Search results for: primary care clinic

Authors: Kouassi Louis Kra

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The nearshore deep-water gravity flow deposits in the Northern steep slope of Dongying depression, Bohai Bay basin, have been acknowledged as important reservoirs in the rift lacustrine basin. These deep strata term as coarse clastic sediment, deposit at the root of the slope have complex depositional processes and involve wide diagenetic events which made high-quality reservoir prediction to be complex. Based on the integrated study of seismic interpretation, sedimentary analysis, petrography, cores samples, wireline logging data, 3D seismic and lithological data, the reservoir formation mechanism deciphered. The Geoframe software was used to analyze 3-D seismic data to interpret the stratigraphy and build a sequence stratigraphic framework. Thin section identification, point counts were performed to assess the reservoir characteristics. The software PetroMod 1D of Schlumberger was utilized for the simulation of burial history. CL and SEM analysis were performed to reveal diagenesis sequences. Backscattered electron (BSE) images were recorded for definition of the textural relationships between diagenetic phases. The result showed that the nearshore steep slope deposits mainly consist of conglomerate, gravel sandstone, pebbly sandstone and fine sandstone interbedded with mudstone. The reservoir is characterized by low-porosity and ultra-low permeability. The diagenesis reactions include compaction, precipitation of calcite, dolomite, kaolinite, quartz cement and dissolution of feldspars and rock fragment. The main types of reservoir space are primary intergranular pores, residual intergranular pores, intergranular dissolved pores, intergranular dissolved pores, and fractures. There are three obvious anomalous high-porosity zones in the reservoir. Overpressure and early hydrocarbon filling are the main reason for abnormal secondary pores development. Sedimentary facies control the formation of high-quality reservoir, oil and gas filling preserves secondary pores from late carbonate cementation.

Keywords: Bohai Bay, Dongying Sag, deep strata, formation mechanism, high-quality reservoir

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Authors: Adetona Abbassa, Aliyu Shakirat B.

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The study area is part of Bosso local Government, enclosed within Longitude 6.25’ to 6.31’ and Latitude 9.35’ to 9.45’, an area of 16x8 km², within the basement region of central Nigeria. The region is a host to Nigerian Airforce base 12 (NAF 12quick response) and its staff quarters, the headquarters of Bosso local government, the Independent National Electoral Commission’s two offices, four government secondary schools, six primary schools and Minna international airport. The area suffers an acute shortage of water from November when rains stop to June when rains commence within North Central Nigeria. A way of addressing this problem is a reconnaissance method to delineate possible fractures and fault lines that exists within the region by sampling the Aeromagnetic data and using an appropriate analytical algorithm to delineate these fractures. This is followed by an appropriate ground truthing method that will confirm if the fracture is connected to underground water movement. The first vertical derivative for structural analysis, reveals a set of lineaments labeled AA’, BB’, CC’, DD’, EE’ and FF’ all trending in the Northeast – Southwest directions. AA’ is just below latitude 9.45’ above Maikunkele village, cutting off the upper part of the field, it runs through Kangwo, Nini, Lawo and other communities. BB’ is at Latitude 9.43’ it truncated at about 2Km before Maikunkele and Kuyi. CC’ is around 9.40’ sitting below Maikunkele runs down through Nanaum. DD’ is from Latitude 9.38’; interestingly no community within this region where the fault passes through. A result from the three sites where Vertical Electrical Sounding was carried out reveals three layers comprised of topsoil, intermediate Clay formation and weathered/fractured or fresh basement. The depth to basement map was also produced, depth to the basement from the ground surface with VES A₂, B5, D₂ and E₁ to be relatively deeper with depth values range between 25 to 35 m while the shallower region of the area has a depth range value between 10 to 20 m. Hence, VES A₂, A₅, B₄, B₅, C₂, C₄, D₄, D₅, E₁, E₃, and F₄ are high conductivity zone that are prolific for groundwater potential. The depth range of the aquifer potential zones is between 22.7 m to 50.4 m. The result from site C is quite unique though the 3 layers were detected in the majority of the VES points, the maximum depth to the basement in 90% of the VES points is below 8 km, only three VES points shows considerably viability, which are C₆, E₂ and F₂ with depths of 35.2 m and 38 m respectively but lack of connectivity will be a big challenge of chargeability.

Keywords: lithology, aeromagnetic, aquifer, geoelectric, iso-resistivity, basement, vertical electrical sounding(VES)

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Authors: Bharathadas Sandhya

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Janamaithri Suraksha Project is the community policing project of Kerala police, fully sponsored by the Government of Kerala and in vogue in Kerala for the last ten years. The socio-economically weaker areas in the hilly terrains consisting of tribal hamlets are given special importance under the project. These hamlets are visited by the beat police officers, and they intervene in various issues in the hamlets. This study is based on data collected from 350 respondents living in the tribal hamlets of the Nilambur area in the District of Malappuram. The respondents were personally interviewed by the research team using a questionnaire consisting of 183 questions, seeking the details regarding their interaction with beat police officers, their ability to prevent or detect crimes, the menace of Maoists (extremist) presence, their interventions in other socio-economic problems like alcoholism, school dropout issues, lack of facilities for preparation for competitive examinations for educated youth, etc. The perception of the tribal population regarding the effectiveness of police intervention in their criminal justice complaints, the attitude of the police officers towards the tribal population when they approach the police station with a criminal complaint, are also studied. The general socio-economic problems of the tribal population as perceived by them are also brought out. Being the visible agency of the government, the police person coming on beat duty to the hamlet is generally seen by the tribal population as a representative to whom they can communicate the issues, even if it’s solution rests with another department like the forest or agriculture. The analysis of the primary data is carried out using computer applications. The amount of social justice benefits the tribal hamlets received through various government schemes, and their deficiencies are brought out in the study. From the conclusions of the study, certain suggestions for positive criminal justice and social justice intervention strategies are made out. The need for various government departments to work in tandem with each other so as to bring out more effectiveness in the socio-economic projects is evident from the study. Whether it is the need to obtain a transport to go to school or problem of drinking water or even opening a bank account, at least occasionally, the visiting beat police officer is of help to the tribal population. Mostly the tribal population feels free to approach the police with a criminal complaint without any inhibitions.

Keywords: community policing, beat police officer, criminal justice, social justice

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Authors: Ashraf Samir Hakim, Randa Mohamed Alarousy

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The consumption of food contaminated with molds (microscopic filamentous fungi) and their toxic metabolites results in the development of food-borne mycotoxicosis. The spores of molds are ubiquitously spread in the environment and can be detected everywhere. Ochratoxin A is a potentially carcinogenic fungal toxin found in a variety of food commodities , not only is considered the most abundant and hence the most commonly detected member but also is the most toxic one.Ochratoxin A is the most abundant and hence the most commonly detected member, but is also the most toxic of the three. A very limited research works concerning foods of porcine origin in Egypt were obtained in spite of presence a considerable swine population and consumers. In this study, the quality of various ready-to-eat local and imported pork meat and meat byproducts sold in Egyptian markets as well as edible organs as liver and kidney were assessed for the presence of various molds and their toxins as a raw material. Mycological analysis was conducted on (n=110) samples which included pig livers n=10 and kidneys n=10 from the Basateen slaughter house; local n=70 and 20 imported processed pork meat byproducts.The isolates were identified using traditional mycological and biochemical tests while, Ochratoxin A levels were quantitatively analyzed using the high performance liquid. Results of conventional mycological tests for detecting the presence of fungal growth (yeasts or molds) were negative, while the results of mycotoxins concentrations were be greatly above the permiceable limits or "tolerable weekly intake" (TWI) of ochratoxin A established by EFSA in 2006 in local pork and pork byproducts while the imported samples showed a very slightly increasing.Since ochratoxin A is stable and generally resistant to heat and processing, control of ochratoxin A contamination lies in the control of the growth of the toxin-producing fungi. Effective prevention of ochratoxin A contamination therefore depends on good farming and agricultural practices. Good Agricultural Practices (GAP) including methods to reduce fungal infection and growth during harvest, storage, transport and processing provide the primary line of defense against contamination with ochratoxin A. To the best of our knowledge this is the first report of mycological assessment, especially the mycotoxins in pork byproducts in Egypt.

