Search results for: native american literature

Authors: I. Berger, N. Machour, F. Portet-Koltalo

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Polycyclic aromatic hydrocarbons (PAHs) are toxic and carcinogenic pollutants produced in majority by incomplete combustion processes in industrialized and urbanized areas. After being emitted in atmosphere, these persistent contaminants are deposited to soils or sediments. Even if persistent, some can be partially degraded (photodegradation, biodegradation, chemical oxidation) and they lead to oxygenated metabolites (oxy-PAHs) which can be more toxic than their parent PAH. Oxy-PAHs are less measured than PAHs in sediments and this study aims to compare different analytical tools in order to extract and quantify a mixture of four hydroxylated PAHs (OH-PAHs) and four carbonyl PAHs (quinones) in sediments. Methodologies: Two analytical systems – HPLC with on-line UV and fluorescence detectors (HPLC-UV-FLD) and GC coupled to a mass spectrometer (GC-MS) – were compared to separate and quantify oxy-PAHs. Microwave assisted extraction (MAE) was optimized to extract oxy-PAHs from sediments. Results: First OH-PAHs and quinones were analyzed in HPLC with on-line UV and fluorimetric detectors. OH-PAHs were detected with the sensitive FLD, but the non-fluorescent quinones were detected with UV. The limits of detection (LOD)s obtained were in the range (2-3)×10-4 mg/L for OH-PAHs and (2-3)×10-3 mg/L for quinones. Second, even if GC-MS is not well adapted to the analysis of the thermodegradable OH-PAHs and quinones without any derivatization step, it was used because of the advantages of the detector in terms of identification and of GC in terms of efficiency. Without derivatization, only two of the four quinones were detected in the range 1-10 mg/L (LODs=0.3-1.2 mg/L) and LODs were neither very satisfying for the four OH-PAHs (0.18-0.6 mg/L). So two derivatization processes were optimized, comparing to literature: one for silylation of OH-PAHs, one for acetylation of quinones. Silylation using BSTFA/TCMS 99/1 was enhanced using a mixture of catalyst solvents (pyridine/ethyle acetate) and finding the appropriate reaction duration (5-60 minutes). Acetylation was optimized at different steps of the process, including the initial volume of compounds to derivatize, the added amounts of Zn (0.1-0.25 g), the nature of the derivatization product (acetic anhydride, heptafluorobutyric acid…) and the liquid/liquid extraction at the end of the process. After derivatization, LODs were decreased by a factor 3 for OH-PAHs and by a factor 4 for quinones, all the quinones being now detected. Thereafter, quinones and OH-PAHs were extracted from spiked sediments using microwave assisted extraction (MAE) followed by GC-MS analysis. Several mixtures of solvents of different volumes (10-25 mL) and using different extraction temperatures (80-120°C) were tested to obtain the best recovery yields. Satisfactory recoveries could be obtained for quinones (70-96%) and for OH-PAHs (70-104%). Temperature was a critical factor which had to be controlled to avoid oxy-PAHs degradation during the MAE extraction process. Conclusion: Even if MAE-GC-MS was satisfactory to analyze these oxy-PAHs, MAE optimization has to be carried on to obtain a most appropriate extraction solvent mixture, allowing a direct injection in the HPLC-UV-FLD system, which is more sensitive than GC-MS and does not necessitate a previous long derivatization step.

Keywords: derivatizations for GC-MS, microwave assisted extraction, on-line HPLC-UV-FLD, oxygenated PAHs, polluted sediments

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Authors: Pui Hong Chung, Cyrus Leung, Jun Li, Kin On Kwok, Ek Yeoh

