Search results for: object of critical infrastructure

Authors: Saeed Rezaeian, M. Rezaee Boroon

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Nitrogen accumulates in soils during the process of fertilizer addition to promote the plant growth. When the organic matter decomposes, the form of available nitrogen produced is in the form of nitrate, which is highly mobile. The most significant health effect of nitrate ingestion is methemoglobinemia in infants under six months of age (blue baby syndrome). The mobile nutrients, like nitrate nitrogen, are not stored in the soil as the available forms for the long periods and in large amounts. It depends on the needs for the crops such as vegetables. On the other hand, the vegetables will compete actively for nitrate nitrogen as a mobile nutrient and water. The mobile nutrients must be shared. The fewer the plants, the larger this share is for each plant. Also, this nitrate nitrogen is poisonous for the people who use these vegetables. Nitrate is converted to nitrite by the existing bacteria in the stomach and the Gastro-Intestinal (GI) tract. When nitrite is entered into the blood cells, it converts the hemoglobin to methemoglobin, which causes the anoxemia and cyanosis. The increasing use of pesticides and chemical fertilizers, especially the fertilizers with nitrates compounds, which have been common for the increased production of agricultural crops, has caused the nitrate pollution in the (soil, water, and environment). They have caused a lot of damage to humans and animals. In this research, the nitrate accumulation in different kind of vegetables such as; green pepper, tomatoes, egg plants, watermelon, cucumber, and red pepper were observed in the suburbs of Mashhad, Neisabour, and Sabzevar cities. In some of these cities, the information forms of agronomical practices collected were such as; different vegetable crops fertilizer recommendations, varieties, pesticides, irrigation schedules, etc., which were filled out by some of our colleagues in the research areas mentioned above. Analysis of the samples was sent to the soil and water laboratory in our department in Mashhad. The final results from the chemical analysis of samples showed that the mean levels of nitrates from the samples of the fruit crops in the mentioned cities above were all lower than the critical levels. These fruit crop samples were in the order of: 35.91, 8.47, 24.81, 6.03, 46.43, 2.06 mg/kg dry matter, for the following crops such as; tomato, cucumber, eggplant, watermelon, green pepper, and red pepper. Even though, this study was conducted with limited samples and by considering the mean levels, the use of these crops from the nutritional point of view will not cause the poisoning of humans.

Keywords: environmental pollution, human health, nitrate accumulations, nitrate fertilizers

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Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Background: Validation of communication activities of daily living-second edition (CADL-2) and assessment of language-related functional activities (ALFA) tests is a critical investment decision, and activities related to language impairments often are underestimated. Literature indicates that age factors, and gender differences may affect the performance of the aphasics. Thus, understanding these influential factors is highly important to neuropsycholinguists and speech language pathologists (SLPs). Purpose: The goal of this study is twofold: (1) to in/validate CADL-2 and ALFA tests, and (2) to investigate whether or not the two assessment tests are reliable. Design: A comparative study is made between the results obtained from the analyses of the Arabic versions of CADL-2 and ALFA tests. Participants: The communication activities of daily-living and language-related functional activities were assessed from the obtained results of 100 adult aphasics (50 males, 50 females; ages 16 to 65). Procedures: Firstly, the two translated and standardized Arabic versions of CADL-2 and ALFA tests were introduced to the Arab aphasics under investigation. Armed with the new two versions of the tests, one of the researchers assessed the language-related functional communication and activities. Outcomes drawn from the obtained analysis of the comparative studies were then qualitatively and statistically analyzed. Main outcomes and Results: Regarding the validity of CADL-2 and ALFA, it is found that …. Is more valid in both pre-and posttests. Concerning the reliability of the two tests, it is found that ….is more reliable in both pre-and-posttests which undoubtedly means that …..is more trustable. Nor must we forget to indicate here that the relationship between age and gender was very weak due to that no remarkable gender differences between the two in both CADL-2 and ALFA pre-and-posttests. Conclusions & Implications: CADL-2 and ALFA tests were found to be valid and reliable tests. In contrast to previous studies, age and gender were not significantly associated with the results of validity and reliability of the two assessment tests. In clearer terms, age and gender patterns do not affect the validation of these two tests. Future studies might focus on complex questions including the use of CADL-2 and ALFA functionally; how gender and puberty influence the results in case the sample is large; the effects of each type of aphasia on the final outcomes, and measurements’ results of imaging techniques.

Keywords: CADL-2, ALFA, comparison, language test, arab aphasics, validity, reliability, neuropsycholinguistics, comparison

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Authors: Nicholas S. Norbert Jr., John E. Bischoff, Christopher J. Willy

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Knowledge Management (KM) is globally recognized as a crucial element in securing competitive advantage through building and maintaining organizational memory, codifying and protecting intellectual capital and business intelligence, and providing mechanisms for collaboration and innovation. KM frameworks and approaches have been developed and defined identifying critical success factors for conducting KM within numerous industries ranging from scientific to business, and for ranges of organization scales from small groups to large enterprises. However, engineering and technical teams operating within restricted environments are subject to unique barriers and KM challenges which cannot be directly treated using the approaches and tools prescribed for other industries. This research identifies barriers in conducting KM within Hardware Development Engineering (HDE) teams and statistically compares significance to barriers upholding the four KM pillars of organization, technology, leadership, and learning for HDE teams. HDE teams suffer from restrictions in knowledge sharing (KS) due to classification of information (national security risks), customer proprietary restrictions (non-disclosure agreement execution for designs), types of knowledge, complexity of knowledge to be shared, and knowledge seeker expertise. As KM evolved leveraging information technology (IT) and web-based tools and approaches from Web 1.0 to Enterprise 2.0, KM may also seek to leverage emergent tools and analytics including expert locators and hybrid recommender systems to enable KS across barriers of the technical teams. The research will test hypothesis statistically evaluating if KM barriers for HDE teams affect the general set of expected benefits of a KM System identified through previous research. If correlations may be identified, then generalizations of success factors and approaches may also be garnered for HDE teams. Expert elicitation will be conducted using a questionnaire hosted on the internet and delivered to a panel of experts including engineering managers, principal and lead engineers, senior systems engineers, and knowledge management experts. The feedback to the questionnaire will be processed using analysis of variance (ANOVA) to identify and rank statistically significant barriers of HDE teams within the four KM pillars. Subsequently, KM approaches will be recommended for upholding the KM pillars within restricted environments of HDE teams.

