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Authors: Chee Young Kim, Tae Hyun Kim, Anbok Lee, Hyun-Ah Kim, Woosung Lim, Ku Sang Kim, Jinsun Lee, Yoo Seok Kim, Beom Seok Ko

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Background: CollatampTM is Gentamicin-containing collagen sponge well known for its hemostatic effect, commonly utilized in surgeries. We inserted CollatempTM wrapped by SurgicelTM (oxidized cellulose polymer) to fill up the defect after breast conserving surgery. The purpose of this study is to verify the furthermore cosmetic value of CollatampTM in breast conserving surgery conducted in breast cancer patients. Methods: 17 patients were enrolled in this study, underwent breast conserving surgery with CollatampTM wrapped by SurgicelTM insertion, in Inje University Busan Paik Hospital from October 2015 to September 2016. Patient satisfaction, cosmetic outcome, results at 6 months from operation was analyzed to verify the effectiveness and usefulness of CollatampTM for cosmetics. Patient satisfaction was investigated through interviews on a scale of good, fair, poor, and the cosmetic outcome was investigated through physical examination by a surgeon who did not participate in the operations. Results: Among 17 patients, nine of them gave ‘good’ for patient satisfaction, eight gave ‘fair’ and none of them ‘poor’. Also, cosmetic outcome came out with 11 ‘good’s, six ‘fair’s, no ‘poor’. In ‘good’ patient satisfaction group, the mean value of resection to breast volume ratio was 16%, compared to 24% of ‘fair’ group. The mean value of actual resection volume was 100.6cm3, 102.7cm3 each. In ‘good’ cosmetic outcome group, the mean value of resection to breast volume ratio was 18%, compared to 23% of ‘fair’ group. The mean value of actual resection volume was 99.2cm3, 105.9cm3 respectively. According to these results, patient satisfaction and cosmetic outcome after surgeries were more reliable on the resection to breast volume ratio, rather than the actual resection volume. There were eight cases of postoperative complications, consisting of a lymphedema, a seroma, and six patients had mild pain. Conclusions: Cosmetic effect of CollatampTM in breast conserving surgery was more reliable on the resection to breast volume ratio, rather than the actual resection volume. In this short term survey, patients were tend to be satisfied with the cosmetics, all giving either good or fair scores. However, long term outcomes should be further assessed.

Keywords: breast cancer, breast conserving surgery, collatamp, cosmetics

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Authors: D. F. Zeynalov, T. V. Kartseva, O. V. Sorokin

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Currently, approaches to assess cardiointervalography are based on the calculation of data variance intervals RR. However, they do not allow the evaluation of features related to a period of the cardiac cycle, so how electromechanical phenomena during cardiac subphase are characterized by differently directed changes. Therefore, we have proposed a method of subphase analysis of the cardiac cycle, developed in the department of hominal physiology Novosibirsk State Medical University to identify the features of the dispersion subphase of the cardiac cycle. In the present paper we have examined the 5-minute intervals cardiointervalography (CIG) to isolate RR-, QT-, ST-ranges in healthy children and children with acute respiratory diseases (ARD) in comparison. It is known that primary school-aged children suffer at ARD 5-7 times per year. Consequently, it is one of the most relevant problems in pediatrics. It is known that the spectral indices and indices of temporal analysis of heart rate variability are highly sensitive to the degree of intoxication during immunological process. We believe that the use of subphase analysis of heart rate will allow more thoroughly evaluate responsiveness of the child organism during the course of ARD. The study involved 60 primary school-aged children (30 boys and 30 girls). In order to assess heart rhythm regulation, the record CIG was used on the "VNS-Micro" device of Neurosoft Company (Ivanovo) for 5 minutes in the supine position and 5 minutes during active orthostatic test. Subphase analysis of variance QT-interval and ST-segment was performed on the "KardioBOS" software Biokvant Company (Novosibirsk). In assessing the CIG in the supine position and in during orthostasis of children with acute respiratory diseases only RR-intervals are observed typical trend of general biological reactions through pressosensitive compensation mechanisms to lower blood pressure, but compared with healthy children the severity of the changes is different, of sick children are more pronounced indicators of heart rate regulation. But analysis CIG RR-intervals and analysis subphase ST-segment have yielded conflicting trends, which may be explained by the different nature of the intra- and extracardiac influences on regulatory mechanisms that implement the various phases of the cardiac cycle.

Keywords: acute respiratory diseases, cardiointervalography, subphase analysis, cardiac cycle

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Authors: Maatouk Mohamed, Nouira Mariem

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: Reet Bishnoi

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Climate change poses a pressing global challenge, with far-reaching consequences for the planet's ecosystems and biodiversity. This abstract introduces the research topic, "Assessing the Impact of Climate Change on Biodiversity Hotspots: A Multidisciplinary Study," which delves into the intricate relationship between climate change and biodiversity in the world's most ecologically diverse regions. Biodiversity hotspots, characterized by their exceptionally high species richness and endemism, are under increasing threat due to rising global temperatures, altered precipitation patterns, and other climate-related factors. This research employs a multidisciplinary approach, incorporating ecological, climatological, and conservationist methodologies to comprehensively analyze the effects of climate change on these vital regions. Through a combination of field research, climate modelling, and ecological assessments, this study aims to elucidate the vulnerabilities of biodiversity hotspots and understand how changes in temperature and precipitation are affecting the diverse species and ecosystems that inhabit these areas. The research seeks to identify potential tipping points, assess the resilience of native species, and propose conservation strategies that can mitigate the adverse impacts of climate change on these critical regions. By illuminating the complex interplay between climate change and biodiversity hotspots, this research not only contributes to our scientific understanding of these issues but also informs policymakers, conservationists, and the public about the urgent need for coordinated efforts to safeguard our planet's ecological treasures. The outcomes of this multidisciplinary study are expected to play a pivotal role in shaping future climate policies and conservation practices, emphasizing the importance of protecting biodiversity hotspots for the well-being of the planet and future generations.

