery, and classroom management. This research seeks to fill the gap in understanding how teachers of non-language subjects use speech acts to manage classroom dynamics and facilitate learning. The study employs a mixed-methods design, combining qualitative and quantitative approaches. Data was collected through direct classroom observation and audio recordings of a one-hour Career Technology lesson. The transcriptions of the lesson were analyzed using John Searle’s taxonomy of speech acts, classifying the teacher’s utterances into directives, assertives, expressives, and commissives. Results show that directives were the most frequently used speech act, accounting for 59.3% of the teacher's utterances. These speech acts were essential in guiding student behavior, giving instructions, and maintaining classroom control. Assertives made up 20.4% of the speech acts, primarily used for stating facts and reinforcing content. Expressives, at 14.2%, expressed emotions such as approval or frustration, helping to manage the emotional atmosphere of the classroom. Commissives were the least used, representing 6.2% of the speech acts, often used to set expectations or outline future actions. No declarations were observed during the lesson. The findings of this study reveal the critical role that speech acts play in managing classroom behavior and delivering content in technical subjects. Directives were crucial for ensuring students followed instructions and completed tasks, while assertives helped in reinforcing lesson objectives. Expressives contributed to motivating or disciplining students, and commissives, though less frequent, helped set clear expectations for students’ future actions. The absence of declarations suggests that the teacher prioritized guiding students over making formal pronouncements. These insights can inform teaching strategies across various subject areas, demonstrating that a diverse use of speech acts can create a balanced and interactive learning environment. This study contributes to the growing field of pragmatics in education and offers practical recommendations for educators, particularly in non-language classrooms, on how to utilize speech acts to enhance both classroom management and student engagement.

Keywords: classroom interaction, pragmatics, speech acts, teacher communication, career technology

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Authors: László L. Lippai

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In addition to the fact that mental health bears great significance to a particular individual, it can also be regarded as an organizational, community and societal resource. Within the Szeged Health Promotion Research Group, we conducted mental health surveys on two levels: The inhabitants of a medium-sized Hungarian town and students of a Hungarian university with a relatively big headcount were requested to participate in surveys whose goals were to define local government priorities and organization-level health promotion programmes, respectively. To facilitate professional decision-making, we defined three, pragmatically relevant, groups of the target population: the mentally healthy, the vulnerable and the endangered. In order to determine which group a person actually belongs to, we designed a simple and quick measurement tool, which could even be utilised as a smoothing method, the Mental State Questionnaire validity of the above three categories was verified by analysis of variance against psychological quality of life variables. We demonstrate the pragmatic significance of our method via the analyses of the scores of our two mental health surveys. On town level, during our representative survey in Hódmezővásárhely (N=1839), we found that 38.7% of the participants was mentally healthy, 35.3% was vulnerable, while 16.3% was considered as endangered. We were able to identify groups that were in a dramatic state in terms of mental health. For example, such a group consisted of men aged 45 to 64 with only primary education qualification and the ratios of the mentally healthy, vulnerable and endangered were 4.5, 45.5 and 50%, respectively. It was also astonishing to see to what a little extent qualification prevailed as a protective factor in the case of women. Based on our data, the female group aged 18 to 44 with primary education—of whom 20.3% was mentally healthy, 42.4% vulnerable and 37.3% was endangered—as well as the female group aged 45 to 64 with university or college degree—of whom 25% was mentally healthy, 51.3 vulnerable and 23.8% endangered—are to be handled as priority intervention target groups in a similarly difficult position. On organizational level, our survey involving the students of the University of Szeged, N=1565, provided data to prepare a strategy of mental health promotion for a university with a headcount exceeding 20,000. When developing an organizational strategy, it was important to gather information to estimate the proportions of target groups in which mental health promotion methods; for example, life management skills development, detection, psychological consultancy, psychotherapy, would be applied. Our scores show that 46.8% of the student participants were mentally healthy, 42.1% were vulnerable and 11.1% were endangered. These data convey relevant information as to the allocation of organizational resources within a university with a considerable headcount. In conclusion, The Mental State Questionnaire, as a valid smoothing method, is adequate to describe a community in a plain and informative way in the terms of mental health. The application of the method can promote the preparation, design and implementation of mental health promotion interventions. 