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Introduction: Studies for TB control in intermediate tuberculosis burden countries (IBCs) comprise a relatively small proportion in TB control literature, as compared to the effort put in high and low burden counterparts. It currently lacks of consensus in the optimal weapons and strategies we can use to combat TB in IBCs; guidelines of TB control are inadequate and thus posing a great obstacle in eliminating TB in these countries. To fill-in the research and services gap, we need to summarize the findings of the effort in this regard and to seek consensus in terms of policy making for TB control, we have devised a series of scoping and Delphi studies for these purposes. Method: The scoping and Delphi studies are conducted in parallel to feed information for each other. Before the Delphi iterations, we have invited three local experts in TB control in Hong Kong to participate in the pre-assessment round of the Delphi study to comments on the validity, relevance, and clarity of the Delphi questionnaire. Result: Two scoping studies, regarding LTBI control in health care workers in IBCs and TB control in elderly of IBCs respectively, have been conducted. The result of these two studies is used as the foundation for developing the Delphi questionnaire, which tapped on seven areas of question, namely: characteristics of IBCs, adequacy of research and services in LTBI control in IBCs, importance and feasibility of interventions for TB control and prevention in hospital, screening and treatment of LTBI in community, reasons of refusal to/ default from LTBI treatment, medical adherence of LTBI treatment, and importance and feasibility of interventions for TB control and prevention in elderly in IBCs. The local experts also commented on the two scoping studies conducted, thus act as the sixth phase of expert consultation in Arksey and O’Malley framework of scoping studies, to either nourish the scope and strategies used in these studies or to supplement ideas for further scoping or systematic review studies. In the subsequent stage, an international expert panel, comprised of 15 to 20 experts from IBCs in Western Pacific Region, will be recruited to join the two-round anonymous Delphi iterations. Four categories of TB control experts, namely clinicians, policy makers, microbiologists/ laboratory personnel, and public health clinicians will be our target groups. A consensus level of 80% is used to determine the achievement of consensus on particular issues. Key messages: 1. Scoping review and Delphi method are useful to identify gaps and then achieve consensus in research. 2. Lots of resources are put in the high burden countries now. However, the usually neglected intermediate-burden countries with TB is an indispensable part for achieving the ambitious WHO End TB 2035 target.

Keywords: dephi questionnaire, tuberculosis, WHO, latent TB infection

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Authors: Nick Woodier, Iain Moppett

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Background: It is estimated that one in ten patients admitted to hospital will suffer an adverse event in their care. While the majority of these will result in low harm, patients are being significantly harmed by the processes meant to help them. Healthcare, therefore, seeks to make improvements in patient safety by taking learning from other industries that are perceived to be more mature in their management of safety events. Of particular interest to healthcare are ‘near misses,’ those events that almost happened but for an intervention. Healthcare does not have any guidance as to how best to manage and learn from near misses to reduce the chances of harm to patients. The authors, as part of a larger study of near-miss management in healthcare, sought to learn from the UK nuclear sector to develop principles for how healthcare can identify, report, and learn from near misses to improve patient safety. The nuclear sector was chosen as an exemplar due to its status as an ultra-safe industry. Methods: A Grounded Theory (GT) methodology, augmented by a scoping review, was used. Data collection included interviews, scenario discussion, field notes, and the literature. The review protocol is accessible online. The GT aimed to develop theories about how nuclear manages near misses with a focus on defining them and clarifying how best to support reporting and analysis to extract learning. Near misses related to radiation release or exposure were focused on. Results: Eightnuclear interviews contributed to the GT across nuclear power, decommissioning, weapons, and propulsion. The scoping review identified 83 articles across a range of safety-critical industries, with only six focused on nuclear. The GT identified that nuclear has a particular focus on precursors and low-level events, with regulation supporting their management. Exploration of definitions led to the recognition of the importance of several interventions in a sequence of events, but that do not solely rely on humans as these cannot be assumed to be robust barriers. Regarding reporting and analysis, no consistent methods were identified, but for learning, the role of operating experience learning groups was identified as an exemplar. The safety culture across nuclear, however, was heard to vary, which undermined reporting of near misses and other safety events. Some parts of the industry described that their focus on near misses is new and that despite potential risks existing, progress to mitigate hazards is slow. Conclusions: Healthcare often sees ‘nuclear,’ as well as other ultra-safe industries such as ‘aviation,’ as homogenous. However, the findings here suggest significant differences in safety culture and maturity across various parts of the nuclear sector. Healthcare can take learning from some aspects of management of near misses in nuclear, such as how they are defined and how learning is shared through operating experience networks. However, healthcare also needs to recognise that variability exists across industries, and comparably, it may be more mature in some areas of safety.