Keywords: engineering management, knowledge barriers, knowledge management, knowledge sharing

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Authors: Vidya Yadav

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India’s youth bulge is now sharpest at the critical 15-24 age group, even as its youngest, and oldest age groups begin to narrow. As the ‘single year, age data’ for the 2011 Census releases the data on the number of people at each year of age in the population. The data shows that India’s working age population (15-64 years) is now 63.4 percent of the total, as against just short of 60 percent in 2001. The numbers also show that the ‘dependency ratio’ the ratio of children (0-14) and the elderly (65 above) to those in the working age has shrunk further to 0.55. “Even as the western world is in ageing situation, these new numbers show that India’s population is still very young”. As the fertility falls faster in urban areas, rural India is younger than urban India; while 51.73 percent of rural Indians are under the age of 24 and 45.9 percent of urban Indians are under 24. The percentage of the population under the age of 24 has dropped, but many demographers say that it should not be interpreted as a sign of the youth bulge is shrinking. Rather it is because of “declining fertility, the number of infants and children reduces first, and this is what we see with the number of under age 24. Indeed the figure shows that the proportion of children in the 0-4 and 5-9 age groups has fallen in 2011 compared to 2001. For the first time, the percentage of children in the 10-14 age group has also fallen, as the effect of families reducing the number of children they have begins to be felt. The present paper key issue is to examine that “whether this growing youth bulge has the right skills for the workforce or not”. The study seeks to examine the youth population structure and employment distribution among them in India during 2001-2011 in different industrial category. It also tries to analyze the workforce participation rate as main and marginal workers both for male and female workers in rural and urban India by utilizing an abundant source of census data from 2001-2011. Result shows that an unconscionable number of adolescents are working when they should study. In rural areas, large numbers of youths are working as an agricultural labourer. Study shows that most of the youths working are in the 15-19 age groups. In fact, this is the age of entry into higher education, but due to economic compulsion forces them to take up jobs, killing their dreams of higher skills or education. Youths are primarily engaged in low paying irregular jobs which are clearly revealed by census data on marginal workers. That is those who get work for less than six months in a year. Large proportions of youths are involved in the cultivation and household industries works.

Keywords: main, marginal, youth, work

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Authors: Elzbieta Sikorska-Simmons

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Dementia is a progressive terminal disease. Despite this recognition, research shows that most family caregivers do not know it, and it is unclear how this knowledge affects the quality of patient care. The aim of this qualitative study of 20 family caregivers for patients with advanced dementia is to examine how the caregiver's knowledge about dementia affects the quality of patient care in the context of healthcare decision-making, advanced care planning, and access to adequate support systems. Knowledge about dementia implies family caregivers' understanding of dementia trajectories, common symptoms/complications, and alternative treatment options (e.g., comfort feeding versus tube feeding). Data were collected in semi-structured interviews with 20 family caregivers. The interviews were conducted in person by the author and designed to elicit rich descriptions of family caregivers' experiences with healthcare decision-making and the management of common symptoms/complications of end-stage dementia as patient healthcare proxies. The study findings suggest that caregivers who recognize that dementia is a terminal disease are less likely to opt for life-extending treatments during the advanced stages. They are also more likely to seek palliative/hospice care, and consequently, they are better able to avoid unnecessary hospitalizations or medical procedures. For example, those who know that dementia is a terminal disease tend to opt for "comfort feeding" rather than "tube feeding" in managing the swallowing difficulties that accompany advanced dementia. In the context of advance care planning, family caregivers who know that dementia is a terminal disease tend to have more meaningful advance directives (e.g., Power of Attorney and Do Not Resuscitate orders). They are better prepared to anticipate common problems and pursue treatments that foster the best quality of patient life and care. Greater knowledge about advanced dementia helps them make more informed decisions that focus on enhancing the quality of patient life rather than just survival. In addition, those who know that dementia is a terminal disease are more likely to establish adequate support systems to help them cope with the complex demands of caregiving. For example, they are more likely to seek dementia-oriented primary care programs that offer house visits or respite services. Based on the study findings, knowledge about dementia as a terminal disease is critical in the optimal management of patient care needs and the establishment of adequate support systems. More research is needed to better understand what caregivers need to know to better prepare them for the complex demands of dementia caregiving.

Keywords: dementia education, family caregiver, management of dementia, quality of care

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Authors: Pao-Huei Chen, Shu-Mei Lin, Yih-Ming Weng, Zer-Ran Yu, Be-Jen Wang

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Pancreatic α-amylase and intestinal α-glucosidase are the critical enzymes for the breakdown of complex carbohydrates into di- or mono-saccharide, which play an important role in modulating postprandial blood sugars. Angiotensin converting enzyme (ACE) converts inactive angiotensin-I into active angiotensin-II, which subsequently increase blood pressure through triggering vasoconstriction and aldosterone secretion. Thus, inhibition of carbohydrate-digestion enzymes and ACE will help the management of blood glucose and blood pressure, respectively. Studies showed Pleurotus citrinopileatus (PC), an edible mushroom and commonly cultured in oriental countries, exerted anticancer, immune improving, antioxidative, hypoglycemic and hypolipidemic effects. Previous studies also showed various molecular weights (MW) fractioned from extracts may affect biological activities due to varying contents of bioactive components. Thus, the objective of this study is to investigate the in vitro antioxidant, hypoglycemic and hypotenstive effects and distribution of active compounds of various MWs of cold water extract from P. citrinopileatus (CWEPC). CWEPC was fractioned into four various MW fractions, PC-I (＜1 kDa), PC-II (1-3.5 kDa), PC-III (3.5-10 kDa), and PC-IV (＞10 kDa), using an ultrafiltration system. The physiological activities, including antioxidant activities, the inhibition capabilities of pancreatic α-amylase, intestinal α-glucosidase, and hypertension-linked ACE, and the active components, including polysaccharides, protein, and phenolic contents, of CWEPC and four fractions were determined. The results showed that fractions with lower MW exerted a higher antioxidant activity (p<0.05), which was positively correlated to the levels of total phenols. In contrast, the inhibition effects on the activities of α-amylase, α-glucosidase, and ACE of PC-IV fraction were significantly higher than CWEPC and the other three low MW fractions (< 10 kDa), which was more related to protein contents. The inhibition capability of CWEPC and PC-IV on α-amylase activity was 1/13.4 to 1/2.7 relative to that of acarbose (positive control), respectively. However, the inhibitory ability of PC-IV on α-glucosidase (IC50 = 0.5 mg/mL) was significantly higher than acarbose (IC50 = 1.7 mg/mL). Kinetic data revealed that PC-IV fraction followed a non-competitive inhibition on α-glucosidase activity. In conclusion, the distribution of various bioactive components contribute to the functions of different MW fractions on oxidative stress prevention, and blood pressure and glucose modulation.

Keywords: α-Amylase, angiotensin converting enzyme, α-Glucosidase, Pleurotus citrinopileatus

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Authors: Hilal Karakuş, Berrin Akman

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Preschool years are considered as critical years because of shaping the future lives of individuals. All of the knowledge, skills, and concepts are acquired during this period. Also, basis of academic skills is based on this period. As all of the developmental areas are the fastest in that period, the basis of mathematics education should be given in this period, too. Mathematics is seen as a difficult and abstract course by the most people. Therefore, the enjoyable side of mathematics should be presented in a concrete way in this period to avoid any bias of children for mathematics. This study is conducted to examine mathematics concept acquisition of children in terms of different variables. Screening model is used in this study which is carried out in a quantity way. The study group of this research consists of total 300 children, selected from each class randomly in groups of five, who are from public and private preschools in Çankaya, which is district of Ankara, in 2014-2015 academic year and attending children in the nursery classes and preschool institutions are connected to the Ministry of National Education. The study group of the research was determined by stage sampling method. The schools, which formed study group, are chosen by easy sampling method and the children are chosen by simple random method. Research data were collected with Bracken Basic Concept Scale–Revised Form and Child’s Personal Information Form generated by the researcher in order to get information about children and their families. Bracken Basic Concept Scale-Revised Form consists of 11 sub-dimensions (color, letter, number, size, shape, comparison, direction-location, and quantity, individual and social awareness, building- material) and 307 items. Subtests related to the mathematics were used in this research. In the “Child Individual Information Form” there are items containing demographic information as followings: age of children, gender of children, attending preschools educational intuitions for children, school attendance, mother’s and father’s education levels. At the result of the study, while it was found that children’s mathematics skills differ from age, state of attending any preschool educational intuitions , time of attending any preschool educational intuitions, level of education of their mothers and their fathers; it was found that it does not differ by the gender and type of school they attend.