Keywords: health promotion, mental health promotion, mental state questionnaire, psychological well-being

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Authors: Milena Trojanowska

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Disability is a phenomenon for which meanings and definitions have evolved over the decades. This became the trigger to start a project to answer the question of what disability constitutes in the course of an incurable chronic disease. The chosen research group are people living with multiple sclerosis.The contextual phase of the research was participant observation at the Polish Multiple Sclerosis Society, the largest NGO in Poland supporting people living with MS and their relatives. The research techniques used in the project are (in order of implementation): group interviews with people living with MS and their relatives, narrative interviews, asynchronous technique, participant observation during events organised for people living with MS and their relatives.The researcher is currently conducting follow-up interviews, as inaccuracies in the respondents' narratives were identified during the data analysis. Interviews and supplementary research techniques were used over the four years of the research, and the researcher also benefited from experience gained from 12 years of working with NGOs (diaries, notes). The research was carried out in Poland with the participation of people living in this country only.The research has been based on grounded theory methodology in a constructivist perspectivedeveloped by Kathy Charmaz. The goal was to follow the idea that research must be reliable, original, and useful. The aim was to construct an interpretive theory that assumes temporality and the processualityof social life. TheAtlas.ti software was used to collect research material and analyse it. It is a program from the CAQDAS(Computer-Assisted Qualitative Data Analysis Software) group.Several key factors influencing the construction of a disability identity by people living with multiple sclerosis was identified:-course of interaction with significant relatives,- the expectation of identification with disability (expressed by close relatives),- economic profitability (pension, allowances),- institutional advantages (e.g. parking card),- independence and autonomy (not equated with physical condition, but access to adapted infrastructure and resources to support daily functioning),- the way a person with MS construes the meaning of disability,- physical and mental state,- medical diagnosis of illness.In addition, it has been shown that making an assumption about the experience of disability in the course of MS is a form of cognitive reductionism leading to further phenomenon such as: the expectation of the person with MS to construct a social identity as a person with a disability (e.g. giving up work), the occurrence of institutional inequalities. It can also be a determinant of the choice of a life strategy that limits social and individual functioning, even if this necessity is not influenced by the person's physical or psychological condition.The results of the research are important for the development of knowledge about the phenomenon of disability. It indicates the contextuality and complexity of the disability phenomenon, which in the light of the research is a set of different phenomenon of heterogeneous nature and multifaceted causality. This knowledge can also be useful for institutions and organisations in the non-governmental sector supporting people with disabilities and people living with multiple sclerosis.

Keywords: disability, multiple sclerosis, grounded theory, poland

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Authors: Matthew Yeager, Christopher Willy, John Bischoff

