Search results for: operation practice

Authors: T. Suleiman, C. Mchugh, H. Ranu

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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

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Authors: Eric Pla Erra, Mariana Jimenez Martinez

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While aggregated loads at a community level tend to be easier to predict, individual household load forecasting present more challenges with higher volatility and uncertainty. Furthermore, the drastic changes that our behavior patterns have suffered due to the COVID-19 pandemic have modified our daily electrical consumption curves and, therefore, further complicated the forecasting methods used to predict short-term electric load. Load forecasting is vital for the smooth and optimized planning and operation of our electric grids, but it also plays a crucial role for individual domestic consumers that rely on a HEMS (Home Energy Management Systems) to optimize their energy usage through self-generation, storage, or smart appliances management. An accurate forecasting leads to higher energy savings and overall energy efficiency of the household when paired with a proper HEMS. In order to study how COVID-19 has affected the accuracy of forecasting methods, an evaluation of the performance of a state-of-the-art LGBM (Light Gradient Boosting Model) will be conducted during the transition between pre-pandemic and lockdowns periods, considering day-ahead electric load forecasting. LGBM improves the capabilities of standard Decision Tree models in both speed and reduction of memory consumption, but it still offers a high accuracy. Even though LGBM has complex non-linear modelling capabilities, it has proven to be a competitive method under challenging forecasting scenarios such as short series, heterogeneous series, or data patterns with minimal prior knowledge. An adaptation of the LGBM model – called “resilient LGBM” – will be also tested, incorporating a concept drift detection technique for time series analysis, with the purpose to evaluate its capabilities to improve the model’s accuracy during extreme events such as COVID-19 lockdowns. The results for the LGBM and resilient LGBM will be compared using standard RMSE (Root Mean Squared Error) as the main performance metric. The models’ performance will be evaluated over a set of real households’ hourly electricity consumption data measured before and during the COVID-19 pandemic. All households are located in the city of Barcelona, Spain, and present different consumption profiles. This study is carried out under the ComMit-20 project, financed by AGAUR (Agència de Gestiód’AjutsUniversitaris), which aims to determine the short and long-term impacts of the COVID-19 pandemic on building energy consumption, incrementing the resilience of electrical systems through the use of tools such as HEMS and artificial intelligence.

Keywords: concept drift, forecasting, home energy management system (HEMS), light gradient boosting model (LGBM)

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Authors: Dede Basturk, Metin Kaya, Halil Taskin, Nurtekin Erkmen

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In total, 29 students studying in Selçuk University Physical Training and Sports School who are recreationally active participated voluntarilyin this study which was carried out in order to examine effects of Vertimax trainings on agility, quickness and acceleration. 3 groups took their parts in this study as Vertimax training group (N=10), Ordinary training group (N=10) and Control group (N=9). Measurements were carried out in performance laboratory of Selçuk University Physical Training and Sports School. A training program for quickness and agility was followed up for subjects 3 days a week (Monday, Wednesday, Friday) for 8 weeks. Subjects taking their parts in vertimax training group and ordinary training group participated in the training program for quickness and agility. Measurements were applied as pre-test and post-test. Subjects of vertimax training group followed the training program with vertimax device and subjects of ordinary training group followed the training program without vertimax device. As to control group who are recreationally active, they did not participate in any program. 4 gate photocells were used for measuring and measurement of distances was carried out in m. Furthermore, single gate photocell and honi were used for agility test. Measurements started with 15 minutes of warm-up. Acceleration, quickness and agility tests were applied on subjects. 3 measurements were made for each subject at 3 minutes resting intervals. The best rating of three measurements was recorded. 5 m quickness pre-test value of vertimax training groups has been determined as 1,11±0,06 s and post-test value has been determined as 1,06 ± 0,08 s (P<0,05). 5 m quickness pre-test value of ordinary training group has been determined as 1,11±0,06 s and post-test value has been determined as 1,07±0,07 s (P<0,05).5 m quickness pre-test value of control group has been determined as 1,13±0,08 s and post-test value has been determined as 1,10 ± 0,07 s (P>0,05). Upon examination of 10 m acceleration value before and after the training, 10 m acceleration pre-test value of vertimax training group has been determined as 1,82 ± 0,07 s and post-test value has been determined as 1,76±0,83 s (P>0,05). 10 m acceleration pre-test value of ordinary training group has been determined as 1,83±0,05 s and post-test value has been determined as 1,78 ± 0,08 s (P>0,05).10 m acceleration pre-test value of control group has been determined as 1,87±0,11 s and post-test value has been determined as 1,83 ± 0,09 s (P>0,05). Upon examination of 15 m acceleration value before and after the training, 15 m acceleration pre-test value of vertimax training group has been determined as 2,52±0,10 s and post-test value has been determined as 2,46 ± 0,11 s (P>0,05).15 m acceleration pre-test value of ordinary training group has been determined as 2,52±0,05 s and post-test value has been determined as 2,48 ± 0,06 s (P>0,05). 15 m acceleration pre-test value of control group has been determined as 2,55 ± 0,11 s and post-test value has been determined as 2,54 ± 0,08 s (P>0,05).Upon examination of agility performance before and after the training, agility pre-test value of vertimax training group has been determined as 9,50±0,47 s and post-test value has been determined as 9,66 ± 0,47 s (P>0,05). Agility pre-test value of ordinary training group has been determined as 9,99 ± 0,05 s and post-test value has been determined as 9,86 ± 0,40 s (P>0,05). Agility pre-test value of control group has been determined as 9,74 ± 0,45 s and post-test value has been determined as 9,92 ± 0,49 s (P>0,05). Consequently, it has been observed that quickness and acceleration features were developed significantly following 8 weeks of vertimax training program and agility features were not developed significantly. It is suggested that training practices used for the study may be used for situations which may require sudden moves and in order to attain the maximum speed in a short time. Nevertheless, it is also suggested that this training practice does not make contribution in development of moves which may require sudden direction changes. It is suggested that productiveness and innovation may come off in terms of training by using various practices of vertimax trainings.

Keywords: vertimax, training, quickness, agility, acceleration

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Authors: Anitha Muralidhara, Victor Engelen, Christophe Len, Pascal Pandard, Guy Marlair

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Production of bio-based chemicals and materials from lignocellulosic biomass is gaining tremendous importance in advanced bio-refineries while aiming towards progressive replacement of petroleum based chemicals in transportation fuels and commodity polymers. One such attempt has resulted in the production of key furan derivatives (FD) such as furfural, HMF, MMF etc., via acid catalyzed dehydration (ACD) of C6 and C5 sugars, which are further converted into key chemicals or intermediates (such as Furandicarboxylic acid, Furfuryl alcohol etc.,). In subsequent processes, many high potential FD are produced, that can be converted into high added value polymers or high energy density biofuels. During ACD, an unavoidable polyfuranic byproduct is generated which is called humins. The family of FD is very large with varying chemical structures and diverse physicochemical properties. Accordingly, the associated risk profiles may largely vary. Hazardous Material (Haz-mat) classification systems such as GHS (CLP in the EU) and the UN TDG Model Regulations for transport of dangerous goods are one of the preliminary requirements for all chemicals for their appropriate classification, labelling, packaging, safe storage, and transportation. Considering the growing application routes of FD, it becomes important to notice the limited access to safety related information (safety data sheets available only for famous compounds such as HMF, furfural etc.,) in these internationally recognized haz-mat classification systems. However, these classifications do not necessarily provide information about the extent of risk involved when the chemical is used in any specific application. Factors such as thermal stability, speed of combustion, chemical incompatibilities, etc., can equally influence the safety profile of a compound, that are clearly out of the scope of any haz-mat classification system. Irrespective of the bio-based origin, FD has so far received inconsistent remarks concerning their toxicity profiles. With such inconsistencies, there is a fear that, a large family of FD may also follow extreme judgmental scenarios like ionic liquids, by ranking some compounds as extremely thermally stable, non-flammable, etc., Unless clarified, these messages could lead to misleading judgements while ranking the chemical based on its hazard rating. Safety is a key aspect in any sustainable biorefinery operation/facility, which is often underscored or neglected. To fill up these existing data gaps and to address ambiguities and discrepancies, the current study focuses on giving preliminary insights on safety assessment of FD and their potential targeted by-products. With the available information in the literature and obtained experimental results, physicochemical safety, environmental safety as well as (a scenario based) fire safety profiles of key FD, as well as side streams such as humins and levulinic acid, will be considered. With this, the study focuses on defining patterns and trends that gives coherent safety related information for existing and newly synthesized FD in the market for better functionality and sustainable applications.

