Search results for: patients’ related risks in the current home hemodialysis practices

Authors: Cristina Hotoleanu

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Introduction: The recent Covid-19 pandemic accelerated the development of e-health, including telemedicine, smartphone applications, and medical wearable devices. Providing remote teleconsultations supposes challenges which may require further face-to-face medical interactions. The aim of this study was to assess the correlation between the types of teleconsultations and the need of onsite medical services (investigations and medical visits) for the diagnosis and treatment. Methods: a retrospective study including all the teleconsultations using the platform offered by a telehealth provider in Romania (Telios Care SA) between May 1, 2021- April 30, 2022, was performed. Binary data were analysed using the chi-square test with a significance level of p < 0.05. Results: out of 7163 consultations, 3961 were phone calls, 1981 were online messages, and 1221 were video calls. Onsite medical services were indicated in 3327 (46.44%) cases; the onsite investigations or the onsite visits were recommended for 2908 patients as follows: 2326 in case of phone calls, 582 in case of online messages, none in case of video calls. Both onsite investigations and visits were indicated for 419 patients. The need for onsite additional medical services was significantly higher in the case of phone calls than in the other 2 types of teleconsultations (Chi square= 1207.06, p= 0.00001). The indication for onsite services was done mainly after teleconsultations covering medical specialties (87.34%), significantly higher than the other specialties (Chi square=914.59, p=0.00001). Teleconsultations in surgical specialties and other fields (pharmacy, dentistry, psychology, wellbeing- nutrition, fitness) resulted in 12.13%, respective less than 1%, indication for onsite investigations or visits, explained by using of video calls in most of the cases. Conclusion: a further onsite medical service was necessary in less than a half of the teleconsultations. This indication was done mainly after phone calls and teleconsultations in medical specialties. Video calls were used mostly in psychology, nutrition, and fitness teleconsultations and did not require a further onsite medical service. Other studies are necessary to assess better the types of teleconsultations and the specialties bringing the biggest benefit for the patients.

Keywords: onsite medical services, phone calls, teleconsultations, telemedicine

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Authors: Hong Im Shin

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Previous research demonstrated that self-objectification (women view themselves as objects for use) is related to system-justification. Three studies investigated whether cultural disposition as its system-justifying function could have an impact on self-objectification and dehumanization of sexualized women and men. Study 1 (N = 91) employed a survey methodology to examine the relationship between cultural disposition (collectivism vs. individualism), trait of system-justification, and self-objectification. The results showed that the higher tendency of collectivism was related to stronger system-justification and self-objectification. Study 2 (N = 60 females) introduced a single category implicit association task (SC-IAT) to assess the extent to which sexually objectified women were associated with uniquely human attributes (i.e., culture) compared to animal-related attributes (i.e., nature). According to results, female participants associated sexually objectified female targets less with human attributes compared to animal-related attributes. Study 3 (N = 46) investigated whether priming to individualism or collectivism was associated to system justification and sexual objectification of men and women with the use of a recognition task involving upright and inverted pictures of sexualized women and men. The results indicated that the female participants primed to individualism showed an inversion effect for sexualized women and men (person-like recognition), whereas there was no inversion effect for sexualized women in the priming condition of collectivism (object-like recognition). This implies that cultural disposition plays a mediating role for rationalizing the gender status, implicit dehumanization of sexualized females and self-objectification. Future research directions are discussed.

Keywords: cultural disposition, dehumanization, implicit test, self-objectification

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Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Evgeniia Surkova, Manal Assaad, Hleb Makeyeu, Juho Makio

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The main objective of STIMEY (Science, Technology, Innovation, Mathematics, Engineering for the Young) project is the delivery of a hybrid learning environment that combines multi-level components such as social media concepts, robotic artefacts, and radio, among others. It is based on a well-researched pedagogical framework to attract European youths to STEM (science, technology, engineering, and mathematics) education and careers. To develop and integrate these various components, STIMEY is executed in iterative research cycles leading to progressive improvements. Scrum was the development methodology of choice in the project, as studies indicated its benefits as an agile methodology in global software development, especially of e-learning and integrated learning projects. This paper describes the project partners’ experience with the Scrum framework, discussing the challenges faced in its implementation and the mitigation practices employed. The authors conclude with exploring user experience tools and principles for future research, as a novel direction in supporting the Scrum development team.

Keywords: e-learning, global software development, scrum, STEM education

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Authors: Kunwar Paritosh, Vivekanand Vivekanand, Nidhi Pareek

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Presently, India depends primarily on fossil fuels for its acute energy demand. The swift in development of India in last two decades is accentuating its natural resources and compelling expenditures to cope energy security for the habitats. A total inhabitant of 1.2 billion, observing growing industrialization; is generating 68.8 million tonnes of municipal solid waste per year, 53.7 million tonnes is collected, and only trifling amount of 10.3 million tonnes of waste is treated per year that integrates to a massive amount of unimaginable land hill. In India, waste is mostly landfilled and/or incinerated with low technology and is poorly managed. Underutilization of this waste not only gulps resources but also stresses environment, public health and bionetwork thus affecting the bioeconomy negatively. It also creates conditions that invoke inevitable expenditures and loss of its renewable energy potential. The non-scientific approach to manage waste may lead to an economy downfall, underutilization and degradation of natural resources. Waste treatment technologies must be scientifically tailored and engineered as per the type of waste where it may be utilized as a source of energy (here biogas) and nutrients employing anaerobic digestion to the sorted waste. This paper presents a brief review on current practices, key achievements and forthcoming aspects of harnessing energy from municipal solid waste in Indian scenario.