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The conceptualization and design phases of a system lifecycle consume a significant amount of the lifecycle budget in the form of direct tasking and capital, as well as the implicit costs associated with unforeseeable design errors that are only realized during downstream phases. Ad hoc or iterative approaches to generating system requirements oftentimes fail to consider the full array of feasible systems or product designs for a variety of reasons, including, but not limited to: initial conceptualization that oftentimes incorporates a priori or legacy features; the inability to capture, communicate and accommodate stakeholder preferences; inadequate technical designs and/or feasibility studies; and locally-, but not globally-, optimized subsystems and components. These design pitfalls can beget unanticipated developmental or system alterations with added costs, risks and support activities, heightening the risk for suboptimal system performance, premature obsolescence or forgone development. Supported by rapid advances in learning algorithms and hardware technology, sensors and sensor systems have become commonplace in both commercial and industrial products. The evolving array of hardware components (i.e. sensors, CPUs, modular / auxiliary access, etc…) as well as recognition, data fusion and communication protocols have all become increasingly complex and critical for design engineers during both concpetualization and implementation. This work seeks to develop and utilize a non-deterministic approach for sensor system design within the multi-attribute tradespace exploration (MATE) paradigm, a technique that incorporates decision theory into model-based techniques in order to explore complex design environments and discover better system designs. Developed to address the inherent design constraints in complex aerospace systems, MATE techniques enable project engineers to examine all viable system designs, assess attribute utility and system performance, and better align with stakeholder requirements. Whereas such previous work has been focused on aerospace systems and conducted in a deterministic fashion, this study addresses a wider array of system design elements by incorporating both traditional tradespace elements (e.g. hardware components) as well as popular multi-sensor data fusion models and techniques. Furthermore, statistical performance features to this model-based MATE approach will enable non-deterministic techniques for various commercial systems that range in application, complexity and system behavior, demonstrating a significant utility within the realm of formal systems decision-making.

Keywords: multi-attribute tradespace exploration, data fusion, sensors, systems engineering, system design

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Authors: Nawal Alawad, Passent Ibrahim Tantawi, Mohamed Abdel Salam Ragheb

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Providing customers with quality experiences has been confirmed to be a sustainable, competitive advantage with a distinct financial impact for companies. The success of service providers now relies on their ability to provide customer-centric services. The importance of perceived service quality and customer experience is widely recognized. The focus of this research is in the area of mobile and fixed broadband services. This study is of dual importance both academically and practically. Academically, this research applies a new model investigating the impact of customer experience quality on loyalty based on modifying the multiple-item scale for measuring customers’ service experience in a new area and did not depend on the traditional models. The integrated scale embraces four dimensions: service experience, outcome focus, moments of truth and peace of mind. In addition, it gives a scientific explanation for this relationship so this research fill the gap in such relations in which no one correlate or give explanations for these relations before using such integrated model and this is the first time to apply such modified and integrated new model in telecom field. Practically, this research gives insights to marketers and practitioners to improve customer loyalty through evolving the experience quality of broadband customers which is interpreted to suggested outcomes: purchase, commitment, repeat purchase and word-of-mouth, this approach is one of the emerging topics in service marketing. Data were collected through 412 questionnaires and analyzed by using structural equation modeling.Findings revealed that both outcome focus and moments of truth have a significant impact on loyalty while both service experience and peace of mind have insignificant impact on loyalty.In addition, it was found that 72% of the variation occurring in loyalty is explained by the model. The researcher also measured the net prompters score and gave explanation for the results. Furthermore, assessed customer’s priorities of broadband services. The researcher recommends that the findings of this research will extend to be considered in the future plans of Telecom Egypt Group. In addition, to be applied in the same industry especially in the developing countries that have the same circumstances with similar service settings. This research is a positive contribution in service marketing, particularly in telecom industry for making marketing more reliable as managers can relate investments in service experience directly with the performance closest to income for instance, repurchasing behavior, positive word of mouth and, commitment. Finally, the researcher recommends that future studies should consider this model to explain significant marketing outcomes such as share of wallet and ultimately profitability.

Keywords: broadband services, customer experience quality, loyalty, net promoters score