Keywords: culture, definitions, near miss, nuclear safety, patient safety

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Authors: Pauline Blanchet

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In a world where images are a prominent part of our daily lives and a way of absorbing information, the analysis of the representation of migration narratives is vital. This thesis raises questions concerning the power of illustrations, drawings and visual culture in order to represent the migration narratives in the age of Instagram. The rise of graphic novels and comics has come about in the last fifteen years, specifically regarding contemporary authors engaging with complex social issues such as migration and refugeehood. Due to this, refugee subjects are often in these narratives, whether they are autobiographical stories or whether the subject is included in the creative process. Growth in discourse around migration has been present in other art forms; in 2018, there has been dedicated exhibitions around migration such as Tania Bruguera at the TATE (2018-2019), ‘Journeys Drawn’ at the House of Illustration (2018-2019) and dedicated film festivals (2018; the Migration Film Festival), which have shown the recent considerations of using the arts as a medium of expression regarding themes of refugeehood and migration. Graphic visuals are fast becoming a key instrument when representing migration, and the central thesis of this paper is to show the strength and limitations of this form as well the methodology used by the actors in the production process. Recent works which have been released in the last ten years have not being analysed in the same context as previous graphic novels such as Palestine and Persepolis. While a lot of research has been done on the mass media portrayals of refugees in photography and journalism, there is a lack of literature on the representation with illustrations. There is little research about the accessibility of graphic novels such as where they can be found and what the intentions are when writing the novels. It is interesting to see why these authors, NGOs, and curators have decided to highlight these migrant narratives in a time when the mainstream media has done extensive coverage on the ‘refugee crisis’. Using primary data by doing one on one interviews with artists, curators, and NGOs, this paper investigates the efficiency of graphic novels for depicting refugee stories as a viable alternative to other mass medium forms. The paper has been divided into two distinct sections. The first part is concerned with the form of the comic itself and how it either limits or strengthens the representation of migrant narratives. This will involve analysing the layered and complex forms that comics allow such as multimedia pieces, use of photography and forms of symbolism. It will also show how the illustration allows for anonymity of refugees, the empathetic aspect of the form and how the history of the graphic novel form has allowed space for positive representations of women in the last decade. The second section will analyse the creative and methodological process which takes place by the actors and their involvement with the production of the works.

Keywords: graphic novel, refugee, communication, media, migration

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Authors: E. Rommes, Els Toonen, Rahil Roodsaz, Suborna Camellia, Farhana Alam, Saad Khan, Jhalok Ranjon Talukder, Tanveer Hassan, Syeda Farjana Ahmed, Sabina Faiz Rashid

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In Bangladesh, a country in which adults (both parents and teachers) find it particularly hard to speak with youth about sexuality, adolescents seem to struggle with various insecurities about their sexual feelings, thoughts, behavior and physical characteristics. On the basis of a large number of interviews and focus groups with rural and urban Bangla adolescent girls and boys of lower and middle class as part of the large-scale three-year project ‘Breaking the Shame’, we have identified ten sexual themes or ‘myths’ that youth struggle with most. These encompass amongst others beliefs and insecurities on masturbation, discharge, same-sex behavior and feelings, the effects of watching porn and gender norms. We argue that the Internet is a particularly suitable medium to ‘debunk’ those myths, as youth can consult it anonymously and privately and so avoid social shame. Moreover, amongst the myths, we have identified two kinds which may need different debunking techniques. One kind of myth concerns scientifically uncontested, generally biological related information, such as the effects of having sex with a pregnant woman, questions on the effects of a penile or vaginal discharge or questions on the effects of masturbation. The second kind of myths concerns more diverse information sources and deals with e.g. religious or culturally specific norms, such as on the meaning and existence of homosexuality or gender appropriate norms of behavior in Bangladesh. For addressing both kinds of myths, expert information including a wealth of references to information resources needs to be provided, which the Internet is very suitable for. For the second kind of myths, adolescents also need to learn how to deal with sometimes conflicting norms and information sources, and they need to develop and reflect on their own opinions as part of their identity formation. On the basis of a literature review, we thus distinguish general information needs from identity formation needs, which includes the need to be able to relate information and opinions to one’s own opinions and situation. Hence, we argue that youth not only need abstract expert information to be able to debunk sexual myths, but also the option to discuss this information with other adolescents and compare their own situation and opinions with other peers, who in that way serve as ‘warm experts’ for each other. In this paper, we will describe the outcomes of our qualitative study above. In addition, we will present our findings of an intervention by presenting youth with general, uncontested information on the Internet with additional peer discussion options to compare the debunking effects on different kinds of myths.