Keywords: municipal discards, organic waste, anaerobic digestion, incineration, energy

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Authors: Amanda Grace Ahl, Matthew Brummer

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‘Smart cities’ are not always as ‘smart’ as the term suggests, which is not often covered in the associated academic and public policy literatures. In what has become known as the smart city approach to urban planning, governments around the world are seeking to harness the power of information and communications technology with increasingly advanced data analytics to address major social, economic, and environmental issues reshaping the ways people live. The definitional and theoretical boundaries of the smart city framework are broad and at times ambiguous, as is empirical treatment of the topic. However, and for all the disparity, in investigating any number of institutional and policy prescriptions to the challenges faced by current and emerging metropoles, scholarly thought has hinged overwhelmingly on value-positive conceptions of informatics-centered design. From enhanced quality of services, to increased efficiency of resources, to improved communication between societal stakeholders, the smart city design is championed as a technological wellspring capable of providing answers to the systemic issues stymying a utopian image of the city. However, it is argued that this ‘techtopia’, has resulted in myopia within the discipline as to value-negative implications of such planning, such as weaknesses in practicality, scalability, social equity and affordability of solutions. In order to more carefully examine this observation - that ‘stupid’ represents an omitted variable bias in the study of ‘smart’ - this paper reviews critical cases of unsuccessful smart city developments. It is argued that also understanding the negative factors affiliated with the development processes is imperative for the advancement of theoretical foundations, policies, and strategies to further the smart city as an equitable, holistic urban innovation. What emerges from the process-tracing carried out in this study are distinctly negative lessons of smart city projects, the significance of which are vital for understanding how best to conceive smart urban planning in the 21st century.

Keywords: case study, city management, innovation system, negative lessons, smart city development

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Authors: Yacine Babou, Nitesh Ranjan, Branimir Radisavljevic , Martin Seeger, Daniel Over, Torsten Votteler, Bernardo Galletti, Paulo Cristini

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In the frame of replacement of Sulfur hexafluoride (SF6) gas as insulating and switching medium, diverse alternative gases, offering acceptable Global Warming Potential and fulfilling requirements in terms of heat dissipation, insulation and arc quenching performances are currently investigated for High Voltage Circuit Breaker applications. Among the potential gases, CO₂ seems a promising candidate for replacing SF6, because on one hand it is environmentally friendly, harmless, non-toxic, non-corrosive, non-flammable and on the other hand previous studies have demonstrated its fair interruption capabilities. The present study aims at investigating the performance of CO₂ for the thermal interruption in high voltage self-blast circuit breakers. In particular, the correlation between thermal interruption performance and arc voltage is considered and the effect of the arc-network interaction on the performance is rigorously analyzed. For the considered designs, the thermal interruption was evaluated by varying the slope at current zero (i.e., di/dt) for which the breaker could interrupt. Besides, the characteristics of the post-arc current are examined in detail for various rated voltages and currents. The outcome of these experimental investigations will be reported and analyzed.

Keywords: current zero measurement, high voltage circuit breaker, thermal arc discharge, thermal interruption

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Authors: Youmen Chaaban, Abdallah Abu-Tineh

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This article examines the development of a professional development (PD) model for educator growth and learning that is embedded into the school context. The School based Support Program (SBSP), designed for the Qatari context, targets the practices, knowledge, and skills of both school leadership and teachers in an attempt to improve students’ learning outcomes. Key aspects of the model include the development of learning communities among teachers, strong leadership that supports school improvement activities, and the use of research-based PD to improve teacher practices and student achievement. This paper further presents the results of a qualitative study examining the perceptions of nineteen instructional coaches about the strengths of the PD program, the challenges they face in their day-to-day implementation of the program, and their suggestions for the betterment of the program’s implementation and outcomes. Data were collected from the instructional coaches through open-ended surveys followed by focus group interviews. The instructional coaches reported several strengths, which were compatible with the literature on effective PD. However, the challenges they faced were deeply rooted within the structure of the program, in addition to external factors operating at the school and Ministry of Education levels. Thus, a general consensus on the way the program should ultimately develop was reached.

Keywords: situated professional development, school reform, instructional coach, school based support program

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Authors: Atousa Khodadadyan, Ali Rostami

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The objective of off-site construction manufacturing is to utilise the workforce and machinery in a controlled environment without external interference for higher productivity and quality. The usage of prefabricated components can save up to 14% of the total energy consumption in comparison with the equivalent number of cast-in-place ones. Despite the benefits of prefabrication construction, its current project practices encompass technical and managerial issues. Building design, precast components’ production, logistics, and prefabrication installation processes are still mostly discontinued and fragmented. Furthermore, collaboration among prefabrication manufacturers, transportation parties, and on-site assemblers rely on real-time information such as the status of precast components, delivery progress, and the location of components. From the technical point of view, in this industry, geometric variability is still prevalent, which can be caused during the transportation or production of components. These issues indicate that there are still many aspects of prefabricated construction that can be developed using disruptive technologies. Practical real-time risk analysis can be used to address these issues as well as the management of safety, quality, and construction environment issues. On the other hand, the lack of research about risk assessment and the absence of standards and tools hinder risk management modeling in prefabricated construction. It is essential to note that no risk management standard has been established explicitly for prefabricated construction projects, and most software packages do not provide tailor-made functions for this type of projects.