Keywords: preschool education, preschool period children, mathematics education, mathematics concept acquisitions

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Authors: Cristóbal Moënne-Loccoz, Rodrigo C. Vergara, Vladimir López, Domingo Mery, Diego Cosmelli

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Our daily interaction with computational interfaces is plagued of situations in which we go from inexperienced users to experts through self-motivated exploration of the same task. In many of these interactions, we must learn to find our way through a sequence of decisions and actions before obtaining the desired result. For instance, when drawing cash from an ATM machine, choices are presented in a step-by-step fashion so that a specific sequence of actions must be performed in order to produce the expected outcome. But, as they become experts in the use of such interfaces, do users adopt specific search and learning strategies? Moreover, if so, can we use this information to follow the process of expertise development and, eventually, predict future actions? This would be a critical step towards building truly adaptive interfaces that can facilitate interaction at different moments of the learning curve. Furthermore, it could provide a window into potential mechanisms underlying decision-making behavior in real world scenarios. Here we tackle this question using a simple game interface that instantiates a 4-level binary decision tree (BDT) sequential decision-making task. Participants have to explore the interface and discover an underlying concept-icon mapping in order to complete the game. We develop a Hidden Markov Model (HMM)-based approach whereby a set of stereotyped, hierarchically related search behaviors act as hidden states. Using this model, we are able to track the decision-making process as participants explore, learn and develop expertise in the use of the interface. Our results show that partitioning the problem space into such stereotyped strategies is sufficient to capture a host of exploratory and learning behaviors. Moreover, using the modular architecture of stereotyped strategies as a Mixture of Experts, we are able to simultaneously ask the experts about the user's most probable future actions. We show that for those participants that learn the task, it becomes possible to predict their next decision, above chance, approximately halfway through the game. Our long-term goal is, on the basis of a better understanding of real-world decision-making processes, to inform the construction of interfaces that can establish dynamic conversations with their users in order to facilitate the development of expertise.

Keywords: behavioral modeling, expertise acquisition, hidden markov models, sequential decision-making

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Authors: K. Genise, S. Murthy

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Introductory Statement: The results of this retrospective chart review suggest the effects of bacterial colonization in critically ill children with viral bronchiolitis, currently unproven, are clinically insignificant. Background: Viral bronchiolitis is one of the most prevalent causes of illness requiring hospitalization among children worldwide and one of the most common reasons for admission to pediatric intensive care. It has been hypothesized that co-infection with bacteria results in more severe clinical outcomes. Conversely, the effects of bacterial colonization in critically ill patients with bronchiolitis are poorly defined. Current clinical management of colonized patients consists primarily of supportive therapies with the role of antibiotics remaining controversial. Methods: A retrospective review of all critically ill children admitted to the BC Children’s Hospital Pediatric Intensive Care Unit (PICU) from 2014-2017 with a diagnosis of bronchiolitis was performed. Routine testing in this time frame consisted of complete pathogen testing, including PCR for Streptococcus pneumoniae. Analyses were performed to determine the impact of bacterial colonization and antibiotic use on a primary outcome of PICU length-of-stay, with secondary outcomes of hospital length-of-stay and duration of ventilation. Results: There were 92 patients with complete pathogen testing performed during the assessed timeframe. A comparison between children with detected Streptococcus pneumoniae (n=22) and those without (n=70) revealed no significant (p=0.20) differences in severity of illness on presentation as per Pediatric Risk of Mortality III scores (mean=3.0). Patients colonized with S. pneumoniae had significantly shorter PICU stays (p=0.002), hospital stays (p=0.0001) and duration of non-invasive ventilation (p=0.002). Multivariate analyses revealed that these effects on length of PICU stay and duration of ventilation do not persist after controlling for antibiotic use, presence of radiographic consolidation, age, and severity of illness (p=0.15, p=0.32). The relationship between colonization and duration of hospital stay persists after controlling for these variables (p=0.008). Conclusions: Children with viral bronchiolitis colonized with S. pneumoniae do not appear to have significantly different PICU length-of-stays or duration of ventilation compared to children who are not colonized. Colonized children appear to have shorter hospital stays. The results of this study suggest bacterial colonization is not associated with increased severity of presenting illness or negative clinical outcomes.

Keywords: bronchiolitis, colonization, critical care, pediatrics, pneumococcal, infection

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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: Yiqi Zhu, Jean Francois Trani, Rameez Ulhassan

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Extreme weather phenomena increased by 46% between 2007 and 2017 and have become more intense with the rise in global average temperatures. This increased intensity of climate variations often induces humanitarian crises and particularly affects vulnerable populations in low- and middle-income countries (LMICs). Expectant and lactating mothers are among the most vulnerable groups. Pakistan ranks 10th among the most affected countries by climate disasters. In 2022, monsoon floods submerged a third of the country, causing the loss of 1,500 lives. Approximately 650,000 expectant and lactating mothers faced systematic stress from climatic disasters. Our study used participatory methods to investigate the systematic impact of climatic disasters on maternal health. In March 2023, we conducted six Group Model Building (GMB) workshops with healthcare workers, fathers, and mothers separately in two of the most affected areas in Pakistan. This study was approved by the Islamic Relief Research Review Board. GMB workshops consist of three sessions. In the first session, participants discussed the factors that impact maternal health. After identifying the factors, they discussed the connections among them and explored the system structures that collectively impact maternal health. Based on the discussion, a causal loop diagram (CLD) was created. Finally, participants discussed action ideas that could improve the system to enhance maternal health. Based on our discussions and the causal loop diagram, we identified interconnected factors at the family, community, and policy levels. Mothers and children are directly impacted by three interrelated factors: food insecurity, unstable housing, and lack of income. These factors create a reinforcing cycle that negatively affects both mothers and newborns. After the flood, many mothers were unable to produce sufficient breastmilk due to their health status. Without breastmilk and sufficient food for complementary feeding, babies tend to get sick in damp and unhygienic environments resulting from temporary or unstable housing. When parents take care of sick children, they miss out on income-generating opportunities. At the community level, the lack of access to clean water and sanitation (WASH) and maternal healthcare further worsens the situation. Structural failures such as a lack of safety nets and programs associated with flood preparedness make families increasingly vulnerable with each disaster. Several families reported that they had not fully recovered from a flood that occurred ten years ago, and this latest disaster destroyed their lives again. Although over twenty non-profit organizations are working in these villages, few of them provide sustainable support. Therefore, participants called for systemic changes in response to the increasing frequency of climate disasters. The study reveals the systematic vulnerabilities of mothers and children after climatic disasters. The most vulnerable populations are often affected the most by climate change. Collaborative efforts are required to improve water and forest management, strengthen public infrastructure, increase access to WASH, and gradually build climate-resilient communities. Governments, non-governmental organizations, and the community should work together to develop and implement effective strategies to prevent, mitigate, and adapt to climate change and its impacts.