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Authors: John Zanetich

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Due to their positive associations with student learning and retention, certain undergraduate opportunities are designated ‘high-impact.’ High-Impact Practices (HIPs) such as, learning communities, community based projects, research, internships, study abroad and culminating senior experience, share several traits bin common: they demand considerable time and effort, learning occurs outside of the classroom, and they require meaningful interactions between faculty and students, they encourage collaboration with diverse others, and they provide frequent and substantive feedback. As a result of experiential learning in these practices, participation in these practices can be life changing. High impact learning helps individuals locate tacit knowledge, and build mental models that support the accumulation of knowledge. On-going learning from experience and knowledge conversion provides the individual with a way to implicitly organize knowledge and share knowledge over a lifetime. Knowledge conversion is a knowledge management component which focuses on the explication of the tacit knowledge that exists in the minds of students and that knowledge which is embedded in the process and relationships of the classroom educational experience. Knowledge conversion is required when working with tacit knowledge and the demand for a learner to align deeply held beliefs with the cognitive dissonance created by new information. Knowledge conversion and tacit knowledge result from the fact that an individual's way of knowing, that is, their core belief structure, is considered generalized and tacit instead of explicit and specific. As a phenomenon, tacit knowledge is not readily available to the learner for explicit description unless evoked by an external source. The development of knowledge–related capabilities such as Aggressive Development of Tacit Knowledge (ADTK) can be used in experiential educational programs to enhance knowledge, foster behavioral change, improve decision making, and overall performance. ADTK allows the student in HIPs to use their existing knowledge in a way that allows them to evaluate and make any necessary modifications to their core construct of reality in order to amalgamate new information. Based on the Lewin/Schein Change Theory, the learner will reach for tacit knowledge as a stabilizing mechanism when they are challenged by new information that puts them slightly off balance. As in word association drills, the important concept is the first thought. The reactionary outpouring to an experience is the programmed or tacit memory and knowledge of their core belief structure. ADTK is a way to help teachers design their own methods and activities to unfreeze, create new learning, and then refreeze the core constructs upon which future learning in a subject area is built. This paper will explore the use of ADTK as a technique for knowledge conversion in the classroom in general and in HIP programs specifically. It will focus on knowledge conversion in curriculum development and propose the use of one-time educational experiences, multi-session experiences and sequential program experiences focusing on tacit knowledge in educational programs.

Keywords: tacit knowledge, knowledge management, college programs, experiential learning

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Authors: Isabelle Gobatto

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Based on an anthropological approach, this paper explores the medical profession and the construction of medical practices by considering the multiform articulations between structural poverty and the production of care from a low-resource francophone West African country, Burkina Faso. This country is considered in its exemplary dimension of culturally differentiated countries of the African continent that share the same situation of structural poverty. The objective is to expose the effects of structural poverty on the ways of constructing professional knowledge and thinking about the sense of the medical profession. If doctors are trained to have the same capacities in South and West countries, which are to treat and save lives whatever the cultural contexts of the practice of medicine, the ways of investing their role and of dealing with this context of action fracture the homogenization of the medical profession. In the line of anthropology of biomedicine, this paper outlines the complex effects of structural poverty on health care, care relations, and the moral economy of doctors. The materials analyzed are based on an ethnography including two temporalities located thirty years apart (1990-1994 and 2020-2021), based on long-term observations of care practices conducted in healthcare institutions, interviews coupled with the life histories of physicians. The findings reveal that disabilities faced by doctors to deliver care are interpreted as policy gaps, but they are also considered by physicians as constitutive of the social and cultural characteristics of patients, making their capacities and incapacities in terms of accompanying caregivers in the production of care. These perceptions have effects on know-how, structured around the need to act even when diagnoses are not made so as not to see patients desert health structures if the costs of care are too high for them. But these interpretations of highly individualizing dimensions of these difficulties place part of the blame on patients for the difficulties in using learned knowledge and delivering effective care. These situations challenge the ethics of caregivers but also of ethnologists. Firstly because the interpretations of disabilities prevent caregivers from considering vulnerabilities of care as constituting a common condition shared with their patients in these health systems, affecting them in an identical way although in different places in the production of care. Correlatively, these results underline that these professional conceptions prevent the emergence of a figure of victim, which could be shared between patients and caregivers who, together, undergo working and care conditions at the limit of the acceptable. This dimension directly involves politics. Secondly, structural poverty and its effects on care challenge the ethics of the anthropologist who observes caregivers producing, without intent to arm, experiences of care marked by an ordinary violence, by not giving them the care they need. It is worth asking how anthropologists could get doctors to think in this light in west-African societies.