Keywords: furanics, humins, safety, thermal and fire hazard, toxicity

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Authors: Mónika Ditta Tóth, Ádám Fritz, Balázs Hankó, György Purebl

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Communication training about depression and suicide prevention for pharmacists – A Hungarian pilot study Mónika Ditta Tóth1, Ádám Fritz2, Balázs Hankó2, György Purebl1 1: Semmelweis University, Institute of Behavioural Sciences 2: Semmelweis University, University Pharmacy Department of Pharmacy Administration Background: Suicide rates in Hungary have been one of the highest in the European Union. Depression is one of the main risk factors for suicide and recognizing and treating depression is an effective way to prevent suicidal behaviour. In their daily practice, pharmacists meet patients with high risk of mental health problems. Therefore they have a key role in the prevention of depression and suicide. Aim: The main aim of this study is to raise pharmacists’ awareness about depression and suicide to enable better recognation of verbal and non-verbal signs of these deseases. Another important objective is to reduce their stigma about depression and increase their confidence in communication with depressed and/or suicidal patients. Methods: A 3-hour communication workshop has been delivered in this pilot study about the reasons, trigger factors, verbal and non-verbal signs of depression and suicide. The training includes communication techniques which have been developed to patients needs, as well as role-playing scenarios. Depression Stigma and Morris Confidence Scales were applied before, after and 6 weeks following the training. The results of the training group are then compared with two of the following pharmacist groups: 1. written material only (N=15), 2. no material (N=15). Results: One-way ANOVA revealed significant differences in the training group regarding the level of confidence in treating and communicating with patients with depression and/or suicide following the training, and after 6 weeks (F(2, 24)= 7,135, p=,004; baseline: 20,37, after training: 30,00, follow up: 27,66). After the 3-hour workshop the personal stigma about depression decreased (baselin: 19,75 after training: 17,00, p=0,075) in the training group (N=9), whilst the perceived stigma did not change (before: 33.54, after: 33,44, p=NS). Trainees assessed the workshop as ‘useful’ and ‘gap filling’. No significant differences was found in the group of pharmacisists who got written material only. Conclusions: Despite the high rates of depression and suicide in Hungary, pharmacists do not receive lectures or seminars about mental health during their university studies. Such half-day workshops could fill this gap and give practical help to recognize and communicate with depressed and/or suicidal patients in a more effective way. This way pharmacists, as community gate-keepers, could contribute to a more effective suicide prevention program in Hungary.

Keywords: communication training, pharmacists, depression, suicide

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Authors: Mustafa Metin Donma

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Metabolic syndrome (MetS) components are noteworthy among children with obesity and morbid obesity because they point out the cases with MetS, which have the great tendency to severe health problems such as cardiovascular diseases both in childhood and adulthood. In clinical practice, considerable efforts are being observed to bring into the open the striking differences between morbid obese cases and those with MetS findings. The most privileged aspect is concerning cardiometabolic features. The aim of this study was to derive an index which behaves different in children with and without MetS from the cardiac point of view. For the purpose, aspartate transaminase (AST), a cardiac enzyme still being used independently to predict cardiac-related problems, was used. One hundred and twenty four children were recruited from the outpatient clinic of Department of Pediatrics in Tekirdag Namik Kemal University, Faculty of Medicine. Forty-three children with normal body mass index, forty-one and forty morbid obese (MO) children with MetS and without the characteristic features of MetS, respectively, were included in the study. Weight, height, waist circumference (WC), hip C (HC), head C (HdC), neck C (NC), systolic and diastolic blood pressure values were measured and recorded. Body mass index and anthropometric ratios were calculated. Fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) analyses were performed. The values for AST, alanin transaminase (ALT) and AST/ALT were obtained. Advanced Donma cardiac index (ADCI) values were calculated. The formula for the index was [(TRG/HDL-C) * (INS/FBG)] * [(WC+HC)/Height] * [(HdC+NC)/Height]. Statistical evaluations including correlation analysis were done by a statistical package program. The statistical significance degree was accepted as p<0.05. The index, ADCI, was developed from both anthropometric and biochemical parameters. All anthropometric measurements except weight were included in the equation. Besides all biochemical parameters concerning MetS components were also added. This index was tested in each of three groups. Its performance was compared with the performance of cardiometabolic index (CMI). It was also checked whether it was compatible with AST activity. The performance of ADCI was better than that of CMI. Instead of double increase, the increase of three times was observed in children with MetS compared to MO children. The index was correlated with AST in MO group and with AST/ALT in MetS group. In conclusion, this index was superior in discovering cardiac problems in MO and in diagnosing MetS in MetS groups. It was also arbiter to point out cardiovascular and MetS aspects among the groups.

Keywords: aspartate transaminase, cardiac, children, index, obesity

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Authors: Mohammadamin Hashemi, Mohammadreza Kashizadeh

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Droughts pose a significant threat to sustainable water resource management, agriculture, and socioeconomic sectors, particularly in the field of climate change. This study investigates drought simulation using rainfall-runoff modelling in the Cuneo district, Italy, over the past 60-year period. The study leverages the TUW model, a lumped conceptual rainfall-runoff model with a semi-distributed operation capability. Similar in structure to the widely used Hydrologiska Byråns Vattenbalansavdelning (HBV) model, the TUW model operates on daily timesteps for input and output data specific to each catchment. It incorporates essential routines for snow accumulation and melting, soil moisture storage, and streamflow generation. Multiple catchments' discharge data within the Cuneo district form the basis for thorough model calibration employing the Kling-Gupta Efficiency (KGE) metric. A crucial metric for reliable drought analysis is one that can accurately represent low-flow events during drought periods. This ensures that the model provides a realistic picture of water availability during these critical times. Subsequent validation of monthly discharge simulations thoroughly evaluates overall model performance. Beyond model development, the investigation delves into drought analysis using the robust Standardized Runoff Index (SRI). This index allows for precise characterization of drought occurrences within the study area. A meticulous comparison of observed and simulated discharge data is conducted, with particular focus on low-flow events that characterize droughts. Additionally, the study explores the complex interplay between land characteristics (e.g., soil type, vegetation cover) and climate variables (e.g., precipitation, temperature) that influence the severity and duration of hydrological droughts. The study's findings demonstrate successful calibration of the TUW model across most catchments, achieving commendable model efficiency. Comparative analysis between simulated and observed discharge data reveals significant agreement, especially during critical low-flow periods. This agreement is further supported by the Pareto coefficient, a statistical measure of goodness-of-fit. The drought analysis provides critical insights into the duration, intensity, and severity of drought events within the Cuneo district. This newfound understanding of spatial and temporal drought dynamics offers valuable information for water resource management strategies and drought mitigation efforts. This research deepens our understanding of drought dynamics in the Cuneo region. Future research directions include refining hydrological modelling techniques and exploring future drought projections under various climate change scenarios.