Keywords: project risk management, risk analysis, risk modelling, prefabricated construction projects

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Authors: Oladele V. Adeniyi, B. Longo-Mbenza, Daniel T. Goon

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Background: Lipids are often low or in the normal ranges and controversial in the atherogenesis among Black Africans. The effect of the severity of obesity on some traditional and novel cardiovascular disease risk factors is unclear before and after a diet and exercise maintenance programme among obese black South Africans with type 2 diabetes mellitus (T2DM). Therefore, this study aimed to identify the risk factors to discriminate obesity classes among patients with T2DM before and after a diet and exercise programme. Methods: This interventional cohort of Black South Africans with T2DM was followed by a very – low calorie diet and exercise programme in Mthatha, between August and November 2013. Gender, age, and the levels of body mass index (BMI), blood pressure, monthly income, daily frequency of meals, blood random plasma glucose (RPG), serum creatinine, total cholesterol (TC), triglycerides (TG), LDL –C, HDL – C, Non-HDL, ratios of TC/HDL, TG/HDL, and LDL/HDL were recorded. Univariate analysis (ANOVA) and multivariate discriminant analysis were performed to separate obesity classes: normal weight (BMI = 18.5 – 24.9 kg/m2), overweight (BMI = 25 – 29.9 kg/m2), obesity Class 1 (BMI = 30 – 34.9 kg/m2), obesity Class 2 (BMI = 35 – 39.9 kg/m2), and obesity Class 3 (BMI ≥ 40 kg/m2). Results: At the baseline (1st Month September), all 327 patients were overweight/obese: 19.6% overweight, 42.8% obese class 1, 22.3% obese class 2, and 15.3% obese class 3. In discriminant analysis, only systolic blood pressure (SBP with positive association) and LDL/HDL ratio (negative association) significantly separated increasing obesity classes. At the post – evaluation (3rd Month November), out of all 327 patients, 19.9%, 19.3%, 37.6%, 15%, and 8.3% had normal weight, overweight, obesity class 1, obesity class 2, and obesity class 3, respectively. There was a significant negative association between serum creatinine and increase in BMI. In discriminant analysis, only age (positive association), SBP (U – shaped relationship), monthly income (inverted U – shaped association), daily frequency of meals (positive association), and LDL/HDL ratio (positive association) classified significantly increasing obesity classes. Conclusion: There is an epidemic of diabesity (Obesity + T2DM) in this Black South Africans with some weight loss. Further studies are needed to understand positive or negative linear correlations and paradoxical curvilinear correlations between these markers and increase in BMI among black South African T2DM patients.

Keywords: atherogenic dyslipidaemia, dietary interventions, obesity, south africans

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Authors: Agah Tugrul Korucu

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Information and communication technologies have become an important part of our daily lives with significant investments in technology in the 21st century. Individuals are more willing to design and implement computer-related activities, and they are the main component of computer self-efficacy and self-efficacy related to the fact that the increase in information technology, with operations in parallel with these activities more successful. The Self-efficacy level is a significant factor which determines how individuals act in events, situations and difficult processes. It is observed that individuals with higher self-efficacy perception of computers who encounter problems related to computer use overcome them more easily. Therefore, this study aimed to examine self-efficacy perceptions of pre-service art and music teachers towards the use of information and communication technologies in terms of different variables. Research group consists of 60 pre-service teachers who are studying at Necmettin Erbakan University Ahmet Keleşoğlu Faculty of Education Art and Music department. As data collection tool of the study; “personal information form” developed by the researcher and used to collect demographic data and "the perception scale related to self-efficacy of informational technology" are used. The scale is 5-point Likert-type scale. It consists of 27 items. The Kaiser-Meyer-Olkin (KMO) sample compliance value is found 0.959. The Cronbach alpha reliability coefficient of the scale is found to be 0.97. computer-based statistical software package (SPSS 21.0) is used in order to analyze the data collected by data collection tools; descriptive statistics, t-test, analysis of variance are used as statistical techniques.

Keywords: self-efficacy perceptions, teacher candidate, information and communication technologies, art teacher

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Authors: Imaneh Abbasi, Ladan Fata, Majid Sadeghi, Sara Banihashemi, Abolfazl Mohammadee

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Background: Dimensional and transdiagnostic approaches as a result of high comorbidity among mental disorders have captured researchers and clinicians interests for exploring the latent factors of development and maintenance of some psychological disorders. The goal of present study is to compare some of these common factors between generalized anxiety disorder and unipolar mood disorder. Methods: 27 patients with generalized anxiety disorder, 29 patients with depression disorder were recruited using SCID-I and 69 non-clinical population were selected using GHQ cut off point. MANCOVA was used for analyzing data. Results: The results show that worry, rumination, intolerance of uncertainty, maladaptive metacognitive beliefs, and experiential avoidance were all significantly different between GAD and unipolar mood disorder groups. However, there were not any significant differences in difficulties in emotion regulation and neuroticism between GAD and unipolar mood disorder groups. Discussion: Results indicate that although there are some transdiagnostic and common factors in GAD and unipolar mood disorder, there may be some specific vulnerability factors for each disorder. Further study is needed for answering these questions.