Keywords: climate change, biodiversity hotspots, ecological diversity, conservation, multidisciplinary study

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Authors: Napasri Suwanajote

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The purposes of this research were to analyze and evaluate successful factors in OTOP production process for the developing of learning center on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The research has been designed as a qualitative study to gather information from 30 OTOP producers in Bangkontee District, Samudsongkram Province. They were all interviewed on 3 main parts. Part 1 was about the production process including 1) production, 2) product development, 3) the community strength, 4) marketing possibility, and 5) product quality. Part 2 evaluated appropriate successful factors including 1) the analysis of the successful factors, 2) evaluate the strategy based on Sufficiency Economic Philosophy, and 3) the model of learning center on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The results showed that the production did not affect the environment with potential in continuing standard quality production. They used the raw materials in the country. On the aspect of product and community strength in the past 1 year, it was found that there was no appropriate packaging showing product identity according to global market standard. They needed the training on packaging especially for food and drink products. On the aspect of product quality and product specification, it was found that the products were certified by the local OTOP standard. There should be a responsible organization to help the uncertified producers pass the standard. However, there was a problem on food contamination which was hazardous to the consumers. The producers should cooperate with the government sector or educational institutes involving with food processing to reach FDA standard. The results from small group discussion showed that the community expected high education and better standard living. Some problems reported by the community included informal debt and drugs in the community. There were 8 steps in developing the model of learning center on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality.

Keywords: production process, OTOP, sufficiency economic philosophy, language choice

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Authors: Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık, Birsel Canan Demirbağ, Hacer Erdöl, Songül Aktaş

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Introduction: As an expression of an emotion which always exists in life, crying is regarded as one of the problematic behaviors of patients by nurses. Towards such patients, nurses may exhibit emotional and behavioral reactions such as feeling helpless, anger, indifferent, defense, and opposition. However crying either meets a need, reduces the tension to cope with problems or helps patient to gain strength. Therefore, nurses must accept that crying is a normal mechanism that reduces emotional tension and should approach a crying patient accordingly. Objective: This study was carried out to evaluate the communicational behaviors of the nurses towards ‘crying patient’. Methods: This descriptive study was conducted with the nurses working at a university hospital in a city in the Eastern Black Sea in June-September 2015. The entire universe was tried to be reached without sampling. 90% of the population was reached and the study was completed with 309 nurses who volunteered to participate in the study. Data were collected through a questionnaire which was prepared reviewing the literature by researchers. Data were evaluated in SPSS analysis program using percentages, numbers and chi-square test with the 95% confidence interval and p <0.05significance level. Findings: The findings showed that the average age of nurses was 31.52 ± 7.96, work experience was 10:09 ± 7.69 and only 22.7% had training about ‘approach to crying patient’ during their education. 97.1% of the nurses often faced with crying patients in their professional lives, 62.8% stated that they faced crying women patients. When they see crying patients, 84.8% of the nurses ‘do not want the patient to cry’, 80.9% wonder ‘why they are crying’, % 79.6 ‘feel uneasiness’,% 79.3 ‘feel sorry’ and 41.4% ‘ feel helpless’. The question ‘Why do you think the patient is crying?’ was answered by 93.5% nurses as ‘they are suffering’, by 86.1% ‘they are helpless’, 80.9% ‘they are sad’, 79.6% ‘they need help’, 54.4% ‘because they feel inadequate,’ and 44.7% ‘they fail to control their crying behavior. ‘How do you approach to your patient when she/he is crying?’ question was answered by 82.5% of nurses as ‘I would console’, 77.3% as ‘I would ask the reason’, 63.1% as ‘I would try to stop her from crying’ all of which are actually inappropriate nursing approaches. However, 92.2% of the nurses stated that ‘I do not judge the crying patient’, ‘87.1% said ‘I allocate time to crying patients’ and 85.8% said ‘ I ask patient whether they want to cry alone’. The study showed that educational background and work experience of the nurses affected the appropriate approach to crying patients (P <0.05). Conclusion: As a result of the study, it was found out that nurses do not want patients to cry, so they exhibit inappropriate approach such as consoling the patients and they have difficulty in approaching crying patients.

Keywords: approach to patient, communication, crying patient, nurse, Turkey

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Authors: Solmaz Jahed Shiran, John Hearne, Tayebeh Saghapour

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Daily travel behavior is strongly influenced by the location of the places of residence, education, and employment. Hence a change in those locations due to a move or changes in an occupation leads to a change in travel behavior. Given the interventions of housing mobility and travel behaviors, the hypothesis is that a mobile housing market allows households to move as a result of any change in their life course, allowing them to be closer to central services, public transport facilities and workplace and hence reducing the time spent by individuals on daily travel. Conversely, household’s immobility may lead to longer commutes of residents, for example, after a change of a job or a need for new services such as schools for children who have reached their school age. This paper aims to investigate the association between residential mobility and travel behavior. The Victorian Integrated Survey of Travel and Activity (VISTA) data is used for the empirical analysis. Car ownership and journey to work time and distance of employed people are used as indicators of travel behavior. Change of usual residence within the last five years used to identify movers and non-movers. Statistical analysis, including regression models, is used to compare the travel behavior of movers and non-movers. The results show travel time, and the distance does not differ for movers and non-movers. However, this is not the case when taking into account the residence tenure-type. In addition, car ownership rate and number found to be significantly higher for non-movers. It is hoped that the results from this study will contribute to a better understanding of factors other than common socioeconomic and built environment features influencing travel behavior.