Keywords: Egyptian markets, mycotoxicosis, ochratoxin A, pork meat, pork by-products

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Authors: Chandra Shekhar Majumder, Orin Sultana Jamie

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Background: Dacryocystorhinostomy (DCR) has been a widely accepted surgical intervention for nasolacrimal duct obstructions. Some previous studies demonstrated the potential benefits of the peroperative application of agents like Mitomycin-C (MMC) with DCR to improve surgical outcomes. Relevant studies are rare in Bangladesh, and there are controversies about the dose, duration of MMC, and outcome. Therefore, the present study aimed to investigate the comparative efficacy of DCR with and without MMC in a tertiary hospital in Bangladesh. Objective: The study aims to determine the outcome of a dacryocystorhinostomy with preoperative local use of mitomycin–C. Methods: An analytical study was conducted in the Department of Ophthalmology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, from January 2023 to September 2023. Seventy patients who were admitted for DCR operation were included according to the inclusion and exclusion criteria. Patients were divided into two groups: those who underwent DCR with peroperative administration of 0.2 mg/ml Mitomycin-C for 5 minutes (Group I) and those who underwent DCR alone (Group II). All patients were subjected to detailed history taking, clinical examination, and relevant investigations. All patients underwent DCR according to standard guidelines and ensured the highest peroperative and postoperative care. Then, patients were followed up at 7th POD, 1-month POD, 3 months POD, and 6 months POD to observe the success rate between the two groups by assessing tearing condition, irrigation, height of tear meniscus, and FDDT- test. Data was recorded using a pre-structured questionnaire, and collected data were analyzed using SPSS 23. Results: The mean age of the study patients was 42.17±6.7 (SD) years and 42.29±7.1 (SD) years in Groups I and II, respectively, with no significant difference (p=0.945). At the 6th month’s follow-up, group I patients were observed with 94.3% frequency of symptom-free, 85.6% patency of lacrimal drainage system, 68.6% had tear meniscus <0.1mm and 88.6% had positive Fluorescence Dye Disappearance Test (FDDT test). In group II, 91.4% were symptom-free, 68.6% showed patency, 57.1% had a height of tear meniscus < 0.1 mm, and 85.6% had FDDT test positive. But no statistically significant difference was observed (p<.05). Conclusion: The use of Mitomycin-C preoperatively during DCR offers better postoperative outcomes, particularly in maintaining patency and achieving symptom resolution with more FDDT test positive and improvement of tear meniscus in the MMC group than the control group. However, this study didn’t demonstrate a statistically significant difference between the two groups. Further research with larger sample sizes and longer follow-up periods would be beneficial to corroborate these findings.

Keywords: dacryocystorhinostomy, mitomycin-c, dacryocystitis, nasolacrimal duct obstruction

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Authors: Spencer Liu, William Chan, Marlena Komatz, Tommy Ramos, Mark Trentalange, Faye Rim, Dae Kim, Mary Kelly, Samuel Schuessler, Roberta Stack, Justas Lauzadis, Kathryn DelPizzo, Seth Waldman, Alexandra Sideris

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Background & Significance: The increasing prevalence of cannabis use in the United States has important safety considerations in the perioperative setting, as chronic or heavy preoperative cannabis use may increase the risk of intraoperative complications, postoperative nausea and vomiting (PONV), increased postoperative pain levels, and acute side effects associated with cannabis use cessation. In this retrospective chart review study, we sought to determine the prevalence of self-reported cannabis use in the past 5-years at a single institution in New York City. We hypothesized that there is an increasing prevalence of preoperative self-reported cannabis use among adult and adolescent patients undergoing orthopedic surgery. Methods: After IRB approval for this retrospective study, surgical cases performed on patients 12 years of age and older at the hospital’s main campus and two ambulatory surgery centers between January 1st, 2018, and December 31st, 2023, with preoperatively self-disclosed cannabis use entered in the social history intake form were identified using the tool SlicerDicer in Epic. Case and patient characteristics were extracted, and trends in utilization over time were assessed by the Cochran-Armitage trend test. Results: Overall, the prevalence of self-reported cannabis use increased from 6.6% in 2018 to 10.6% in 2023. By age group, the prevalence of self-reported cannabis use among adolescents remained consistently low (2018: 2.6%, 2023: 2.6%) but increased with significant evidence for a linear trend (p < 0.05) within every adult age group. Among adults, patients who were 18-24 years old (2018: 18%, 2023: 20.5%) and 25-34 years old (2018: 15.9%, 2023: 24.2%) had the highest prevalences of disclosure, whereas patients who were 75 years of age or older had the lowest prevalence of disclosure (2018: 1.9%, 2023: 4.6%). Patients who were 25-34 years old had the highest percent difference in disclosure rates of 8.3%, which corresponded to a 52.2% increase from 2018 to 2023. The adult age group with the highest percent change was patients who were 75 years of age or older, with a difference of 2.7%, which corresponded to a 142.1% increase from 2018 to 2023. Conclusions: These trends in preoperative self-reported cannabis use among patients undergoing orthopedic surgery have important implications for perioperative care and clinical outcomes. Efforts are underway to refine and standardize cannabis use data capture at our institution.

Keywords: orthopedic surgery, cannabis, postoperative pain, postoperative nausea

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Authors: Binaya Tamang, Buddhi R. Pokharel, Narayan Gautam, Puspa R. Dhakal, Yuresh Twayana