Keywords: Africa, care, ethics, poverty

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Authors: Bagireanu Astrid, Bros-Williamson Julio, Duncheva Mila, Currie John

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The Architecture, Engineering, and Construction (AEC) sector plays a critical role in the global transition toward sustainable and net-zero built environments. However, the industry faces unique challenges in planning for net-zero while struggling with low productivity, cost overruns and overall resistance to change. Traditional practices fall short due to their inability to meet the requirements for systemic change, especially as governments increasingly demand transformative approaches. Working in silos and rigid hierarchies and a short-term, client-centric approach prioritising immediate gains over long-term benefit stands in stark contrast to the fundamental requirements for the realisation of net-zero objectives. These practices have limited capacity to effectively integrate AEC stakeholders and promote the essential knowledge sharing required to address the multifaceted challenges of achieving net-zero. In the context of built environment, procurement may be described as the method by which a project proceeds from inception to completion. Collaborative procurement methods under the Integrated Practices (IP) umbrella have the potential to align more closely with net-zero objectives. This paper explores the synergies between collaborative procurement principles and the pursuit of net zero in the AEC sector, drawing upon the shared values of cross-disciplinary collaboration, Early Supply Chain involvement (ESI), use of standards and frameworks, digital information management, strategic performance measurement, integrated decision-making principles and contractual alliancing. To investigate the role of collaborative procurement in advancing net-zero objectives, a structured research methodology was employed. First, the study focuses on a systematic review on the application of collaborative procurement principles in the AEC sphere. Next, a comprehensive analysis is conducted to identify common clusters of these principles across multiple procurement methods. An evaluative comparison between traditional procurement methods and collaborative procurement for achieving net-zero objectives is presented. Then, the study identifies the intersection between collaborative procurement principles and the net-zero requirements. Lastly, an exploration of key insights for AEC stakeholders focusing on the implications and practical applications of these findings is made. Directions for future development of this research are recommended. Adopting collaborative procurement principles can serve as a strategic framework for guiding the AEC sector towards realising net-zero. Synergising these approaches overcomes fragmentation, fosters knowledge sharing, and establishes a net-zero-centered ecosystem. In the context of the ongoing efforts to amplify project efficiency within the built environment, a critical realisation of their central role becomes imperative for AEC stakeholders. When effectively leveraged, collaborative procurement emerges as a powerful tool to surmount existing challenges in attaining net-zero objectives.

Keywords: collaborative procurement, net-zero, knowledge sharing, architecture, built environment

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Authors: Huang Wei-Yi

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Objective: This article explores the intensive care nursing experience of a lung cancer patient with pulmonary embolism who was placed on ECMO. Following a sudden change in the patient’s condition and a consensus reached during a family meeting, the decision was made to withdraw life-sustaining equipment and collaborate with the palliative care team. Methods: The nursing period was from October 20 to October 27, 2023. The author monitored physiological data, observed, provided direct care, conducted interviews, performed physical assessments, and reviewed medical records. Together with the critical care team and bypass personnel, a comprehensive assessment was conducted using Gordon's Eleven Functional Health Patterns to identify the patient’s health issues, which included pain related to lung cancer and invasive devices, fear of death due to sudden deterioration, and altered tissue perfusion related to hemodynamic instability. Results: The patient was admitted with fever, back pain, and painful urination. During hospitalization, the patient experienced sudden discomfort followed by cardiac arrest, requiring multiple CPR attempts and ECMO placement. A subsequent CT angiogram revealed a pulmonary embolism. The patient's condition was further complicated by severe pain due to compression fractures, and a diagnosis of terminal lung cancer was unexpectedly confirmed, leading to emotional distress and uncertainty about future treatment. Throughout the critical care process, ECMO was removed on October 24, stabilizing the patient’s body temperature between 36.5-37°C and maintaining a mean arterial pressure of 60-80 mmHg. Pain management, including Morphine 8mg in 0.9% N/S 100ml IV drip q6h PRN and Ultracet 37.5 mg/325 mg 1# PO q6h, kept the pain level below 3. The patient was transferred to the ward on October 27 and discharged home on October 30. Conclusion: During the care period, collaboration with the medical team and palliative care professionals was crucial. Adjustments to pain medication, symptom management, and lung cancer-targeted therapy improved the patient’s physical discomfort and pain levels. By applying the unique functions of nursing and the four principles of palliative care, positive encouragement was provided. Family members, along with social workers, clergy, psychologists, and nutritionists, participated in cross-disciplinary care, alleviating anxiety and fear. The consensus to withdraw ECMO and life-sustaining equipment enabled the patient and family to receive high-quality care and maintain autonomy in decision-making. A follow-up call on November 1 confirmed that the patient was emotionally stable, pain-free, and continuing with targeted lung cancer therapy.