Keywords: journey to work, regression models, residential mobility, commute mode, car ownership

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Authors: Youssef El Makhrout, Aude Pommeret, Tunç Durmaz

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This paper analyses the consequences of a heat pump on the optimal behavior of a prosumer. A theoretical microeconomic model is developed for household heating and electricity consumption to analyze the profitability of installing a solar PV system with a heat pump, battery storage, and grid use. The aim is to present the optimal scenario of investment in renewable energy equipment to cover domestic and heating needs. Simulation data of a French house of 170m² in Chambery are used in this paper. The house is divided into 5 zones with 3 heated zones of 89.4 m² occupied by two people. The analysis is based on hourly data for one year, from 00:00 01/01/2021 to 23:00 31/12/2021. Results indicate that without taking the cost of materials and no financial aid, the most profitable scenario for a household is when he owns solar panels, a heat pump, and battery storage. However, with the costs and financial aid of the French government for energy renovation, the net economic surplus change and the profitability during 20 years are important when the household decides to add a heat pump to existing solar panels. In this scenario, the household can realize 35.84% as a surplus change improvement, but this cannot cover all installation costs. The household can get benefits and cover all installation costs after exploiting financial support in the case of adopting a heat pump. The investment in a battery is still not profitable because of its high cost and the lack of financial aid. Some public policy recommendations are proposed, especially for solar panels and battery storage.

Keywords: household’s heating, prosumer, electricity consumption, renewable energy, welfare gain, comfort, solar PV, heat pumps, storage

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Authors: Jude Harrison

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Child protection is a complex and sensitive practice. The core responsibility is the care and protection of children and young people who have been subject to or who are at risk from abuse and neglect. The work involves investigating allegations of harm, preparing for and making representations to the legal system, and case planning and management across a continuum of complicated care interventions. Professionals’ learning for child protection practice is evident in a range of literature investigating multiple learning processes such as university preparation, student placements, professional supervision, training, and other post-qualifying professional development experiences at work. There is, however, very limited research into how caseworkers learn in and through their daily practice. Little is known, therefore, about how learning at work unfolds for caseworkers, the dimensions in which it can be understood or the ways in which it can be best facilitated and supported. Compounding this, much of the current child protection learning literature reflects an orthodox conception of learning as mentalistic and individualised, in which knowledge is typically understood as abstract theory or as technical skill or competency. This presentation outlines key findings from a PhD research study that explored learning at work for statutory child protection caseworkers from an alternative interpretation of learning using a practice theory approach. Practice theory offers an interpretation of learning as performative and grounded in situated experience. The findings of the study show that casework practice is both a mode and site of learning. The study was ethnographic in design based and followed 17 child protection caseworkers via in-depth interviews, observations and participant reflective journaling. Inductive and abductive analysis was used to organise and interpret the data and expand analysis, leading to themes. Key findings show learning to be a sociomaterial property of doing; the social ontological character of learning; and teleoaffectivity as a feature of learning. The findings contribute to theoretical and practical understandings of learning and practice in child protection, child welfare and the professional learning literature more broadly. The findings have potential to contribute to policy directions at state, territory and national levels to enhance child protection practice and systems.

Keywords: adiult learning, workplace learning, child welfare, sociomaterial, practice theory

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Authors: Jane E. Souyave, Judith Bower

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This study is an ongoing collaborative project between the University of Central Lancashire and the Alzheimer’s Society to design and test the idea of using interactive tools for a person living with dementia and their carers. It is hoped that the tools will fulfill the possible needs of engagement and interaction as dementia progresses, therefore enhancing wellbeing and improving quality of life for the person with dementia and their carers. The project was informed by Kitwood’s five psychological needs for producing wellbeing and explored evidence that fidgeting is often seen as a form of agitation and a negative symptom of dementia. Although therapy for agitation may be well established, there is a lack of appropriate items aimed at people in the later stage of dementia, that are not childlike or medical in their aesthetic. Individuals may fidget in a particular way and the tools in the Fidget Widget Toolkit have been designed to encourage repetitive movements of the hand, specifically to address the abilities of people with relatively advanced dementia. As an intervention, these tools provided a new approach that had not been tested in dementia care. Prototypes were created through an iterative design process and tested with a number of people with dementia and their carers, using quantitative and qualitative methods. Dementia Care Mapping was used to evaluate the impact of the intervention in group settings. Cohen Mansfield’s Agitation Inventory was used to record the daily use and interest of the intervention for people in their usual place of residence. The results informed the design of a new set of devices to promote safe, stigma free fidgeting as a positive experience, meaningful activity and enhance wellbeing for people in the later stage of dementia. The outcomes addressed the needs of individuals by reducing agitation and restlessness through helping them to connect, engage and act independently, providing the means of doing something for themselves that they were able to do. The next stage will be to explore the commercial feasibility of the Fidget Widget Toolkit so that it can be introduced as good practice and innovation in dementia care. It could be used by care homes, with carers and their families to support wellbeing and lead the way in providing some positive experiences and person-centred approaches that are lacking in the later stage of dementia.

Keywords: dementia, design, fidgeting, healthcare, positive moments, quality of life, wellbeing

Procedia PDF Downloads 259

Authors: Bisola Olumegbon

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Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature review and the evidence of political determinants gathered in the data. Participants’ in-depth interviews were used to collect data from frontline personnel. Data triangulation was done using thematic analysis, a method used to identify patterns and themes in qualitative data. The study findings revealed a correlation between political determinants of health and malaria management efforts in Nigeria. Some influencing factors included voting challenges, inadequate funding, lack of health priority from the government, noncompliance among patients, and hurdles to effective communication. The findings suggest a need to deliberately increase dedication to the political agenda, provide sufficient financial resources, enhance communication, and active community involvement to address the persistent malaria endemic effectively. Further study is recommended to identify interventions to address identified factors of political determinants of health to reduce malaria in Nigeria. Such intervention must involve collaboration with diverse stakeholders such as policymakers, healthcare professionals, community leaders, and researchers.