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Background and Objective: Microalbuminuria is often regarded as a sign of end-organ damage due to hypertension, with an increased risk for renal diseases. The present study was designed to find the prevalence of microalbuminuria in hypertensive patients by determining albumin creatinine ratio (ACR) and the association of ACR and microalbuminuria status with different stages and duration of hypertension (HTN). Also, to establish the correlation of systolic and diastolic blood pressure (SBP and DBP) with various parameters viz; ACR, urinary microalbumin (UMA), estimated glomerular filtration rate (eGFR), urinary creatinine (Ucreat), serum creatinine (Screat), and find out their significance among HTN and ACR status. Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Biochemistry in collaboration with the Department of Internal Medicine, UCMS, Bhairahawa, Nepal from April 2019 to September 2019 after obtaining ethical approval from institutional review committee (IRC), UCMS. A total of 120 hypertensive patients were enrolled whose blood, and spot urine samples were taken. eGFR was calculated by using Cockcroft-Gault formula after determining Screat while ACR was calculated after measuring Ucreat and UMA from the spot urine sample. Creatinine was estimated from modified jaffes’ reaction, whereas urinary micro albumin was done by Mispa i3 analyzer. Data were analyzed by using SPSS. 20 using p-value ≤ 0.05 as statistically significant. Results: In our study, the highest enrolled were grade II HTN (36.7%) followed by normal (33.3%), grade I (20.8%) and grade III (9.2%). Evaluating the ACR status, 19.2% were microalbuminuria, and the rest were normal. Though the ACR status (normal and microalbuminuria) was not statistically significant with HTN status (P=0.860) and the duration of HTN status (P=0.165), 5 (45.5%) out of 11 grade III HTN were microalbuminuria and the prevalence was also higher for longer duration .i.e., more than 10 years. In microalbuminuria, both the SBP (p=0.023, r=0.471) and DBP (P=0.034, r= 0.444) were strongly and positively correlated with Screat, in contrast to eGFR, which was negatively but weakly correlated. With the significant difference between the HTN group, the mean ACR (P=0.047) and UMA (P=0.02) were found to be highest among grade III patients, i.e., 84.3 ± 113.3 mg/gm. and 88.4 ± 83.9 mg/l respectively. The mean eGFR (64.2 ± 24.8 vs 77.2 ± 18.1 ml/min) was considerably lower in microalbuminuria ( p=0.026) than the normal in contrast to the SBP (160 ± 33.7 vs. 146.6 ± 19.5 mm of Hg) which was significantly higher (P=0.008). Among the different BMI category, the mean ACR was found to be significantly different (P= 0.01) with the highest value in underweight (115.2 ± 51.5 mg/gm.) and lowest in overweight (31.8 ± 4.3 mg/gm.). Conclusion: The study recommends that the microalbuminuria can be a very useful and imperative predictor of deranged kidney functions in hypertensive patients. The high value of ACR and UMA in hypertensive patients along with significant increased Screat, SBP whereas decreased eGFR in microalbuminuria patients explicitly supports the above statement.

Keywords: albumin creatinine ratio, hypertension, microalbuminuria, renal disease

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Authors: Dejen Alemu, Murray E. Jennex, Temtim Assefa

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This paper is investigated to understand the design, the use, and the consequence of Knowledge Management System (KMS) for knowledge systems sharing and integration. A KMS for knowledge systems sharing and integration is designed to meet the challenges raised by knowledge management researchers and practitioners: the technical, the human, and social factors. Agricultural KMS involves various members coming from different Communities of Practice (CoPs) who possess their own knowledge of multiple practices which need to be combined in the system development. However, the current development of the technology ignored the indigenous knowledge of the local communities, which is the key success factor for agriculture. This research employed the multi-methodological approach to KMS research in action research perspective which consists of four strategies: theory building, experimentation, observation, and system development. Using the KMS development practice of Ethiopian agricultural transformation agency as a case study, this research employed an interpretive analysis using primary qualitative data acquired through in-depth semi-structured interviews and participant observations. The Orlikowski's structuration model of technology has been used to understand the design, the use, and the consequence of the KMS. As a result, the research identified three basic components for the architecture of the shared KMS, namely, the people, the resources, and the implementation subsystems. The KMS were developed using web 2.0 tools to promote knowledge sharing and integration among diverse groups of users in a distributed environment. The use of a shared KMS allows users to access diverse knowledge from a number of users in different groups of participants, enhances the exchange of different forms of knowledge and experience, and creates high interaction and collaboration among participants. The consequences of a shared KMS on the social system includes, the elimination of hierarchical structure, enhance participation, collaboration, and negotiation among users from different CoPs having common interest, knowledge and skill development, integration of diverse knowledge resources, and the requirement of policy and guideline. The research contributes methodologically for the application of system development action research for understanding a conceptual framework for KMS development and use. The research have also theoretical contribution in extending structuration model of technology for the incorporation of variety of knowledge and practical implications to provide management understanding in developing strategies for the potential of web 2.0 tools for sharing and integration of indigenous knowledge.

Keywords: communities of practice, indigenous knowledge, participation, structuration model of technology, Web 2.0 tools

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Authors: Sadhana Deshmukh

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Objective: Men represent only a fraction of the medical aesthetic practice. They are increasingly becoming more cosmetically-inclined. The primary objective is to harmonize facial proportion by prioritizing and focusing on forehead nose, cheek and chin complex. Introduction: Despite tremendous variability, diverse population of the Indian subcontinent, the male skull is unique in its overall larger size, and shape. Men tend to have a large forehead with prominent supraorbital ridges, wide glabella, square orbit, and a prominent protruding mandible. Men have increased skeletal muscle mass, with less facial subcutaneous fat. Facial aesthetics is evolving rapidly. Commonly published canons of facial proportions usually represent feminine standards and are not applicable to males. Strict adherence to these norms is therefore not necessary to obtain satisfying results in male patients. Materials and Methods: Male patients age group 30-60 years have been enrolled. Botulinum toxin and hyaluronic acid fillers were used to update consensus recommendations for facial rejuvenation using these two types of products alone and in combination. Results: There are specific recommendations by facial area, focusing on relaxing musculature, restoring volume, recontouring using toxin and dermal fillers alone and in combination. For upper face, though botulinum toxin remains the cornerstone of treatment, temples and forehead fillers are recommended for optimal results. In Mid face, these fillers are placed more laterally to maintain the masculine look. Botulinum toxin and fillers in combination can improve outcomes in the lower face. Chin augmentation remains the center point for lower face. Conclusions: Males are more likely to have shorter doctor visits, less likely to ask questions, have a lower attention to bodily changes. The physician must patiently gauge male patients’ aging and cosmetic goals. Clinicians can also benefit from ongoing guidance on products, tailoring treatments, treating multiple facial areas, and using combinations of products. An appreciation that rejuvenation is 3-dimensional process involving muscle control, volume restoration and recontouring helps.

Keywords: male aesthetics, botulinum toxin, hyaluronic acid dermal fillers, Asian patients

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Authors: Cledinaldo A. Dias, Isabela C. Santos, Marcus V. S. Siqueira

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In the contemporary globalization, the competitiveness generated in the search of new markets aiming at the growth of productivity and, consequently, of profits, implies the redefinition of productive processes and new forms of work organization. As a result of this structuring, unemployment, labor force turnover and the increase in outsourcing and informal work occur. Considering the different relationships and working conditions of outsourced employees, this study aims to identify the most present stressors among outsourced service providers from a Federal Institution of Higher Education in Brazil. To reach this objective, a descriptive exploratory study with a quantitative approach was carried out. The qualitative approach was chosen to provide an in-depth analysis of the occupational conditions of outsourced workers since this method seeks to focus on the social as a world of investigated meanings and the language or speech of each subject as the object of this approach. The survey was conducted in the city of Montes Claros - Minas Gerais (Brazil) and involved eighty workers from companies hired by the institution, including armed security guards, porters, cleaners, drivers, gardeners, and administrative assistants. The choice of professionals obeyed non-probabilistic criteria for convenience or accessibility. Data collection was performed by means of a structured questionnaire composed of sixty questions, in a Likert-type frequency interval scale format, in order to identify potential organizational stressors. The results obtained evidence that the stress factors pointed out by the workers are, in most cases, a determining factor due to the low productive performance at work. Amongst the factors associated with stress, the ones that stood out most were those related to organizational communication failures, the incentive to competition, lack of expectations of professional growth, insecurity and job instability. Based on the results, the need for greater concern and organizational responsibility with the well-being and mental health of the outsourced worker and the recognition of their physical and psychological limitations, and care that goes beyond the functional capacity for the work. Specifically for the preservation of mental health, physical and quality of life, it is concluded that it is necessary for the professional to be inserted in the external world that favors it internally since this set is complemented so that the individual remains in balance and obtain satisfaction in your work.