Keywords: intensive care, lung cancer, pulmonary embolism, ECMO

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Authors: P. M. Natarajan, Shambhu Kallolikar, S. Ganesh

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By size and volume of water, Ganges River basin is the biggest among the fourteen major river basins in India. By Hindu’s faith, it is the main ‘holy river’ in this nation. But, of late, the pollution load, both domestic and industrial sources are deteriorating the surface and groundwater as well as land resources and hence the environment of the Ganges River basin is under threat. Seeing this scenario, the Indian government began to reclaim this river by two Ganges Action Plans I and II since 1986 by spending Rs. 2,747.52 crores ($457.92 million). But the result was no improvement in the water quality of the river and groundwater and environment even after almost three decades of reclamation, and hence now the New Indian Government is taking extra care to rejuvenate this river and allotted Rs. 2,037 cores ($339.50 million) in 2014 and Rs. 20,000 crores ($3,333.33 million) in 2015. The reasons for the poor water quality and stinking environment even after three decades of reclamation of the river are either no treatment/partial treatment of the sewage. Hence, now the authors are suggesting a tertiary level treatment standard of sewages of all sources and origins of the Ganges River basin and recycling the entire treated water for nondomestic uses. At 20million litres per day (MLD) capacity of each sewage treatment plant (STP), this basin needs about 2020 plants to treat the entire sewage load. Cost of the STPs is Rs. 3,43,400 million ($5,723.33 million) and the annual maintenance cost is Rs. 15,352 million ($255.87 million). The advantages of the proposed exercise are: we can produce a volume of 1,769.52 million m³ of biogas. Since biogas is energy, can be used as a fuel, for any heating purpose, such as cooking. It can also be used in a gas engine to convert the energy in the gas into electricity and heat. It is possible to generate about 3,539.04 million kilowatt electricity per annum from the biogas generated in the process of wastewater treatment in Ganges basin. The income generation from electricity works out to Rs 10,617.12million ($176.95million). This power can be used to bridge the supply and demand gap of energy in the power hungry villages where 300million people are without electricity in India even today, and to run these STPs as well. The 664.18 million tonnes of sludge generated by the treatment plants per annum can be used in agriculture as manure with suitable amendments. By arresting the pollution load the 187.42 cubic kilometer (km³) of groundwater potential of the Ganges River basin could be protected from deterioration. Since we can recycle the sewage for non-domestic purposes, about 14.75km³ of fresh water per annum can be conserved for future use. The total value of the water saving per annum is Rs.22,11,916million ($36,865.27million) and each citizen of Ganges River basin can save Rs. 4,423.83/ ($73.73) per annum and Rs. 12.12 ($0.202) per day by recycling the treated water for nondomestic uses. Further the environment of this basin could be kept clean by arresting the foul smell as well as the 3% of greenhouse gages emission from the stinking waterways and land. These are the ways to reclaim the waterways of Ganges River basin from deterioration.