Keywords: peer discussion, intervention, sexual myths, shame

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Authors: Sinem Bulkan

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This study introduces the construct of psychopathic manager behaviour and aims for the development of psychopathic manager behaviour (Psycho-Man B) measure. The study also aims for the understanding of the relationship between psychopathic manager behaviour and workplace deviance while investigating the mediating role of a revenge motive and the moderating roles of the core self-evaluations and the attitude importance. Data were collected from 519 employees from a wide variety of jobs and industries who currently work for or previously worked for a manager in a collectivist culture, Turkey. Psycho-Man B Measure was developed resulting in five dimensions as opposed to the proposed ten dimensions. Simple linear and hierarchical regression analyses were conducted to test the hypotheses. The results of simple linear regression analyses showed that psychopathic manager behaviour was positively significantly related to supervisor-directed and organisation-directed deviance. Revenge motive towards the manager partially mediated the relationship between psychopathic manager behaviour and supervisor-directed deviance. Similarly, revenge motive towards the organisation partially mediated the relationship between psychopathic manager behaviour and organisation-directed deviance. Furthermore, no support was found for the expected moderating role of core self-evaluations in the revenge motive towards the manager-supervisor-directed deviance and revenge motive towards the organisation-organisation-directed deviance relationships. Attitude importance moderated the relationship between revenge motive towards the manager and supervisor-directed deviance; revenge motive towards the organisation and organisation-directed deviance. Moderated-mediation hypotheses were not supported for core self-evaluations but were supported for the attitude importance. Additional analyses for sub-dimensions were conducted to further examine the hypotheses. Demographic variables were examined through independent samples t-tests, and one way ANOVA. Finally, findings are discussed; limitations, suggestions and implications are presented. The major contribution of this study is that ‘psychopathic manager behaviour’ construct was introduced to the literature and a scale for the reliable identification of psychopathic manager behaviour was developed in to evaluate managers’ level of sub-clinical psychopathy in the workforce. The study introduced that employees engage in different forms of supervisor-directed deviance and organisation-directed deviance depending on the level of the emotions and personal goals. Supervisor-directed deviant behaviours and organisation-directed deviant behaviours became distinct in a way as impulsive and premeditated, active or passive, direct and indirect actions. Accordingly, it is important for organisations to notice that employees’ level of affective state and attitude importance for psychopathic manager behaviours predetermine the certain type of employee deviant behaviours.

Keywords: attitude importance, core self evaluations, psychopathic manager behaviour, revenge motive, workplace deviance

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Authors: Ahmad Kayvani Fard, Gordon Mckay, Muataz Hussien

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Adsorption/sorption is believed to be one of the optimal processes for the removal of heavy metals from water due to its low operational and capital cost as well as its high removal efficiency. Different materials have been reported in literature as adsorbent for heavy metal removal in waste water such as natural sorbents, organic polymers (synthetic) and mineral materials (inorganic). The selection of adsorbents and development of new functional materials that can achieve good removal of heavy metals from water is an important practice and depends on many factors, such as the availability of the material, cost of material, and material safety and etc. In this study we reported the synthesis of doped Activated carbon and Carbon nanotube (CNT) with different loading of metal oxide nanoparticles such as Fe2O3, Fe3O4, Al2O3, TiO2, SiO2 and Ag nanoparticles and their application in removal of heavy metals, hydrocarbon, and organics from waste water. Commercial AC and CNT with different loadings of mentioned nanoparticle were prepared and effect of pH, adsorbent dosage, sorption kinetic, and concentration effects are studied and optimum condition for removal of heavy metals from water is reported. The prepared composite sorbent is characterized using field emission scanning electron microscopy (FE-SEM), high transmission electron microscopy (HR-TEM), thermogravimetric analysis (TGA), X-ray diffractometer (XRD), the Brunauer, Emmett and Teller (BET) nitrogen adsorption technique, and Zeta potential. The composite materials showed higher removal efficiency and superior adsorption capacity compared to commercially available carbon based adsorbent. The specific surface area of AC increased by 50% reaching up to 2000 m2/g while the CNT specific surface area of CNT increased by more than 8 times reaching value of 890 m2/g. The increased surface area is one of the key parameters along with surface charge of the material determining the removal efficiency and removal efficiency. Moreover, the surface charge density of the impregnated CNT and AC have enhanced significantly where can benefit the adsorption process. The nanoparticles also enhance the catalytic activity of material and reduce the agglomeration and aggregation of material which provides more active site for adsorbing the contaminant from water. Some of the results for treating wastewater includes 100% removal of BTEX, arsenic, strontium, barium, phenolic compounds, and oil from water. The results obtained are promising for the use of AC and CNT loaded with metal oxide nanoparticle in treatment and pretreatment of waste water and produced water before desalination process. Adsorption can be very efficient with low energy consumption and economic feasibility.

Keywords: carbon nanotube, activated carbon, adsorption, heavy metal, water treatment

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Authors: Cazadira Fediva Tamzil, Agung Sulthonaulia Utama