Keywords: occupational health, outsourced, organizational studies, stressors

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Authors: D. Nagalakshmi, S. Parashuramulu K. Sadasiva Rao, G. Aruna, L. Vikram

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The zinc (Zn) is the second most abundant trace element in mammals and birds, forming structural component of over 300 enzymes, playing an important role in anti-oxidant defense, immune response and reproduction. Organic trace minerals are more readily absorbed from the digestive tract and more biologically available compared with its inorganic salt. Thus, the present study was undertaken on 60 adult female Sprague Dawley rats (275±2.04 g) for experimental duration of 12 weeks to investigate the effect of dietary Zn supplementation from various organic sources on immunity, reproduction, oxidative defense mechanism and blood biochemical profile. The rats were randomly allotted to 30 replicates (2 per replicate) which were in turn randomly allotted to 5 dietary treatments varying in Zn source i.e., one inorganic source (Zn carbonate) and 4 organic sources (Zn-proteinate, Zn-propionate, Zn-amino acid complex and Zn-methionine) so as to supply NRC recommended Zn concentration (12 ppm Zn). Supplementation of organic Zn had no effect on various haematological and serum biochemical constituents compared to inorganic Zn fed rats. The TBARS and protein carbonyls concentration in liver indicative of oxidative stress was comparable between various organic and inorganic groups. The glutathione reductase activity in haemolysate (P<0.05) and reduced glutathione concentration in liver (P<0.01) was higher when fed organic Zn and RBC catalase activity was higher (P<0.01) on Zn methionine compared to other organic sources tested and the inorganic source. The humoral immune response assessed as antibody titres against sheep RBC was higher (P<0.05) when fed organic sources of zinc compared to inorganic source. The cell mediated immune response expressed as delayed type hypersensitivity reaction was higher (P<0.05) in rats fed Zn propionate with no effect of other organic Zn sources. The serum progesterone concentration was higher (P<0.05) in rats fed organic Zn sources compared to inorganic zinc. The data on ovarian folliculogenesis indicated that organic Zn supplementation increased (P<0.05) the number of graafian follicles and corpus luteum with no effect on primary, secondary and tertiary follicle number. The study indicated that rats fed organic sources of Zn had higher antioxidant enzyme activities, immune response and serum progesterone concentration with higher number of mature follicles. Though the effect of feeding various organic sources were comparable, rats fed zinc methionine had higher antioxidant activity and cell mediated immune response was higher in rats on Zn propionate.

Keywords: organic zinc, immune, rats, reproductive

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Authors: Isabel Freitas, Paula Remoaldo, Olga Matos, Ricardo Goja, Juliana Araujo, Vitor Ribeiro, Miguel Pereira

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Several destinations have been experiencing a transition from a massified cultural tourism to a creative tourism approach. In this new segment of tourism, urban territories have been the focus for several decades. Urban studies on creative industries and initiatives have been taking place in big cities marginalizing small towns and more specifically rural areas. This paper envisages evaluating the differences between rural and urban institutions/platforms, mostly certified by the Creative Tourism Network, in what concerns the practices and initiatives in creative tourism worldwide. In the research carried out between March 2017 and March 2018, we had three levels of primary data and qualitative analysis: i) research on Google (web) by using several keywords like 'creative tourism initiatives', 'creative cities', 'best practices in creative tourism' (from March to August 2017). With the help of the certification of institutions/platforms by the Creative Tourism Network, 24 institutions were found and declared to be developing creative initiatives. It was decided to try to unravel the type of activities and some practices and initiatives carried out by these institutions and the analysis of the differences between rural and urban initiatives. A database of 20 items (e.g., institutions in charge of implementing the initiatives, year of implementation, site, activities developed, place of development, country of origin, type of partners chosen) was created for each institution/platform; ii) A deeper analysis was made on the websites’ information on the institutions (from September to December 2017). The type of professionals involved in the activities, the language used in the activities and the type of activity performed were some of the data analysed and iii) To complement these data, semi-structured interviews were done to representatives of the institutions, conducted mainly by Skype from July 2017 to April 2018. The interviews consisted of 17 questions. In the present paper, these interviews are used to complement the analysis of the same items. Some of the qualitative analysis was supported by the narratives of the leaders of the twenty-four institutions that were surveyed. The results indicate that creative tourism is more active and diverse in urban areas. Some more consolidated communication strategies and partnerships are needed for these activities to become economically more sustainable. The findings of this research provide researchers and practitioners with a better understanding of creative tourism and give some information of how creative tourism is developed in rural and urban areas, the gaps and lack of information, and all the possible directions towards the development of the creative tourism industry.

Keywords: creative tourism, practices of creative tourism, rural areas, urban areas

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Authors: Neeraj Vij, Christian Leber, Kenneth Schmidt

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Introduction: Total knee arthroplasty is a common procedure. It is well known that the biomechanics of the knee do not fully return to their normal state. Motion analysis has been used to study the biomechanics of the knee after total knee arthroplasty. The purpose of this scoping review is to summarize the current use of gait analysis in total knee arthroplasty and to identify the preoperative motion analysis parameters for which a systematic review aimed at determining the reliability and validity may be warranted. Materials and Methods: This IRB-exempt scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist strictly. Five search engines were searched for a total of 279 articles. Articles underwent a title and abstract screening process followed by full-text screening. Included articles were placed in the following sections: the role of gait analysis as a research tool for operative decisions, other research applications for motion analysis in total knee arthroplasty, gait analysis as a tool in predicting radiologic outcomes, gait analysis as a tool in predicting clinical outcomes. Results: Eleven articles studied gait analysis as a research tool in studying operative decisions. Motion analysis is currently used to study surgical approaches, surgical techniques, and implant choice. Five articles studied other research applications for motion analysis in total knee arthroplasty. Other research applications for motion analysis currently include studying the role of the unicompartmental knee arthroplasty and novel physical therapy protocols aimed at optimizing post-operative care. Two articles studied motion analysis as a tool for predicting radiographic outcomes. Preoperative gait analysis has identified parameters than can predict postoperative tibial component migration. 15 articles studied motion analysis in conjunction with clinical scores. Conclusions: There is a broad range of applications within the research domain of total knee arthroplasty. The potential application is likely larger. However, the current literature is limited by vague definitions of ‘gait analysis’ or ‘motion analysis’ and a limited number of articles with preoperative and postoperative functional and clinical measures. Knee adduction moment, knee adduction impulse, total knee range of motion, varus angle, cadence, stride length, and velocity have the potential for integration into composite clinical scores. A systematic review aimed at determining the validity, reliability, sensitivities, and specificities of these variables is warranted.

Keywords: motion analysis, joint replacement, patient-reported outcomes, knee surgery

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Authors: Walid Al-Qerem, Ruba Zumot

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Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.

