Search results for: advance care planning

Authors: Radul Shishkov, Orlin Davchev

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The digital era has revolutionized architectural practices, with building information modeling (BIM) emerging as a pivotal tool for architects, engineers, and construction professionals. However, the transition from traditional methods to BIM-centric approaches poses significant challenges, particularly in the context of existing structures. This research introduces a technical approach to bridge this gap through the development of algorithms that facilitate the automated transformation of 3D point cloud data into detailed BIM models. The core of this research lies in the application of algorithmic modeling and computational design methods to interpret and reconstruct point cloud data -a collection of data points in space, typically produced by 3D scanners- into comprehensive BIM models. This process involves complex stages of data cleaning, feature extraction, and geometric reconstruction, which are traditionally time-consuming and prone to human error. By automating these stages, our approach significantly enhances the efficiency and accuracy of creating BIM models for existing buildings. The proposed algorithms are designed to identify key architectural elements within point clouds, such as walls, windows, doors, and other structural components, and to translate these elements into their corresponding BIM representations. This includes the integration of parametric modeling techniques to ensure that the generated BIM models are not only geometrically accurate but also embedded with essential architectural and structural information. Our methodology has been tested on several real-world case studies, demonstrating its capability to handle diverse architectural styles and complexities. The results showcase a substantial reduction in time and resources required for BIM model generation while maintaining high levels of accuracy and detail. This research contributes significantly to the field of architectural technology by providing a scalable and efficient solution for the integration of existing structures into the BIM framework. It paves the way for more seamless and integrated workflows in renovation and heritage conservation projects, where the accuracy of existing conditions plays a critical role. The implications of this study extend beyond architectural practices, offering potential benefits in urban planning, facility management, and historic preservation.

Keywords: BIM, 3D point cloud, algorithmic modeling, computational design, architectural reconstruction

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Authors: Gabriel G. Gaft, Xayvinay Xiong, Amanda Sunday

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The emergent pandemic from COVID-19 virus has forced people to adjust to major changes. These changes include all elements of family and work life and required people to engage in novel behaviors. For many people, the social norms to which they have been accustomed no longer prevail. Not surprisingly, such enormous changes in daily life have been associated with greater problems in mental health; and research regarding ways in which mental health professionals can support people is more necessary than ever before. It is often useful to assess people’s reactions through surveys and utilize quantitative data to answer questions about coping strategies etc. It is also likely, however, that a host of individual factors are going to contribute to what might be considered 'good' or 'bad' coping mechanisms to a worldwide pandemic. To this end, qualitative studies—where the individual’s subjective experience is highlighted—are likely to provide more vital information for mental health professionals interested in supporting the particular person in front of them. This study reports on qualitative data, where X participants were asked questions about social distancing, coping strategies, and general attitudes towards social changes resulting from the COVID-19 pandemic. Informal interviews were conducted during the months of June-July 2020. Data were analyzed using Interpretative Phenomenological Analyses. Themes were identified first for each participant and then compared across different individual participants. Several findings emerged. First, all participants understood major health messages being imparted by governing bodies such as the CDC and WHO. The researchers feel this finding is important as it suggests health messages are at least being effectively communicated. Second, there was a clear trend for themes which highlighted the conflicting emotions participants felt about the changes they were expected to endure: positive and negative elements were identified, although a participant who had pre-existing conditions placed greater emphasis on the negative elements. One participant who was particularly interested in impression management also exclusively emphasized negative emotions. Third, participants who were able to reevaluate priorities—what Lazarus might call secondary appraisals—experienced social distancing as a positive rather than negative phenomenon. Finally, participants who were able to develop specific strategies—such as boundaries for work and self-care—reported themes of adjustment and contentment. Taken together, these findings suggest mental health practitioners can assist people to adjust more positively through specific techniques focusing on re-evaluation of life priorities and strategic coping skills.

Keywords: COVID-19, pandemic, phenomenology, virus

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Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

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The improvement of surgical techniques in recent years has reduced the frequency of postoperative complications in kidney transplant recipients. Novel immunosuppressive agents have reduced rates of graft loss due to acute rejection to less than 1%. However, surgical complications may still lead graft loss and morbidity in recipients. Because of potent immunosuppression, impaired wound healing and complications are frequent after transplantation. We compared the frequency of post-operative surgical complications in diabetic and non-diabetic patients after kidney transplantation. Materials and Methods: This retrospective study conducted in consecutive patients (213 females, 285 males, median age 39 years) who underwent kidney transplant surgery at our center between December 2005 and October 2015. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). Characteristics of both groups were obtained from medical records. Results: We performed 225 living and 273 deceased donor transplantations. Renal replacement type was hemodialysis in 60.8%, peritoneal dialysis in 17.3% and preemptive in 12%. The mean body mass indexes of the recipients were 24 ± 4.6 kg/m², donor age was 48.6 ± 14.3 years, cold ischemic time was 11.3 ± 6.1 hours, surgery time was 4.9 ± 1.2 hours, and recovery time was 54±31 min. The mean hospitalization duration was 19.1 ± 13.5 days. The frequency of postoperative surgical complications was 43.8%. There was no significant difference between the ratios of post-operative surgical complications in non-diabetic (43.5%) and diabetic (47.4%) groups (p=0.648). Post-operative surgical complications were lymphocele (24.6% vs. 23.7%), delayed wound healing (13.2% vs. 7.6%), hematoma (7.8% vs.15.8 %), urinary leak (4.6% vs. 5.3%), hemorrhage (5.1% vs. 0%), hydronephrosis (2.2% vs. 0%), renal artery thrombosis (1.5% vs. 0%), renal vein thrombosis (1% vs. 2.6%), urinoma (0.7% vs. 0%), urinary obstruction (0.5% vs. 0%), ureteral stenosis (0.5% vs. 0%) and ureteral reflux (0.2% vs. 0%) in non-diabetic and diabetic groups, respectively (p > 0.05). Mean serum creatinine levels in non-diabetics and diabetics were 1.43 ± 0.81 and 1.61 ± 0.96 mg/dL at 1st month (p=0.198). At the 6th month, the mean graft and patient survival times in patients with post-operative surgical complications were significantly lower than in those who did not (162.9 ± 3.4 vs. 175.6 ± 1.5 days, p=0.008, and 171 ± 2.9 vs. 176.1 ± 1.6 days, p=0.047, respectively). However, patient survival durations of non-diabetic (173 ± 27) and diabetic (177 ± 13 day) groups were comparable (p=0.396). Conclusion: As a result, we concluded that surgical complications such as lymphocele and delayed wound healing were common and that frequency of these complications in diabetic recipients did not differ from non-diabetic one. All persons involved in the postoperative care of kidney transplant recipients be aware of the potential surgical complications for rapid diagnosis and treatment.