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The rise in popularity of Indonesian Islamic fashion displayed and sold through social networking sites, especially Instagram, might seem at first glance like a commonplace and localized phenomenon. However, when analyzed critically, it actually reveals the relations between the global and local Indonesian economy, as well as a deep socio-anthropological dimension relating to religion, culture, class, work, identity. Conducted using a qualitative methodology, data collection technique of literature review, and observation of various social networking sites, this research finds four things that lead to the aforementioned conclusion. First, the rise of online Islamic fashion retailers was triggered by the shift in the structure of global and national Indonesian economy as well as the free access of information made possible by democratization in Indonesia and worldwide advances in terms of technology. All of those factors combined together gave birth to a large amount of middle-class Indonesians with high consumer culture and entrepreneurial flair. Second, online Islamic fashion retailers are the new cultural trendsetters in society. All these show how Indonesians are becoming increasingly pious, no longer only adhere to Western conception of luxury and that many are increasingly exploiting Islam commercial and status-acquiring purposes. Third, the online Islamic fashion retailers actually reveal a shift in the conception of ‘work’ – social media has made work no longer only confined to the toiling activities inside factories, but instead something that can be done from any location only through posting online words or pictures that can increase a fashion product’s capital value. Without realizing it, many celebrities and online retailers who promote Islamic fashion through social media on a daily basis are now also ‘semi-free immaterial labors’ – a slight reconceptualization to Tiziana Terranova’s concept of ‘free labor’ and Maurizio Lazzarato’s ‘immaterial labor’, which basically refer to people who create economic value and thus help out capitals from producing immaterial things with only little compensation in return. Fourth, this research also shows that the diversity of Islamic fashion styles being sold on Instagram reflects the polarized identity of Islam in Indonesia. In stark contrast with the theory which states that globalization always leads to the strengthening and unification of identity, this research shows how polarized the Islamic identity in Indonesia really is – even in the face of globalization.

Keywords: global economy, Indonesian online Islamic fashion, political relations, socio-anthropology

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Authors: Wisdom Robert Duruji

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The outbreak of SARS-CoV-2 serotype infection was recorded in January 2020 in Wuhan City, Hubei Province, China. This study examines the concepts of the COVID-19 pandemic and the implications of vaccines for health security in Nigeria and Diasporas. It challenges the widely accepted assumption that the first case of coronavirus infection in Nigeria was recorded on February 27th, 2020, in Lagos. The study utilizes a range of research methods to achieve its objectives. These include the double-layered culture technique, literature review, website knowledge, Google search, news media information, academic journals, fieldwork, and on-site observations. These diverse methods allow for a comprehensive analysis of the concepts and the implications being studied. The study finds that coronavirus infection can be asymptomatic; it may be the antigenicity of the leukocytes (white blood cells), which produce immunogenic hapten or interferons (α, β and γ) that fight infectious parasites, was an immune response that prevented severe virulence in healthy individuals; the reason healthy patients of coronavirus infection in Nigeria naturally recovered after two to three weeks of on-set of infection and test negative. However, the fatality data from the Nigerian Centre for Disease Control (NCDC) is incorrect in this study’s finding; it perused that the fatalities were primarily due to underlying ailments, hunger, and malnutrition in debilitated, comorbid, or compromised patients. This study concluded that the kits and Polymerase Chain Reaction (PCR) machine currently used by the Nigerian Centre for Disease Control (NCDC) in testing and confirming COVID-19 in Nigeria is not ideal; it is programmed and negates separating the strain to its specific serotypes amongst its genera coronavirus, and family Coronaviridae; and might have confirmed patients with the symptoms of febrile caused by cough, catarrh, typhoid and malaria parasites as Covid-19 positive. Therefore, it is recommended that the coronavirus species infected in Nigeria are opportunistic parasites that thrive in human immuno-suppressed conditions like the herpesvirus; it cannot be eradicated by vaccines; the only virucides are interferons, immunoglobulins, and probably synthetic antiviral guanosine drugs like copegus or ribavirin. The findings emphasized that COVID-19 is not the primary pandemic disease in Nigeria; the lockdown was a mirage and not necessary; but rather, pandemic diseases in Nigeria are corruption, nepotism, hunger, and malnutrition caused by ineptitude in governance, religious dichotomy, and ethnic conflicts.

Keywords: coronavirus, corruption, Covid-19 pandemic, lock-down, Nigeria, vaccine