Keywords: climatic disasters, maternal health, Pakistan, systematic impact, flood, disaster relief.

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Authors: Orkide Donma, Mustafa M. Donma

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Obesity is associated with increased fat mass as well as fat percentage. Minerals are the elements, which are of vital importance. In this study, the relationships between body as well as bone mineral profile and the percentage as well as mass values of fat, fat-free portion, protein, skeletal muscle were evaluated in adult men with normal body mass index (N-BMI), and those classified according to different stages of obesity. A total of 103 adult men classified into five groups participated in this study. Ages were within 19-79 years range. Groups were N-BMI (Group 1), overweight (OW) (Group 2), first level of obesity (FLO) (Group 3), second level of obesity (SLO) (Group 4) and third level of obesity (TLO) (Group 5). Anthropometric measurements were performed. BMI values were calculated. Obesity degree, total body fat mass, fat percentage, basal metabolic rate (BMR), visceral adiposity, body mineral mass, body mineral percentage, bone mineral mass, bone mineral percentage, fat-free mass, fat-free percentage, protein mass, protein percentage, skeletal muscle mass and skeletal muscle percentage were determined by TANITA body composition monitor using bioelectrical impedance analysis technology. Statistical package (SPSS) for Windows Version 16.0 was used for statistical evaluations. The values below 0.05 were accepted as statistically significant. All the groups were matched based upon age (p > 0.05). BMI values were calculated as 22.6 ± 1.7 kg/m², 27.1 ± 1.4 kg/m², 32.0 ± 1.2 kg/m², 37.2 ± 1.8 kg/m², and 47.1 ± 6.1 kg/m² for groups 1, 2, 3, 4, and 5, respectively. Visceral adiposity and BMR values were also within an increasing trend. Percentage values of mineral, protein, fat-free portion and skeletal muscle masses were decreasing going from normal to TLO. Upon evaluation of the percentages of protein, fat-free portion and skeletal muscle, statistically significant differences were noted between NW and OW as well as OW and FLO (p < 0.05). However, such differences were not observed for body and bone mineral percentages. Correlation existed between visceral adiposity and BMI was stronger than that detected between visceral adiposity and obesity degree. Correlation between visceral adiposity and BMR was significant at the 0.05 level. Visceral adiposity was not correlated with body mineral mass but correlated with bone mineral mass whereas significant negative correlations were observed with percentages of these parameters (p < 0.001). BMR was not correlated with body mineral percentage whereas a negative correlation was found between BMR and bone mineral percentage (p < 0.01). It is interesting to note that mineral percentages of both body as well as bone are highly affected by the visceral adiposity. Bone mineral percentage was also associated with BMR. From these findings, it is plausible to state that minerals are highly associated with the critical stages of obesity as prominent parameters.

Keywords: bone, men, minerals, obesity

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Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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Authors: Meng Miao, Jeongwoo Han, Cam Nguyen

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Ultra-wideband (UWB) time-domain impulse communication and radar systems use ultra-short duration pulses in the sub-nanosecond regime, instead of continuous sinusoidal waves, to transmit information. The pulse directly generates a very wide-band instantaneous signal with various duty cycles depending on specific usages. In UWB systems, the total transmitted power is spread over an extremely wide range of frequencies; the power spectral density is extremely low. This effectively results in extremely small interference to other radio signals while maintains excellent immunity to interference from these signals. UWB devices can therefore work within frequencies already allocated for other radio services, thus helping to maximize this dwindling resource. Therefore, impulse UWB technique is attractive for realizing high-data-rate, short-range communications, ground penetrating radar (GPR), and military radar with relatively low emission power levels. UWB antennas are the key element dictating the transmitted and received pulse shape and amplitude in both time and frequency domain. They should have good impulse response with minimal distortion. To facilitate integration with transmitters and receivers employing microwave integrated circuits, UWB antennas enabling direct integration are preferred. We present the development of two UWB antennas operating from 3.1 to 10.6 GHz and 0.3-6 GHz for UWB systems that provide direct integration with microwave integrated circuits. The operation of these antennas is based on the principle of wave propagation on a non-uniform transmission line. Time-domain EM simulation is conducted to optimize the antenna structures to minimize reflections occurring at the open-end transition. Calculated and measured results of these UWB antennas are presented in both frequency and time domains. The antennas have good time-domain responses. They can transmit and receive pulses effectively with minimum distortion, little ringing, and small reflection, clearly demonstrating the signal fidelity of the antennas in reproducing the waveform of UWB signals which is critical for UWB sensors and communication systems. Good performance together with seamless microwave integrated-circuit integration makes these antennas good candidates not only for UWB applications but also for integration with printed-circuit UWB transmitters and receivers.

Keywords: antennas, ultra-wideband, UWB, UWB communication systems, UWB radar systems

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Authors: Chang Hsueh-Sheng, Chen Tzu-Ling

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Earthquake is an unpredictable natural disaster and intensive earthquakes have caused serious impacts on social-economic system, environmental and social resilience, and further increase vulnerability. Due to earthquakes do not kill people, buildings do. When buildings located nearby earthquake-prone areas and constructed upon poorer soil areas might result in earthquake-induced ground damage. In addition, many existing buildings built before any improved seismic provisions began to be required in building codes and inappropriate land usage with highly dense population might result in much serious earthquake disaster. Indeed, not only do earthquake disaster impact seriously on urban environment, but urban growth might increase the vulnerability. Since 1980s, ‘Cutting down risks and vulnerability’ has been brought up in both urban planning and architecture and such concept has way beyond retrofitting of seismic damages, seismic resistance, and better anti-seismic structures, and become the key action on disaster mitigation. Land use planning and zoning are two critical non-structural measures on controlling physical development while it is difficult for zoning boards and governing bodies restrict development of questionable lands to uses compatible with the hazard without credible earthquake loss projection. Therefore, identifying potential earthquake exposure, vulnerability people and places, and urban development areas might become strongly supported information for decision makers. Taiwan locates on the Pacific Ring of Fire where a seismically active zone is. Some of the active faults have been found close by densely populated and highly developed built environment in the cities. Therefore, this study attempts to base on the perspective of carrying capacity and draft out micro-zonation according to both vulnerability index and urban growth index while considering spatial variances of multi factors via geographical weighted principle components (GWPCA). The purpose in this study is to construct supported information for decision makers on revising existing zoning in high-risk areas for a more compatible use and the public on managing risks.