Keywords: kidney transplantation, diabetes mellitus, surgery, complication

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Authors: Masauso Moses Phiri

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Frequent glucose monitoring is essential to the management of diabetes. Plasmonic enzyme-based glucose biosensors have the advantages of greater specificity, simplicity and rapidity. The aim of this study was to develop a rapid plasmonic colorimetric glucose biosensor based on biocatalytic enlargement of AuNS guided by GOx. Gold nanoparticles of 18 nm in diameter were synthesized using the citrate method. Using these as seeds, a modified seeded method for the synthesis of monodispersed gold nanostars was followed. Both the spherical and star-shaped nanoparticles were characterized using ultra-violet visible spectroscopy, agarose gel electrophoresis, dynamic light scattering, high-resolution transmission electron microscopy and energy-dispersive X-ray spectroscopy. The feasibility of a plasmonic colorimetric assay through growth of AuNS by silver coating in the presence of hydrogen peroxide was investigated by several control and optimization experiments. Conditions for excellent sensing such as the concentration of the detection solution in the presence of 20 µL AuNS, 10 mM of 2-(N-morpholino) ethanesulfonic acid (MES), ammonia and hydrogen peroxide were optimized. Using the optimized conditions, the glucose assay was developed by adding 5mM of GOx to the solution and varying concentrations of glucose to it. Kinetic readings, as well as color changes, were observed. The results showed that the absorbance values of the AuNS were blue shifting and increasing as the concentration of glucose was elevated. Control experiments indicated no growth of AuNS in the absence of GOx, glucose or molecular O₂. Increased glucose concentration led to an enhanced growth of AuNS. The detection of glucose was also done by naked-eye. The color development was near complete in ± 10 minutes. The kinetic readings which were monitored at 450 and 560 nm showed that the assay could discriminate between different concentrations of glucose by ± 50 seconds and near complete at ± 120 seconds. A calibration curve for the qualitative measurement of glucose was derived. The magnitude of wavelength shifts and absorbance values increased concomitantly with glucose concentrations until 90 µg/mL. Beyond that, it leveled off. The lowest amount of glucose that could produce a blue shift in the localized surface plasmon resonance (LSPR) absorption maxima was found to be 10 – 90 µg/mL. The limit of detection was 0.12 µg/mL. This enabled the construction of a direct sensitivity plasmonic colorimetric detection of glucose using AuNS that was rapid, sensitive and cost-effective with naked-eye detection. It has great potential for transfer of technology for point-of-care devices.

Keywords: colorimetric, gold nanostars, glucose, glucose oxidase, plasmonic

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Authors: Aisha Giwa, Mohammed-Faosy Adeniran, Olufunke Femi-Ojo

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Four decades ago, the World Health Organization (WHO) launched the Expanded Programme on Immunization (EPI). The EPI blueprint laid out the technical and managerial functions necessary to routinely vaccinate children with a limited number of vaccines, providing protection against diphtheria, tetanus, whooping cough, measles, polio, and tuberculosis, and to prevent maternal and neonatal tetanus by vaccinating women of childbearing age with tetanus toxoid. Despite global efforts, the Routine Immunization (RI) coverage in two of the World Health Organization (WHO) regions; the African Region and the South-East Asia Region, still remains short of its targets. As a result, the WHO Regional Director for Africa declared 2012 as the year for intensifying RI in these regions and this also coincided with the declaration of polio as a programmatic emergency by the WHO Executive Board. In order to intensify routine immunization, the National Routine Immunization Strategic Plan (2013-2015) stated that its core priority is to ensure 100% adequacy and availability of vaccines for safe immunization. To achieve 100% availability, the “PUSH System” and then “Push-Plus” were adopted for vaccine distribution, which replaced the inefficient “PULL” method. The NPHCDA plays the key role in coordinating activities in area advocacy, capacity building, engagement of 3PL for the state as well as monitoring and evaluation of the vaccine delivery process. eHealth Africa (eHA) is a player as a 3PL service provider engaged by State Primary Health Care Boards (SPHCDB) to ensure vaccine availability through Vaccine Direct Delivery (VDD) project which is essential to successful routine immunization services. The VDD project ensures the availability and adequate supply of high-quality vaccines and immunization-related materials to last-mile facilities. eHA’s commitment to the VDD project saw the need for an assessment of the project vis-a-vis the overall project performance, evaluation of a process for necessary improvement suggestions as well as general impact across Kano State (Where eHA had transitioned to the state), Bauchi State (currently manage delivery to all LGAs except 3 LGAs currently being managed by the state), Sokoto State (eHA currently covers all LGAs) and Zamfara State (Currently, in-sourced and managed solely by the state).

Keywords: cold chain logistics, health supply chain system strengthening, logistics management information system, vaccine delivery traceability and accountability

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Authors: Reshma Parvin Nuri, Heather Michelle Aldersey, Setareh Ghahari

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Objectives: Worldwide, it is well known that taking care of children with disabilities (CWD) can have a significant impact on the entire family unit. Over the last few decades, an increased number of studies have been conducted on families of CWD in higher income countries, and much of this research has identified family needs and strategies to meet those needs. However, family needs are incredibly under-studied in developing countries. Therefore, the aims of this study were to: (a) explore the needs of families of children with cerebral palsy (CP) in Bangladesh; (b) investigate how some of the family needs have been met and (c) identify the sources of supports that might help the families to meet their needs in the future. Methods: A face to face, semi-structured in-depth interview was conducted with 20 family members (12 mothers, 4 fathers, 1 sister, 2 grandmothers, and 1 aunt) who visited the Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh between June and August 2016. Constant comparison method of grounded theory approach within the broader spectrum of qualitative study was used to analyze the data. Results: Participants identified five categories of needs: (a) financial needs, (b) access to disability-related services, (c) family and community cohesion, (d) informational needs, and (e) emotional needs. Participants overwhelmingly reported that financial need is their greatest family need. Participants noted that families encountered additional financial expenses for a child with CP, beyond what they would typically pay for their other children. Participants were seeing education as their non-primary need as they had no hope that their children would be physically able to go to school. Some participants also shared their needs for social inclusion and participation and receiving emotional support. Participants further expressed needs to receive information related to the child’s health condition and availability/accessibility of governmental support programs. Besides unmet needs, participants also highlighted that some of their needs have been met through formal and informal support systems. Formal support systems were mainly institution-based and run by non-governmental organizations, whereas participants identified informal support coming from family, friends and community members. Participants overwhelmingly reported that they receive little to no support from the government. However, participants identified the government as the key stakeholder who can play vital role in meeting their unmet needs. Conclusions: In the next phase of this research, the plan is to understand how the Government of the People’s Republic of Bangladesh is working to meet the needs of families of CWD. There is also need for further study on needs of families of children with conditions other than CP and those who live in the community and do not have access to the CRP Services. There is clear need to investigate ways to enable children with CP have better access to education in Bangladesh.

Keywords: Bangladesh, children with cerebral palsy, family needs, support

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Authors: Mary Ann L. Halliday, Zoengpari Gohain

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The stigma associated with HIV-AIDS negatively affect mental health and ability to effectively manage the disease. While the number of People living with HIV/AIDS (PLHIV) has been increasing day by day in Mizoram (a small north-eastern state in India), research on HIV/AIDS stigma has so far been limited. Despite the potential significance of Internalized HIV Stigma (IHS) in the lives of PLHIV, there has been very limited research in this area. It was therefore, felt necessary to explore the internalized HIV stigma, mental health, coping and perceived social support of PLHIV in Aizawl District, Mizoram. The present study was designed with the objectives to determine the degree of IHS, to study the relationship between the socio-demographic characteristics and level of IHS, to highlight the mental health status, coping strategies and perceived social support of PLHIV and to elucidate the relationship between these psychosocial variables. In order to achieve the objectives of the study, six hypotheses were formulated and statistical analyses conducted accordingly. The sample consisted of 300 PLWHA from Aizawl District, 150 males and 150 females, of the age group 20 to 70 years. Two- way classification of “Gender” (male and female) and three-way classification of “Level of IHS” (High IHS, Moderate IHS, Low IHS) on the dependent variables was employed, to elucidate the relationship between Internalized HIV Stigma, mental health, coping and perceived social support of PLHIV. The overall analysis revealed moderate level of IHS (67.3%) among PLHIV in Aizawl District, with a small proportion of subjects reporting high level of IHS. IHS was found to be significantly different on the basis of disclosure status, with the disclosure status of PLHIV accounting for 9% variability in IHS.  Results also revealed more or less good mental health among the participants, which was assessed by minimal depression (50.3%) and minimal anxiety (45%), with females with high IHS scoring significantly higher in both depression and anxiety (p<.01). Examination of the coping strategies of PLHIV found that the most frequently used coping styles were Acceptance (91%), Religion (84.3%), Planning (74.7%), Active Coping (66%) and Emotional Support (52.7%). High perception of perceived social support (48%) was found in the present study. Correlation analysis revealed significant positive relationships between IHS and depression as well as anxiety (p<.01), thus revealing that IHS negatively affects the mental health of PLHIV. Results however revealed that this effect may be lessened by the use of various coping strategies by PLHIV as well as their perception of social support.