Keywords: hydrologic extremes, hydrological drought, hydrological modelling, machine learning, rainfall-runoff modelling

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Authors: Lydia Ouma Radoli

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The paradox of documenting history through visuals that objectify gruesome images to depict the prominence of stories intrigues media researchers. In East Africa, the topic has been captured in a variety of media frames, but scantly in scholarly work. This paper adopts Visual Rhetoric and Framing Theories to tease out the drivers behind the criteria for the selection of violent visuals. The paper projects that quantitative and qualitative literature regarding journalists’ personal and work-related exposure to PSTD will give insights into the concept of trauma journalism - reporting of horrific events, e.g., violent crime and terror. The data will be collected through methods such as document analysis (photographs and videos) and in-depth interviews to summarize the informational contents with respect to the research objectives and questions. The study is hinged on the background that the criterion for news production is constructed from the idea that ‘if there’s violence, conflict, and death involved, the story gets top priority.’ The anticipated outcome is to establish trauma experiences of visual rhetors, suggest mitigations, and address gaps in academic research. The findings of the study will sustain the critical role of visual rhetors. Further, media practitioners may find the study useful in assessing the effects and values of visual witnessing. Historically, the criterion for visual news production has been that if there’s violence, conflict, and death involved, the story gets top priority. To capture the goriness of the images, media theorists and sociologists have used the expression: “If it bleeds, it leads.” The statement assumes that audiences are attracted to pictures that show violent images. Further, research on visual aspects of Television news has shown its ability to hold viewers’ attention and cause aggression. This paper samples images and narratives from Journalists who have covered trauma-related events. The samples are indicative of the problem under study, which depicts journalists exposed to traumatic events as not receiving any Psycho-social support within newsrooms. It is hoped that the study could inform policy and practice within developing countries through the interpretations of theoretical and empirical explanations of existing trauma phenomena among journalists.

Keywords: visual-witnessing, media culture, visual rhetoric, imaging violence in East Africa

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Authors: Jared R. Chapman

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This study introduces a type of motivational information system called an educational engagement information system (EEIS). An EEIS draws on principles of behavioral economics, motivation theory, and learning cognition theory to design information systems that help students want to improve their performance. This study compares academic outcomes for course sections taught by part- and full-time instructors both with and without an EEIS. Without an EEIS, students in the part-time instructor's course sections demonstrated significantly higher failure rates (a 143.8% increase) and dropout rates (a 110.4% increase) with significantly fewer students scoring a B- or higher (39.8% decrease) when compared to students in the course sections taught by a full-time instructor. It is concerning that students in the part-time instructor’s course without an EEIS had significantly lower academic outcomes, suggesting less understanding of the course content. This could impact retention and continuation in a major. With an EEIS, when comparing part- and full-time instructors, there was no significant difference in failure and dropout rates or in the number of students scoring a B- or higher in the course. In fact, with an EEIS, the failure and dropout rates were statistically identical for part- and full-time instructor courses. When using an EEIS (compared with not using an EEIS), the part-time instructor showed a 62.1% decrease in failures, a 61.4% decrease in dropouts, and a 41.7% increase in the number of students scoring a B- or higher in the course. We are unaware of other interventions that yield such large improvements in academic performance. This suggests that using an EEIS such as Delphinium may compensate for part-time instructors’ limitations of expertise, time, or rewards that can have a negative impact on students’ academic outcomes. The EEIS had only a minimal impact on failure rates (7.7% decrease) and dropout rates (18.8% decrease) for the full-time instructor. This suggests there is a ceiling effect for the improvements that an EEIS can make in student performance. This may be because experienced instructors are already doing the kinds of things that an EEIS does, such as motivating students, tracking grades, and providing feedback about progress. Additionally, full-time instructors have more time to dedicate to students outside of class than part-time instructors and more rewards for doing so. Using adjunct and other types of part-time instructors will likely remain a prevalent practice in higher education management courses. Given that using part-time instructors can have a negative impact on student graduation and persistence in a field of study, it is important to identify ways we can augment part-time instructors’ performance. We demonstrated that when part-time instructors use an EEIS, it can result in significantly lower students’ failure and dropout rates and an increase in the rate of students earning a B- or above; and bring their students’ performance to parity with the performance of students taught by a full-time instructor.

Keywords: gamification, engagement, motivation, academic outcomes

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Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller

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Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.

Keywords: ambulatory care, lean, pediatric primary care, system efficiency

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Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

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Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

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Authors: Teresa Wills, Geraldine Mccarthy, Nicola Cornally

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Background: Obesity is an emerging healthcare epidemic affecting virtually all age and socio-economic groups and is one of the most serious and prevalent diseases of the 21st century. It is a public health challenge because of its prevalence, associated costs and health effects. The increasing prevalence of obesity has created a social perception that overweight body sizes are healthy and normal. This normalization of obesity within our society and the acceptance of higher body weights have led to individuals being unaware of the reality of their weight status and gravity of this situation thus impeding recognition of obesity. Given the escalating global health problem of obesity and its co-morbidities, the need to re-appraise its management is more compelling than ever. It is widely accepted that the causes of obesity are complex and multi-factorial. Engagement of individuals in weight management programmes is difficult if they do not perceive they have a problem with their weight. Recognition of the problem is a key component of obesity management and identifying the main predictors of behaviour is key to designing health behaviour interventions. Aim: The aim of the research was to determine factors relating to motivation to change behaviours in individuals who perceive themselves to be overweight. Method: The research design was quantitative, correlational and cross-sectional. The design was guided by the Health Belief Model. Data were collected online using a multi-section and multi-item questionnaire, developed from a review of the theoretical and empirical research. A sample of 202 men and women who perceived themselves to be overweight participated in the research. Descriptive and inferential statistical analyses were employed to describe relationships between variables. Findings: Following multivariate regression analysis, perceived barriers to weight loss and perceived benefits of weight loss were significant predictors of motivation to change behaviour. The perceived barriers to weight loss which were significant were psychological barriers to weight loss (p = < 0.019) and environmental barriers to physical activity (p= < 0.032).The greatest predictor of motivation to change behaviour was the perceived benefits of weight loss (p < 0.001). Perceived susceptibility to obesity and perceived severity of obesity did not emerge as significant predictors in this model. Total variance explained by the model was 33.5%. Conclusion: Perceived barriers to weight loss and perceived benefits of weight loss are important determinants of motivation to change behaviour. These findings have important implications for health professionals to help inform their practice and for the development of intervention programmes to prevent and control obesity.