Keywords: malaria, malaria management, health worker, stakeholders, political determinant of health

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Authors: S. Potgieter-Vermaak, N. Bain, A. Brown, K. Shaw

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It is well-known from public news media that air pollution is a health hazard and is responsible for early deaths. The quantification of the relationship between air quality and health is a probing question not easily answered. It is known that airborne particulate matter (APM) <2.5µm deposits in the tracheal and alveoli zones and our research probes the possibility of quantifying pulmonary injury by linking reactive oxygen species (ROS) in these particles to DNA damage. Currently, APM mass concentration is linked to early deaths and limited studies probe the influence of other properties on human health. To predict the full extent and type of impact, particles need to be characterised for chemical composition and structure. APMs are routinely analysed for their bulk composition, but of late analysis on a micro level probing single particle character, using micro-analytical techniques, are considered. The latter, single particle analysis (SPA), permits one to obtain detailed information on chemical character from nano- to micron-sized particles. This paper aims to provide a snapshot of studies using data obtained from chemical characterisation and its link with in-vitro studies to inform on personal health risks. For this purpose, two studies will be compared, namely, the bioaccessibility of the inhalable fraction of urban road dust versus total suspended solids (TSP) collected in the same urban environment. The significant influence of metals such as Cu and Fe in TSP on DNA damage is illustrated. The speciation of Hg (determined by SPA) in different urban environments proved to dictate its bioaccessibility in artificial lung fluids rather than its concentration.

Keywords: air pollution, human health, in-vitro studies, particulate matter

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Authors: Fatihin Khoirul, Muhammad Muqorrobin Ist

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Bojonegoro Regency is one of the districts that use the concept Agropolitan as the Territorial Development Policy. Three sub-district designated as Area Development District of Agropolitan are Kapas, Dander, and Kalitidu or commonly called KADEKA. Current policy has been shown results, but there was an inequality of results in some areas. One of them occurred in the Ngringinrejo village with the main commodities is Starfruit and Wedi village with the main commodities is Salak fruit. Therefore, a comparative study is used to search for causal factors of inequality result of the policy by using the 5 aspects compared, namely: (1) Management Development Agropolitan; (2) Physical Condition agropolitan Region; (3) Implementing Agency at the Village Level; (4) Village Government Support; and (5) Community support. Based on the discussion of qualitative analysis, it was found that five aspects have their respective roles in creating inequality of outcomes that occur in both villages. But beyond that, there are conditions where the two villages experienced the same condition that is when the initial implementation of the policy. The condition is referred to as 'the phenomenon of price trap.' The condition is caused by lower commodity prices, causing the village government's commitment in implementing policies too low, followed by public awareness in support of the policy is also low, so care for commodities is also low, and the quality is too low lead and eventually back causing low price. However, the difference is that the village Ngringinrejo able to get out of this condition with 'the new culture of administration' at the end of 2013. While the conditions in the village of Wedi compounded by not respected request assistance by the irrigation district.

Keywords: comparative policy analysis, qualitative comparative, inequallity, price trap, new culture of administration

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Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith

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Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.

Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care

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Authors: Rachel K. Cremona

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Forty years ago, Vila Autodromo was a small fishing settlement in southwest Rio de Janeiro. By 2012, Vila Autodromo had established itself into a working class neighborhood – certainly not a slum, but nonetheless designated as a ‘favela’ as a consequence of its history as an illegal settlement that was thus never provided with public services. Vila Autodromo sits on a large lagoon, adjacent to the Olympic Park being constructed for the 2016 Olympic Games to be held in Rio, and looks out over the expensive high rise condominiums that have sprouted across the water. In 2009, when Rio submitted their bid for the Olympic games, there were approximately 900 families that called Vila Autodromo home, and the original plans for the games clearly show their homes remaining in place. Today, only a handful of these homes remain. This paper will utilize the case study of Vila Autodromo to examine the broader issue of Favelas in 21st century Rio de Janeiro. While race and poverty have become synonymous with Brazil’s inegalitarian social order – and personified by the thousands of favelas scattered in and around large cities like Rio and Sao Paulo – much less attention has been given to the political status of the nation’s invisible majority. In particular, this research will examine the question of citizenship and argue that the most fundamental problem of inequality in Brazil is not simply a product of history, race and social order, but more specifically a problem of ‘personhood’. The political marginalization of Brazil’s poor does not simply reinforce their social marginalization, it institutionalizes it in a way that makes it almost impossible to escape. The story of Vila Autodromo captures this problem in a way that not only illustrates the clear (though ambiguous) role of the state in the perpetuation of Brazil’s underclass, but also the human resilience that it has fostered.

Keywords: citizenship, poverty, displacement, favela

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Authors: Fatih Eren

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This research aims to find an answer to the question of which knowledge and skills do the Turkish urban planners need in their business practice. Understanding change in cities, making a prediction, making an urban decision and putting it into practice, working together with actors from different organizations from various academic disciplines, persuading people to accept something and developing good personal and professional relationships have become very complex and difficult in today’s world. The truth is that urban planners work in many institutions under various positions which are not similar to each other by field of activity and all planners are forced to develop some knowledge and skills for success in their business in Turkey. This study targets to explore what urban planners do in the global information age. The study is the product of a comprehensive nation-wide research. In-depth interviews were conducted with 174 experienced urban planners, who work in different public institutions and private companies under varied positions in the Turkish Planning System, to find out knowledge and skills needed by next-generation urban planners. The main characteristics of next-generation urban planners are defined; skills that planners needed today are explored in this paper. Findings show that the positivist (traditional) planning approach has given place to anti-positivist planning approaches in the Turkish Planning System so next-generation urban planners who seek success and want to carve out a niche for themselves in business life have to equip themselves with innovative skills. The result section also includes useful and instructive findings for planners about what is the meaning of being an urban planner and what is the ideal content and context of planning education at universities in the global age.