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Authors: Yogita Patil-Sen

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Superparamagnetic Iron Oxide Nanoparticles (SPIONs) have become increasingly important materials for separation of specific bio-molecules, drug delivery vehicle, contrast agent for MRI and magnetic hyperthermia for cancer therapy. Hyperthermia is emerging as an alternative cancer treatment to the conventional radio- and chemo-therapy, which have harmful side effects. When subjected to an alternating magnetic field, the magnetic energy of SPIONs is converted into thermal energy due to movement of particles. The ability of SPIONs to generate heat and potentially kill cancerous cells, which are more susceptible than the normal cells to temperatures higher than 41 °C forms the basis of hyerpthermia treatement. The amount of heat generated depends upon the magnetic properties of SPIONs which in turn is affected by their properties such as size and shape. One of the main problems associated with SPIONs is particle aggregation which limits their employability in in vivo drug delivery applications and hyperthermia cancer treatments. Coating the iron oxide core with thermally responsive lipid based nanostructures tend to overcome the issue of aggregation as well as improve biocompatibility and can enhance drug loading efficiency. Herein we report suitability of SPIONs and silica coated core-shell SPIONs, which are further, coated with various lipids for drug delivery and magnetic hyperthermia applications. The synthesis of nanoparticles is carried out using the established methods reported in the literature with some modifications. The nanoparticles are characterised using Infrared spectroscopy (IR), X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM) and Vibrating Sample Magnetometer (VSM). The heating ability of nanoparticles is tested under alternating magnetic field. The efficacy of the nanoparticles as drug carrier is also investigated. The loading of an anticancer drug, Doxorubicin at 18 °C is measured up to 48 hours using UV-visible spectrophotometer. The drug release profile is obtained under thermal incubation condition at 37 °C and compared with that under the influence of alternating magnetic field. The results suggest that the nanoparticles exhibit superparamagnetic behaviour, although coating reduces the magnetic properties of the particles. Both the uncoated and coated particles show good heating ability, again it is observed that coating decreases the heating behaviour of the particles. However, coated particles show higher drug loading efficiency than the uncoated particles and the drug release is much more controlled under the alternating magnetic field. Thus, the results demonstrate that lipid coated SPIONs exhibit potential as drug delivery vehicles for magnetic hyperthermia based cancer therapy.

Keywords: drug delivery, hyperthermia, lipids, superparamagnetic iron oxide nanoparticles (SPIONS)

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Authors: Mario Chiasson, Monique Boudreau

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Problem statement: Innovation in education has become a central topic of discussion at various levels, including schools and scholarly literature, driven by the global technological advancements of Industry 4.0. This study aims to contribute to the ongoing dialogue by examining the role of innovation in transforming school culture through the reimagination of traditional structures. The study argues that such a transformation necessitates an understanding and experience of systems leadership. This paper presents the case of the Francophone South School District, where a transformative initiative created an innovative learning environment by engaging students, teachers, and community members collaboratively through eco-communities. Traditional barriers and structures in education were dismantled to facilitate this process. The research component of this paper focuses on the Intr’Appreneur project, a unique initiative launched by the district team in the New Brunswick, Canada to support a system-wide transformation towards progressive and innovative organizational models. Methods This study is part of a larger research project that focuses on the transformation of educational systems in six pilot schools involved in the Intr’Appreneur project. Due to COVID-19 restrictions, the project was downscaled to three schools, and virtual qualitative interviews were conducted with volunteer teachers and administrators. Data was collected from students, teachers, and principals regarding their perceptions of the new learning environment and experiences. The analysis process involved developing categories, establishing codes for emerging themes, and validating the findings. The study emphasizes the importance of system leadership in achieving successful transformation. Results: The findings demonstrate that school principals played a vital role in enabling system-wide change by fostering a dynamic, collaborative, and inclusive culture, coordinating and mobilizing community members, and serving as educational role models who facilitated active and personalized pedagogy among the teaching staff. These qualities align with the characteristics of Leadership 4.0 and are crucial for successful school system transformations. Conclusion: This paper emphasizes the importance of systems leadership in driving educational transformations that extend beyond pedagogical and technological advancements. The research underscores the potential impact of such a leadership approach on teaching, learning, and leading processes in Education 4.0.

Keywords: leadership, system transformation, innovation, innovative learning environment, Education 4.0, system leadership

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Authors: Mathieu Bourdeau, Philippe Basset, Julien Waeytens, Elyes Nefzaoui

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As residential buildings account for a third of the overall energy consumption and greenhouse gas emissions in Europe, building energy modeling is an essential tool to reach energy efficiency goals. In the energy modeling process, calibration is a mandatory step to obtain accurate and reliable energy simulations. Nevertheless, the comparison between simulation results and the actual building energy behavior often highlights a significant performance gap. The literature discusses different origins of energy performance gaps, from building design to building operation. Then, building operation description in energy models, especially energy usages and users’ behavior, plays an important role in the reliability of simulations but is also the most accessible target for post-occupancy energy management and optimization. Therefore, the present study aims to discuss results on the calibration ofresidential building energy models using real operation data. Data are collected through a sensor network of more than 180 sensors and advanced energy meters deployed in three collective residential buildings undergoing major retrofit actions. The sensor network is implemented at building scale and in an eight-apartment sample. Data are collected for over one year and half and coverbuilding energy behavior – thermal and electricity, indoor environment, inhabitants’ comfort, occupancy, occupants behavior and energy uses, and local weather. Building energy simulations are performed using a physics-based building energy modeling software (Pleaides software), where the buildings’features are implemented according to the buildingsthermal regulation code compliance study and the retrofit project technical files. Sensitivity analyses are performed to highlight the most energy-driving building features regarding each end-use. These features are then compared with the collected post-occupancy data. Energy-driving features are progressively replaced with field data for a step-by-step calibration of the energy model. Results of this study provide an analysis of energy performance gap on an existing residential case study under deep retrofit actions. It highlights the impact of the different building features on the energy behavior and the performance gap in this context, such as temperature setpoints, indoor occupancy, the building envelopeproperties but also domestic hot water usage or heat gains from electric appliances. The benefits of inputting field data from an extensive instrumentation campaign instead of standardized scenarios are also described. Finally, the exhaustive instrumentation solution provides useful insights on the needs, advantages, and shortcomings of the implemented sensor network for its replicability on a larger scale and for different use cases.