Keywords: Aizawl, anxiety, depression, internalized HIV stigma, HIV/AIDS, mental health, mizoram, perceived social support

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Authors: J. Szpor, K. Witczak, M. Storman, A. Orchel, D. Hodorowicz-Zaniewska, K. Okoń, A. Klimkowska

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Core needle biopsy (CNB) is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease. In comparison to fine needle aspiration (FNA), CNB provides more architectural information allowing for the evaluation of prognostic and predictive factors for breast cancer, including histological grade—one of three prognostic factors used to calculate the Nottingham Prognostic Index. Several studies have previously described the concordance rate between CNB and surgical excision specimen in determination of histological grade (HG). The concordance rate previously ascribed to overall grade varies widely across literature, ranging from 59-91%. The aim of this study is to see how the data looks like in material at authors’ institution and are the results as compared to those described in previous literature. The study population included 157 women with a breast tumor who underwent a core needle biopsy for breast carcinoma and a subsequent surgical excision of the tumor. Both materials were evaluated for the determination of histological grade (scale from 1 to 3). HG was assessed only in core needle biopsies containing at least 10 well preserved HPF with invasive tumor. The degree of concordance between CNB and surgical excision specimen for the determination of tumor grade was assessed by Cohen’s kappa coefficient. The level of agreement between core needle biopsy and surgical resection specimen for overall histologic grading was 73% (113 of 155 cases). CNB correctly predicted the grade of the surgical excision specimen in 21 cases for grade 1 tumors (Kappa coefficient κ = 0.525 95% CI (0.3634; 0.6818), 52 cases for grade 2 (Kappa coefficient κ = 0.5652 95% CI (0.458; 0.667) and 40 cases for stage 3 tumors (Kappa coefficient κ = 0.6154 95% CI (0.4862; 0.7309). The highest level of agreement was observed in grade 3 malignancies. In 9 of 42 (21%) discordant cases, the grade was higher in the CNB than in the surgical excision. This composed 6% of the overall discordance. These results correspond to the noted in the literature, showing that underestimation occurs more frequently than overestimation. This study shows that authors’ institution’s histologic grading of CNBs and surgical excisions shows a fairly good correlation and is consistent with findings in previous reports. Despite the inevitable limitations of CNB, CNB is an effective method for diagnosing breast cancer and managing treatment options. Assessment of tumour grade by CNB is useful for the planning of treatment, so in authors’ opinion it is worthy to implement it in daily practice.

Keywords: breast cancer, concordance, core needle biopsy, histological grade

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Authors: Gavin Quibell, Martin Kleynhans, Margot Soler

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The Sendai Framework notes that disaster risk reduction is essential for sustainable development, and Disaster Risk Reduction is included in 3 of the Sustainable Development Goals (SDGs), and 4 of the SDG targets. However, apart from promoting better governance and resourcing of disaster management agencies, little guidance is given how low-income nations can balance investments across the SDGs to achieve sustainable development in an increasingly climate vulnerable world with increasing prevalence of flood and drought disasters. As one of the world’s poorest nations, Malawi must balance investments across all the SDGs. This paper explores how Malawi’s National Guidelines for Community-based Flood Risk Management integrate sustainable development and flood management objectives at different administrative levels. While Malawi periodically suffers from large, widespread flooding, the greatest impacts are felt through the smaller annual floods and flash floods. The Guidelines address this through principles that recognize that while the protection of human life is the most important priority for flood risk management, addressing the impacts of floods on the rural poor and the economy requires different approaches. The National Guidelines are therefore underpinned by the following; 1. In the short-term investments in flood risk management must focus on breaking the poverty – vulnerability cycle; 2. In the long-term investments in the other SDGs will have the greatest flood risk management benefits; 3. If measures are in place to prevent loss of life and protect strategic infrastructure, it is better to protect more people against small and medium size floods than fewer people against larger floods; 4. Flood prevention measures should focus on small (1:5 return period) floods; 5. Flood protection measures should focus on small and medium floods (1:20 return period) while minimizing the risk of failure in larger floods; 6. The impacts of larger floods ( > 1:50) must be addressed through improved preparedness; 7. The impacts of climate change on flood frequencies are best addressed by focusing on growth not overdesign; and 8. Manage floods and droughts conjunctively. The National Guidelines weave these principles into Malawi’s approach to flood risk management through recommendations for planning and implementing flood prevention, protection and preparedness measures at district, traditional authority and village levels.

Keywords: flood risk management in low-income countries, sustainable development, investments in prevention, protection and preparedness, community-based flood risk management, Malawi

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Authors: Mei Li, Victor Meddalena

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Background: Newfoundland and Labrador (NL) has rapidly aging population and is characterized by its vast geography with high proportion of dispersed rural communities when compared to other provinces in Canada. Structural, demographic and geographic factors have created big gaps for rural residents across NL with respect to accessing various health and social services. While the barriers are well documented for patients’ access to cancer care in rural and remote areas, challenges faced by family caregivers are not fully recognized. Caregiving burden coupled with challenges associated with relocation and frequent travels create situations where caregivers are vulnerable physically, emotionally, financially and socially. This study examines the experiences of family caregivers living in rural NL through a social justice lens. It is expected to identify the gaps existing in social policy and support for rural family caregivers. It will make a novel contribution to the literature in this regard. Methods: Design: This qualitative study adopted the hermeneutic phenomenology to best describe and interpret rural-based family caregivers’ living experiences and explore the meaning, impact, and the influence of both individual experience and contextual factors shaping these experiences. Data Collection: In-depth interviews with key informants were conducted with 12 participants from various rural communities in NL. A case study was also used to explore an individual’s experience in complex social units consisting of multiple variables of in-depth understanding of the reality. Data Analysis: Thematic analysis guided by the Voice-Centred Relational (VCR) method was employed to explore the relationships and contexts of participants. Emerging Themes: Six major emerging themes were identified, namely, overwhelming caregiving burden on rural family caregivers, long existing financial hardship, separation from family and community, low level of social support and self-reliance coping strategies, and social vulnerability and isolation. Conclusion: Understanding the lived experiences of rural-based family caregivers is critical to inform the policy makers the gap of health and social service in NL. The findings of this study also have implications for family caregivers who are vulnerable in other similar contexts. This study adds innovative insights for policy making and service provision in this regard.

Keywords: family caregivers, policy, relocation, rural

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Authors: Hailemeleak Regassa

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Traditional medicines use medicinal plants as a source of ingredients, and many modern medications are indirectly derived from plants. Consumers in affluent nations are growing disenchanted with contemporary healthcare and looking for alternatives. Oxidative stress is the primary cause of multiple diseases, and exogenous antioxidant supplementation or strengthening the body's endogenous antioxidant defenses are potential ways to counteract the negative effects of oxidative damage. Plants can biosynthesize non-enzymatic antioxidants that can reduce ROS-induced oxidative damage. Aging often aids the propagation and development of carcinogenesis, and older animals and older people exhibit increased vulnerability to tumor promoters. Cancer is a major public health issue, with several anti-cancer medications in clinical use. Potential drugs such as flavopiridol, roscovitine, combretastatin A-4, betulinic acid, and silvestrol are in the clinical or preclinical stages of research. Methodology: Microbial Growth media, Dimethyl sulfoxide (DMSO), methanol, ethyl acetate, and n-hexane were obtained from Himedia Labs, Mumbai, India. plant were collected from the Herbal Garden of Shoolini University campus, Solan, India (Latitude - 30.8644° N and longitude - 77.1184° E). The identity was confirmed by Dr. Y.S. Parmar University of Horticulture and Forestry, Nauni, Solan (H.P.), India, and documented in Voucher specimens - UHF- Herbarium no. 13784; vide book no. 3818 Receipt No. 086. The plant materials were washed with tap water, and 0.1% mercury chloride for 2 minutes, rinsed with distilled water, air dried, and kept in a hot air oven at 40ºc on blotting paper until all the water evaporated and became well dried for grinding. After drying, the plant materials were grounded using a mixer grinder into fine powder transferred into airtight containers with proper labeling, and stored at 4ºc for future use (Horablaga et al., 2023). The extraction process was done according to Altemimi et al., 2017. The 5g powder was mixed with 15 ml of the respective solvents (n-hexane, ethyl acetate, and methanol), and kept for 4-5 days on the platform shaker. The solvents used are based on their increasing polarity index. Then the extract was centrifuged at 10,000rpm for 5 minutes and filtered using No.1 Whatman filter paper.