Keywords: global information age, Turkish Planning System, the institutional approach, urban planners, roles, skills, values

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Authors: Essa Alenazi, Zulfikar Adamu

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The Kingdom of Saudi Arabia (KSA) is not an exception in relying on the growth of its construction industry to support rapid population growth. However, its need for infrastructure development is constrained by low productivity levels and cost overruns caused by factors such as delays to project completion. Delays in delivering a construction project are a global issue and while theories such as Optimism Bias have been used to explain such delays, in KSA, client-related causes of delays are also significant. The objective of this paper is to develop a framework-based approach to explore how the country’s construction industry can manage and reduce delays in construction projects through building information modelling (BIM) in order to mitigate the cost consequences of such delays.  It comprehensively and systematically reviewed the global literature on the subject and identified gaps, critical delay factors and the specific benefits that BIM can deliver for the delay management.  A case study comprising of nine hospital projects that have experienced delay and cost overruns was also carried out. Five critical delay factors related to the clients were identified as candidates that can be mitigated through BIM’s benefits. These factors are: Ineffective planning and scheduling of the project; changes during construction by the client; delay in progress payment; slowness in decision making by the client; and poor communication between clients and other stakeholders. In addition, data from the case study projects strongly suggest that optimism bias is present in many of the hospital projects. Further validation via key stakeholder interviews and documentations are planned.

Keywords: building information modelling (BIM), clients perspective, delay management, optimism bias, public sector projects

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Authors: Sophia Yakhlef

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Norm-critical pedagogy is an approach originating from intersectional gender pedagogy, feminist pedagogy, queer pedagogy, and critical pedagogy. In the Swedish context, the norm critical approach is rising in popularity, and norms that are highlighted or challenged are, for example, various dimensions of power such as ’whiteness norm’, discourses of ’Swedishness’, ’middle class norm’, heteronormativity, and body functionality. Instead of seeing students as a homogenous group, intersectional pedagogy focuses on the consequences of differences and on critically paying attention to differences. The perspective encourages teachers to assess their teaching methods, material, and the course literature provided in their education. The classical sociological literature that most students encounter when studying behaviour science or sociology has, in recent years, been referred to as the sociological canon. The sociological perspectives of the classical scholars included in the canon have, in many ways, shaped how we perceive the history of sociology and theories of the modern world in general. The sociological canon has, in recent decades, been challenged by, amongst others, feminist, post-colonial, and queer theorists. This urges us to further investigate the implications that this might have on sociological and behavioural science education, as well as on pedagogical considerations and teaching methods. This qualitative case study focuses on the experiences of implementing a norm critical pedagogical perspective in an online behavioural science programme at Kristianstad University in Sweden. Interviews and informal conversations were conducted in 2022 with teachers regarding their experiences of teaching online, of implementing a student-centred learning approach, and their experiences of implementing a norm critical perspective in sociology and criminology courses. The study demonstrates the inclusion aspect of online education, the benefits of adopting a norm critical perspective, the challenges that arise when updating course literature, and the urgent need for guidance and education for teachers regarding inclusion and paying attention to power asymmetry.

Keywords: norm critical pedagogy, online-education, sociological canon, sweden

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Authors: Amna Khaliq

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In this research paper, a comparison study has been undertaken between Canada and Denmark to analyze the education system between the countries in entrepreneurship. Denmark, a land of high wages and high taxes, and Canada, a land of immigrants and opportunities, have seen a positive relationship in entrepreneurs' growth. They are both considered one of the top ten countries to start a business and to have government support globally. However, education is entirely free to Danish students, including university degrees, compared to Canadians, which can further hurdle for Canadian millennials to grow in the business world—the business experience more growth with educated entrepreneurs with international backgrounds in new immigrants. Denmark has seen a gradual increase in female entrepreneurs over the decade but is still lower than OECD countries. Compassionate management and work-life balance are prioritized in Denmark, unlike in Canada. Danish are early adopters of technology and have excellent infrastructure to support the technology industry, whereas Canada is still a service-oriented and manufacturer-based country. 2018 has been the highest number of opening businesses for Canada and Denmark. Some companies offer high wages, hiring bonuses, flexible working hours, wellness, and mental health benefits during Pandemic to keep the companies running and keep their workers' morale high. Pandemic has taught consumers new patterns to shop online. It is essential now to use technology and automation to increase productivity in businesses. Only those companies will survive that are applying this strategy. The Pandemic has ultimately changed entrepreneurs' and employees' behavior in the business world. Along with Ph.D. professors, entrepreneurs should be allowed to teach at learning intuitions. Millennials turn out to be the most entrepreneurial generation in both countries. Entrepreneurship education will only be beneficial when students create businesses and learn from real-life experiences. Managing physical, mental, emotional, and psychological health while dealing with high pressure in entrepreneurship are soft skills learned through practical work.