Keywords: earthquake disaster, vulnerability, urban growth, carrying capacity, /geographical weighted principle components (GWPCA), bivariate spatial association statistic

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Authors: Martha Lilia Del Rio Duque, Michelle Bonatti, Katharina Loehr, Marcos Lana, Tatiana Rodriguez, Stefan Sieber

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Nowadays, most agricultural practices can reduce the ability of ecosystems to provide goods and services. To enhance environmentally friendly food production and to maximize social and economic benefits, sustainable land use systems (SLUS) are one of the most critical strategies increasingly/strongly promoted by donors organizations, international agencies, and policymakers. This process involves the question of how SLUS can be scaled out also large-scale landscapes and not merely isolated experiments. As SLUS are context-specific strategies, diffusion and replication of successful SLUS in Colombia required the identification of main factors that facilitate this scaling out process. We applied a case study approach to investigate the scaling out process of SLUS in cocoa and livestock sector within peacebuilding territories in Colombia, specifically, in Cesar and Caqueta region. These two regions are contrasting, but both have a current trend of increasing land degradation. Presently in Colombia, Caqueta is one of the most deforested departments, and Cesar has some most degraded soils. Following a qualitative research approach, 19 semi-structured interviews and 2 focus groups were conducted with agroforestry experts in both regions to analyze (1) what does it mean a sustainable land use system in Cocoa/Livestock, specifically in Caqueta or Cesar and (2) to identify the key elements at the level of the following dimensions: biophysical, economic and profitability, market, social, policy and institutions that can explain how and why SLUS are replicated and spread among more producers. The Interviews were coded and analyzed using MAXQDA to identify, analyze and report patterns (themes) within data. As the results show, key themes, among which: premium market, solid regional markets and price stability, water availability and management, generational renewal, land use knowledge and diversification, producer organization and certifications are crucial to understand how the SLUS can have an impact across large-scale landscapes and how the scaling out process can be set up best in order to be successful across different contexts. The analysis further reveals which key factors might affect SLUS efficiency.

Keywords: agroforestry, cocoa sector, Colombia, livestock sector, sustainable land use system

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Authors: Selin Kara-Bahçekapılı, Bengisu Nehir Aydın

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Objective: In this study, it is aimed to examine the relationship between childhood traumas (overprotection-control, emotional/physical/sexual abuse, emotional/physical neglect), age, emotional regulation difficulties, and the tendency of violence in adults. In the study, the direct and indirect effects of 6 sub-factors of childhood traumas, emotion regulation difficulties, and age on tendency to violence are evaluated on a model that theoretically reveals. Method: The population of this cross-sectional study consists of individuals between the ages of 18-65 living in Turkey. The data from 527 participants were obtained by online surveys and convenience sampling method within the scope of the study. As a result of exclusion criteria and then outlier data analysis, the data of 443 participants were included in the analysis. Data were collected by demographic information form, childhood trauma scale, emotion regulation difficulty scale, and violence tendency scale. Research data were analyzed by SPSS and AMOS using correlation, path analysis, direct and indirect effects. Results: According to the research findings, the variables in the model explained 28.2% of the variance of the mean scores of the individuals' tendency to violence. Emotion regulation difficulties have the most direct effect on the tendency to violence (d=.387; p<.01). The effects of excessive protection and control, emotional neglect, and physical neglect variables on the tendency to violence are not significant. When the significant and indirect effects of the variables on tendency to violence over emotion regulation difficulties are examined, age has a negative effect, emotional neglect has a positive effect, emotional abuse has a positive effect, and overprotection-control has a positive effect. The indirect effects of sexual abuse, physical neglect, and physical abuse on tendency to violence are not significant. Childhood traumas and age variables in the model explained 24.1% of the variance of the mean scores of the individuals’ emotion regulation difficulties. The variable that most affects emotion regulation difficulties is age (d=-.268; p<.001). The direct effects of sexual abuse, physical neglect, and physical abuse on emotion regulation difficulties are not significant. Conclusion: The results of the research emphasize the critical role of difficulty in emotion regulation on the tendency to violence. Difficulty in emotion regulation affects the tendency to violence both directly and by mediating different variables. In addition, it is seen that some sub-factors of childhood traumas have direct and/or indirect effects on the tendency to violence. Emotional abuse and age have both direct and indirect effects on the tendency to violence over emotion regulation difficulties.

Keywords: childhood trauma, emotion regulation difficulties, tendency to violence, path analysis

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Authors: Pisut Boonkaew, Jatuporn Thongsri

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In hard disk drive manufacturing industry, the process of reducing an unnecessary part and qualifying the quality of part before assembling is important. Thus, clamp was designed and fabricated as a fixture for holding in testing process. Basically, testing by trial and error consumes a long time to improve. Consequently, the simulation was brought to improve the part and reduce the time taken. The problem is the present clamp has a low life expectancy because of the critical stress that occurred. Hence, the simulation was brought to study the behavior of stress and compressive force to improve the clamp expectancy with all probability of designs which are present up to 27 designs, which excluding the repeated designs. The probability was calculated followed by the full fractional rules of six sigma methodology which was provided correctly. The six sigma methodology is a well-structured method for improving quality level by detecting and reducing the variability of the process. Therefore, the defective will be decreased while the process capability increasing. This research focuses on the methodology of stress and fatigue reduction while compressive force still remains in the acceptable range that has been set by the company. In the simulation, ANSYS simulates the 3D CAD with the same condition during the experiment. Then the force at each distance started from 0.01 to 0.1 mm will be recorded. The setting in ANSYS was verified by mesh convergence methodology and compared the percentage error with the experimental result; the error must not exceed the acceptable range. Therefore, the improved process focuses on degree, radius, and length that will reduce stress and still remain in the acceptable force number. Therefore, the fatigue analysis will be brought as the next process in order to guarantee that the lifetime will be extended by simulating through ANSYS simulation program. Not only to simulate it, but also to confirm the setting by comparing with the actual clamp in order to observe the different of fatigue between both designs. This brings the life time improvement up to 57% compared with the actual clamp in the manufacturing. This study provides a precise and trustable setting enough to be set as a reference methodology for the future design. Because of the combination and adaptation from the six sigma method, finite element, fatigue and linear regressive analysis that lead to accurate calculation, this project will able to save up to 60 million dollars annually.