Keywords: transdiagnostic, depression, generalized anxiety disorder, emotion regulation

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Authors: Zinhle Cindi, Collet Dandara, Mpiko Ntsekhe, Edson Makambwa, Miguel Larceda

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Background: Warfarin is the most commonly used drug in the management of thromboembolic disease. However, there is a huge variability in the time, number of doses or starting doses for patients to achieve the required international normalised ratio (INR) which is compounded by a narrow therapeutic index. Many genetic-association studies have reported on European and Asian populations which have led to the designing of specific algorithms that are now being used to assist in warfarin dosing. However, very few or no studies have looked at the pharmacogenetics of warfarin in African populations, yet, huge differences in dosage requirements to reach the same INR have been observed. Objective: We set out to investigate the distribution of 3 SNPs CYP4F2 c.1347C > T, VKORC1 g.-1639G > A and VKORC1 c.1173C > T among South African Mixed Ancestry (MA) and Black African patients. Methods: DNA was extracted from 383 participants and subsequently genotyped using PCR/RFLP for the CYP4F2 c.1347 (V433M) (rs2108622), VKORC1 g.-1639 (rs9923231) and VKORC1 c.1173 (rs9934438) SNPs. Results: Comparing the Black and MA groups, significant differences were observed in the distribution of the following genotypes; CYP4F2 c.1347C/T (23% vs. 39% p=0.03). All VKORC1 g.-1639G > A genotypes (p < 0.006) and all VKORC1 c.1173C > T genotypes (p < 0.007). Conclusion: CYP4F2 c.1347T (V433M) reduces CYP4F2 protein levels and therefore expected to affect the amount of warfarin needed to block vitamin k recycling. The VKORC1 g-1639A variant alters transcriptional regulation therefore affecting the function of vitamin k epoxide reductase in vitamin k production. The VKORC1 c.1173T variant reduces the enzyme activity of VKORC1 consequently enhancing the effectiveness of warfarin. These are preliminary results; more genetic characterization is required to understand all the genetic determinants affecting how patients respond to warfarin.

Keywords: algorithms, pharmacogenetics, thromboembolic disease, warfarin

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Authors: M. Amparo Nunez-Andres, Nieves Lantada

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One of the most harmful geological risks is rockfalls. They cause both economic lost, damaged in buildings and infrastructures, and personal ones. Therefore, in order to estimate the risk of the exposed elements, it is necessary to know the mechanism of this kind of events, since the characteristics of the rock walls, to the propagation of fragments generated by the initial detached rock mass. In the framework of the research RockModels project, several inventories of rockfalls were carried out along the northeast of the Spanish peninsula and the Mallorca island. These inventories have general information about the events, although the important fact is that they contained detailed information about fragmentation. Specifically, the IBSD (Insitu Block Size Distribution) is obtained by photogrammetry from drone or TLS (Terrestrial Laser Scanner) and the RBSD (Rock Block Size Distribution) from the volume of the fragment in the deposit measured by hand. In order to share all this information with other scientists, engineers, members of civil protection, and stakeholders, it is necessary a platform accessible from the internet and following interoperable standards. In all the process, open-software have been used: PostGIS 2.1., Geoserver, and OpenLayers library. In the first step, a spatial database was implemented to manage all the information. We have used the data specifications of INSPIRE for natural risks adding specific and detailed data about fragmentation distribution. The next step was to develop a WMS with Geoserver. A previous phase was the creation of several views in PostGIS to show the information at different scales of visualization and with different degrees of detail. In the first view, the sites are identified with a point, and basic information about the rockfall event is facilitated. In the next level of zoom, at medium scale, the convex hull of the rockfall appears with its real shape and the source of the event and fragments are represented by symbols. The queries at this level offer a major detail about the movement. Eventually, the third level shows all elements: deposit, source, and blocks, in their real size, if it is possible, and in their real localization. The last task was the publication of all information in a web mapping site (www.rockdb.upc.edu) with data classified by levels using libraries in JavaScript as OpenLayers.

Keywords: geological risk, web mapping, WMS, rockfalls

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Authors: Oluwambe Akinmoye

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The textile industry in Nigeria has grown rapidly, fueled by rising demand for fast fashion driven by celebrity culture, fashion TV, and the Internet. However, this growth has come at a cost, with the industry contributing to environmental degradation, waste management crises, economic imbalances, and social injustices. This paper examines the attitudes of consumers and designers toward sustainability in the Nigerian textile and fast fashion industry. The study adopts a mixed-methods research design. Both qualitative and quantitative data were drawn from fast fashion consumers and designers. The sample of consumers and designers was determined using random and purposive sampling techniques. Data were elicited from the consumers and designers using questionnaires and focus group discussions, respectively, coupled with comprehensive literature reviews. The collected data were analyzed using descriptive statistics, content, and thematic analyses. Findings indicate that the strata of Nigerian society pay little attention to fast fashion sustainability. Conversely, designers have started to innovate and adopt sustainable practices by sourcing eco-friendly materials, yet they face significant barriers. The study emphasizes the need for a shift in the industry's approach to sustainability, with a greater concern on circular economy principles, sustainable materials, and fair labour practices.

Keywords: Fast fashion, textiles, sustainability, Climate crises, consumers, designers

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Authors: Kgabo H. Badimo, Sheryl Buckley

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Knowledge is increasingly recognised in this, the knowledge era, as a strategic resource, by public sector organisations, in view of the public sector reform initiatives. People and knowledge play a vital role in attaining improved organisational performance and high service quality. Many government departments in the public sector have started to realise the importance of knowledge management in streamlining their operations and processes. This study focused on knowledge management in the public healthcare service organisations, where the concept of service provider competitiveness pales to insignificance, considering the huge challenges emanating from the healthcare and public sector reforms. Many government departments are faced with challenges of improving organisational performance and service delivery, improving accountability, making informed decisions, capturing the knowledge of the aging workforce, and enhancing partnerships with stakeholders. The purpose of this paper is to examine the knowledge management practices of the Gauteng Department of Health in South Africa, in order to understand how knowledge management practices influence improvement in organisational performance and healthcare service delivery. This issue is explored through a review of literature on dominant views on knowledge management and healthcare service delivery, as well as results of interviews with, and questionnaire responses from, the general staff of the Gauteng Department of Health. Web-based questionnaires, face-to-face interviews and organisational documents were used to collect data. The data were analysed using both the quantitative and qualitative methods. The central question investigated was: To what extent can the conditions required for successful knowledge management be observed, in order to improve organisational performance and healthcare service delivery in the Gauteng Department of Health. The findings showed that the elements of knowledge management capabilities investigated in this study, namely knowledge creation, knowledge sharing and knowledge application, have a positive, significant relationship with all measures of organisational performance and healthcare service delivery. These findings thus indicate that by employing knowledge management principles, the Gauteng Department of Health could improve its ability to achieve its operational goals and objectives, and solve organisational and healthcare challenges, thereby improving organisational.