Keywords: calibration, building energy modeling, performance gap, sensor network

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Authors: David Tennison

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In the wake of the Covid-19 pandemic, a new chronic illness emerged onto the global stage: Long Covid. Long Covid presents with several symptoms commonly seen in other poorly-understood illnesses, such as fibromyalgia (FM) and myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). However, while Long Covid has swiftly become a recognised illness, FM and ME/CFS are still seen as contested, which impacts patient care and healthcare experiences. This study aims to examine what the differences are between Long Covid and FM; and if the Long Covid case can provide guidance for how to address the healthcare challenge of contested illnesses. To address this question, this study performed comprehensive research into the history of FM; our current biomedical understanding of it; and available healthcare interventions (within the context of the UK NHS). Analysis was undertaken of the stigma and stereotypes around FM, and a comparison made between FM and the emerging Long Covid literature, along with the healthcare response to Long Covid. This study finds that healthcare for chronic contested illnesses in the UK is vastly insufficient - in terms of pharmaceutical and holistic interventions, and the provision of secondary care options. Interestingly, for Long Covid, many of the treatment suggestions are pulled directly from those used for contested illnesses. The key difference is in terms of funding and momentum – Long Covid has generated exponentially more interest and research in a short time than there has been in the last few decades of contested illness research. This stands to help people with FM and ME/CFS – for example, research has recently been funded into “brain fog”, a previously elusive and misunderstood symptom. FM is culturally regarded as a “women’s disease” and FM stigma stems from notions of “hysteria”. A key finding is that the idea of FM affecting women disproportionally is not reflected in modern population studies. Emerging data on Long Covid also suggests a slight leaning towards more female patients, however it is less feminised, potentially due to it emerging in the global historical moment of the pandemic. Another key difference is that FM is rated as an extremely low-prestige illness by healthcare professionals, while it was in large part due to the advocacy of affected healthcare professionals that Long Covid was so quickly recognised by science and medicine. In conclusion, Long Covid (and the risk of future pandemics and post-viral illnesses) highlight a crucial need for implementing new, and reinforcing existing, care networks for chronic illnesses. The difference in how contested illnesses like FM, and new ones like Long Covid are treated have a lot to do with the historical moment in which they emerge – but cultural stereotypes, from within and without medicine, need updating. Particularly as they contribute to disease stigma that causes genuine harm to patients. However, widespread understanding and acceptance of Long Covid could help fight contested illness stigma, and the attention, funding and research into Long Covid may actually help raise the profile of contested illnesses and uncover answers about their symptomatology.

Keywords: long COVID, fibromyalgia, myalgic encephalomyelitis, chronic fatigue syndrome, NHS, healthcare, contested illnesses, chronic illnesses, COVID-19 pandemic

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Authors: Dino Carpentras, Paul J. Maher, Caoimhe O'Reilly, Michael Quayle

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Opinion dynamics is a sub-field of agent-based modeling that focuses on people’s opinions and their evolutions over time. Despite the rapid increase in the number of publications in this field, it is still not clear how to apply these models to real-world scenarios. Indeed, there is no agreement on how people update their opinion while interacting. Furthermore, it is not clear if different topics will show the same dynamics (e.g., more polarized topics may behave differently). These problems are mostly due to the lack of experimental validation of the models. Some previous studies started bridging this gap in the literature by directly measuring people’s opinions before and after the interaction. However, these experiments force people to express their opinion as a number instead of using natural language (and then, eventually, encoding it as numbers). This is not the way people normally interact, and it may strongly alter the measured dynamics. Another limitation of these studies is that they usually average all the topics together, without checking if different topics may show different dynamics. In our work, we collected data from 200 participants on 5 unpolarized topics. Participants expressed their opinions in natural language (“agree” or “disagree”). We also measured the certainty of their answer, expressed as a number between 1 and 10. However, this value was not shown to other participants to keep the interaction based on natural language. We then showed the opinion (and not the certainty) of another participant and, after a distraction task, we repeated the measurement. To make the data compatible with opinion dynamics models, we multiplied opinion and certainty to obtain a new parameter (here called “continuous opinion”) ranging from -10 to +10 (using agree=1 and disagree=-1). We firstly checked the 5 topics individually, finding that all of them behaved in a similar way despite having different initial opinions distributions. This suggested that the same model could be applied for different unpolarized topics. We also observed that people tend to maintain similar levels of certainty, even when they changed their opinion. This is a strong violation of what is suggested from common models, where people starting at, for example, +8, will first move towards 0 instead of directly jumping to -8. We also observed social influence, meaning that people exposed with “agree” were more likely to move to higher levels of continuous opinion, while people exposed with “disagree” were more likely to move to lower levels. However, we also observed that the effect of influence was smaller than the effect of random fluctuations. Also, this configuration is different from standard models, where noise, when present, is usually much smaller than the effect of social influence. Starting from this, we built an opinion dynamics model that explains more than 80% of data variance. This model was also able to show the natural conversion of polarization from unpolarized states. This experimental approach offers a new way to build models grounded on experimental data. Furthermore, the model offers new insight into the fundamental terms of opinion dynamics models.