Keywords: entrepreneurship education, millennials, pandemic, Denmark, Canada

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Authors: R. T. Aggangan, R. J. Cabangon

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Bamboo is getting worldwide attention over the last 20 to 30 years due to numerous uses and it is regarded as the closest material that can be used as substitute to wood. In the domestic market, high quality bamboo products are sold in high-end markets while lower quality products are generally sold to medium and low income consumers. The global market in 2006 stands at about 7 billion US dollars and was projected to increase to US$ 17 B from 2015 to 2020. The Philippines had been actively producing and processing bamboo products for the furniture, handicrafts and construction industry. It was however in 2010 that the Philippine bamboo industry was formalized by virtue of Executive Order 879 that stated that the Philippine bamboo industry development is made a priority program of the government and created the Philippine Bamboo Industry Development Council (PBIDC) to provide the overall policy and program directions of the program for all stakeholders. At present, the most extensive use of bamboo is for the manufacture of engineered bamboo for school desks for all public schools as mandated by EO 879. Also, engineered bamboo products are used for high-end construction and furniture as well as for handicrafts. Development of cheap adhesives, preservatives, and finishing chemicals from local species of plants, development of economical methods of drying and preservation, product development and processing of lesser-used species of bamboo, development of processing tools, equipment and machineries are the strategies that will be employed to reduce the price and mainstream engineered bamboo products in the local and foreign market. In addition, processing wastes from bamboo can be recycled into fuel products such as charcoal are already in use. The more exciting possibility, however, is the production of bamboo pellets that can be used as a substitute for wood pellets for heating, cooking and generating electricity.

Keywords: bamboo charcoal and light distillates, engineered bamboo, furniture and handicraft industries, housing and construction, pellets

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Authors: Leyla Sattarzadeh, Maghsoud Peeri, Mohammadali Azarbaijani, Hasan Matin Homaee

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Inflammation by various mechanisms may cause atherosclerosis. Systemic circulating inflammatory markers such as C-reactive protein (CRP), pro-inflammatory cytokines such as Interleukin-6 (IL-6) and adhesion molecules like Intracellular Adhesion Molecule-1 (ICAM-1) are the predictors of cardiovascular diseases. Regarding the conflicting results about the effect of resistance exercise training on these inflammatory markers, the present study aimed to examine the effect of eight week different patterns of resistance exercise training on CRP, IL-6 and ICAM-1 levels in healthy untrained women. 40 volunteered and healthy untrained female university students (aged: 21+ 3 yr., Body Mass Index: 21.5+ 3.5 kg/m2) were selected purposefully and divided into three groups. At the end of training protocol and after subjects drop during the protocol in upper body exercise training (n=11), lower body (n=12) completed the eight week of training period although the control group (n=7) did anything. Blood samples gathered pre and post experimental period and CRP, IL-6 and ICAM-1 levels were evaluated using special laboratory kits, then the difference of pre and post values of each indices analyzed using one way Analysis of Variance (α < 0.05). The results of one way ANOVA for difference of pre and post values of CRP and ICAM-1 showed no significant changes due to the exercise training. But there were significant differences between groups about IL-6. Tukey post- hoc test indicated that there is significant difference between the differences of pre and post values of IL-6 between lower body exercise training group and control group, and eight weeks of lower body exercise training lead to significant changes in IL-6 values. There were no changes in anthropometric indices. The findings show that the different patterns of upper and lower body exercise training by involving the different amount of muscles altered the IL-6 values in lower body exercise training group probably because of engaging the bigger amount of muscles, but showed any significant changes about CRP and ICAM-1 probably due to intensity and duration of exercise or the lower levels of these markers at baseline of healthy people.

Keywords: C-reactive protein, interleukin-6, intracellular adhesion molecule-1, resistance training

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Authors: Ibrahim Alhassan Libata

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This study was carried out to assess attitude of secondary school students towards science and technical education in Yauri metropolis, Kebbi State, Nigeria. The population of the study was 200. Proportionate random sampling method was used in selecting 132 as sample size. Science and technical education is the most powerful forces for change in the world today, and students who hope to have a hand in shaping a better future must participate for their advancements. Four Null hypotheses were generated to guide the conduct of the study, questionnaire was the only instrument used in the study; the instrument was subjected to test-retest reliability. The reliability index of the instrument was 0.69. Overall scores of the Students were analyzed and a mean score was determined, the mean score of students was 85. There were no significant differences between the attitudes of male and female students towards science and technical education. The results also revealed that there was significant difference between the attitude of boding and day school students towards science and technical education, personality constraints of students is one factor militating against the participation of students in science and technical education, socio-economic status of the parents over the years have been the dominant factor of student’s inadequate representation in the field of science and technical education. Based on the findings of this study, the researcher recommended that teachers should motivate students, which they can do through their teaching styles and by showing them the relevance of the learning topics to their everyday lives. Government and the school management should create the learning environment that helps motivate students not only to come to classes but also want to learn and enjoy learning science and technical education, establishment of more Science and Technical Colleges education, more Public enlightenment campaigns to motivate parents and the entire community to support their children in studying science and technical education.

Keywords: attitude, students, science, Yauri

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Authors: Sreeja Shaw, Prosenjit Samanta, Asish Kumar Mukhopadhyay

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Cholera is still a global public health burden and is caused by Vibrio cholerae O1 and O139 serogroups. Evidence from recent outbreaks in Haiti and Yemen suggested that circulating V. cholerae O1 El Tor variant strains are continuously changing to cause more ruinous outbreaks worldwide, and most of them have emerged from the Indian subcontinents. Therefore, we studied the changing virulence characteristics along with the antibiotic resistance profile of V. cholerae O1strains isolated from seasonal outbreaks in three cholera endemic regions during 2018, Gujarat and Maharashtra in Western India (87 strains), and to compare those features with the isolates of West Bengal in Eastern India (48 strains) collected during the same period. All the strains from Western India were of Ogawa serotype, polymyxin B-sensitive, hemolytic, and contained a large fragment deletion in VSP-II genomic region similar with Yemen outbreak strains and carried more virulent Haitian genetic alleles of major virulence associated genes ctxB, tcpA, and rtxA. Conversely, 14.6% (7/48) of the strains from Eastern India were belong to the Inaba serotype, polymyxin B-resistant, non-hemolytic, harbored intact VSP-II region, classical ctxB, Haitian tcpA, and El Tor rtxA alleles. Interestingly, resistance to tetracycline and chloramphenicol was seen in isolates from both regions, which are not very common among V. cholerae O1 isolates in India. Therefore, this study indicated West Bengal as a diverse region where two different types of El Tor variant hypervirulent strains are co-existed, probably competing for their better environmental survival, which may result in severe irrepressible disease outcome in the future.