Keywords: CDC, obesity, childhood, Jordan

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Authors: Ruth Nalugya, Claire Nimusiima, Elizabeth Kawesa, Harriet Nambejja, Geert van Hove, Janet Seeley, Femke Bannink Mbazzi

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Background: ‘Obuntu bulamu’, an intervention for children, parents, and teachers to improve the participation and inclusion of children with disabilities (CwD) through peer-to-peer support, was developed and tested in central Uganda between 2017 and 2019. The intervention consisted of children, parents, and teachers' training sessions and peer to peer support activities directed at disability inclusion using an African disability framework. In this paper, we discuss parent participation in and parent evaluation of the ‘Obuntu bulamu’ intervention. Methods: This qualitative Afrocentric intervention study was implemented in 10 communities in the Wakiso district in Central Uganda. We purposely selected children aged 8 to 14 years with different impairments, their peers, and parents, with different levels of household income and familial support, who were enrolled in primary schools in the ten communities with on average three children with disabilities per community. Sixty four parents (33 parents of CwDs and 31 peers) participating in the ‘Obuntu bulamu’ study were interviewed at baseline and endline. Two focus group discussions were held with parents at the midline. Parents also participated in a consultative meeting about the intervention design at baseline, and two evaluation workshops held at midline and endline. Thematic data analysis of the interview and focus group data was conducted. Results: Findings showed parents found the group-based activities inspiring and said they built hope and confidence. Parents felt the intervention was acceptable, culturally appropriate, and supportive as it built on values and practices from their own traditions. Parents reported the intervention enhanced a sense of togetherness and belonging through the group meetings and follow-up activities. Parents also mentioned that the training helped them develop more positive attitudes towards CwD and disability inclusion. Parents felt that the invention increased a child’s participation and inclusion at home, school, and in communities. Conclusion: The Obuntu bulamu peer to peer support intervention is an acceptable, culturally appropriate intervention that has the potential to improve the inclusion of CwD. A larger randomized control trial is needed to evaluate the impact of the intervention model.

Keywords: inclusion, participation, inclusive education, peer support, belonging, Ubuntu, ‘Obuntu bulamu’

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Authors: Rohit Kothari

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Background: Leprosyis a chronic granulomatous diseasecaused by Mycobacterium leprae (M. Lepra). Reactions may interrupt its usual chronic course.Type-1 (T1R)and type-2 lepra reaction(T2R) are acute events and signifytype-IV and type-III hypersensitivity responses, respectively. Various chemokines like CCL3, 5, 11, and CCL24 may be increased during the course of leprosy or during reactions and may serve as markers of early diagnosis, response to therapy, and prognosis. Objective: To find correlation of CCL3, 5, 11, and CCL24 in leprosy patients on multidrug therapy and their family contacts after ruling out active disease during leprosy treatment and during periods of lepra reactions. Methodology: This randomized control trial was conducted in 50 clinico-histopathologically diagnosed cases of leprosy in a tertiary care hospital in Bengaluru, India. 50 of their family contacts were adequately examined and investigated should the need be to rule out active disease. The two study-groups comprised of leprosy cases, and the age, sex, and area of residence matched healthy contactswho were given single-dose rifampicin prophylaxis, respectively. Blood samples were taken at baseline, six months, and after one yearin both the groups (on completion of MDT in leprosy cases)and also during periods of reaction if occurred in leprosy cases. Results: Our study found that at baseline, CCL5, 11, and 24 were higher in leprosy cases as compared to the healthy contacts, and the difference was statistically significant.CCL3 was also found to be higherat baseline in leprosy cases, however, the difference was not statistically significant. At six months and one year, the levels of CCL 5, 11, and 24 reduced, and the difference was statistically significant in leprosy cases, whereas it remained almost static in all the healthy contacts. Twenty patients of leprosy developed lepra reaction during the course of one year, and during reaction, the increase in CCL11 and 24 was statistically significant from baseline, whereas CCL3 and 5 did not rise significantly. One of the healthy contacts developed signs of leprosy in the form of hypopigmented numb patch and was clinico-histopathologically, and CCL11 and 24 were found to be higher with a statistically significant difference from the baseline values. Conclusion: CCL5, 11, and 24 are sensitive markers of diagnosing leprosy, response to MDT, and prognosis and are not increased in healthy contacts. CCL11 and 24 are sensitive markers of lepra reactions and may serve as one of the early diagnostic modalities for identifying lepra reaction and also leprosy in healthy contacts. To the best of our knowledge, this is the first study to evaluate these biomarkers in leprosy cases and their healthy contacts with a follow-up of upto one year with one of them developing the disease, and the same was confirmed based on these biomarkers as well.

Keywords: chemokine profile, healthy contacts, leprosy, lepra reactions

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Authors: Luís Miguel Cabeça Marques, Alberto Manuel Martinho Vale, José Pedro Miragaia Trancoso Vaz, Ana Sofia Baptista Fernandes, Rui Alexandre de Barros Coito, Tiago Miguel Prates da Costa

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The detection and localization of hidden radioactive sources are of significant importance in countering the illicit traffic of Special Nuclear Materials and other radioactive sources and materials. Radiation portal monitors are commonly used at airports, seaports, and international land borders for inspecting cargo and vehicles. However, these equipment can be expensive and are not available at all checkpoints. Consequently, the localization of SNM and other radioactive sources often relies on handheld equipment, which can be time-consuming. The current study presents the advantages of real-time analysis of gamma-ray count rate data from a mobile radiation detection system based on simulated data and field tests. The incorporation of profit functions and decision criteria to optimize the detection system's path significantly enhances the radiation field information and reduces survey time during cargo inspection. For source position estimation, a maximum likelihood estimation algorithm is employed, and confidence intervals are derived using the Fisher information. The study also explores the impact of uncertainties, baselines, and thresholds on the performance of the profit function. The proposed detection system, utilizing a plastic scintillator with silicon photomultiplier sensors, boasts several benefits, including cost-effectiveness, high geometric efficiency, compactness, and lightweight design. This versatility allows for seamless integration into any mobile platform, be it air, land, maritime, or hybrid, and it can also serve as a handheld device. Furthermore, integration of the detection system into drones, particularly multirotors, and its affordability enable the automation of source search and substantial reduction in survey time, particularly when deploying a fleet of drones. While the primary focus is on inspecting maritime container cargo, the methodologies explored in this research can be applied to the inspection of other infrastructures, such as nuclear facilities or vehicles.

Keywords: plastic scintillators, profit functions, path planning, gamma-ray detection, source localization, mobile radiation detection system, security scenario

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Authors: Jarot Mahendra

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The primary objective of this paper is to provide a view in the interpretation of the revitalization of heritage buildings. This objective is achieved by analyzing the concept of interpretation that is oriented in the perspective of law, urban spatial planning, and stakeholder perspective, and then develops the theoretical framework of interpretation in the cultural resources management through issues of identity, heritage as a process, and authenticity in heritage. The revitalization of heritage buildings with the interpretation of these three issues is that interpretation can be used as a communication process to express the meaning and relation of heritage to the community so as to avoid the conflict that will arise and develop as a result of different perspectives of stakeholders. Using case studies in Indonesia, this study focuses on the revitalization of heritage sites in the National Gallery of Indonesia (GNI). GNI is a cultural institution that uses several historical buildings that have been designated as heritage and have not been designated as a heritage according to the regulations applicable in Indonesia, in carrying out its function as the center of Indonesian art development and art museums. The revitalization of heritage buildings is taken as a step to meet space needs in running the current GNI function. In the revitalization master plan, there are physical interventions on the building of heritage and the removal of some historic buildings which will then be built new buildings at that location. The research matrix was used to map out the main elements of the study (the concept of GNI revitalization, heritage as identity, heritage as a process, and authenticity in the heritage). Expert interviews and document studies are the main tools used in collecting data. Qualitative data is then analyzed through content analysis and template analysis. This study identifies the significance of historic buildings (heritage buildings and buildings not defined as heritage) as an important value of history, architecture, education, and culture. The significance becomes the basis for revisiting the revitalization master plan which is then reviewed according to applicable regulations and the spatial layout of Jakarta. The interpretation that is built is (1) GNI is one of the elements of the embodiment of the National Cultural Center in the context of the region, where there are National Monument, National Museum and National Library in the same area, so the heritage not only gives identity to the past culture but the culture of current community; (2) The heritage should be seen as a dynamic cultural process towards the cultural change of community, where heritage must develop along with the urban development, so that the heritage buildings can remain alive and side by side with modern buildings but still observe the principles of preservation of heritage; (3) The authenticity of heritage should be able to balance the cultural heritage conservation approach with urban development, where authenticity can serve as a 'Value Transmitter' so that authenticity can be used to evaluate, preserve and manage heritage buildings by considering tangible and intangible aspects.