Keywords: motivation to change behaviours, obesity, predictors of behavior, interventions, overweight

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Authors: Francisco Vidal Vázquez, Pekka Simell, Christian Frilund, Matti Reinikainen, Ilkka Hiltunen, Tim Böltken, Benjamin Andris, Paolo Piermartini

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Carbon capture and utilization (CCU) are one of the key topics in mitigation of CO2 emissions. There are many different technologies that are applied for the production of diverse chemicals from CO2 such as synthetic natural gas, Fischer-Tropsch products, methanol and polymers. Power-to-Gas and Power-to-Liquids concepts arise as a synergetic solution for storing energy and producing value added products from the intermittent renewable energy sources and CCU. VTT is a research and technology development company having energy in transition as one of the key focus areas. VTT has extensive experience in piloting and upscaling of new energy and chemical processes. Recently, VTT has developed and commissioned a Mobile Synthesis Unit (MOBSU) in close collaboration with INERATEC, a spin-off company of Karlsruhe Institute of Technology (KIT, Germany). The MOBSU is a multipurpose synthesis unit for CO2 upgrading to energy carriers and chemicals, which can be transported on-site where CO2 emission and renewable energy are available. The MOBSU is initially used for production of fuel compounds and chemical intermediates by combination of two consecutive processes: reverse Water-Gas Shift (rWGS) and Fischer-Tropsch synthesis (FT). First, CO2 is converted to CO by high-pressure rWGS and then, the CO and H2 rich effluent is used as feed for FT using an intensified reactor technology developed and designed by INERATEC. Chemical equilibrium of rWGS reaction is not affected by pressure. Nevertheless, compression would be required in between rWGS and FT in the case when rWGS is operated at atmospheric pressure. This would also require cooling of rWGS effluent, water removal and reheating. For that reason, rWGS is operated using precious metal catalyst in the MOBSU at similar pressure as FT to simplify the process. However, operating rWGS at high pressures has also some disadvantages such as methane and carbon formation, and more demanding specifications for materials. The main parts of FT module are an intensified reactor, a hot trap to condense the FT wax products, and a cold trap to condense the FT liquid products. The FT synthesis is performed using cobalt catalyst in a novel compact reactor technology with integrated highly-efficient water evaporation cooling cycle. The MOBSU started operation in November 2016. First, the FT module is tested using as feedstock H2 and CO. Subsequently, rWGS and FT modules are operated together using CO2 and H2 as feedstock of ca. 5 Nm3/hr total flowrate. On spring 2017, The MOBSU unit will be integrated together with a direct air capture (DAC) of CO2 unit, and a PEM electrolyser unit at Lappeenranta University of Technology (LUT) premises for demonstration of the SoletAir concept. This would be the first time when synthetic fuels are produced by combination of DAC unit and electrolyser unit which uses solar power for H2 production.

Keywords: CO2 utilization, demonstration, Fischer-Tropsch synthesis, intensified reactors, reverse water-gas shift

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Authors: Gamze Safak, Umut Arslanoglu

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Cultural and tourism conservation and development zones and tourism centers are the boundaries declared for the purpose of protecting, using, and evaluating the sectoral development and planned development in areas where historical and cultural values are heavily involved and/or where tourism potential is high. The most rapidly changing regions in Turkey are tourism areas, especially the coastal areas. Planning these regions is not about only an economic gain but also a natural and physical environment and refers to a complex process. If the tourism sector is not well controlled, excessive use of natural resources and wrong location choices may cause damage to natural areas, historical values, and socio-cultural structure. Since the strategic decisions taken in the environmental order and zoning plans, which are the means of guiding the physical environment of the Ministry of Culture and Tourism, which have the authority to make plans in tourism centers, are transformed into plan decisions that find the spatial expression, comprehensive evaluation of all kinds of data, following the historical development and based on the correct and current data is required. In addition, the authority has a number of competences in tourism promotion as well as the authority to plan, leading to the necessity of taking part in the applications requiring complex analysis such as the management and integration of the country's economic, political, social and cultural resources. For this purpose, Tourism Inventory System (TES) project, which consists of a series of subsystems, has been developed in order to solve complex planning and method problems in the management of site-related information. The scope of the project is based on the integration of numerical and verbal data in the regions within the jurisdiction of the authority, and the monitoring of the historical development of urban planning studies, making the spatial data of the institution easily accessible, shared, questionable and traceable in international standards. A dynamic and continuous system design has been put into practice by utilizing the advantage of the use of Geographical Information Systems in the planning process to play a role in making the right decisions, revealing the tools of social, economic, cultural development, and preservation of natural and cultural values. This paper, which is prepared by the project team members in TES (Tourism Inventory System), will present a study regarding the applicability of GIS in cultural and natural heritage conservation.

Keywords: cultural conservation, GIS, geographic information system, tourism inventory system, urban planning

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Authors: Hatem Abou-Senna, Essam Radwan

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With increasing traffic and limited resources, accommodating left-turning traffic has been a challenge for traffic engineers as they seek balance between intersection capacity and safety; these are two conflicting goals in the operation of a signalized intersection that are mitigated through signal phasing techniques. Hence, to increase the left-turn capacity and reduce the delay at the intersections, the Florida Department of Transportation (FDOT) moves forward with a vision of optimizing intersection control using innovative intersection designs through the Transportation Systems Management & Operations (TSM&O) program. These alternative designs successfully eliminate the left-turn phase, which otherwise reduces the conventional intersection’s (CI) efficiency considerably, and divide the intersection into smaller networks that would operate in a one-way fashion. This study focused on the Crossover Displaced Left-turn intersections (XDL), also known as Continuous Flow Intersections (CFI). The XDL concept is best suited for intersections with moderate to high overall traffic volumes, especially those with very high or unbalanced left turn volumes. There is little guidance on determining whether partial XDL intersections are adequate to mitigate the overall intersection condition or full XDL is always required. The primary objective of this paper was to evaluate the overall intersection performance in the case of different partial XDL designs compared to a full XDL. The XDL alternative was investigated for 4 different scenarios; partial XDL on the east-west approaches, partial XDL on the north-south approaches, partial XDL on the north and east approaches and full XDL on all 4 approaches. Also, the impact of increasing volume on the intersection performance was considered by modeling the unbalanced volumes with 10% increment resulting in 5 different traffic scenarios. The study intersection, located in Orlando Florida, is experiencing recurring congestion in the PM peak hour and is operating near capacity with volume to a capacity ratio closer to 1.00 due to the presence of two heavy conflicting movements; southbound and westbound. The results showed that a partial EN XDL alternative proved to be effective and compared favorably to a full XDL alternative followed by the partial EW XDL alternative. The analysis also showed that Full, EW and EN XDL alternatives outperformed the NS XDL and the CI alternatives with respect to the throughput, delay and queue lengths. Significant throughput improvements were remarkable at the higher volume level with percent increase in capacity of 25%. The percent reduction in delay for the critical movements in the XDL scenarios compared to the CI scenario ranged from 30-45%. Similarly, queue lengths showed percent reduction in the XDL scenarios ranging from 25-40%. The analysis revealed how partial XDL design can improve the overall intersection performance at various demands, reduce the costs associated with full XDL and proved to outperform the conventional intersection. However, partial XDL serving low volumes or only one of the critical movements while other critical movements are operating near or above capacity do not provide significant benefits when compared to the conventional intersection.