Keywords: cancer, phytomedicine, medicinal plants, oncology

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Authors: Chyong-Ru Liu, Wen-Shiung Huang, Wan-Ching Tang, Shan-Pei Chen

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Two of the biggest challenges companies involved in sports and exercise information services face are how to strengthen participation in virtual sports/exercise communities and how to increase the ongoing participatoriness of those communities. In the past, relatively little research has explored mechanisms for strengthening alignment practice and community response from the perspective of self-construal, and as such this study seeks to explore the self-construal of virtual sports/exercise communities, the role it plays in the emotional commitment of forming communities, and the factor that can strengthen alignment practice. Moreover, which factor of the emotional commitment of forming virtual communities have the effect of strengthening interference in the process of transforming customer citizenship behaviors? This study collected 625 responses from the two leading websites in terms of fan numbers in the provision of information on road race and marathon events in Taiwan, with model testing conducted through linear structural equation modelling and the bootstrapping technique to test the proposed hypotheses. The results proved independent construal had a stronger positive direct effect on affective commitment to fellow customers than did interdependent construal, and the influences of affective commitment to fellow customers in enhancing customer citizenship behavior. Public self-consciousness moderates the relationships among independent self-construal and interdependent self-construal on effective commitment to fellow customers. Perceived playfulness moderates the relationships between effective commitment to fellow customers and customer citizenship behavior. The findings of this study provide significant insights for the researchers and related organizations. From the theoretical perspective, this is empirical research that investigated the self-construal theory and responses (i.e., affective commitment to fellow customers, customer citizenship behavior) in virtual sports/exercise communities. We further explore how to govern virtual sports/exercise community participants’ heterogeneity through public self-consciousness mechanism to align participants’ affective commitment. Moreover, perceived playfulness has the effect of strengthening effective commitment to fellow customers with customer citizenship behaviors. The results of this study can provide a foundation for the construction of future theories and can be provided to related organizations for reference in their planning of virtual communities.

Keywords: self-construal theory, public self-consciousness, affective commitment, customer citizenship behavior

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Authors: Natchaphon Auampradit, Patama Vapattanawong, Sureeporn Punpuing, Malee Sunpuwan, Tawanchai Jirapramukpitak

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Longitudinal studies related to cognitive impairment in elderly are necessary for health promotion and development. The purposes of this study were (1) to examine changes in cognition of elderly over time and (2) to examine the impacts of changes in social determinants of health (SDH) toward changes in cognition of elderly by using the secondary data derived from the Kanchanaburi Demographic Surveillance System (KDSS) by the Institute for Population and Social Research (IPSR) which contained longitudinal data on individuals, households, and villages. Two selected projects included the Health and Social Support for Elderly in KDSS in 2007 and the Population, Economic, Social, Cultural, and Long-term Care Surveillance for Thai Elderly People’s Health Promotion in 2011. The samples were 586 elderly participated in both projects. SDH included living arrangement, social relationships with children, relatives, and friends, household asset-based wealth index, household monthly income, loans for livings, loans for investment, and working status. Cognitive impairment was measured by category fluency and delayed recall. This study employed Generalized Estimating Equation (GEE) model to investigate changes in cognition by taking SDH and other variables such as age, gender, marital status, education, and depression into the model. The unstructured correlation structure was selected to use for analysis. The results revealed that 24 percent of elderly had cognitive impairment at baseline. About 13 percent of elderly still had cognitive impairment during 2007 until 2011. About 21 percent and 11 percent of elderly had cognitive decline and cognitive improvement, respectively. The cross-sectional analysis showed that household asset-based wealth index, social relationship with friends, working status, age, marital status, education, and depression were significantly associated with cognitive impairment. The GEE model revealed longitudinal effects of household asset-based wealth index and working status against cognition during 2007 until 2011. There was no longitudinal effect of social conditions against cognition. Elderly living with richer household asset-based wealth index, still being employed, and being younger were less likely to have cognitive impairment. The results strongly suggested that poorer household asset-based wealth index and being unemployed were served as a risk factor for cognitive impairment over time. Increasing age was still the major risk for cognitive impairment as well.

Keywords: changes in cognition, cognitive impairment, elderly, KDSS, longitudinal study

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Authors: Murray Anderson, Galina Freed, Karli Jahn

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Trauma is increasingly recognized as an important construct that has health implications for those who struggle with various mental health issues. For those individuals who meet the criteria for a diagnosis of hoarding disorder (HD), many have experienced some form of trauma. Further, some of the therapeutic interventions for those with HD can further perpetuate or magnify the experience of trauma. Therefore, the aim of this scoping review is to identify and document the nature and extent of research evidence related to trauma as it connects with HD. This review was guided by the questions, ‘How can our understanding of the trauma cycle help us to better appreciate the experiences of individuals who hoard, and how will a trauma informed lens inform the interventions for hoarding disorder? A comprehensive literature search was performed to identify original studies that contained the words “hoarding” and “trauma.” PsychINFO”,''EBSCO host,” “CINAHL” and “PubMed” were searched between January 2005 and April 2021. Articles were screened by three reviewers. Data extracted included publication date, demographics, study design, type of analysis, and noted connections between hoarding and trauma. Of the 329 articles, all duplicates, articles on hoardings of animals, articles not in English, and those without full-text availability were removed. Five categories were found in the remaining 45 articles, including (a) traumatic and stressful life events; (b) the link between posttraumatic stress disorder, trauma, and hoarding; (c) the relationships between different comorbidities, trauma, and hoarding; (d) the lack of early emotional expression and other forms of parental deprivation; and (e) the role of attachment. Lastly, the literature explains how the links between hoarding and trauma are difficult to study due to the highly stigmatized identities with this population. The review provided strong support for the connections between the experience of trauma and HD. What is missing from the literature is the use of a trauma-informed lens to better account for the ways in which hoarding disorder is understood. Other missing pieces in the literature are the potential uses of a trauma-informed lens to enhance the therapeutic process, to understand and reduce treatment attrition, and to improve treatment outcomes. The application of a trauma informed lens could improve our understanding of effective interactions among clients, families, and communities and improve the education around hoarding-related matters. Exploring the connections between trauma and HD can improve therapeutic delivery and destigmatize the experience of dealing with clutter and hoarding concerns. This awareness can also provide health care professionals with both the language and skills to liberate them from a reductionist view on HD.

Keywords: hoarding, attachment, parental deprivation, trauma

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Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović

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Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.

Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment

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Authors: S. Mamoucha, J. Rahul, N. Christodoulakis

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Introduction: Nature has been the source of medicinal agents since the dawn of the human existence on Earth. Currently, millions of people, in the developing world, rely on medicinal plants for primary health care, income generation and lifespan improvement. In Greece, more than 5500 plant taxa are reported while about 250 of them are considered to be of great pharmaceutical importance. Among the plants used for medical purposes, Vitex agnus-castus L. (Verbenaceae) is known since ancient times. It is a small tree or shrub, widely distributed in the Mediterranean basin up to the Central Asia. It is also known as chaste tree or monks pepper. Theophrastus mentioned the shrub several times, as ‘agnos’ in his ‘Enquiry into Plants’. Dioscorides mentioned the use of V. agnus-castus for the stimulation of lactation in nursing mothers and the treatment of several female disorders. The plant has important medicinal properties and a long tradition in folk medicine as an antimicrobial, diuretic, digestive and insecticidal agent. Materials and methods: Leaves were cleaned, detached, fixed, sectioned and investigated with light and Scanning Electron Microscopy (SEM). Histochemical tests were executed as well. Specific histochemical reagents (osmium tetroxide, H2SO4, vanillin/HCl, antimony trichloride, Wagner’ s reagent, Dittmar’ s reagent, potassium bichromate, nitroso reaction, ferric chloride and di methoxy benzaldehyde) were used for the sub cellular localization of secondary metabolites. Results: Light microscopical investigations of the elongated leaves of V. agnus-castus revealed three layers of palisade parenchyma, just below the single layered adaxial epidermis. The spongy parenchyma is rather loose. Adaxial epidermal cells are larger in magnitude, compared to those of the abaxial epidermis. Four different types of capitate, secreting trichomes, were localized among the abaxial epidermal cells. Stomata were observed at the abaxial epidermis as well. SEM revealed the interesting arrangement of trichomes. Histochemical treatment on fresh and plastic embedded tissue sections revealed the nature and the sites of secondary metabolites accumulation (flavonoids, steroids, terpenes). Acknowledgment: This work was supported by IKY - State Scholarship Foundation, Athens, Greece.

Keywords: Vitex agnus-castus, leaf anatomy, histochemical reagents, secondary metabolites

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Authors: Jiahao Tian, Michael D. Porter

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Law enforcement agencies are tasked with crime prevention and crime reduction under limited resources. Having an accurate temporal estimate of the crime rate would be valuable to achieve such a goal. However, estimation is usually complicated by the interval-censored nature of crime data. We cast the problem of intensity estimation as a Poisson regression using an EM algorithm to estimate the parameters. Two special penalties are added that provide smoothness over the time of day and day of the week. This approach presented here provides accurate intensity estimates and can also uncover day-of-week clusters that share the same intensity patterns. Anticipating where and when crimes might occur is a key element to successful policing strategies. However, this task is complicated by the presence of interval-censored data. The censored data refers to the type of data that the event time is only known to lie within an interval instead of being observed exactly. This type of data is prevailing in the field of criminology because of the absence of victims for certain types of crime. Despite its importance, the research in temporal analysis of crime has lagged behind the spatial component. Inspired by the success of solving crime-related problems with a statistical approach, we propose a statistical model for the temporal intensity estimation of crime with censored data. The model is built on Poisson regression and has special penalty terms added to the likelihood. An EM algorithm was derived to obtain maximum likelihood estimates, and the resulting model shows superior performance to the competing model. Our research is in line with the smart policing initiative (SPI) proposed by the Bureau Justice of Assistance (BJA) as an effort to support law enforcement agencies in building evidence-based, data-driven law enforcement tactics. The goal is to identify strategic approaches that are effective in crime prevention and reduction. In our case, we allow agencies to deploy their resources for a relatively short period of time to achieve the maximum level of crime reduction. By analyzing a particular area within cities where data are available, our proposed approach could not only provide an accurate estimate of intensities for the time unit considered but a time-variation crime incidence pattern. Both will be helpful in the allocation of limited resources by either improving the existing patrol plan with the understanding of the discovery of the day of week cluster or supporting extra resources available.

Keywords: cluster detection, EM algorithm, interval censoring, intensity estimation

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Authors: Elena Pummer, Holger Schuettrumpf

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By today underground pumped storage plants as an outstanding alternative for classical pumped storage plants do not exist. They are needed to ensure the required balance between production and demand of energy. As a short to medium term storage pumped storage plants have been used economically over a long period of time, but their expansion is limited locally. The reasons are in particular the required topography and the extensive human land use. Through the use of underground reservoirs instead of surface lakes expansion options could be increased. Fulfilling the same functions, several hydrodynamic processes result in the specific design of the underground reservoirs and must be implemented in the planning process of such systems. A combined 3D numerical and experimental approach leads to currently unknown results about the occurring wave types and their behavior in dependence of different design and operating criteria. For the 3D numerical simulations, OpenFOAM was used and combined with an experimental approach in the laboratory of the Institute of Hydraulic Engineering and Water Resources Management at RWTH Aachen University, Germany. Using the finite-volume method and an explicit time discretization, a RANS-Simulation (k-ε) has been run. Convergence analyses for different time discretization, different meshes etc. and clear comparisons between both approaches lead to the result, that the numerical and experimental models can be combined and used as hybrid model. Undular bores partly with secondary waves and breaking bores occurred in the underground reservoir. Different water levels and discharges change the global effects, defined as the time-dependent average of the water level as well as the local processes, defined as the single, local hydrodynamic processes (water waves). Design criteria, like branches, directional changes, changes in cross-section or bottom slope, as well as changes in roughness have a great effect on the local processes, the global effects remain unaffected. Design calculations for underground pumped storage plants were developed on the basis of existing formulae and the results of the hybrid approach. Using the design calculations reservoirs heights as well as oscillation periods can be determined and lead to the knowledge of construction and operation possibilities of the plants. Consequently, future plants can be hydraulically optimized applying the design calculations on the local boundary conditions.

Keywords: energy storage, experimental approach, hybrid approach, undular and breaking Bores, 3D numerical approach

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Authors: Alexandra Shipley

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Background: Undergraduate paediatric teaching must overcome two major challenges: 1) balancing patient safety with active student engagement and 2) exposing students to a comprehensive range of pathologies within a relatively short clinical placement. Whilst lectures and shadowing on paediatric wards constitute the mainstay of learning, Simulation and Virtual Reality (VR) are emerging as effective teaching tools, which - immune to the unpredictability and seasonal variation of hospital presentations - could expose students to the entire syllabus more reliably, efficiently, and independently. We aim to evaluate the potential utility of Simulation and VR in addressing gaps within the traditional paediatric curriculum from the perspective of medical students. Summary of Work: Exposure to and perceived utility of various learning opportunities within the Paediatric and Emergency Medicine courses were assessed through a questionnaire completed by 5th year medical students (n=23). Summary of Results: Students reported limited exposure to several common acute paediatric presentations, such as bronchiolitis (41%), croup (32%) or pneumonia (14%), and to clinical emergencies, including cardiac/respiratory arrests or trauma calls (27%). Across all conditions, average self-reported confidence in assessment and management to the level expected of an FY1 is greater amongst those who observed at least one case (e.g. 7.6/10 compared with 3.6/10 for croup). Students rated exposure through Simulation or VR to be of similar utility to witnessing a clinical scenario on the ward. In free text responses, students unanimously favoured being ‘challenged’ through ‘hands-on’ patient interaction over passive shadowing, where it is ‘easy to zone out.’ In recognition of the fact that such independence is only appropriate in certain clinical situations, many students reported wanting more Simulation and VR teaching. Importantly, students raised the necessity of ‘proper debriefs’ after these sessions to maximise educational value. Discussion and Conclusion: Our questionnaire elicited several student-perceived challenges in paediatric education, including incomplete exposure to common pathologies and limited opportunities for active involvement in patient care. Indeed, these experiences seem to be important predictors of confidence. Quantitative and qualitative feedback suggests that VR and Simulation satisfy students’ self-reported appetite for independent engagement with authentic clinical scenarios. Take-aways: Our findings endorse further development of VR and Simulation as high-yield adjuncts to paediatric education.