Keywords: Holy Ganges River, lifeline of India, wastewater treatment and management, making Ganges permanently holy

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Authors: Adeiza Matthew, Oluwadamilola Abubakar

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Wood energy, also known as wood fuel, is a renewable energy source that is derived from woody biomass, which is organic matter that is harvested from forests, woodlands, and other lands. Woody biomass includes trees, branches, twigs, and other woody debris that can be used as fuel. Wood energy can be classified based on its sources, such as trees outside forests, residues from wood harvesting and conversion, and energy plantations. There are several policy frameworks that support the use of wood energy, including participatory forest management and agroforestry. These policies aim to promote the sustainable use of woody biomass as a source of energy while also protecting forests and wildlife habitats. There are several options for using wood as a fuel, including central heating systems, pellet-based systems, wood chip-based systems, log boilers, fireplaces, and stoves. Each of these options has its own benefits and drawbacks, and the most appropriate option will depend on factors such as the availability of woody biomass, the heating needs of the household or facility, and the local climate. In order to use wood as a fuel, it must be harvested and stored properly. Hardwood or softwood can be used as fuel, and the heating value of firewood depends on the species of tree and the degree of moisture content. Proper harvesting and storage of wood can help to minimize environmental impacts and improve wildlife habitats. The use of wood energy has several environmental impacts, including the release of greenhouse gases during combustion and the potential for air pollution from combustion by-products. However, wood energy can also have positive environmental impacts, such as the sequestration of carbon in trees and the reduction of reliance on fossil fuels. The regulation and legislation of wood energy vary by country and region, and there is an ongoing debate about the potential use of wood energy in renewable energy technologies. Wood energy is a renewable energy source that can be used to generate electricity, heat, and transportation fuels. Woody biomass is abundant and widely available, making it a potentially significant source of energy for many countries. The use of wood energy can create local economic and employment opportunities, particularly in rural areas. Wood energy can be used to reduce reliance on fossil fuels and reduce greenhouse gas emissions. Properly managed forests can provide a sustained supply of woody biomass for energy, helping to reduce the risk of deforestation and habitat loss. Wood energy can be produced using a variety of technologies, including direct combustion, co-firing with fossil fuels, and the production of biofuels. The environmental impacts of wood energy can be minimized through the use of best practices in harvesting, transportation, and processing. Wood energy is regulated and legislated at the national and international levels, and there are various standards and certification systems in place to promote sustainable practices. Wood energy has the potential to play a significant role in the transition to a low-carbon economy and the achievement of climate change mitigation goals.

Keywords: biomass, timber, charcoal, firewood

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Authors: Vinod Balakrishnan, Chrisalice Ela Joseph