Keywords: knowledge management, Healthcare Service Delivery, public healthcare, public sector

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Authors: Abrar Ajmal

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The language used in literature reveals the culture and social gestalt of any society in which it has been constructed and consumed. This paper carries the same rationale, which aims to track certain socio-religious and cultural-economic disparities and discrepancies towards minorities, particularly Christians, in an Islamic re(public) where there is a clear majority of Muslims with the help of analysis of instances of language used in the narratives “Our Lady of Alice Bhatt” by Mohammad Hanif. It would highlight social inequalities practiced deeply in sociocultural discourse. Moreover, this research would also touch upon the question of gender discrimination and gender construction as a female entity in a male-chauvinistic scenic turnout using language since the novel revolves around communicative forfeits of Alice Bhatti’s life where she is fraying in fisticuffs to befit herself in a miss-fitted society. It would employ using Fairclough's framework for analysis to conduct a critical discourse analysis of the text at three axiom levels namely textual analysis, discursive practices, and socio-cultural analysis. Thus, the results would reveal textual findings in linguistic analysis, a range of embedded discourses in discursive practices, and consumption of the text into socio-cultural explications with the use of language and lexicalization employed in the selected excerpts.

Keywords: gendered discourse, socio-economic disparities minorities, Islamization, analytical framework

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Authors: Chih-Wei Cheng, Wei-Jen Chan, Yu-Han Huang, Yi-Tsung Lin, Yen-Wei Huang, Min-Cheng Chen, Shou-Zen Chang, G. Chern, Yuan-Chieh Tseng

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How to develop spin-orbit-torque (SOT) devices with the virtues of field-free, perpendicular magnetic anisotropy (PMA), and low switching current is one of the many challenges in spintronics today. We propose a CoFeB/Ta/CoFeB tri-layer antiferromagnetic SOT device that could meet the above requirements. The device’s PMA was developed by adopting CoFeB–MgO interface. The key to the success of this structure is to ensure that (i)changes of the inter-layer coupling(IEC) and CoFeB anisotropy can occur simultaneously; (ii) one of the CoFeB needs to have a slightly tilted moment in the beginning. When sufficient current is given, the SHEreverses the already-tiltedCoFeB, and the other CoFeB can be reversed simultaneously by the IEC with the field-free nature. Adjusting the thickness of Ta can modify the coupling state to reduce the switching current while the field-free nature was preserved. Micromagnetic simulation suggests that the Néel orange peel effect (NOPE) is non-negligible due to interface roughness and coupling effect in the presence of perpendicular anisotropy. Fortunately, the Néel field induced by the NOPE appears to favor the field-free reversal.

Keywords: CoFeB, spin-orbit torque, antiferromagnetic, MRAM, trilayer

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Authors: Anna Rinaldi, Pierfrancesco Dellino

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COVID-19 vaccine hesitancy can be observed at different rates in different countries. In June 2021, 1,068 people were surveyed in France and Italy to inquire about individual potential acceptance, focusing on time preferences in a risk-return framework: having the vaccination today, in a month, and in 3 months; perceived risks of vaccination and COVID-19; and expected benefit of the vaccine. A randomized controlled trial was conducted to understand how everyday stimuli like fact-based news about vaccines impact an audience's acceptance of vaccination. The main experiment involved two groups of participants and two different articles about vaccine-related thrombosis taken from two Italian newspapers. One article used a more abstract description and language, and the other used a more anecdotal description and concrete language; each group read only one of these articles. Two other groups were assigned categorization tasks; one was asked to complete a concrete categorization task, and the other an abstract categorization task. Individual preferences for vaccination were found to be variable and unstable over time, and individual choices of accepting, refusing, or delaying could be affected by the way news is written. In order to understand these dynamic preferences, the present work proposes a new model based on seven categories of human behaviors that were validated by a neural network. A treatment effect was observed: participants who read the articles shifted to vaccine hesitancy categories more than participants assigned to other treatments and control. Furthermore, there was a significant gender effect, showing that the type of language leading to a lower hesitancy rate for men is correlated with a higher hesitancy rate for women and vice versa. This outcome should be taken into consideration for an appropriate gender-based communication campaign aimed at achieving herd immunity. The trial was registered at ClinicalTrials.gov NCT05582564 (17/10/2022).