Keywords: paediatric emergency education, simulation, virtual reality, medical education

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Authors: Peyman Mosberian-Tanha, Mona Rezaei

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Aquaculture sector is the fastest growing food sector with annual growth rate of about 10%. The sustainability of aquaculture production, however, has been debated mainly in relation to the feed ingredients used for farmed fish. The industry has been able to decrease its dependency on marine-based ingredients in line with policies for more sustainable production. As a result, plant-based ingredients have increasingly been incorporated in aquaculture feeds, especially in feeds for popular carnivorous species, salmonids. The effect of these ingredients on salmonids’ health and performance has been widely studied. In most cases, plant-based diets are associated with varying degrees of health and performance issues across salmonids, partly depending on inclusion levels of plant ingredients and the species in question. However, aquaculture sector is facing another challenge of concern. Environmental challenges in association with climate change is another issue the aquaculture sector must deal with. Data from trials in salmonids subjected to environmental challenges of various types show adverse physiological responses, partly in relation to stress. To date, there are only a limited number of studies reporting the interactive effects of adverse environmental conditions and dietary regimens on salmonids. These studies have shown that adverse environmental conditions exacerbate the detrimental effect of plant-based diets on digestive function and health in salmonids. This indicates an additional challenge for the aquaculture sector to grow in a sustainable manner. The adverse environmental conditions often studied in farmed fish is the change in certain water quality parameters such as oxygen and/or temperature that are typically altered in response to climate change and, more specifically, global warming. In a challenge study, we observed that the in the fish fed a plant-based diet, the fish’s ability to absorb dietary energy was further reduced when reared under low oxygen level. In addition, gut health in these fish was severely impaired. Some other studies also confirm the adverse effect of environmental challenge on fish’s gut health. These effects on the digestive function and gut health of salmonids may result in less resistance to diseases and weaker performance with significant economic and ethical implications. Overall, various findings indicate the multidimensional negative effects of climate change, as a major environmental issue, in different sectors, including aquaculture production. Therefore, a comprehensive evaluation of different ways to cope with climate change is essential for planning more sustainable strategies in aquaculture sector.

Keywords: aquaculture, climate change, sustainability, salmonids

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Authors: Cemil Akcay, Goksun Yerlikaya

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Buildings are the living spaces of people with an active role in every aspect of life in today's world. While some structures have survived from the early ages, most of the buildings that completed their lifetime have not transported to the present day. Nowadays, buildings that do not meet the social, economic, and safety requirements of the age return to life with a transformation process. This transformation is called urban transformation. Urban transformation is the renewal of the areas with a risk of disaster and the technological infrastructure required by the structure. The transformation aims to prevent damage to earthquakes and other disasters by rebuilding buildings that have completed their non-earthquake-resistant economic life. It is essential to decide on other issues related to conversion and transformation in places where most of the building stock should transform into the first-degree earthquake belt, such as Istanbul. In urban transformation, property owners, local authority, and contractor must deal at a common point. Considering that hundreds of thousands of property owners are sometimes in the areas of transformation, it is evident how difficult it is to make the deal and decide. For the optimization of these decisions, the use of game theory is foreseeing. The main problem in this study is that the urban transformation is carried out in place, or the building or buildings are transport to a different location. There are many stakeholders in the Istanbul University Cerrahpaşa Medical Faculty Campus, which is planned to be carried out in the process of urban transformation, was tried to solve the game theory applications. An analysis of the decisions given on a real urban transformation project and the logical suitability of decisions taken without the use of game theory were also supervised using game theory. In each step of this study, many decision-makers are classifying according to a specific logical sequence, and in the game trees that emerged as a result of this classification, Nash balances were tried to observe, and optimum decisions were determined. All decisions taken for this project have been subjected to two significant differentiated comparisons using game theory, and as decisions are taken without the use of game theory, and according to the results, solutions for the decision phase of the urban transformation process introduced. The game theory model developed from beginning to the end of the urban transformation process, particularly as a solution to the difficulty of making rational decisions in large-scale projects with many participants in the decision-making process. The use of a decision-making mechanism can provide an optimum answer to the demands of the stakeholders. In today's world for the construction sector, it is also seeing that the game theory is a non-surprising consequence of the fact that it is the most critical issues of planning and making the right decision in future years.

Keywords: urban transformation, the game theory, decision making, multi-actor project

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Authors: Changdong Oh

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With the arrival of post-industrial society, social scientists have been giving attention to issues of which factors shape cleavage of political parties. Especially, there is a heated controversy over whether and how social and cultural values influence the identities of parties and voting behavior. Drawing from Moral Foundations Theory (MFT), which approached similar issues by considering the effect of five moral foundations on political decision-making of people, this study investigates the role of moral rhetoric in the evolution of Korean political parties. Researcher collected official announcements released by the major two parties (Democratic Party of Korea, Saenuri Party) from 2007 to 2016, and analyzed the data by using Word2Vec algorithm and Moral Foundations Dictionary. Five moral decision modules of MFT, composed of care, fairness (individualistic morality), loyalty, authority and sanctity (group-based, Durkheimian morality), can be represented in vector spaces consisted of party announcements data. By comparing the party vector and the five morality vectors, researcher can see how the political parties have actively used each of the five moral foundations to express themselves and the opposition. Results report that the conservative party tends to actively draw on collective morality such as loyalty, authority, purity to differentiate itself. Notably, such moral differentiation strategy is prevalent when they criticize an opposition party. In contrast, the liberal party tends to concern with individualistic morality such as fairness. This result indicates that moral cleavage does exist between parties in South Korea. Furthermore, individualistic moral gaps of the two political parties are eased over time, which seems to be due to the discussion of economic democratization of conservative party that emerged after 2012, but the community-related moral gaps widened. These results imply that past political cleavages related to economic interests are diminishing and replaced by cultural and social values associated with communitarian morality. However, since the conservative party’s differentiation strategy is largely related to negative campaigns, it is doubtful whether such moral differentiation among political parties can contribute to the long-term party identification of the voters, thus further research is needed to determine it is sustainable. Despite the limitations, this study makes it possible to track and identify the moral changes of party system through automated text analysis. More generally, this study could contribute to the analysis of various texts associated with the moral foundation and finding a distributed representation of moral, ethical values.

Keywords: moral foundations theory, moral politics, party system, Word2Vec

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Authors: Nana Yaw Ofori Gyasi

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Under the Common Law, there was a procedure called pleading the belly which allowed a woman who had reached the advanced stage of pregnancy to receive a reprieve of her death sentence until after she had put to bed. The plea was replaced with a legislation, which provides that a pregnant woman would automatically have her death sentence commuted to life imprisonment with hard labour. This Common Law principle has been continued and enacted into law by the various countries where the Common Law is practiced. This paper takes a look at what it terms as Pregnancy Legislations in some selected Common Law countries such as United States of America, Canada, England and Wales, Ghana and India to examine the scope, procedure and effect of such legislations. The paper adopts a comparative study approach to ascertain the country with the widest scope, non-complicated procedure and far-reaching effects of the Pregnancy Legislations. It is observed that some legislations make provision for the conversion of death penalty to life imprisonment for capital offences and also prescribe non-custodial sentence for non-capital offences. There are other legislations that merely suspend the death penalty while the convict is found to be pregnant. In terms of the procedure, some of the legislations make the issue of pregnancy a question of fact to be determined by a jury and in other legislations, the trial judge makes that determination after the judge is satisfied on the question of the convict being pregnant. The effects of the Pregnancy Legislation are observed to be varying. Women who give birth in prison are highly at risk of having stillbirth. Most of the prisons do not have adequate facilities to support expectant and lactating mothers while in prison. It has also been observed that with the number of female prisoners increasing over the years, custodial sentence for convicted pregnant women has a wider societal effect. The paper identifies certain gaps left in some of the legislations which relate to the procedure to be followed after custodial sentence is suspended for a convicted pregnant woman. The time the accused person got pregnant- whether before her arrest or during trial- and the effect of the timing of the pregnancy are gaps left in some of the legislations. The paper argues that such gaps should be filled by the legislator to prevent accused persons taking undue advantage of the Pregnancy Legislations. It is further argued that if convicted pregnant women will have to spend time in prison at all for very heinous crimes, the prison facilities should be improved so that expectant and lactating mothers can comfortably care for their babies and themselves to prevent dire health consequences for such mothers and the society at a whole.