Keywords: clamp, finite element analysis, structural, six sigma, linear regressive analysis, fatigue analysis, probability

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Authors: Diego Caballero Vélez

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In 1997 the Schengen Convention was incorporated in the mainstream of EU law by the Amsterdam Treaty. It came into effect in 1999 with the abolition of internal border controls in the EU, a milestone in the European integration project. In the meantime, due to the Yugoslav wars, nearly 700,000 asylum applications were filed in the European countries provoking a major refugee crisis. During this period, the opening of Eastern Europe fostered more cooperation and policy-making at the EU level in migration issues. Currently, a similar migratory crisis is taking place in Europe. The Syrian war has caused the most massive influx of immigrants in Europe since World War II. Nevertheless, the EU is adopting different migration policies from those implemented during the Yugoslav migration crisis. The current crisis has not led to a common European position but national responses have been offered on migration policies and responsibility for border security and asylum-seekers. A lot of factors can explain this change from a cooperation scenario to a no cooperation one, such as the economic crisis, but this research is focused on the premise that 'threat perception' lies at the core of some states grand strategies towards migration and it also influences in multilateral or unilateral responses. Migration rests at the nexus of three dimensions of security, including geopolitical interests, material production, and internal security. According to some scholars, migration policy is an 'integral instrument' of state grand strategy in that context. Political integration at the EU might be altered with the emergence of existential threats. In other words, some areas of the European cooperation can be transformed when a 'critical juncture' occurs, for instance a migration crisis. In that instance, Member states could see migration as a matter of threat that modifies their national interests and willingness to embrace international cooperation. This research will focus on EU Member states´ perceptions of the 90´s migration crisis and the current one. The goal is to evaluate to what extent the perceptions of threat are one of the main factors for explaining the transition from a cooperation scenario to a no-cooperation one in European asylum and security policies. To analyze threat perception in both migration crisis, some relevant Member states are treated as cases of study and a comparative analysis is carried out based on public opinion polls, public and policy discourse in migration, voting practices and deconstruction of the migration policies themselves both at EU level and a national one.

Keywords: cooperation, migration crisis, national responses, threat perception

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Authors: Steven Walker

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This paper assesses recent data on the prevalence of poverty among children and young people diagnosed with mental health problems. The paper will demonstrate that the current hierarchy of risk factors for developing mental health problems needs adjusting to place poverty among the highest risk factors. Globally poverty is calculated to keep rising especially among less developed countries, and the post-Covid 19 economic recession in developed countries is set to rise. The experience of young people enduring Pandemic isolation is already being quantified and is expected to increase referrals for specialist intervention. Searches on several medical/psychological/social databases using keywords: poverty, children, mental illness were undertaken between 2018 and 2021. Worldwide, 700 million people still live in extreme poverty, half of whom are children. Children are physically and mentally disproportionately affected. Children who grow up impoverished lack the basic necessities they need to survive and thrive. 150 million children have been plunged into multidimensional poverty due to COVID-19. The poorest children are twice as likely to die in childhood than their wealthier peers. For those growing up in humanitarian crises such as Ukraine, the risks of deprivation and exclusion are magnified. In the world’s richest countries, one in seven children still live in poverty. Currently, one in four children in the European Union are at risk of falling into poverty. In Europe the impact of Brexit on the UK economy is predicted to reduce GDP by 5% in 2021 with a corresponding rise in poverty. According to the global charity Oxfam wealth inequality impacts levels of child abuse and affects women and girls worse and is a contributory factor in the risk of developing childhood mental illness. In the UK 2000 Foodbanks have opened since 2010, handing out 2 million food parcels annually, where there are currently 4 million children officially living in poverty. This research demonstrates that there is a strong association between families’ socio-economic circumstances and the chances that their children will experience mental illness. Evidence of this association is found repeatedly across developed countries. The paper will conclude by arguing that psychologists, psychiatrists, psychotherapists, social workers and CAMHS specialists need to place more importance on this critical socio-economic variable when assessing referred children and also advocate for political priorities in governments to reduce poverty and lower the risk of childhood mental illness.

Keywords: poverty, resilience, risk factor, socio economic, susceptibility

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Authors: Robert Ab Butarbutar, Sutan Musa Buyana

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Purpose: The purpose of this study is to empirically test the correlation between several variables: perceived quality, overall customer satisfaction and brand attitude to brand loyalty on Maxim magazine in Indonesia. Since the room of adult magazine in Indonesia is restricted, the study of this category has became so interesting to reveal how those variables occur. Design/ methodology/ approach: The combination of exploratory, descriptive and causal research design used in this study. Non-probability sampling, specifically purposive sampling used to determine 160 respondents. Path analysis used to examine the contribution of antecedents variables, perceived quality, overall satisfaction and brand attitude in contribution to brand loyalty. Additional respondents serve for in-depth interview to enrich findings from questionnaire that directly distributed. Findings: The research shows that perceived quality positively contribute to overall satisfaction and brand attitude. Overall satisfaction also positively influence brand attitude and brand loyalty. Finally, brand attitude directly impact to brand loyalty. Despite the hypothesis testing, qualitative research also shows specific behavior of Indonesian customer in consuming adult magazine. Research limitation/implication: This research limited to adult male (18 years at minimum) and who live in big city as Jakarta. Broader geographical coverage is advisable for further research. This study also serves a call for additional empirical research into different product category that targeted to adult male, Since the research of this segment is quite scarce. Managerial Implications: Since findings show perceived quality positively impact and strong contribute to overall satisfaction and brand attitude, it implies for adult magazine to be driven by quality of content. The selection of model, information of current lifestyle of urban male became prioritizes in developing perceived quality. Differentiation also emerges as critical issues since consumer difficult to differentiate significantly one magazine to another. The way magazine deliver its content toward distinctive communication is highly recommended. Furthermore, brand loyalty faces big challenge. Interactivity toward events and social media become critically important. Originality/ value: perceived quality plays as prerequisite to develop overall satisfaction and brand attitude. Finding shows customer difficult to differentiate among adult magazines. Therefore, brand loyalty become a big challenge for company.

Keywords: perceived quality, overall satisfaction, brand attitude, adult magazine

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Authors: Lamia Emam

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The attractiveness of entrepreneurship education stems from its perceived value as a venue through which students can develop an entrepreneurial mindset, skill set, and practice, which may not necessarily lead to them starting a new business, but could, more importantly, be manifested as a life skill that could be applied to all types of organizations and career endeavors. This, in turn, raises important questions about what happens in our classrooms; our role as educators, the role of students, center of learning, and the instructional approach; all of which eventually contribute to achieving the desired EE outcomes. With application to an undergraduate entrepreneurship course -Entrepreneurship as Practice- the current paper aims to explore the effect of entrepreneurship education on the development of students’ general entrepreneurial tendencies. Towards that purpose, the researcher herein uses a pre-test and post-test quasi-experimental research design where the Durham University General Enterprising Tendency Test (GET2) is administered to the same group of students before and after course delivery. As designed and delivered, the Entrepreneurship as Practice module is a highly applied and experiential course where students are required to develop an idea for a start-up while practicing the entrepreneurship-related knowledge, mindset, and skills that are taught in class, both individually and in groups. The course is delivered using a combination of short lectures, readings, group discussions, case analysis, guest speakers, and, more importantly, actively engaging in a series of activities that are inspired by diverse methods for developing successful and innovative business ideas, including design thinking, lean-start up and business feasibility analysis. The instructional approach of the course particularly aims at developing the students' critical thinking, reflective, analytical, and creativity-based problem-solving skills that are needed to launch one’s own start-up. The analysis and interpretation of the experiment’s outcomes shall simultaneously incorporate the views of both the educator and students. As presented, the study responds to the rising call for the application of experimental designs in entrepreneurship in general and EE in particular. While doing so, the paper presents an educator’s perspective of EE to complement the dominant stream of research which is constrained to the students’ point of view. Finally, the study sheds light on EE in the MENA region, where the study is applied.