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The Burmese Exodus of 1942, which left more than 4 lakh as refugees and thousands dead, is one of the worst forced migrations in recorded history. Adding to the woes of the refugees is the lack of credible documentation of their lived experiences, trauma, and stories and their erasure from recorded history. Media reports, national records, and mainstream narratives that have registered the exodus provide sanitized versions which have reduced the refugees to a nameless, faceless mass of travelers and obliterated their lived experiences, trauma, and sufferings. This attitudinal problem compels the need to stem the insensitivity that accompanies institutional memory by making a case for a more humanistically evolved policy that puts in place protocols for the way the humanities would voice the concern for the refugee. A definite step in this direction and a far more relevant project in our times is the need to build a comprehensive refugee archive that can be a repository of the refugee experiences and perspectives. The paper draws on Hannah Arendt’s position on the Jewish refugee crisis, Agamben’s work on statelessness and citizenship, Foucault’s notion of governmentality and biopolitics, Edward Said’s concepts on Exile, Fanon’s work on the dispossessed, Derrida’s work on ‘the foreigner and hospitality’ in order to conceptualize the refugee condition which will form the theoretical framework for the paper. It also refers to the existing scholarship in the field of refugee studies such as Roger Zetter’s work on the ‘refugee label’, Philip Marfleet’s work on ‘refugees and history’, Lisa Malkki’s research on the anthropological discourse of the refugee and refugee studies. The paper is also informed by the work that has been done by the international organizations to address the refugee crisis. The emphasis is on building a strong argument for the establishment of the refugee archive that finds but a passing and a none too convincing reference in refugee studies in order to enable a multi-dimensional understanding of the refugee crisis. Some of the old questions cannot be dismissed as outdated as the continuing travails of the refugees in different parts of the world only remind us that they are still, largely, unanswered. The questions are -What is the nature of a Refugee Archive? How is it different from the existing historical and political archives? What are the implications of the refugee archive? What is its contribution to refugee studies? The paper draws on Diana Taylor’s concept of the archive and the repertoire to theorize the refugee archive as a repository that has the documentary function of the ‘archive’ and the ‘agency’ function of the repertoire. It then reads Ayya’s Accounts- a memoir by Anand Pandian -in the light of Hannah Arendt’s concepts of the ‘refugee as vanguard’ and ‘story telling as political action’- to illustrate how the memoir contributes to the refugee archive that provides the refugee a place and agency in history. The paper argues for a refugee archive that has implications for the formulation of inclusive refugee policies.

Keywords: Ayya’s Accounts, Burmese Exodus, policy protocol, refugee archive

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Authors: David Hough

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Indigenous peoples can generally be described as the original or first peoples of a land prior to colonization. While there is no single definition of indigenous peoples, the United Nations has developed a general understanding based on self-identification and historical continuity with pre-colonial societies. Indigenous peoples are often traditional holders of unique languages, knowledge systems and beliefs who possess valuable knowledge and practices which support sustainable management of natural resources. They often have social, economic, political systems, languages and cultures, which are distinct from dominant groups in the society or state where they live. They generally resist attempts by the dominant culture at assimilation and endeavour to maintain and reproduce their ancestral environments and systems as distinctive peoples and communities. In 2007, the United Nations General Assembly passed a declaration on the rights of indigenous peoples, known as UNDRIP. It (in addition to other international instruments such as ILO 169), sets out far-reaching guidelines, which – among other things – attempt to protect and promote indigenous languages and cultures. Paragraphs 13 and 14 of the declaration state the following regarding language, culture and education: Article 13, Paragraph 1: Indigenous peoples have the right to revitalize, use, develop and transmit for future generations their histories, languages, oral traditions, philosophies, writing systems, and literatures, and to designate and retain their own names for communities, places and persons. Article 14, Paragraph I: Indigenous peoples have the right to establish and control their educational systems and institutions providing education in their own languages, in a manner appropriate to their cultural methods of teaching and learning. These two paragraphs call for the right of self-determination in education. Paragraph 13 gives indigenous peoples the right to control the content of their teaching, while Paragraph 14 states that the teaching of this content should be based on methods of teaching and learning which are appropriate to indigenous peoples. This paper reviews an approach to furthering linguistic and cultural human rights for indigenous peoples in education, which supports UNDRIP. It has been employed in countries in Asia and the Pacific, including the Republic of the Marshall Islands, the Federated States of Micronesia, Far East Russia and Nepal. It is based on bottom-up community-based initiatives where students, teachers and local knowledge holders come together to produce classroom materials in their own languages that reflect their traditional beliefs and value systems. They may include such things as knowledge about herbal medicines and traditional healing practices, local history, numerical systems, weights and measures, astronomy and navigation, canoe building, weaving and mat making, life rituals, feasts, festivals, songs, poems, etc. Many of these materials can then be mainstreamed into math, science language arts and social studies classes.

Keywords: Indigenous peoples, linguistic and cultural human rights, materials development, teacher training, traditional knowledge

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