Keywords: sentence of pregnant women, custodial sentence, , pregnant women, , common law

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Authors: Yang Chen, Lili Fu

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Promoting urban regeneration in existing areas has been elevated to a national strategy in China. In this context, because of the multidimensional sustainable effect through the intensive use of land, mixed-use development has become an important objective for high-quality urban regeneration in the inner city. However, in the long period of time since China's reform and opening up, the "unbalanced phenomenon" of mixed-use development in China's inner cities has been very serious. On the one hand, the excessive focus on certain individual spaces has led to an increase in the level of mixed-use development in some areas, substantially ahead of others, resulting in a growing gap between different parts of the inner city; On the other hand, the excessive focus on a one-dimensional element of the spatial organization of mixed-use development, such as the enhancement of functional mix or spatial capacity, has led to a lagging phenomenon or neglect in the construction of other dimensional elements, such as pedestrian permeability, green environmental quality, social inclusion, etc. This phenomenon is particularly evident in the central area of the inner city, and it clearly runs counter to the need for sustainable development in China's new era. Therefore, a rational qualitative and quantitative analysis of the "unbalanced phenomenon" will help to identify the problem and provide a basis for the formulation of relevant optimization plans in the future. This paper builds a dynamic evaluation method of mixed-use development based on a meta-dimensional model and then uses spatial evolution analysis and spatial consistency analysis with ArcGIS software to reveal the "unbalanced phenomenon " in over the past 40 years of the central city area in Nanjing, a China’s typical city facing regeneration. This study result finds that, compared to the increase in functional mix and capacity, the dimensions of residential space mix, public service facility mix, pedestrian permeability, and greenness in Nanjing's city central area showed different degrees of lagging improvement, and the unbalanced development problems in each part of the city center are different, so the governance and planning plan for future mixed-use development needs to fully address these problems. The research methodology of this paper provides a tool for comprehensive dynamic identification of mixed-use development level’s change, and the results deepen the knowledge of the evolution of mixed-use development patterns in China’s inner cities and provide a reference basis for future regeneration practices.

Keywords: mixed-use development, unbalanced phenomenon, the meta-dimensional model, over the past 40 years of Nanjing, China

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Authors: Michelann Parr

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Family-school-community engagement enhances family-school-community well-being, collective confidence, and school climate. While it is often referred to as a positive thing in the literature for families, schools, and communities, it does not come without its struggles. While there are numerous things families, schools, and communities do each and every day to enhance engagement, it is often difficult to find our way to true belonging and engagement. Working our way surface level barriers is easy; we can provide childcare, transportation, resources, and refreshments. We can even change the environment so that families will feel welcome, valued, and respected. But there are often mindsets and perpsectives buried deep below the surface, most often grounded in societal, familial, and political norms, expectations, pressures, and narratives. This work requires ongoing energy, commitment, and engagement of all stakeholders, including families, schools, and communities. Each and every day, we need to take a reflective and introspective stance at what is said and done and how it supports the overall goal of family-school-community engagement. And whatever we must occur within a paradigm of care in additional to one of critical thinking and social justice. Families, and those working with families, must not simply accept all that is given, but should instead ask these types of questions: a) How, and by whom, are the current philosophies and practices of family-school engagement interrogated? b) How might digging below surface level meanings support understanding of what is being said and done? c) How can we move toward meaningful and authentic engagement that balances knowledge and power between family, school, district, community (local and global), and government? This type of work requires conscious attention and intentional decision-making at all levels bringing us one step closer to authentic and meaningful partnerships. Strategies useful to building a growth mindset include: a) interrogating and exploring consistencies and inconsistencies by looking at what is done and what is not done through multiple perspectives; b) recognizing that enhancing family-engagement and changing mindsets take place at the micro-level (e.g., family and school), but also require active engagement and awareness at the macro-level (e.g., community agencies, district school boards, government); c) taking action as an advocate or activist. Negative narratives about families, schools, and communities should not be maintained, but instead critical and courageous conversations in and out of school should be initiated and sustained; and d) maintaining consistency, simplicity, and steady progress. All involved in engagement need to be aware of the struggles, but keep them in check with the many successes. Change may not be observed on a day-to-day basis or even immediately, but stepping back and looking from the outside in, might change the view. Working toward a growth mindset will produce better results than a fixed mindset, and this takes time.

Keywords: family engagment, family-school-community engagement, parent engagement, parent involvment

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Authors: Shilpa Avarebeel

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Background: India is one of the seven identified countries in South-East Asia region, regularly reporting dengue infection and may soon transform into a major niche for dengue epidemics. Objective: To study the clinical profile of dengue in our setting with special reference to respiratory complication. Study design: Descriptive and exploratory study, for one year in 2014. All patients confirmed as dengue infection were followed and their clinical profile, along with outcome was determined. Study proforma was designed based on the objective of the study and it was pretested and used after modification. Data was analyzed using statistical software SPSS-Version 16. Data were expressed as mean ±S .D for parametric variables and actual frequencies or percentage for non-parametric data. Comparison between groups was done using students’ t-test for independent groups, Chie square test, one-way ANOVA test, Karl Pearson’s correlation test. Statistical significance is taken at P < 0.05. Results: Study included 134 dengue positive cases. 81% had dengue fever, 18% had dengue hemorrhagic fever, and one had dengue shock syndrome. Most of the cases reported were during the month of June. Maximum number of cases was in the age group of 26-35 years. Average duration of hospital stay was less than seven days. Fever and myalgia was present in all the 134 patients, 16 had bleeding manifestation. 38 had respiratory symptoms, 24 had breathlessness, and 14 had breathlessness and dry cough. On clinical examination of patients with respiratory symptoms, all twenty-eight had hypoxia features, twenty-four had signs of pleural effusion, and four had ARDS features. Chest x-ray confirmed the same. Among the patients with respiratory symptoms, the mean platelet count was 26,537 c/cmm. There was no statistical significant difference in the platelet count in those with ARDS and other dengue complications. Average four units of platelets were transfused to all those who had ARDS in view of bleeding tendency. Mechanical ventilator support was provided for ARDS patients. Those with pleural effusion and pulmonary oedema were given NIV (non-invasive ventilation) support along with supportive care. However, steroids were given to patients with ARDS and 10 patients with signs of respiratory distress. 100%. Mortality was seen in patients with ARDS. Conclusion: Dengue has to be checked for those presenting with fever and breathlessness. Supportive treatments remain the cornerstone of treatment. Platelet transfusion has to be given only by clinical judgment. Steroids have no role except in early ARDS, which is controversial. Early NIV support helps in speedy recovery of dengue patients with respiratory distress.