Keywords: vaccine hesitancy, risk elicitation, neural network, covid19

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Authors: Fang Liu, JunShuai Xue, JiaJia Yao, XueYan Yang, ZuMao Li, GuanLin Wu, HePeng Zhang, ZhiPeng Sun

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III-Nitride resonant tunneling diode (RTD) is one of the most promising candidates for multiple-valued logic (MVL) elements. Here, we report a monolithic integration of GaN resonant tunneling diodes to realize multiple negative differential resistance (NDR) regions for MVL application. GaN RTDs, composed of a 2 nm quantum well embedded in two 1 nm quantum barriers, are grown by plasma-assisted molecular beam epitaxy on free-standing c-plane GaN substrates. Negative differential resistance characteristic with a peak current density of 178 kA/cm² in conjunction with a peak-to-valley current ratio (PVCR) of 2.07 is observed. Statistical properties exhibit high consistency showing a peak current density standard deviation of almost 1%, laying the foundation for the monolithic integration. After complete electrical isolation, two diodes of the designed same area are connected in series. By solving the Poisson equation and Schrodinger equation in one dimension, the energy band structure is calculated to explain the transport mechanism of the differential negative resistance phenomenon. Resonant tunneling events in a sequence of the series-connected RTD pair (SCRTD) form multiple NDR regions with nearly equal peak current, obtaining three stable operating states corresponding to ternary logic. A frequency multiplier circuit achieved using this integration is demonstrated, attesting to the robustness of this multiple peaks feature. This article presents a monolithic integration of SCRTD with multiple NDR regions driven by the resonant tunneling mechanism, which can be applied to a multiple-valued logic field, promising a fast operation speed and a great reduction of circuit complexity and demonstrating a new solution for nitride devices to break through the limitations of binary logic.

Keywords: GaN resonant tunneling diode, multiple-valued logic system, frequency multiplier, negative differential resistance, peak-to-valley current ratio

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Authors: Jung Yoon Kim

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Introduction: Wounds inevitably cause patients to experience discomfort, distress, and consequentially reduced quality of life due to entailed pain, maceration, and foul odor. The dressing has been a universal wound care method in which wounds are covered and protected, and an optimum environment for healing is provided. This study aimed to investigate Korean nurses’ level of awareness of pain and skin tearing in wound beds and/or peri-wound skin at dressing change. Methods: A descriptive study was performed. Convenience sampling was employed, and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed the questionnaire. Data were collected from September to November 2022. Results: Many of them perceived skin tearing and wound-related pain associated with dressing changes, but most of them did not assess and record pain and skin tearing at dressing change. More than half of the respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing changes was needed. Discussion: Many of the respondents were aware of pain and skin tearing at dressing change but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professionals needs to be developed and implemented in Korea’s hospital settings.

Keywords: skin tearing, pain, dressing change, nurses

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Authors: Sophia El Ouazzani, Amer M. Burhan, Mary Wickenden

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Background: Despite improvements in recent years, the Moroccan mental healthcare system still face disparity between available resources and the current population’sneeds. The societal stigma, and limited economic, political, and human resources are all factors in shaping the psychiatric system, exacerbating the discontinuity of services for users after discharged from the hospital. As a result, limited opportunities for social inclusion and meaningful community engagement undermines human rights and recovery potential for people with mental health problems, especially those with psychiatric disabilities from serious mental illness (SMI). Recovery-oriented practice, such as mental health rehabilitation, addresses the complex needs of patients with SMI and support their community inclusion. The cultural acceptability of recovery-oriented practice is an important notion to consider for a successful implementation. Exploring the extent to which recovery-oriented practices are used in Morocco is a necessary first step to assess the cultural relevance of such a practice model. Aims: This study aims to explore understanding and knowledge, perception, and perspective about core concepts in mental health rehabilitation, including psychiatric disability, recovery, and engagement in meaningful occupations for people with SMI in Morocco. Methods: A pilot qualitative study was undertaken. Data was collected via semi-structured interviews and focusgroup discussions with healthcare professional students. Questions were organised around the following themes: 1) students’ perceptions, understanding, and expectations around concepts such as SMI, mental health disability, and recovery, and 2) changes in their views and expectations after starting their professional training. Further analysis of students’ perspectives on the concept of ‘meaningful occupation’ and how is this viewed within the context of the research questions was done. The data was extracted using an inductive thematic analysis approach. This is a pilot stage of a doctoral project, further data will be collected and analysed until saturation is reached. Results: A total of eight students were included in this study which included occupational therapy and mental health nursing students receiving training in Morocco. The following themes emerged as influencing students’ perceptions and views around the main concepts: 1) Stigma and discrimination, 2) Fatalism and low expectations, 3) Gendered perceptions, 4) Religious causation, 5) Family involvement, 6) Professional background, 7) Inaccessibility of services and treatment. Discussion/Contribution: Preliminary analysis of the data suggests that students’ perceptions changed after gaining more clinical experiences and being exposed to people with psychiatric disabilities. Prior to their training, stigma shaped greatly how they viewed people with SMI. The fear, misunderstanding, and shame around SMI and their functional capacities may contribute to people with SMI being stigmatizedand marginalised from their family and their community. Religious causations associated to SMIsare understood as further deepening the social stigma around psychiatric disability. Perceptions are influenced by gender, with women being doubly discriminated against in relation to recovery opportunities. Therapeutic pessimism seems to persist amongst students and within the mental healthcare system in general and regarding the recovery potential and opportunities for people with SMI. The limited resources, fatalism, and stigma all contribute to the low expectations for recovery and community inclusion. Implications and future directions will be discussed.