Keywords: continuous flow intersections, crossover displaced left-turn, microscopic traffic simulation, transportation system management and operations, VISSIM simulation model

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Authors: Mostafa Shahriari, Theophile Chaumont-Frelet, David Pardo

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Resistivity measurements are used to characterize the Earth’s subsurface. They are categorized into two different groups: (a) those acquired on the Earth’s surface, for instance, controlled source electromagnetic (CSEM) and Magnetotellurics (MT), and (b) those recorded with borehole logging instruments such as Logging-While-Drilling (LWD) devices. LWD instruments are mostly used for geo-steering purposes, i.e., to adjust dip and azimuthal angles of a well trajectory to drill along a particular geological target. Modern LWD tools measure all nine components of the magnetic field corresponding to three orthogonal transmitter and receiver orientations. In order to map the Earth’s subsurface and perform geo-steering, we invert measurements using a gradient-based method that utilizes the derivatives of the recorded measurements with respect to the inversion variables. For resistivity measurements, these inversion variables are usually the constant resistivity value of each layer and the bed boundary positions. It is well-known how to compute derivatives with respect to the constant resistivity value of each layer using semi-analytic or numerical methods. However, similar formulas for computing the derivatives with respect to bed boundary positions are unavailable. The main contribution of this work is to provide an adjoint-based formulation for computing derivatives with respect to the bed boundary positions. The key idea to obtain the aforementioned adjoint state formulations for the derivatives is to separate the tangential and normal components of the field and treat them differently. This formulation allows us to compute the derivatives faster and more accurately than with traditional finite differences approximations. In the presentation, we shall first derive a formula for computing the derivatives with respect to the bed boundary positions for the potential equation. Then, we shall extend our formulation to 3D Maxwell’s equations. Finally, by considering a 1D domain and reducing the dimensionality of the problem, which is a common practice in the inversion of resistivity measurements, we shall derive a formulation to compute the derivatives of the measurements with respect to the bed boundary positions using a 1.5D variational formulation. Then, we shall illustrate the accuracy and convergence properties of our formulations by comparing numerical results with the analytical derivatives for the potential equation. For the 1.5D Maxwell’s system, we shall compare our numerical results based on the proposed adjoint-based formulation vs those obtained with a traditional finite difference approach. Numerical results shall show that our proposed adjoint-based technique produces enhanced accuracy solutions while its cost is negligible, as opposed to the finite difference approach that requires the solution of one additional problem per derivative.

Keywords: inverse problem, bed boundary positions, electromagnetism, potential equation

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Authors: Anne Prip, Kirsten Alling Møller, Dorte Lisbet Nielsen, Mary Jarden, Marie-Helene Olsen, Anne Kjaergaard Danielsen

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Background: The development in cancer care has shifted towards shorter hospital stays and more outpatient treatment. Today, cancer care and treatment predominantly takes place in outpatient settings where encounters between patients and health care professionals are often brief. This development will probably continue internationally as the global cancer burden seems to be growing significantly. Furthermore, the number of patients who require ambulatory treatments such as chemotherapy is increasing. Focusing on the encounters between health care professionals and patients during oncology treatment has thus become increasingly important due to a growing trend in outpatient cancer management. Objective: The aim of the systematic review was to summarize the literature from the perspective of the patient, on experiences of and the need for communication and relationships with the health care professional during chemotherapy treatment in an outpatient setting. Method: The review was designed and carried out according to the PRISMA guidelines and PICO framework. The systematic search was conducted in Medline, CINAHL, The Cochrane Library and Joanna Briggs Institute Evidence Based Practice Database. Results: In all, 1174 studies were identified by literature search. After duplicates were removed, the remaining studies (n = 1053) were screened for inclusion. Nine studies were included; qualitative (n = 5) and quantitative (n = 4) as they met the inclusions criteria. The review identified that communication and relationships between health care professionals and patients were important for the patients’ ability to cope with cancer and also had an impact on patients’ satisfaction with care in the outpatient clinic. Furthermore, the review showed that hope and positivity was a need and strategy for patients with cancer and was facilitated by health care professionals. Finally, it revealed that outpatient clinic visits framed and influenced communication and relationships. Conclusions: This review identified the significance of communication and the relationships between patients and health care professionals in the outpatient setting as it supports patients’ ability to cope with cancer. The review showed the need for health care professionals to pay attention to the relational aspects of communication in an outpatient clinic as encounters are often brief. Furthermore, the review helps to specify which elements of the communication are central in the patient-health care professional interaction from the patients' perspective. Finally, it shows a need for more research to investigate which type of interaction and intervention would be the most effective in supporting patients’ coping during chemotherapy in an outpatient clinic.

Keywords: ambulatory chemotherapy, communication, health care professional-patient relation, nurse-patient relation, outpatient care, systematic review

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Authors: Lori Lioce, Gary Maddux, Norven Goddard, Ishella Fogle, Bernard Schroer

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This paper presents the integration of technologies into nursing education. The collaborative effort includes the College of Nursing (CoN) at the University of Alabama in Huntsville (UAH) and the UAH Systems Management and Production Center (SMAP). The faculty at the CoN conducts needs assessments to identify education and training requirements. A team of CoN faculty and SMAP engineers then prioritize these requirements and establish improvement/development teams. The development teams consist of nurses to evaluate the models and to provide feedback and of undergraduate engineering students and their senior staff mentors from SMAP. The SMAP engineering staff develops and creates the physical models using 3D printing, silicone molds and specialized molding mixtures and techniques. The collaboration has focused on developing teaching and training, or clinical, simulators. In addition, the onset of the Covid-19 pandemic has intensified this relationship, as 3D modeling shifted to supplied personal protection equipment (PPE) to local health care providers. A secondary collaboration has been introducing students to clinical benchmarking through the UAH Center for Management and Economic Research. As a result of these successful collaborations the Model Exchange & Development of Nursing & Engineering Technology (MEDNET) has been established. MEDNET seeks to extend and expand the linkage between engineering and nursing to K-12 schools, technical schools and medical facilities in the region to the resources available from the CoN and SMAP. As an example, stereolithography (STL) files of the 3D printed models, along with the specifications to fabricate models, are available on the MEDNET website. Ten 3D printed models have been developed and are currently in use by the CoN. The following additional training simulators are currently under development:1) suture pads, 2) gelatin wound models and 3) printed wound tattoos. Specification sheets have been written for these simulations that describe the use, fabrication procedures and parts list. These specifications are available for viewing and download on MEDNET. Included in this paper are 1) descriptions of CoN, SMAP and MEDNET, 2) collaborative process used in product improvement/development, 3) 3D printed models of training and teaching simulators, 4) training simulators under development with specification sheets, 5) family care practice benchmarking, 6) integrating the simulators into the nursing curriculum, 7) utilizing MEDNET as a pandemic response, and 8) conclusions and lessons learned.

Keywords: 3D printing, nursing education, simulation, trainers

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Authors: Geng Cui, Naoto Imura, Katsuhiro Nishinari, Takahiro Ezaki

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The bullwhip effect, which refers to the amplification of demand variance as one moves up the supply chain, has been observed in various industries and extensively studied through analytic approaches. Existing methods to mitigate the bullwhip effect, such as decentralized demand information, vendor-managed inventory, and the Collaborative Planning, Forecasting, and Replenishment System, rely on the willingness and ability of supply chain participants to share their information. However, in practice, information sharing is often difficult to realize due to privacy concerns. The purpose of this study is to explore new ways to mitigate the bullwhip effect without the need for information sharing. This paper proposes a 'bullwhip absorption strategy' (BAS) to alleviate the bullwhip effect by absorbing it downstream in the supply chain. To achieve this, a two-stage supply chain system was employed, consisting of a single retailer and a single manufacturer. In each time period, the retailer receives an order generated according to an autoregressive process. Upon receiving the order, the retailer depletes the ordered amount, forecasts future demand based on past records, and places an order with the manufacturer using the order-up-to replenishment policy. The manufacturer follows a similar process. In essence, the mechanism of the model is similar to that of the beer game. The BAS is implemented at the retailer's level to counteract the bullwhip effect. This strategy requires the retailer to reduce the uncertainty in its orders, thereby absorbing the bullwhip effect downstream in the supply chain. The advantage of the BAS is that upstream participants can benefit from a reduced bullwhip effect. Although the retailer may incur additional costs, if the gain in the upstream segment can compensate for the retailer's loss, the entire supply chain will be better off. Two indicators, order variance and inventory variance, were used to quantify the bullwhip effect in relation to the strength of absorption. It was found that implementing the BAS at the retailer's level results in a reduction in both the retailer's and the manufacturer's order variances. However, when examining the impact on inventory variances, a trade-off relationship was observed. The manufacturer's inventory variance monotonically decreases with an increase in absorption strength, while the retailer's inventory variance does not always decrease as the absorption strength grows. This is especially true when the autoregression coefficient has a high value, causing the retailer's inventory variance to become a monotonically increasing function of the absorption strength. Finally, numerical simulations were conducted for verification, and the results were consistent with our theoretical analysis.