Keywords: authenticity, culture process, identity, interpretation, revitalization

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Authors: Irfan Ahmed Rind

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Science education has recently become the top priority of government of Pakistan. Number of schemes has been initiated for the improvement of science teaching and learning at primary and secondary levels of education, most importantly training in-service science teachers on inquiry based teaching and learning to empower students and encourage creativity, critical thinking, and innovation among them. Therefore, this approach has been promoted in the recent continuous professional development trainings for the in-service teachers. However, the follow ups on trained science teachers and educators suggest that these teachers fail to implement the inquiry based teaching and learning in their classes. In addition, these trainings also fail to bring any significant change in students’ science content knowledge and understanding as per the annual national level surveys conducted by government and independent agencies. Research suggests that science has been taught using scientific positivism, which supports objectivity based on experiments and mathematics. In contrary, the inquiry based teaching and learning are based on constructivism, which conflicts with the positivist epistemology of science teachers. It was, therefore, assumed that science teachers struggle to implement the inquiry based teaching approach as it conflicts with their basic epistemological beliefs. With this assumption, this research aimed to (i) understand how science teachers conceptualize the nature of science, and how this influence their understanding of learning, learners, their own roles as teachers and their teaching strategies, (ii) identify the conflict of science teachers’ epistemological beliefs with the inquiry based teaching approach, and (iii) find the ways in which science teachers epistemological beliefs may be developed from positivism to constructivism, so that they may effectively use the inquiry based teaching approach in teaching science. Using qualitative case study approach, thirty six secondary and higher secondary science teachers (21 male and 15 female) were selected. Data was collected using interviewed, participatory observations (sixty lessons were observed), and twenty interviews from students for verifications of teachers’ responses. The findings suggest that most of the science teacher were positivist in defining the nature of science. Most of them limit themselves to one fix answer that is provided in the books and that there is only one 'right' way to teach science. There is no room for students’ or teachers’ own opinion or bias when it comes to scientific concepts. Inquiry based teaching seems 'no right' to them. They find it difficult to allow students to think out of the box. However, some interesting exercises were found to be very effective in bringing the change in teachers’ epistemological beliefs. These will be discussed in detail in the paper. The findings have major implications for the teachers, educators, and policymakers.

Keywords: science teachers, epistemology, metacognition, inquiry based teaching

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Authors: G. Barański, P. Kacejko, M. Wendeker

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The impact of the ignition advance control algorithms of the ASz-62IR-16X aircraft piston engine on a combustion process has been presented in this paper. This aircraft engine is a nine-cylinder 1000 hp engine with a special electronic control ignition system. This engine has two spark plugs per cylinder with an ignition advance angle dependent on load and the rotational speed of the crankshaft. Accordingly, in most cases, these angles are not optimal for power generated. The scope of this paper is focused on developing algorithms to control the ignition advance angle in an electronic ignition control system of an engine. For this type of engine, i.e. radial engine, an ignition advance angle should be controlled independently for each cylinder because of the design of such an engine and its crankshaft system. The ignition advance angle is controlled in an open-loop way, which means that the control signal (i.e. ignition advance angle) is determined according to the previously developed maps, i.e. recorded tables of the correlation between the ignition advance angle and engine speed and load. Load can be measured by engine crankshaft speed or intake manifold pressure. Due to a limited memory of a controller, the impact of other independent variables (such as cylinder head temperature or knock) on the ignition advance angle is given as a series of one-dimensional arrays known as corrective characteristics. The value of the ignition advance angle specified combines the value calculated from the primary characteristics and several correction factors calculated from correction characteristics. Individual cylinder control can proceed in line with certain indicators determined from pressure registered in a combustion chamber. Control is assumed to be based on the following indicators: maximum pressure, maximum pressure angle, indicated mean effective pressure. Additionally, a knocking combustion indicator was defined. Individual control can be applied to a single set of spark plugs only, which results from two fundamental ideas behind designing a control system. Independent operation of two ignition control systems – if two control systems operate simultaneously. It is assumed that the entire individual control should be performed for a front spark plug only and a rear spark plug shall be controlled with a fixed (or specific) offset relative to the front one or from a reference map. The developed algorithms will be verified by simulation and engine test sand experiments. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: algorithm, combustion process, radial engine, spark plug

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Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

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Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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Authors: Yarra Sulina, Nunna Tagore Sai Priya, Ankhi Banerjee

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With the rapid growth in tourist arrivals, there has been a huge demand for the growth of infrastructure in the destinations. With the increasing preference of tourists to stay near attractions, there has been a considerable change in the land use around tourist sites. However, with the inclusion of certain regulations and guidelines provided by the authorities based on the nature of tourism activity and geographical constraints, the pattern of growth of built form is different for various tourist sites. Therefore, this study explores the patterns of growth of built-up for a decade from 2009 to 2019 through two-dimensional and three-dimensional analysis. Land use maps are created through supervised classification of satellite images obtained from LANDSAT 4-5 and LANDSAT 8 for 2009 and 2019, respectively. The overall expansion of the built-up area in the region is analyzed in relation to the distance from the city's geographical center and the tourism-related growth regions are identified which are influenced by the proximity of tourist attractions. The primary tourist sites of various destinations with different geographical characteristics and tourism activities, that have undergone a significant increase in built-up area and are occupied with tourism-related infrastructure are selected for further study. Proximity analysis of the tourism-related growth sites is carried out to delineate the influence zone of the tourist site in a destination. Further, a temporal analysis of volumetric growth of built form is carried out to understand the morphology of the tourist precincts over time. The Digital Surface Model (DSM) and Digital Terrain Model (DTM) are used to extract the building footprints along with building height. Factors such as building height, and building density are evaluated to understand the patterns of three-dimensional growth of the built area in the region. The study also explores the underlying reasons for such changes in built form around various tourist sites and predicts the impact of such growth patterns in the region. The building height and building density around tourist site creates a huge impact on the appeal of the destination. The surroundings that are incompatible with the theme of the tourist site have a negative impact on the attractiveness of the destination that leads to negative feedback by the tourists, which is not a sustainable form of development. Therefore, proper spatial measures are necessary in terms of area and volume of the built environment for a healthy and sustainable environment around the tourist sites in the destination.