Keywords: adult respiratory distress syndrome, dengue fever, non-invasive ventilation, pulmonary complication

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Authors: J. Knight, E. Barberà

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Language learning strategies have been defined as thoughts and actions, consciously chosen and operationalized by language learners, to help them in carrying out a multiplicity of tasks from the very outset of learning to the most advanced levels of target language performance. While research in the field of Second Language Acquisition has focused on ‘good’ language learners, the effectiveness of strategy-use and orchestration by effective learners in face-to-face classrooms much less research has attended to learner strategies in online contexts, particular strategies in relation to technological tool use which can be part of a task design. In addition, much research on learner strategies and strategy use has been explored focusing on cognitive, attitudinal and metacognitive behaviour with less research focusing on the social aspect of strategies. This study focuses on how learners mediate with a technological tool designed to support synchronous spoken interaction and how this shape their spoken interaction in the opening of their talk. A case study approach is used incorporating notions from communities of practice theory to analyse and understand learner strategies of dyads carrying out a role play task. The study employs analysis of transcripts of spoken interaction in the openings of the talk along with log files of tool use. The study draws on results of previous studies pertaining to the same tool as a form of triangulation. Findings show how learners gain pre-task planning time through technological tool control. The strategies involving learners’ choices to enter and exit the tool shape their spoken interaction qualitatively, with some cases demonstrating long silences whilst others appearing to start the pedagogical task immediately. Who/what learners orientate to in the openings of the talk: an audience (i.e. the teacher), each other and/or screen-based signifiers in the opening moments of the talk also becomes a focus. The study highlights how tool use as a social practice should be considered a learning strategy in online contexts whereby different usages may be understood in the light of the more usual asynchronous social practices of the online community. The teachers’ role in the community is also problematised as the evaluator of the practices of that community. Results are pertinent for task design for synchronous speaking tasks. The use of community of practice theory supports an understanding of strategy use that involves both metacognition alongside social context revealing how tool-use strategies may need to be orally (socially) negotiated by learners and may also differ from an online language community.

Keywords: learner strategy, tool use, community of practice, speaking task

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Authors: Papali Elizabeth Maqalika

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Introduction: Dress is used daily and can be used to define culture, and through it, individuals form a sense of self and identity. One of the characteristics of culture is that it evolves; Basotho culture is no exception to this. It has evolved through rites of entry, significant ceremonies, daily living, and an approach to others. Most of these affect and have been affected by the local/traditional dress. The study focused on the evolution of culture, and the role played by dress as it is one of the major contributors to non-verbal communication. Methodology: Secondary data were used since most of the original cultural practices are no longer held dear in the value system and so no longer practiced. Interviews were conducted to get some insights from the senior citizens and their responses compared to those of the present adults. Content analysis was used for the interview data. Results: The nature of governance in Lesotho has clearly contributed to the current cultural state of confusion. The Basotho culture has indeed shifted, and the difference in dress code explains it. Acculturation, the alteration in environments, and the type of occasions Basotho attended lately contributed to the shift. Technology brought about a difference in the mode of transport, sports, household activities, and gender roles. Conclusion and Recommendations: It was concluded that since culture is imparted through socialisation, a change in availability of most Basotho women leaves little time left for socialisation with children and resorts to other upbringing patterns, most of which are not cultural; this has brought a cultural shift. In addition, acculturation has contributed massively to the value system of Basotho. The type of dress worn by Basotho presently shifts the culture, and the shifting culture also shifts the dress required to suit the present culture. Because of the type of mindset Basotho has now, it is recommended that cultural days be observed in schools, including the multi-racial ones, and media should assist in this information transmission. The campaigns regarding the value of traditional dress and what it represents are recommended. The local dressmakers manufacturing the Seshoeshoe and any other traditional dress need to be educated about the fabric history, fiber content, and consequent care to be in a position to guide ultimate consumers of the products. Awareness campaigns that the culture shifts and may not necessarily result in negative should be ventured. Cultural exhibitions should also be held ideally at places that hold some cultural heritage. The ministry of sports and culture, together with that of tourism, should run with cultural awareness and enriching vision with a focus on education as opposed to revenue collection.

Keywords: Basotho, culture, dress, acculturation, influence, cultural heritage, socialization, non-verbal communication, Seshoeshoe

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Authors: Margo O'Sullivan, Xuefeng Chen, Qi Zhao, J. Jiang, Ning Fu

Abstract:

Early childhood development, or ECD, is about the 'whole child' – the physical, social and emotional, cognitive thinking and language progression of each young individual. Overwhelming evidence is now available to support investment in Early Childhood Development internationally, attendance at ECD leads to: improved learning outcomes; improved completion and reduced less dropout rates; and most notably, Professor Heckman, Nobel Laureate’s, findings that for every dollar invested, there is an economic return of up to 17%. Notably, ECD has been included in the 2015-2030 Sustainable Development Goals. The Government of China (GOC) has embraced this research and in 2010, State Council, announced focus on ECD setting a target to provide access to ECD for 85% of 3-6 year olds by 2020; to date, the target has surpassed expectations and reached 70.4%. GoC is also increasingly focusing on the even more critical 0-3 age group, when the plasticity of the brain is at its peak and neurons form connections as fast as 1,000 per second. Key to ECD are parents and caregivers of young children, with parental education critical to fully exploiting the significant potential of the early years of children. In China, with such vast numbers, one in seven pre-school age children in the world live in China, the Ministry of Education (MoE) and the National Centre for Education Technology, explored how to best provide parental education and provide key child developmental related knowledge to parents and caregivers. In response, MoE and UNICEF created a resource for parenting information that began with a computer website in 2012, followed by piloting a kiosk service in 2013 for parents in remote areas without access to the internet, and then a mobile phone application in 2014. The resource includes 269 ECD messages and 200 micro-videos covering critical issues of early childhood development from birth to age 6 years: daily care, nutrition and feeding, disease prevention, immunization, development and education, and safety and protection. To date, there have been 397,599 unique views on the website, and data for the mobile app currently being analysed (Links: http://yuer.cbern.gov.cn/; App: https://appsto.re/cn/OiKPZ.i). This paper will explore the development of this resource, its use by parents and the public, efforts to assess the effectiveness in improving parenting and child development, and future plans to roll an updated version in 2016 to all parents.

Keywords: early childhood development, mobile apps for education, parental education, China

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Authors: Kateriina Rannula, Elle Sõrmus, Siret Piirsalu

Abstract:

Mixed generation classroom is a phenomenon that current higher education establishments are faced with daily trying to meet the needs of modern labor market with its emphasis on lifelong learning and retraining. Representatives of mainly X and Y generations in one classroom acquiring higher education is a challenge to lecturers considering all the characteristics that differ one generation from another. The importance of outlining different strategies and considering the needs of the students lies in the necessity for everyone to acquire the maximum of the provided knowledge as well as to understand each other to study together in one classroom and successfully cooperate in future workplaces. In addition to different generations, there are also learners with different native languages which have an impact on reading and understanding texts in third languages, including possible translation. Current research aims to investigate, describe and compare reading strategies among the representatives of generation X and Y. Hypotheses were formulated - representatives of generation X and Y use different reading strategies which is also different among first and third year students of the before mentioned generations. Current study is an empirical, qualitative study. To achieve the aim of the research, relevant literature was analyzed and a semi-structured questionnaire conducted among the first and third year students of Tallinn Health Care College. Questionnaire consisted of 25 statements on the text reading strategies, 3 multiple choice questions on preferences considering the design and medium of the text, and three open questions on the translation process when working with a text in student’s third language. The results of the questionnaire were categorized, analyzed and compared. Both, generation X and Y described their reading strategies to be 'scanning' and 'surfing'. Compared to generation X, first year generation Y learners valued interactivity and nonlinear texts. Students frequently used strategies of skimming, scanning, translating and highlighting together with relevant-thinking and assistance-seeking. Meanwhile, the third-year generation Y students no longer frequently used translating, resourcing and highlighting while Generation X learners still incorporated these strategies. Knowing about different needs of the generations currently inside the classrooms and on the labor market enables us with tools to provide sustainable education and grants the society a work force that is more flexible and able to move between professions. Future research should be conducted in order to investigate the amount of learning and strategy- adoption between generations. As for reading, main suggestions arising from the research are as follows: make a variety of materials available to students; allow them to select what they want to read and try to make those materials visually attractive, relevant, and appropriately challenging for learners considering the differences of generations.

Keywords: generation X, generation Y, learning strategies, reading strategies

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