Keywords: bullwhip effect, supply chain management, inventory management, demand forecasting, order-to-up policy

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Authors: Chidiebere Joy Nwankwo, Benjamin S. C. Uzochukwu, Florence T. Sibeudu

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Background: Family planning is one of the most cost-effective ways to prevent maternal, infant, and child mortality. It can decrease maternal mortality by reducing the number of unintended pregnancies, the number of abortions, and the proportion of births at high risk. It has been seen to improve the health and economic well-being of families and communities and ensures women’s planned childbearing in order to achieve education and career goals which could raise family income thereby reducing poverty. The choice and use of a particular family planning method and their sources vary globally. Rural Communities often face significant challenges in accessing and utilizing family planning services. Aim: This study set out to assess Access and Utilization of Family Planning Services among Women of Reproductive Age in a Rural Community of Enugu state, Nigeria. Rural communities were chosen for this study because past demographic surveys have shown that women in urban areas are more likely to accept and practice family planning compared to those in rural areas. Method: A Descriptive Cross-sectional Research design was employed to achieve the aim and objectives of the study. Data collected from 177 consenting participants using interviewer-administered questionnaires was analysed using Descriptive statistics to summarize the Socio-demographic characteristics of the participants and Access and Utilization of Family Planning Services among the participants including Reasons for using different Family Planning Methods and Barriers encountered in Access and Utilization of these services. A Cross-tabulation between Socio-demographic Characteristics of respondents and the use of Family Planning services was carried out. Result: The findings of this study revealed that majority of the participants (72.9%) have not utilized any family planning service. Out of those (27.1%) that have used any family planning service, majority of them are still currently using a form of family planning service and have access to them in health facilities, patent medicine vendors and others based on multiple responses. Male condoms were the most utilized modern family planning service. Based on multiple responses, inaccessibility, personal beliefs and partner’s objection were the most identified barriers encountered in accessing family planning services. Conclusion: Access and uptake of family planning services in rural communities is lower than the national average. Increasing access to family planning is an urgent priority for rural areas Interventions that will scale up Access and Utilization of family planning services in rural communities should be intensified.

Keywords: access, family planning, rural community, utilization

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Authors: Ajay Das, Sandip Basu

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Introduction: There is increasing recognition that diverse streams of knowledge can often be recombined in novel ways to generate new knowledge. However, knowledge recombination theory has not been applied to examine the effects of collaborator diversity on the quality of knowledge such collaborators produce. This is surprising because one would expect that a collaborative team with certain aspects of diversity should be able to recombine process elements related to knowledge development, which are relatively tacit, but also complementary because of the collaborator’s varying backgrounds. Theory and Hypotheses: We propose to examine two aspects of diversity in the environments of collaborative teams to try and capture such potential recombinations of relatively tacit, process knowledge. The first aspect of diversity in team members’ environments is geographical. Collaborators with more geographical distance between them (perhaps working in different countries) often have more autonomy in the processes they adopt for knowledge development. In the absence of overt monitoring, such collaborators are likely to adopt differing approaches to knowledge development. The sharing of such varying approaches among collaborators is likely to result in greater quality of the common collaborative pursuit. The second aspect is diversity in the work backgrounds of team members. Such diversity can also increase the potential for knowledge recombination. For example, if one or more members are from a manufacturing center (versus all of them being from a purely R&D center), such members will provide unique perspectives on the implementation of innovative ideas. Again, knowledge that has been evaluated from these diverse perspectives is likely to be of a higher quality. In addition to the above aspects of environmental diversity among team members, we also plan to examine the extent to which individual collaborators are in different environments from the primary innovation center of their employing firms. Proposed Methods: We will test our model on a sample of firms in the semiconductor industry. Our level of analysis will be individual patents generated by these firms and the teams involved in the generation of these. Information on manufacturing activities of our sample firms will be obtained from SEMI, a proprietary database of the semiconductor industry, as well as company 10-K reports. Conclusion: We believe that our results will represent a preliminary attempt to understand how various forms of diversity in collaborative teams impact the knowledge development process. Our dependent variable of knowledge quality is important to study since higher values of this variable can not only drive firm performance but the broader development of regions and societies through spillover impacts on future innovation. The results of this study will, therefore, inform future research and practice in innovation, geographical location, and vertical integration.

Keywords: innovation, manufacturing strategy, knowledge, diversity

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Authors: Alireza Barari, Saeed Shirali, Ahmad Abdi

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Introduction: Exercise has contradictory effects on the immune system. Glutamine supplementation may increase the resistance of the immune system in athletes. The Glutamine is one of the most recognized immune nutrients that as a fuel source, substrate in the synthesis of nucleotides and amino acids and is also known to be part of the antioxidant defense. Several studies have shown that improving glutamine levels in plasma and tissues can have beneficial effects on the function of immune cells such as lymphocytes and neutrophils. This study aimed to investigate the effects of resistance training and training combined with glutamine supplementation to improve the levels of cortisol and immunoglobulin in untrained young men. The research shows that physical training can increase the cytokines in the athlete’s body of course; glutamine can counteract the negative effects of resistance training on immune function and stability of the mast cell membrane. Materials and methods: This semi-experimental study was conducted on 30 male non-athletes. They were randomly divided into three groups: control (no exercise), resistance training, resistance training and glutamine supplementation, respectively. Resistance training for 4 weeks and glutamine supplementation in 0.3 gr/kg/day after practice was applied. The resistance-training program consisted of eight exercises (leg press, lat pull, chest press, squat, seatedrow, abdominal crunch, shoulder press, biceps curl and triceps press down) four times per week. Participants performed 3 sets of 10 repetitions at 60–75% 1-RM. Anthropometry indexes (weight, body mass index, and body fat percentage), oxygen uptake (VO2max) Maximal, cortisol levels of immunoglobulins (IgA, IgG, IgM) were evaluated Pre- and post-test. Results: Results showed four week resistance training with and without glutamine cause significant increase in body weight, BMI and significantly decreased (P < 0/001) in BF. Vo2max also increased in both groups of exercise (P < 0/05) and exercise with glutamine (P < 0/001), such as in both groups significant reduction in IgG (P < 0/05) was observed. But no significant difference observed in levels of cortisol, IgA, IgM in any of the groups. No significant change observed in either parameter in the control group. No significant difference observed between the groups. Discussion: The alterations in the hormonal and immunological parameters can be used in order to assess the effect overload on the body, whether acute or chronically. The plasmatic concentration of glutamine has been associated to the functionality of the immunological system in individuals sub-mitted to intense physical training. resistance training has destructive effects on the immune system and glutamine supplementation cannot neutralize the damaging effects of power exercise on the immune system.