Keywords: disability, mental health rehabilitation, recovery, serious mental illness, transcultural psychiatry

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Authors: Raed Hameed Allawi

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Wellbore instability problems are considered the majority challenge for several wells in the Ratawi shale formation. However, it results in non-productive (NPT) time and increased well-drilling expenditures. This work aims to construct an integrated mechanical earth model (MEM) to predict the wellbore failure and design optimum mud weight to improve the drilling efficiency of future wells. The MEM was based on field data, including open-hole wireline logging and measurement data. Several failure criteria were applied in this work, including Modified Lade, Mogi-Coulomb, and Mohr-Coulomb that utilized to calculate the proper mud weight and practical drilling paths and orientations. Results showed that the leading cause of wellbore instability problems was inadequate mud weight. Moreover, some improper drilling practices and heterogeneity of Ratawi formation were additional causes of the increased risk of wellbore instability. Therefore, the suitable mud weight for safe drilling in the Ratawi shale formation should be 11.5-13.5 ppg. Furthermore, the mud weight should be increased as required depending on the trajectory of the planned well. The outcome of this study is as practical tools to reduce non-productive time and well costs and design future neighboring deviated wells to get high drilling efficiency. In addition, the current results serve as a reference for similar fields in that region because of the lacking of published studies regarding wellbore instability problems of the Ratawi Formation in southern Iraqi oilfields.

Keywords: wellbore stability, hole collapse, horizontal stress, MEM, mud window

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Authors: Ting-I Lin

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Purpose: This article explores the care experience of a 34-year-old female breast cancer patient who was admitted to the intensive care unit after undergoing a modified radical mastectomy. The patient discovered a lump in her right breast during a self-examination and, after mammography and ultrasound-guided biopsy, was diagnosed with a malignant tumor in the right breast. The tumor measured 1.5 x 1.4 x 2 cm, and the patient underwent a modified radical mastectomy. Postoperatively, she exhibited feelings of inferiority due to changes in her appearance. Method: During the care period, we engaged in conversations, observations, and active listening, using Gordon's Eleven Functional Health Patterns for a comprehensive assessment. In collaboration with the critical care team, a psychologist, and an oncology case manager, we conducted an interdisciplinary discussion and reached a consensus on key nursing issues. These included pain related to postoperative tumor excision and disturbed body image due to changes in appearance after surgery. Result: During the care period, a private space was provided to encourage the patient to express her feelings about her altered body image. Communication was conducted through active listening and a non-judgmental approach. The patient's anxiety level, as measured by the depression and anxiety scale, decreased from moderate to mild, and she was able to sleep for 6-8 hours at night. The oncology case manager was invited to provide education on breast reconstruction using breast models and videos to both the patient and her husband. This helped rebuild the patient's confidence. With the patient's consent, a support group was arranged where a peer with a similar experience shared her journey, offering emotional support and encouragement. This helped alleviate the psychological stress and shock caused by the cancer diagnosis. Additionally, pain management was achieved through adjusting the dosage of analgesics, administering Ultracet 37.5 mg/325 mg 1# Q6H PO, along with distraction techniques and acupressure therapy. These interventions helped the patient relax and alleviate discomfort, maintaining her pain score at a manageable level of 3, indicating mild pain. Conclusion: Disturbance in body image can cause significant psychological stress for patients. Through support group discussions, encouraging patients to express their feelings, and providing appropriate education on breast reconstruction and dressing techniques, the patient's self-concept was positively reinforced, and her emotions were stabilized. This led to renewed self-worth and confidence.

Keywords: breast cancer, modified radical mastectomy, acupressure therapy, Gordon's 11 functional health patterns

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Authors: Esteban Maioli

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Generational studies have an important research tradition in social and human sciences. On the one hand, the speed of social change in the context of globalization imposes the need to research the transformations are identified both the subjectivity of the agents involved and its inclusion in the institutional matrix, specifically employment. Generation Z, (generally considered as the population group whose birth occurs after 1995) have unique psycho-social characteristics. Gen Z is characterized by a different set of values, beliefs, attitudes and ambitions that impact in their concrete action in organizational structures. On the other hand, managers often have to deal with generational differences in the workplace. Organizations have members who belong to different generations; they had never before faced the challenge of having such a diverse group of members. The members of each historical generation are characterized by a different set of values, beliefs, attitudes and ambitions that are manifest in their concrete action in organizational structures. Gen Z it’s the only one who can fully be considered "global," while its members were born in the consolidated context of globalization. Some salient features of the Generation Z can be summarized as follows. They’re the first fully born into a digital world. Social networks and technology are integrated into their lives. They are concerned about the challenges of the modern world (poverty, inequality, climate change, among others). They are self-expressive, more liberal and open to change. They often bore easily, with short attention spans. They do not like routine tasks. They want to achieve a good life-work balance, and they are interested in a flexible work environment, as opposed to traditional work schedule. They are critical thinkers, who come with innovative and creative ideas to help. Research design considered methodological triangulation. Data was collected with two techniques: a self-administered survey with multiple choice questions and attitudinal scales applied over a non-probabilistic sample by reasoned decision. According to the multi-method strategy, also it was conducted in-depth interviews. Organizations constantly face new challenges. One of the biggest ones is to learn to manage a multi-generational scope of work. While Gen Z has not yet been fully incorporated (expected to do so in five years or so), many organizations have already begun to implement a series of changes in its recruitment and development. The main obstacle to retaining young talent is the gap between the expectations of iGen applicants and what companies offer. Members of the iGen expect not only a good salary and job stability but also a clear career plan. Generation Z needs to have immediate feedback on their tasks. However, many organizations have yet to improve both motivation and monitoring practices. It is essential for companies to take a review of organizational practices anchored in the culture of the organization.