Keywords: sustainable tourism, growth patterns, land-use changes, 3-dimensional analysis of built-up area

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Authors: Ana Carolina Felizardo Da Silva

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People with disabilities are those who have limitations of a physical, mental, intellectual or sensory nature and who, therefore, should not be excluded or marginalized. In Brazil, the Brazilian Law for the Inclusion of People with Disabilities defines that people with disabilities have the right to culture, sport, tourism and leisure on an equal basis with other people. Sport for people with disabilities, in its genesis, had a character aimed at rehabilitating men and soldiers, that is, the male figure who returned wounded from war and needed care. By gaining practitioners, the marketing issue emerges and, successively, high performance, what we call Paralympic sport. We found that sport for people with disabilities was designed for men, corroborating the social idea that sport is a masculine and masculinizing environment. In this way, the inclusion of women with disabilities in sports becomes a double challenge because they are women and have a disability. From data collected from official documents of the International Paralympic Committee, it is found that the first report on the participation of women in the Paralympic Games was in 1948, in England, in Stoke Mandeville, a championship considered the firstborn of the games, later, became called the “Paralympic Games”. However, due to the lack of information, the return of the appearance of women participating in the Paralympics took place after long 40 years, in 1984, which demonstrates a large gap of records on the official website referring to women in the games. Despite the great challenge, the number of women has been growing substantially. When collecting data from participants of all 16 editions of the Paralympic Games, in its last edition, held in Tokyo, out of 4,400 competing athletes, 1,853 were women, which represents 42% of the total number of athletes. In this same edition, we had the largest delegation of Brazilian women, represented by 96 athletes out of a total of 260 Brazilian athletes. It is estimated that in the next edition, to be taken place in Paris in 2024, the participation of women will equal or surpass that of men. The certain invisibility of women participating in the Paralympic Games is noticed when we access the database of the Brazilian Paralympic Committee website. It is possible to identify all women medalists of a given edition. On the other side, participating female athletes who did not medal are not registered on the site. Regarding the participation of Brazilian women in the Paralympics, there was a considerable growth in the last two editions, in 2012 there were only 69 women participating, going to 102 in 2016 and 96 in 2021. The same happened in relation to the medalists, going from 8 Brazilians in 2012 to 33 in 2016 and 27 in 2021. In this sense, the present study, aims to analyze how Brazilian women participate in the Paralympics, giving visibility and voice to female athletes. Structured interviews are being carried out with the participants of the games, identifying the difficulties and potentialities of participating with athletes in the competition. The analysis will be carried out through Bardin’s content analysis.

Keywords: paralympics, sport for people with disabilities, woman, woman in sport

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Authors: Sungeun Hyun, Sooin Lee, Gyewan Moon

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Work-Family Conflict has been an active research area for the past decades. Work-Family Conflict harms individuals and organizations, it is ultimately expected to bring the cost of losses to the company in the long run. WFC has mainly focused on effects of organizational effectiveness and job attitude such as Job Satisfaction, Organizational Commitment, and Turnover Intention variables. This study is different from consequence variable with previous research. For this purpose, we selected the positive job attitude 'Work Engagement' as a consequence of WFC. This research has its primary research purpose in identifying the negative effects of the Work-Family Conflict, and started out from the recognition of the problem that the research on the direct relationship on the influence of the WFC on Work Engagement is lacking. Based on the COR(Conservation of resource theory) and JD-R(Job Demand- Resource model), the empirical study model to examine the negative effects of WFC with Emotional Exhaustion as the link between WFC and Work Engagement was suggested and validated. Also, it was analyzed how much Positive Psychological Capital may buffer the negative effects arising from WFC within this relationship, and the Mediated Moderation model controlling the indirect effect influencing the Work Engagement by the Positive Psychological Capital mediated by the WFC and Emotional Exhaustion was verified. Data was collected by using questionnaires distributed to 500 employees engaged manufacturing, services, finance, IT industry, education services, and other sectors, of which 389 were used in the statistical analysis. The data are analyzed by statistical package, SPSS 21.0, SPSS macro and AMOS 21.0. The hierarchical regression analysis, SPSS PROCESS macro and Bootstrapping method for hypothesis testing were conducted. Results showed that all hypotheses are supported. First, WFC showed a negative effect on Work Engagement. Specifically, WIF appeared to be on more negative effects than FIW. Second, Emotional exhaustion found to mediate the relationship between WFC and Work Engagement. Third, Positive Psychological Capital showed to moderate the relationship between WFC and Emotional Exhaustion. Fourth, the effect of mediated moderation through the integration verification, Positive Psychological Capital demonstrated to buffer the relationship among WFC, Emotional Exhastion, and Work Engagement. Also, WIF showed a more negative effects than FIW through verification of all hypotheses. Finally, we discussed the theoretical and practical implications on research and management of the WFC, and proposed limitations and future research directions of research.

Keywords: emotional exhaustion, positive psychological capital, work engagement, work-family conflict

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Authors: Jessica Gu, Yu Chen

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Knowledge Management (KM) is undoubtable crucial to organizational value creation, learning, and adaptation. Although the rapidly growing KM domain has been fueled with full-fledged methodologies and technologies, studies on KM evolution that bridge the organizational performance and adaptation to the organizational environment are still rarely attempted. In particular, creation (or generation) and diffusion (or share/exchange) of knowledge are of the organizational primary concerns on the problem-solving perspective, however, the optimized distribution of knowledge creation and diffusion endeavors are still unknown to knowledge workers. This research proposed an agent-based model of knowledge creation and diffusion in an organization, aiming at elucidating how the intertwining knowledge flows at microscopic level lead to optimized organizational performance at macroscopic level through evolution, and exploring what exogenous interventions by the policy maker and endogenous adjustments of the knowledge workers can better cope with different environmental conditions. With the developed model, a series of simulation experiments are conducted. Both long-term steady-state and time-dependent developmental results on organizational performance, network and structure, social interaction and learning among individuals, knowledge audit and stocktaking, and the likelihood of choosing knowledge creation and diffusion by the knowledge workers are obtained. One of the interesting findings reveals a non-monotonic phenomenon on organizational performance under turbulent environment while a monotonic phenomenon on organizational performance under a stable environment. Hence, whether the environmental condition is turbulence or stable, the most suitable exogenous KM policy and endogenous knowledge creation and diffusion choice adjustments can be identified for achieving the optimized organizational performance. Additional influential variables are further discussed and future work directions are finally elaborated. The proposed agent-based model generates evidence on how knowledge worker strategically allocates efforts on knowledge creation and diffusion, how the bottom-up interactions among individuals lead to emerged structure and optimized performance, and how environmental conditions bring in challenges to the organization system. Meanwhile, it serves as a roadmap and offers great macro and long-term insights to policy makers without interrupting the real organizational operation, sacrificing huge overhead cost, or introducing undesired panic to employees.

Keywords: knowledge creation, knowledge diffusion, agent-based modeling, organizational performance, decision making evolution

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Authors: Annette Cosgrove

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The objectives of this research study is to examine the impact of professional development in Technology Enhanced Learning (TEL) and the digitisation of learning in teaching communities across multiple higher education sites in the ATU (Atlantic Technological University *) ( 2020-2025), including the proposal of an evidence based digital teaching model for use in a future pandemic. The research strategy undertaken for this PhD Study is a multi-site study using mixed methods. Qualitative & quantitative methods are being used in the study to collect data. A pilot study was carried out initially , feedback collected and the research instrument was edited to reflect this feedback, before being administered. The purpose of the staff questionnaire is to evaluate the impact of professional development in the area of TEL, and to capture the practitioners views on the perceived impact on their teaching practice in the higher education sector across ATU (West of Ireland – 5 Higher education locations ). The phenomenon being explored is ‘ the impact of professional development in the area of technology enhanced learning and on teaching practice in a higher education institution.’ The research methodology chosen for this study is an Action based Research Study. The researcher has chosen this approach as it is a prime strategy for developing educational theory and enhancing educational practice . This study includes quantitative and qualitative methods to elicit data which will quantify the impact that continuous professional development in the area of digital teaching practice and technologies has on the practitioner’s teaching practice in higher education. The research instruments / data collection tools for this study include a lecturer survey with a targeted TEL Practice group ( Pre and post covid experience) and semi-structured interviews with lecturers.. This research is currently being conducted across the ATU multisite campus and targeting Higher education lecturers that have completed formal CPD in the area of digital teaching. ATU, a west of Ireland university is the focus of the study , The research questionnaire has been deployed, with 75 respondents to date across the ATU - the primary questionnaire and semi- formal interviews are ongoing currently – the purpose being to evaluate the impact of formal professional development in the area of TEL and its perceived impact on the practitioners teaching practice in the area of digital teaching and learning . This paper will present initial findings, reflections and data from this ongoing research study.