Keywords: glutamine, resistance traning, immuglobulins, cortisol

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Authors: Stephanie Wall, Guido Wimmers

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The construction and operation of buildings greatly contribute to environmental degradation through resource and energy consumption and greenhouse gas emissions. The design of the envelope system affects the environmental impact of a building in two major ways; 1) high thermal performance and air tightness can significantly reduce the operational energy of the building and 2) the material selection for the envelope largely impacts the embodied energy of the building. Life cycle assessment (LCA) is a scientific methodology that is used to systematically analyze the environmental load of processes or products, such as buildings, over their life. The paper will discuss the results of a comparative LCA of different envelope designs and the long-term monitoring of the Wood Innovation Research Lab (WIRL); a Passive House (PH), industrial building under construction in Prince George, Canada. The WIRL has a footprint of 30m x 30m on a concrete raft slab foundation and consists of shop space as well as a portion of the building that includes a two-story office/classroom space. The lab building goes beyond what was previously thought possible in regards to energy efficiency of industrial buildings in cold climates due to their large volume to surface ratio, small floor area, and high air change rate, and will be the first PH certified industrial building in Canada. These challenges were mitigated through the envelope design which utilizes solar gains while minimizing overheating, reduces thermal bridges with thick (570mm) prefabricated truss walls filled with blown in mineral wool insulation and a concrete slab and roof insulated with EPS rigid insulation. The envelope design results in lower operational and embodied energy when compared to buildings built to local codes or with steel. The LCA conducted using Athena Impact Estimator for Buildings identifies project specific hot spots as well illustrates that for high-efficiency buildings where the operational energy is relatively low; the embodied energy of the material selection becomes a significant design decision as it greatly impacts the overall environmental footprint of the building. The results of the LCA will be reinforced by long-term monitoring of the buildings envelope performance through the installation of temperature and humidity sensors throughout the floor slab, wall and roof panels and through detailed metering of the energy consumption. The data collected from the sensors will also be used to reinforce the results of hygrothermal analysis using WUFI®, a program used to verify the durability of the wall and roof panels. The WIRL provides an opportunity to showcase the use of wood in a high performance envelope of an industrial building and to emphasize the importance of considering the embodied energy of a material in the early stages of design. The results of the LCA will be of interest to leading researchers and scientists committed to finding sustainable solutions for new construction and high-performance buildings.

Keywords: high performance envelope, life cycle assessment, long term monitoring, passive house, prefabricated panels

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Authors: Vadim Kulikov

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The classical Stroop effect is the phenomenon that it takes more time to name the ink color of a printed word if the word denotes a conflicting color than if it denotes the same color. Over the last 80 years, there have been many variations of the experiment revealing various mechanisms behind semantic, attentional, behavioral and perceptual processing. The Stroop task is known to exhibit asymmetry. Reading the words out loud is hardly dependent on the ink color, but naming the ink color is significantly influenced by the incongruent words. This asymmetry is reversed, if instead of naming the color, one has to point at a corresponding color patch. Another debated aspects are the notions of automaticity and how much of the effect is due to semantic and how much due to response stage interference. Is automaticity a continuous or an all-or-none phenomenon? There are many models and theories in the literature tackling these questions which will be discussed in the presentation. None of them, however, seems to capture all the findings at once. A computational model is proposed which is based on the philosophical idea developed by the author that the mind operates as a collection of different information processing modalities such as different sensory and descriptive modalities, which produce emergent phenomena through mutual interaction and coherence. This is the framework theory where ‘framework’ attempts to generalize the concepts of modality, perspective and ‘point of view’. The architecture of this computational model consists of blocks of neurons, each block corresponding to one framework. In the simplest case there are four: visual color processing, text reading, speech production and attention selection modalities. In experiments where button pressing or pointing is required, a corresponding block is added. In the beginning, the weights of the neural connections are mostly set to zero. The network is trained using Hebbian learning to establish connections (corresponding to ‘coherence’ in framework theory) between these different modalities. The amount of data fed into the network is supposed to mimic the amount of practice a human encounters, in particular it is assumed that converting written text into spoken words is a more practiced skill than converting visually perceived colors to spoken color-names. After the training, the network performs the Stroop task. The RT’s are measured in a canonical way, as these are continuous time recurrent neural networks (CTRNN). The above-described aspects of the Stroop phenomenon along with many others are replicated. The model is similar to some existing connectionist models but as will be discussed in the presentation, has many advantages: it predicts more data, the architecture is simpler and biologically more plausible.

Keywords: connectionism, Hebbian learning, artificial neural networks, philosophy of mind, Stroop

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Authors: Cetin Balanuye

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

Keywords: democracy, Islam, power, Spinoza

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Authors: Veronica Onyemauwa

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This research work examines the socio-ethical issues embedded in resource management and wealth creation in Nigeria, using Akwa Ibom State as a case study. The work is poised to proffer answers to the problematic questions raised, “why is the wealth of Akwa Ibom State not prudently managed, and wastages curbed in order to cater for the satisfaction of the indigent citizens, as Jesus Christ did in the feeding of five thousand people (John 6:12) ? Could ethical and responsible resource management not solve the paradox of poverty stricken people of Akwa Ibom in a rich economy? What ought to be done to better the lot of Akwa Ibomites? The research adopts phenomenological and sociological research methodology with primary and secondary sources of information to explore the socio-ethical issues embedded in resource management and wealth creation in Akwa Ibom State. Findings revealed that, reckless exploitation and mismanagement of the rich natural and human resources of Akwa Ibom State have spelt doom to the economic progress and survival of Akwa Ibomites in particular and Nigerians in general. Hence, hunger and poverty remain adversaries to majority of the people. Again, the culture of diversion of funds and squandermania institutionalized within the confine of Akwa Ibom State government, deter investment in economic enterprises, job and wealth creation that would have yielded economic dividends for Akwa Ibomites. These and many other unwholesome practices are responsible for the present deplorable condition of Akwa Ibom State in particular and Nigerian society in general. As a way out of this economic quagmire, it is imperative that, every unwholesome practice within the State be tackled more proactively and innovatively in the interest of the masses through responsible resource management and wealth creation. It is believed that, an effective leadership, a statesman with vision and commitment would transform the abundant resources to achieve meaningful development, create wealth and reduce poverty. Ethical leadership is required in all the tiers of government and public organizations to transform resources into more wealth. Thus, this paper advocates for ethics of virtue: a paradigm shift from exploitative leadership style to productive leadership style; change from atomistic human relation to corporative human relation; change from being subsistence to abundant in other to maximize the available resources in the State. To do otherwise is unethical and lack moral justification.