Keywords: employment, expectations, generation Z, organizational culture, organizations, psycho-social characteristics

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Authors: Raveena Naz

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The concept of ‘Corporate Social Responsibility’ (CSR) has often relied on firms thinking beyond their economic interest despite the larger debate of shareholder versus stakeholder interest. India gave legal recognition to CSR in the Companies Act, 2013 which promises better corporate governance. CSR in India is believed to be different for two reasons: the dominance of family business and the history of practice of social responsibility as a form of philanthropy (mainly among the family business). This paper problematises the actual structure of business houses in India and the role of CSR in India. When the law identifies each company as a separate business entity, the economics of institutions emphasizes the ‘business group’ consisting of a plethora of firms as the institutional organization of business. The capital owned or controlled by the family group is spread across the firms through the interholding (interlocked holding) structures. This creates peculiar implications for CSR legislation in India. The legislation sets criteria for individual firms to undertake liability of mandatory CSR if they are above a certain threshold. Within this framework, the largest family firms which are all part of family owned business groups top the CSR expenditure list. The interholding structures, common managers, auditors and series of related party transactions among these firms help the family to run the business as a ‘family business’ even when the shares are issued to the public. This kind of governance structure allows family owned business group to show mandatory compliance of CSR even when they actually spend much less than what is prescribed by law. This aspect of the family firms is not addressed by the CSR legislation in particular or corporate governance legislation in general in India. The paper illustrates this with an empirical study of one of the largest family owned business group in India which is well acclaimed for its CSR activities. The individual companies under the business group are identified, shareholding patterns explored, related party transactions investigated, common managing authorities are identified; and assets, liabilities and profit/loss accounting practices are analysed. The data has been mainly collected from mandatory disclosures in the annual reports and financial statements of the companies within the business group accessed from the official website of the ultimate controlling authority. The paper demonstrates how the business group through these series of shareholding network reduces its legally mandated CSR liability. The paper thus indicates the inadequacy of CSR legislation in India because the unit of compliance is an individual firm and it assumes that each firm is independent and only connected to each other through market dealings. The law does not recognize the inter-connections of firms in corporate governance structures of family owned business group and hence is inadequate in its design to effect the threshold level of CSR expenditure. This is the central argument of the paper.

Keywords: business group, corporate governance, corporate social responsibility, family firm

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Authors: Tahsien Okasha

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Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page." .The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: postoperative care, organ transplant, clinical pathway, patient

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Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

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Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

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Authors: Catherine McWhorter

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Robotics is a fast-evolving field lacking comprehensive and harm-mitigating regulation; it also lacks critical data on how human-robot interaction (HRI) may affect human psychology. As most anthropomorphic robots are intended as substitutes for humans, this paper asserts that the commercial robotics industry should be preemptively regulated at the federal level such that robots capable of embodying a victim role in criminal scenarios (“vicbots”) are prohibited until clinical studies determine their effects on the user and society. The results of these studies should then inform more permanent legislation that strives to mitigate risks of harm without infringing upon fundamental rights or stifling innovation. This paper explores these concepts through the lens of the sex robot industry. The sexbot industry offers some of the most realistic, interactive, and customizable robots for sale today. From approximately 2010 until 2017, some sex robot producers, such as True Companion, actively promoted ‘vicbot’ culture with personalities like “Frigid Farrah” and “Young Yoko” but received significant public backlash for fetishizing rape and pedophilia. Today, “Frigid Farrah” and “Young Yoko” appear to have vanished. Sexbot producers have replaced preprogrammed vicbot personalities in favor of one generic, customizable personality. According to the manufacturer ainidoll.com, when asked, there is only one thing the user won’t be able to program the sexbot to do – “…give you drama”. The ability to customize vicbot personas is possible with today’s generic personality sexbots and may undermine the intent of some current legislative efforts. Current debate on the effects of vicbots indicates a lack of consensus. Some scholars suggest vicbots may reduce the rate of actual sex crimes, and some suggest that vicbots will, in fact, create sex criminals, while others cite their potential for rehabilitation. Vicbots may have value in some instances when prescribed by medical professionals, but the overall uncertainty and lack of data further underscore the need for preemptive regulation and clinical research. Existing literature on exposure to media violence and its effects on prosocial behavior, human aggression, and addiction may serve as launch points for specific studies into the hyperrealism of vicbots. Of course, the customization, anthropomorphism and artificial intelligence of sexbots, and therefore more mainstream robots, will continue to evolve. The existing sexbot industry offers an opportunity to preemptively regulate and to research answers to these and many more questions before this type of technology becomes even more advanced and mainstream. Robots pose complicated moral, ethical, and legal challenges, most of which are beyond the scope of this paper. By examining the possibility for custom vicbots via the sexbots industry, reviewing existing literature on regulation, media violence, and vicbot user effects, this paper strives to underscore the need for preemptive federal regulation prohibiting vicbot capabilities in robots while advocating for further research into the potential for the user and societal harm by the same.

Keywords: human-robot interaction effects, regulation, research, robots

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Authors: Maedeh Gharazi

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Distinguishing proof of entrepreneurial open doors in the field of nutrition counseling is a focal issue in utilizing nutrition experts and addressing the needs of patients with chronic diseases better. To this end, this review has been directed keeping in mind the end goal to investigate the supply and interest patterns of diabetes sustenance advising as a fundamental stride toward recognizing the entrepreneurial open doors for nutrition advisors in Tehran, Iran. To execute this expressive overview concentrate on, a survey in light of Likert scale was sent via email to 100 dynamic experts in the field of nutrition counseling services in Tehran, of whom 52 reacted to its inquiries. At that point, the mean estimations of members' reactions were ascertained utilizing SPSS programming and contrasted to each other. The outcome acquired in view of members' reactions uncovered that the requirement for "healthful guiding as a treatment group" was basically not met in diverse age, training and salary gatherings of diabetic patients. Along these lines, nutrition counseling as a treatment group can be considered as a suitable field for entrepreneurial exercises.

Keywords: nutrition counseling, chronic diseases, diabetes, likert scale, SPSS programming

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