Keywords: entrepreneurship education, andragogy and heutagogy, scholarship of teaching and learning, experiment

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Authors: Paolo Guzzini, Emad Samuel M. Ebeid

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Bridges and Railways are critical infrastructures. Ensuring safety for transports using such assets is a primary goal as it directly impacts the lives of people. By the way, improving safety could require increased investments in O&M, and therefore optimizing resource usage for asset maintenance becomes crucial. Drones4Safety (D4S), a European project funded under the H2020 Research and Innovation Action (RIA) program, aims to increase the safety of the European civil transport by building a system that relies on 3 main pillars: • Drones operating autonomously in swarm mode; • Drones able to recharge themselves using inductive phenomena produced by transmission lines in the nearby of bridges and railways assets to be inspected; • Data acquired that are analyzed with AI-empowered algorithms for defect detection This paper describes the business model behind this disruptive project. The Business Model is structured in 2 parts: • The first part is focused on the design of the business model Canvas, to explain the value provided by the Drone4safety project; • The second part aims at defining a detailed financial analysis, with the target of calculating the IRR (Internal Return rate) and the NPV (Net Present Value) of the investment in a 7 years plan (2 years to run the project + 5 years post-implementation). As to the financial analysis 2 different points of view are assumed: • Point of view of the Drones4safety company in charge of designing, producing, and selling the new system; • Point of view of the Utility company that will adopt the new system in its O&M practices; Assuming the point of view of the Drones4safety company 3 scenarios were considered: • Selling the drones > revenues will be produced by the drones’ sales; • Renting the drones > revenues will be produced by the rental of the drones (with a time-based model); • Selling the data acquisition service > revenues will be produced by the sales of pictures acquired by drones; Assuming the point of view of a utility adopting the D4S system, a 4th scenario was analyzed taking into account the decremental costs related to the change of operation and maintenance practices. The paper will show, for both companies, what are the key parameters affecting most of the business model and which are the sustainable scenarios.

Keywords: a swarm of drones, AI, bridges, railways, drones4safety company, utility companies

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Authors: Muhammad Arif Khan, Haroon Idrees, Imran Aziz, Sidra Mushtaq

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The purpose of this study is to investigate the current level of knowledge mapping skills of the public sector employees in Pakistan. National Institute of Management is one of the premiere public sector training organization for mid-career public sector employees in Pakistan. This study is conducted on participants of fourteen weeks long training course called Mid-Career Management Course (MCMC) which is mandatory for public sector employees in order to ascertain how to enhance their knowledge mapping skills. Methodology: Researcher used both qualitative and quantitative approach to conduct this study. Primary data about current level of participants’ understanding of knowledge mapping was collected through structured questionnaire. Later on, Participant Observation method was used where researchers acted as part of the group to gathered data from the trainees during their performance in training activities and tasks. Findings: Respondents of the study were examined for skills and abilities to organizing ideas, helping groups to develop conceptual framework, identifying critical knowledge areas of an organization, study large networks and identifying the knowledge flow using nodes and vertices, visualizing information, represent organizational structure etc. Overall, the responses varied in different skills depending on the performance and presentations. However, generally all participants have demonstrated average level of using both the IT and Non-IT K-mapping tools and techniques during simulation exercises, analysis paper de-briefing, case study reports, post visit presentation, course review, current issue presentation, syndicate meetings, and daily synopsis. Research Limitations: This study is conducted on a small-scale population of 67 public sector employees nominated by federal government to undergo 14 weeks extensive training program called MCMC (Mid-Career Management Course) at National Institute of Management, Peshawar, Pakistan. Results, however, reflects only a specific class of public sector employees i.e. working in grade 18 and having more than 5 years of work. Practical Implications: Research findings are useful for trainers, training agencies, government functionaries, and organizations working for capacity building of public sector employees.

Keywords: knowledge management, km in public sector, knowledge management and professional development, knowledge management in training, knowledge mapping

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Authors: Ashish Trivedi, Amol Singh

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In the recent years, the magnitude and frequency of disasters have increased at an alarming rate. Every year, more than 400 natural disasters affect global population. A large-scale disaster leads to destruction or damage to houses, thereby rendering a notable number of residents homeless. Since humanitarian response and recovery process takes considerable time, temporary establishments are arranged in order to provide shelter to affected population. These shelter areas are vital for an effective humanitarian relief; therefore, they must be strategically planned. Choosing the locations of temporary shelter areas for accommodating homeless people is critical to the quality of humanitarian assistance provided after a large-scale emergency. There has been extensive research on the facility location problem both in theory and in application. In order to deliver sufficient relief aid within a relatively short timeframe, humanitarian relief organisations pre-position warehouses at strategic locations. However, such approaches have received limited attention from the perspective of providing shelters to disaster-affected people. In present research work, this aspect of humanitarian logistics is considered. The present work proposes a hybrid decision support model to determine relative preference of potential shelter locations by assessing them based on key subjective criteria. Initially, the factors that are kept in mind while locating potential areas for establishing temporary shelters are identified by reviewing extant literature and through consultation from a panel of disaster management experts. In order to determine relative importance of individual criteria by taking into account subjectivity of judgements, a hybrid approach of fuzzy sets and Analytic Hierarchy Process (AHP) was adopted. Further, Technique for order preference by similarity to ideal solution (TOPSIS) was applied on an illustrative data set to evaluate potential locations for establishing temporary shelter areas for homeless people in a disaster scenario. The contribution of this work is to propose a range of possible shelter locations for a humanitarian relief organization, using a robust multi criteria decision support framework.

Keywords: AHP, disaster preparedness, fuzzy set theory, humanitarian logistics, TOPSIS, temporary shelters

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Authors: Siddharth Krishnaswamy

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Problem Statement: Currently, when analyzing household food security, the most commonly studied food access indicators are household income and expenditure. Larger studies do take into account other indices such as credit and employment. But these are baselines studies and by definition are conducted infrequently. Food security analysis for access is usually dedicated to analyzing income and expenditure indicators. And both these indicators are notoriously inconsistent. Yet this data can very often end up being the basis on which household food access is calculated; and by extension, be used for decision making. Objectives: This paper argues that along with income and expenditure, credit and debit information should be collected so that an accurate analysis of household food security (and in particular) food access can be determined. The lack of collection and analysis of this information routinely means that there is often a “masking” of the actual situation; a household’s food access and food availability patterns may be adequate mainly as a result of borrowing and may even be due to a long- term dependency (a debt cycle). In other words, such a household is, in reality, worse off than it appears a factor masked by its performance on basic access indicators. Procedures/methodologies/approaches: Existing food security data sets collected in 2005 in Azerbaijan, 2010 across Myanmar and 2014-15 across Uganda were used to support the theory that analyzing income and expenditure of a HHs and analyzing the same in addition to data on credit & borrowing patterns will result in an entirely different scenario of food access of the household. Furthermore, the data analyzed depicts food consumption patterns across groups of households and then relates this to the extent of dependency on credit, i.e. households borrowing money in order to meet food needs. Finally, response options that were based on analyzing only income and expenditure; and response options based on income, expenditure, credit, and borrowing – from the same geographical area of operation are studied and discussed. Results: The purpose of this work was to see if existing methods of household food security analysis could be improved. It is hoped that food security analysts will collect household level information on credit and debit and analyze them against income, expenditure and consumption patterns. This will help determine if a household’s food access and availability are dependent on unsustainable strategies such as borrowing money for food or undertaking sustained debts. Conclusions: The results clearly show the amount of relevant information that is missing in Food Access analysis if debit and borrowing of the household is not analyzed along with the typical Food Access indicators that are usually analyzed. And the serious repercussions this has on Programmatic response and interventions.