Keywords: TEL, DTL, digital teaching, digital assessment

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Authors: Shashi Kant Verma, S. L. Sinha, D. K. Chandraker

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Numerical simulations of selected subchannel tracer (Potassium Nitrate) based experiments have been performed to study the capabilities of state-of-the-art of Computational Fluid Dynamics (CFD) codes. The Computational Fluid Dynamics (CFD) methodology can be useful for investigating the spacer effect on turbulent mixing to predict turbulent flow behavior such as Dimensionless mixing scalar distributions, radial velocity and vortices in the nuclear fuel assembly. A Gibson and Launder (GL) Reynolds stress model (RSM) has been selected as the primary turbulence model to be applied for the simulation case as it has been previously found reasonably accurate to predict flows inside rod bundles. As a comparison, the case is also simulated using a standard k-ε turbulence model that is widely used in industry. Despite being an isotropic turbulence model, it has also been used in the modeling of flow in rod bundles and to produce lateral velocities after thorough mixing of coolant fairly. Both these models have been solved numerically to find out fully developed isothermal turbulent flow in a 30º segment of a 54-rod bundle. Numerical simulation has been carried out for the study of natural mixing of a Tracer (Passive scalar) to characterize the growth of turbulent diffusion in an injected sub-channel and, afterwards on, cross-mixing between adjacent sub-channels. The mixing with water has been numerically studied by means of steady state CFD simulations with the commercial code STAR-CCM+. Flow enters into the computational domain through the mass inflow at the three subchannel faces. Turbulence intensity and hydraulic diameter of 1% and 5.9 mm respectively were used for the inlet. A passive scalar (Potassium nitrate) is injected through the mass fraction of 5.536 PPM at subchannel 2 (Upstream of the mixing section). Flow exited the domain through the pressure outlet boundary (0 Pa), and the reference pressure was 1 atm. Simulation results have been extracted at different locations of the mixing zone and downstream zone. The local mass fraction shows uniform mixing. The effect of the applied turbulence model is nearly negligible just before the outlet plane because the distributions look like almost identical and the flow is fully developed. On the other hand, quantitatively the dimensionless mixing scalar distributions change noticeably, which is visible in the different scale of the colour bars.

Keywords: single-phase flow, turbulent mixing, tracer, sub channel analysis

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Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries

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Background: Commonly, womanhood is defined as the qualities considered to be natural to or characteristic of a woman. However, womanhood is not a static concept; it is contextual and negotiable. For women with disabilities, gender roles or ‘qualities’ of womanhood are often overstated or contradicted because of assumptions of weakness, passivity, asexuality and infertility. Currently, little is known about how disability stigma intersects with notions of womanhood to make women with disabilities vulnerable to violence, or how women navigate this intersection to prevent or protect themselves from violence. Objective: To describe how the stigmatized constructions of womanhood and disability promote women with physical disabilities’ exposure to or protection from violence. Methods: Qualitative data for this paper comes from a doctoral study involving women with disabilities living in Cape Town, South Africa. It presents data from repeat in-depth interviews with 30 women with a range of physical impairments. Women attending protective workshops, rehabilitative centers and residential care facilities for people living with disabilities were invited to participate. Consent procedures and interviews were conducted by the first author (who is herself a woman living with a physical disability), and a female research assistant/translator who is a qualified occupational therapist. Reasonable accommodation is central to the methodology and the study as a whole. Findings: Descriptive and thematic analyses reveal how stigma and local constructions around womanhood, as well as women’s self-image and physical limitations, promotes women’s exposure to psychological, physical and sexual violence. It reveals how disabled women feel they are presumed incapable of living up to expectations of a ‘proper’ woman. This plays out as psychological violence, with women reporting that they feel ‘devalued,' ‘rejected’ and deprived of lasting intimate relationships. Furthermore, forms of psychological violence perpetuate physical and sexual violence. Women also discuss using strategies to prevent violence; by refusing to date, avoiding certain places or avoiding isolation, creating awareness, hiding their physical impairments, and exaggerating their ‘femininity.' Implications: Service providers need to be made aware of women’s violence experiences, and provide a range of accessible psychological and mental health services to women living with disabilities, as well as raising awareness around disability, and violence prevention, among caregivers, men, and women. Violence awareness and prevention interventions need to involve disability experts, researchers and people with disabilities.

Keywords: disability, gender, stigma, violence awareness and prevention interventions

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Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

Abstract:

Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

Procedia PDF Downloads 102

Authors: Emmanuelle Merat, Arnaud Aubert, Sophie Cambos, Francis Vial, Patrick Beau

Abstract:

Basically, consumers are sensitive to many stimuli when applying a cream: brand, packaging and indeed formulation compositions. Many studies demonstrated the influence of some stimuli such as brand, packaging, formula color and odor (e.g. in make-up applications). Those parameters influence perceived quality of the product. The objective of this work is to further investigate the relationship between nude skincare basic compositions with different textures and consumer experience. A tentative final step will be to connect the consumer feelings with key ingredients in the compositions. A new approach was developed to better understand touch-related subjective experience in consumers based on a combination of methods: sensory analysis with ten experts, preference mapping on one hundred female consumers and emotional assessments on thirty consumers (verbal and non-verbal through prosody and gesture monitoring). Finally, a methodology based on ‘sensorial trip’ (after olfactory, haptic and musical stimuli) has been experimented on the most interesting textures with 10 consumers. The results showed more or less impact depending on compositions and also on key ingredients. Three types of formulation particularly attracted the consumer: an aqueous gel, an oil-in-water emulsion, and a patented gel-in-oil formulation type. Regarding these three formulas, the preferences were both revealed through sensory and emotion tests. One was recognized as the most innovative in consumer sensory test whereas the two other formulas were discriminated in emotions evaluation. The positive emotions were highlighted especially in prosody criteria. The non-verbal analysis, which corresponds to the physical parameters of the voice, showed high pitch and amplitude values; linked to positive emotions. Verbatim, verbal content of responses (i.e., ideas, concepts, mental images), confirmed the first conclusion. On the formulas selected for their positive emotions generation, the ‘sensorial trip’ provided complementary information to characterize each emotional profile. In the second step, dedicated to better understand ingredients power, two types of ingredients demonstrated an obvious input on consumer preference: rheology modifiers and emollients. As a conclusion, nude cosmetic compositions with well-chosen textures and ingredients can positively stimulate consumer emotions contributing to capture their preference. For a complete achievement of the study, a global approach (Asia, America territories...) should be developed.

Keywords: sensory, emotion, cosmetic formulations, ingredients' influence

Procedia PDF Downloads 179