Keywords: corrective, mismanagement, resources, virtue ethics

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Authors: Gertrude I Hewapathirana, Mohamed M. Moustafa, Michel G. Zaitouni

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The purposes of this research are: (a) to provide an epistemological and ontological understanding of the WLB theory, practice, and research to illuminate how the WLB evolved between 2000 to 2020 and (b) to analyze peer-reviewed research to identify the gaps, hotspots, underlying dynamics, theoretical and thematic trends, influential authors, research collaborations, geographic networks, and the multidisciplinary nature of the WLB theory to guide future researchers. The research used four-step bibliometric network analysis to explore five research questions. Using keywords such as WLB and associated variants, 1190 peer-reviewed articles were extracted from the Scopus database and transformed to a plain text format for filtering. The analysis was conducted using the R version 4.1 software (R Development Core Team, 2021) and several libraries such as bibliometrics, word cloud, and ggplot2. We used the VOSviewer software (van Eck & Waltman, 2019) for network visualization. The WLB theory has grown into a multifaceted, multidisciplinary field of research. There is a paucity of research between 2000 to 2005 and an exponential growth from 2006 to 2015. The rapid increase of WLB research in the USA, UK, and Australia reflects the increasing workplace stresses due to hyper competitive workplaces, inflexible work systems, and increasing diversity and the emergence of WLB support mechanisms, legal and constitutional mandates to enhance employee and family wellbeing at multilevel social systems. A severe knowledge gap exists due to inadequate publications disseminating the "core" WLB research. "Locally-centralized-globally-discrete" collaboration among researchers indicates a "North-South" divide between developed and developing nations. A shortage in WLB research in developing nations and a lack of research collaboration hinder a global understanding of the WLB as a universal phenomenon. Policymakers and practitioners can use the findings to initiate supporting policies, and innovative work systems. The boundary expansion of the WLB concepts, categories, relations, and properties would facilitate researchers/theoreticians to test a variety of new dimensions. This is the most comprehensive WLB landscape analysis that reveals emerging trends, concepts, networks, underlying dynamics, gaps, and growing theoretical and disciplinary boundaries. It portrays the WLB as a universal theory.

Keywords: work-life balance, co-citation networks; keyword co-occurrence network, bibliometric analysis

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Authors: R. Kaleeswari

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An investigation was carried out to assess the soil biological quality parameters in rice soils under rainfed and to compare soil quality indexing methods viz., Principal component analysis, Minimum data set and Indicator scoring method and to develop soil quality indices for formulating soil and crop management strategies.Soil samples were collected and analyzed for soil biological properties by adopting standard procedure. Biological indicators were determined for soil quality assessment, viz., microbial biomass carbon and nitrogen (MBC and MBN), potentially mineralizable nitrogen (PMN) and soil respiration and dehydrogenease activity. Among the methods of rice cultivation, Organic nutrition, Integrated Nutrient Management (INM) and System of Rice Intensification (SRI ), rice cultivation registered higher values of MBC, MBN and PMN. Mechanical and conventional rice cultivation registered lower values of biological quality indicators. Organic nutrient management and INM enhanced the soil respiration rate. SRI and aerobic rice cultivation methods increased the rate of soil respiration, while conventional and mechanical rice farming lowered the soil respiration rate. Dehydrogenase activity (DHA) was registered to be higher in soils under organic nutrition and Integrated Nutrient Management INM. System of Rice Intensification SRI and aerobic rice cultivation enhanced the DHA; while conventional and mechanical rice cultivation methods reduced DHA. The microbial biomass carbon (MBC) of the rice soils varied from 65 to 244 mg kg-1. Among the nutrient management practices, INM registered the highest available microbial biomass carbon of 285 mg kg-1.Potentially mineralizable N content of the rice soils varied from 20.3 to 56.8 mg kg-1. Aerobic rice farming registered the highest potentially mineralizable N of 78.9 mg kg-1..The soil respiration rate of the rice soils varied from 60 to 125 µgCO2 g-1. Nutrient management practices ofINM practice registered the highest. soil respiration rate of 129 µgCO2 g-1.The dehydrogenase activity of the rice soils varied from 38.3 to 135.3µgTPFg-1 day-1. SRI method of rice cultivation registered the highest dehydrogenase activity of 160.2 µgTPFg-1 day-1. Soil variables from each PC were considered for minimum soil data set (MDS). Principal component analysis (PCA) was used to select the representative soil quality indicators. In intensive rice cultivating regions, soil quality indicators were selected based on factor loading value and contribution percentage value using principal component analysis (PCA).Variables having significant difference within production systems were used for the preparation of minimum data set (MDS).

Keywords: soil quality, rice, biological properties, PCA analysis

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Authors: Pauline Cuenin, Marcelo Leles Romarco Oliveira

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Based on their localities and following their ecological rationality, family-based farmers have experimented, adapted and innovated to improve their production systems continuously for millennia. With the technological package transfer processes of the so-called Green Revolution for agricultural holdings, farmers have become increasingly dependent on ready-made "recipes" built from so-called "universal" and global knowledge to face the problems that emerge in the management of local agroecosystems, thus reducing their creative and experiential capacities. However, the production of novelties within farms is fundamental to the transition to more sustainable agro food systems. In fact, as the fruits of local knowledge and / or the contextualization of exogenous knowledge, novelties are seen as seeds of transition. By presenting new techniques, new organizational forms and epistemological approaches, agroecology was pointed out as a way to encourage and promote the creative capacity of farmers. From this perspective, this theoretical work aims to analyze how agroecology encourages the innovative capacity of farmers, and in general, the production of novelties. For this, an analysis was made of the theoretical and methodological bases of agroecology through a literature review, specifically looking for the way in which it articulates the local with the global, complemented by an analysis of agro ecological Brazilian experiences. It was emphasized that, based on the peasant way of doing agriculture, that is, on ecological / social co-evolution or still called co-production (interaction between human beings and living nature), agroecology recognizes and revalues peasant involves the deep interactions of the farmer with his site (bio-physical and social). As a "place science," practice and movement, it specifically takes into consideration the local and empirical knowledge of farmers, which allows questioning and modifying the paradigms that underpin the current agriculture that have disintegrated farmers' creative processes. In addition to upgrade the local, agroecology allows the dialogue of local knowledge with global knowledge, essential in the process of changes to get out of the dominant logic of thought and give shape to new experiences. In order to reach this articulation, agroecology involves new methodological focuses seeking participatory methods of study and intervention that express themselves in the form of horizontal spaces of socialization and collective learning that involve several actors with different knowledge. These processes promoted by agroecology favor the production of novelties at local levels for expansion at other levels, such as the global, through trans local agro ecological networks.

Keywords: agroecology, creativity, global, local, novelty

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Authors: Prakash Chittoor

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In the recent past, it is realised especially in third sector that employing social innovation is crucial for achieving viable and long lasting social transformation. In this context, education is one among many sectors that have opened up itself for such move where employing social innovation emerges as key for reaching out to the excluded sections who are often failed to get support from either policy or market interventions. In fact, education is being as a crucial factor for social development is well understood at both academic and policy level. In order to move forward to achieve better results, interventions from multiple sectors may be required as its reach cultivates capabilities and skill of the deprived in order to ensure both market and social participation in the long run. Despite state’s intervention, it is found that still millions of children are out of school due to lack of political will, lapses in policy implementation and neoliberal intervention of marketization. As a result, universalisation of elementary education became as an elusive goal to poor and marginalised sections where state obtain constant pressure by corporate sector to withdraw from education sector that led convince in providing quality education. At this juncture, the role of third sector organizations plays is quite remarkable. Especially, it has evolved as a key player in education sector to reach out to the poor and marginalised in the far-flung areas. These organisations work in resources constrain environment, yet, in order to achieve larger social impact they adopt various social innovations from time to time to reach out to the unreached. Their attempts not only limited to just approaching the unreached children but to retain them for long-time in the schooling system in order to ripe the results for their families and communities. There is a need to highlight various innovative ways adopted and practiced by the third sector organisations in India to achieve the elusive goal of universal access of primary education with quality. With this background, the paper primarily attempts to present an in-depth understanding about innovative practices employed by third sectors organisations like Isha Vidya through government schools adoption programme in India where it engages itself with government and build capabilities among the government teachers to promote state run schooling with quality and better infrastructure. Further, this paper assess whether such innovative attempts succeeded in to achieving universal quality education in the areas where it operates and draws implications for State policy.

Keywords: school education, third sector organisations, social innovation, market domination

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