Keywords: analysis, food security indicators, response, resilience analysis

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Authors: Bahman Ghorashi

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The immense awareness of the global climate change has compelled traditional fossil fuel companies to develop strategies to reduce their carbon footprint and simultaneously consider the production of various sources of clean energy in order to mitigate the environmental impact of their operations. Similarly, supply chain issues, the scarcity of certain raw materials, energy costs as well as market needs, and changing consumer expectations have forced the traditional chemical industry to reexamine their time-honored modes of operation. This study examines how such transformative change might occur through the applications of agile principles as well as industry 4.0 technologies. Clearly, such a transformation is complex, costly, and requires a total commitment on the part of the top leadership and the entire management structure. Factors that need to be considered include organizational speed of change, a restructuring that would lend itself toward collaboration and the selling of solutions to customers’ problems, rather than just products, integrating ‘along’ as well as ‘across’ value chains, mastering change and uncertainty as well as a recognition of the importance of concept-to-cash time, i.e., the velocity of introducing new products to market, and the leveraging of people and information. At the same time, parallel to implementing such major shifts in the ethos, and the fabric of the organization, the change leaders should remain mindful of the companies’ DNA while incorporating the necessary DNA defying shifts. Furthermore, such strategic maneuvers should inevitably incorporate the managing of the upstream and downstream operations, harnessing future opportunities, preparing and training the workforce, implementing faster decision making and quick adaptation to change, managing accelerated response times, as well as forming autonomous and cross-functional teams. Moreover, the leaders should establish the balance between high-value solutions versus high-margin products, fully implement digitization of operations and, when appropriate, incorporate the latest relevant technologies, such as: AI, IIoT, ML, and immersive technologies. This study presents a summary of the agile principles and the relevant technologies and draws lessons from some of the best practices that are already implemented within the chemical industry in order to establish a roadmap to agility. Finally, the critical role of educational institutions in preparing the future workforce for Industry 4.0 is addressed.

Keywords: agile principles, immersive technologies, industry 4.0, workforce preparation

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Authors: Bridgette Merriman, Wen Fan

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Background: Existing cancer survivorship literature explores varying physical, psychosocial, and psychological late effects experienced by survivors of childhood cancer. However, adolescent and young adult (AYA) survivors of childhood cancer are understudied compared to their adult and pediatric cancer counterparts. Furthermore, existing quality of life (QoL) research fails to account for how cancer survivorship affects survivors across the lifespan. Given that prior research suggests positive cognitive appraisals of adverse events - such as cancer - mitigate detrimental psychosocial symptomologies later in life; it is crucial to understand cancer’s impacts on AYA survivors of childhood malignancies across the life course in order to best support these individuals and prevent maladaptive psychosocial outcomes. Methods: This qualitative study adopted the life-course perspective to investigate the experiences of AYA survivors of childhood malignancies. Eligible patients included AYA 21-30 years old who were diagnosed with cancer <18 years old and off active treatment for >2 years. Participants were recruited through social media posts. Study fulfillment included taking part in one semi-structured video interview to explore areas of survivorship previously identified as being specific to AYA survivors. Interviews were transcribed, coded, and analyzed in accordance with narrative analysis and life-course theory. This study was approved by the Boston College Institutional Review Board. Results: Of 28 individuals who met inclusion criteria and expressed interest in the study, nineteen participants (12 women, 7 men, mean age 25.4 years old) completed the study. Life course theory analysis revealed that events relating to childhood cancer are interconnected throughout the life course rather than isolated events. This “trail of survivorship” includes age at diagnosis, transitioning to life after cancer, and relationships with other childhood survivors. Despite variability in objective characteristics surrounding these events, participants recalled positive experiences regarding at least one checkpoint, ultimately finding positive meaning from their cancer experience. Conclusions: These findings suggest that favorable subjective experiences at these checkpoints are critical in fostering positive conceptions of childhood malignancy for AYA survivors of childhood cancer. Ultimately, healthcare professionals and communities may use these findings to guide support resources and interventions for childhood cancer patients and AYA survivors, therein minimizing detrimental psychosocial effects and maximizing resiliency.

Keywords: medical sociology, pediatric oncology, survivorship, qualitative, life course perspective

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Authors: Jessica Ding

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The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

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Authors: Sadam Elayah

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Background: One of the most critical competencies in advanced dentistry is alveolar ridge preservation after exodontia. The aim of this clinical trial was to assess the impact of autologous concentrated growth factor (CGF) as a socket-filling material and its ridge preservation properties following the lower third molar extraction. Materials and Methods: A total of 60 sides of 30 participants who had completely symmetrical bilateral impacted lower third molars were enrolled. The short-term outcome variables were wound healing, swelling and pain, clinically assessed at different time intervals (1st, 3rd & 7th days). While the long-term outcome variables were bone height & width, bone density and socket surface area in the coronal section. Cone beam computed tomography images were obtained immediately after surgery and three months after surgery as a temporal measure. Randomization was achieved by opaque, sealed envelopes. Follow-up data were compared to baseline using Paired & Unpaired t-tests. Results: The wound healing index was significantly better in the test sides (P =0.001). Regarding the facial swelling, the test sides had significantly fewer values than the control sides, particularly on the 1st (1.01±.57 vs 1.55 ±.56) and 3rd days (1.42±0.8 vs 2.63±1.2) postoperatively. Nonetheless, the swelling disappeared within the 7th day on both sides. The pain scores of the visual analog scale were not a statistically significant difference between both sides on the 1st day; meanwhile, the pain scores were significantly lower on the test sides compared with the control sides, especially on the 3rd (P=0.001) and 7th days (P˂0.001) postoperatively. Regarding long-term outcomes, CGF sites had higher values in height and width when compared to Control sites (Buccal wall 32.9±3.5 vs 29.4±4.3 mm, Lingual wall 25.4±3.5 vs 23.1±4 mm, and Alveolar bone width 21.07±1.55vs19.53±1.90 mm) respectively. Bone density showed significantly higher values in CGF sites than in control sites (Coronal half 200±127.3 vs -84.1±121.3, Apical half 406.5±103 vs 64.2±158.6) respectively. There was a significant difference between both sites in reducing periodontal pockets. Conclusion: CGF application following surgical extraction provides an easy, low-cost, and efficient option for alveolar ridge preservation. Thus, dentists may encourage using CGF during dental extractions, particularly when alveolar ridge preservation is required.

Keywords: platelet, extraction, impacted teeth, alveolar ridge, regeneration, CGF

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