Keywords: cholera, vibrio cholerae, polymyxin B, Non-hemolytic, ctxB, tcpA, rtxA, VSP-II

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Authors: Ruttana Phetsitong, Patama Vapattanawong, Malee Sunpuwan, Marc Voelker

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The majority of care for older people at home in Thai society falls upon caregivers resulting in caregiver’s mental health problem. Beyond individual characteristics, household factors might have a profound effect on the caregiver’s mental health. But reliable data capturing this at the household level have been limited to date. The objectives of the present study were to explore the levels of Thai caregiver’s mental health and to investigate the factors affecting the mental health at household level. Data were obtained from the 2011 National Survey of Thai Older Persons conducted by the National Statistical Office of Thailand. Caregiver’s mental health was measured by using the 15- items-short version of the Thai Mental Health Indicator (TMHI-15) developed by the Department of Mental Health, the Ministry of Public Health. Multivariate logistic regression models were used to explore the impact of potential factors on caregiver’s mental health. The THMI-15 produced an overall average caregiver mental health score of 30.9 out of 45 (SD 5.3). The score can be categorized into good (34.02-45), fair (27.01-34), and poor (0-27). Duration of care for older people, household wealth, and functional dependency of the older people significantly predicted total caregiver’s mental health. Household economic factor was key in predicting better mental health. Compared to those poorest households, the adjusted effect of the fifth quintile household wealth was high (OR=2.34; 95%CI=1.47-3.73). The findings of this study provide a fuller picture to a better understanding of the level and factors that cause the mental health of Thai caregivers. Health care providers and policymakers should consider these factors when designing interventions aimed at alleviating caregiver’s psychological burden when provided care for older people at home.

Keywords: caregiver’s mental health, household, older people, Thailand

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Authors: Ali Christian Chinedu, Asogwa Vincent Chidindu, Ejiofor Toochukwu Eleazar, Okadi Ashagwu Ojang

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The increasing rate of Boko Haram insurgency, farmer-herder clashes, and kidnapping in Nigeria has resulted in food shortages and high cost of protein sources like beef and fish. This challenge could be curbed with the production of edible insects, which contain several nutritional benefits like calories, protein, fat, vitamins, and minerals, depending on their species, metamorphic stage, and diet. Unfortunately, the benefits and competencies in producing, preserving, and marketing edible insects are still unknown to the public, including prospective farmers in Nigeria. Hence, this study determined teachers’ perception of integrating edible insects into the Animal Husbandry Curriculum in Senior Secondary Schools in Nigeria to equip the future generation with the relevant competencies for alternative sustainable protein supply. The study was carried out in Enugu State, Nigeria. The participants for the study comprised 162 agricultural science teachers. A questionnaire titled: Edible Insects Integration in Animal Husbandry Curriculum Questionnaire (EIIAHCQ) was used to collect data using a descriptive survey research design. We conducted data collection with the help of six research assistants. The study identified 11 objectives, 11 contents, 10 teaching methods, and 9 evaluation methods that could be integrated into the existing curriculum of animal husbandry in Nigeria. Among others, the Ministry of Education should integrate the finding of this study into the curriculum of Animal Husbandry in Nigeria to enhance the protein supply and curb food insecurity now and in the future.

Keywords: animal husbandry curriculum, edible insects, entomophagy, integration, secondary school, Nigeria

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Authors: Julia Hoefer Martí

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While research has consistently found a significant motherhood wage penalty for heterosexual women, where homosexual women are concerned, evidence has appeared to suggest no effect, or possibly even a wage bonus. This paper presents a model of the household with a public good that requires both a monetary expense and a labour investment, and where the household budget is shared between partners. Lower-wage partners will do relatively more of the household labour while higher-wage partners will specialise in market labour, and the arrival of a child exacerbates this split, resulting in the lower-wage partner taking on even more of the household labour in relative terms. Employers take this gender-sexuality dyad as a signal for employees’ commitment to the labour market after having a child, and use the information when setting wages after employees become parents. Given that women empirically earn lower wages than men, in a heterosexual couple the female partner will often do more of the household labour. However, as not every female partner has a lower wage, this results in an over-adjustment of wages that manifests as an unexplained motherhood wage penalty. On the other hand, in homosexual couples wage distributions are ex ante identical, and gender is no longer a useful signal to employers as to whether the partner is likely to specialise in household labour or market labour. This model is then tested using longitudinal data from the EU Standards of Income and Living Conditions (EU-SILC) to investigate the hypothesis that women experience different wage effects of motherhood depending on their sexual orientation. While heterosexual women receive a significant motherhood wage penalty of 8-10%, homosexual mothers do not receive any significant wage bonus or penalty of motherhood, consistent with the hypothesis presented above.

Keywords: discrimination, gender, motherhood, sexual orientation, labor economics

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Authors: Hamzeh Awad

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Disability is considered to be a worldwide complex phenomenon which rising at a phenomenal rate and caused by many different factors. Chronic diseases such as cardiovascular disease and diabetes can lead to mobility disability in particular and disability in general. The ICF is an integrative bio-psycho-social model of functioning and disability and considered by the World Health Organization (WHO) to be a reference for disability classification using its categories and core set to classify disorder’s functional limitations. Specialist programs at Sultan Bin Abdul Aziz Humanitarian City (SBAHC) are providing both inpatient and outpatient services have started to implement the ICF and use it as a problem solving tool in Rehab. Diabetes is leading contributing factor for disability and considered epidemic in several Gulf countries including the Kingdom of Saudi Arabia (KSA), where its prevalence continues to increase dramatically. Metabolic disorders, mainly diabetes are not well covered in Rehab field. The purpose of this study is present to research and clinical rehabilitation field of DREAM and ICF as a framework in clinical and research setting in Rehab service. Also, shed the light on using the ICF as problem solving tool at SBAHC. There are synergies between disability causes and wider public health priorities in relation to both chronic disease and disability prevention. Therefore, there is a need for strong advocacy and understanding of the role of ICF as a reference in Rehab settings in Middle East if we wish to seize the opportunity to reverse current trends of acquired disability in the region.

Keywords: international classification of functioning, disability and health (ICF), prototype, rehabilitation and diabetes

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Authors: Sara D. Garduno-Diaz, Philippe Y. Garduno-Diaz

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To date, one of the few comprehensive indicators for the measurement of food security is the Global Food Security Index. This index is a dynamic quantitative and qualitative bench marking model, constructed from 28 unique indicators, that measures drivers of food security across both developing and developed countries. Whereas the Global Food Security Index has been calculated across a set of 109 countries, in this paper we aim to present and compare, for the Middle East and North Africa (MENA), 1) the Food Security Index scores achieved and 2) the data available on affordability, availability, and quality of food. The data for this work was taken from the latest (2014) report published by the creators of the GFSI, which in turn used information from national and international statistical sources. According to the 2014 Global Food Security Index, MENA countries rank from place 17/109 (Israel, although with resent political turmoil this is likely to have changed) to place 91/109 (Yemen) with household expenditure spent in food ranging from 15.5% (Israel) to 60% (Egypt). Lower spending on food as a share of household consumption in most countries and better food safety net programs in the MENA have contributed to a notable increase in food affordability. The region has also however experienced a decline in food availability, owing to more limited food supplies and higher volatility of agricultural production. In terms of food quality and safety the MENA has the top ranking country (Israel). The most frequent challenges faced by the countries of the MENA include public expenditure on agricultural research and development as well as volatility of agricultural production. Food security is a complex phenomenon that interacts with many other indicators of a country’s well-being; in the MENA it is slowly but markedly improving.

Keywords: diet, food insecurity, global food security index, nutrition, sustainability

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Authors: Peder O. Laugen Heggdal, Oyvind Nordvik, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing loss (HL) affect people of all ages and stages in life. To author's best knowledge, if patients with an HL have reduced Generic Quality of life (QoL), has yet not been answered. Aim: The aim of the present study was to investigate the relationship between HL and generic and disease-specific Health Related Quality of Life (HRQoL) in adult patients (aged 18–78 years) with an HL, seeking Hearing Aid (HA). Material and Methods: 158 adult (aged 18-78 years) patients with HL, referred for HA fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals, were included. First-time users had been pre-examined by an Ear Nose and Throat specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2 and 4 kHz) was determined for each ear. The generic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire general part and a shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) were answered. In addition, EORTC HRQoL answers from a general population and patients with former head and neck cancer served as comparison. Results: In general, no lowered HRQoL scores were determined among HL patients compared to the general population. Patients with unilateral HL to some extent showed lower HRQoL than those with bilateral HL (social function and fatigue). The APHAB scores correlated significantly with the EORTC HRQoL scores. By stepwise linear regression analysis, the APHAB scores were scored secondary to PTA (best ear), cognitive and physical function. Conclusion: HRQoL scores in HL patients, in general, seems to be at the population level, but the unilateral HL patients scored to some extent lower than the bilateral HI patients. APHAB and generic QoL scores levels are associated. Both HRQoL and APHAB scores are generated more complexly than anticipated.

Keywords: quality of life, hearing loss, hearing impairment, distress, depression, anxiety, hearing aid

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Authors: Chibuzo Okoye Daniels, Gillian Glegg, Lynda Rodwell

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The continuously growing quantity of very slow degrading litter deliberately discarded into the coastal waters around Lagos as marine debris is obvious. What is not known is how to tackle this problem to reduce its prevalence and impact on the environment, economy and community. To identify ways of tackling the marine debris problem two case study areas (Ikoyi and Victoria Islands of Lagos State) were used to assess the root causes, the threat posed by marine debris in the coastal waters around Lagos and the efficacy of current instruments, programmes and initiatives that address marine debris in the study areas. The following methods were used: (1) Self-completed questionnaires for households and businesses within the study areas; (2) Semi-structured interviews with key stakeholders; (3) Observational studies of waste management from collection to disposal and waste management facilities for waste originating from land and maritime sources; (4) Beach surveys and marine debris surveys on shorelines and ports; and (5) Fishing for marine debris. Results of this study identified the following root causes: (1) Indiscriminate human activities and behaviors, and lack of awareness on the part of the main stakeholders and the public of the potential consequences of their actions; (2) Poor solid waste management practices; (3) Lack of strict legal frameworks addressing waste and marine debris problem; and (4) Disposal of non-degradable wastes into domestic sewer system and open streets drains. To effectively tackle marine debris problem in the study areas, adequate, appropriate and cost effective solutions to the above mentioned root causes needs to be identified and effectively transferred for implementation in the study areas.

Keywords: marine debris problem, Lagos state, litter, coastal waters

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