Keywords: experimental validation, micro-dynamics rule, opinion dynamics, update rule

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Authors: Maggie Mosher, Adam Carreon, Sean Smith

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A systematic literature review was conducted to explore the evidence base on the use of augmented reality (AR), virtual reality (VR), mixed reality (MR), and extended reality (XR) to present social skill instruction to school-age students with autism spectrum disorder (ASD). Specifically, the systematic review focus was on a. the participants and intervention agents using AR, VR, MR, and XR for social skill acquisition b. the social skills taught through these mediums and c. the social validity measures (i.e., goals, procedures, and outcomes) reported in these studies. Forty-one articles met the inclusion criteria. Researchers in six studies taught social skills to students through AR, in 27 studies through non-immersive VR, and in 10 studies through immersive VR. No studies used MR or XR. The primary targeted social skills were relationship skills, emotion recognition, social awareness, cooperation, and executive functioning. An intervention to improve many social skills was implemented by 73% of researchers, 17% taught a single skill, and 10% did not clearly state the targeted skill. The intervention was considered effective in 26 of the 41 studies (63%), not effective in four studies (10%), and 11 studies (27%) reported mixed results. No researchers reported information for all 17 social validity indicators. The social validity indicators reported by researchers ranged from two to 14. Social validity measures on the feelings toward and use of the technology were provided in 22 studies (54%). Findings indicated both AR and VR are promising platforms for providing social skill instruction to students with ASD. Studies utilizing this technology show a number of social validity indicators. However, the limited information provided on the various interventions, participant characteristics, and validity measures, offers insufficient evidence of the impact of these technologies in teaching social skills to students with ASD. Future research should develop a protocol for training treatment agents to assess the role of different variables (i.e., whether agents are customizing content, monitoring student learning, using intervention specific vocabulary in their day to day instruction). Sustainability may be increased by providing training in the technology to both treatment agents and participants. Providing scripts of instruction occurring within the intervention would provide the needed information to determine the primary method of teaching within the intervention. These variables play a role in maintenance and generalization of the social skills. Understanding the type of feedback provided would help researchers determine if students were able to feel rewarded for progressing through the scenarios or if students require rewarding aspects within the intervention (i.e., badges, trophies). AR has the potential to generalize instruction and VR has the potential for providing a practice environment for performance deficits. Combining these two technologies into a mixed reality intervention may provide a more cohesive and effective intervention.

Keywords: autism, augmented reality, social and emotional learning, social skills, virtual reality

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Authors: Michael Nolte, Iwona Kasior, Kala Flagg, Spiro Karavatas

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Background: Cryotherapy has been used as a post-exercise recovery modality for decades. Whole-body cryotherapy (WBC) is an intervention which involves brief exposures to extremely cold air in order to induce therapeutic effects. It is currently being investigated for its effectiveness in treating certain exercise-induced impairments. Purpose: The purpose of this systematic review was to determine whether WBC as a recovery intervention is more, less, or equally as effective as other interventions at reducing perceived levels of muscle soreness and promoting recovery of muscle function after exercise-induced muscle damage (EIMD) from running. Methods: A systematic review of the current literature was performed utilizing the following MeSH terms: cryotherapy, whole-body cryotherapy, exercise-induced muscle damage, muscle soreness, muscle recovery, and running. The databases utilized were PubMed, CINAHL, EBSCO Host, and Google Scholar. Articles were included if they were published within the last ten years, had a CEBM level of evidence of IIb or higher, had a PEDro scale score of 5 or higher, studied runners as primary subjects, and utilized both perceived levels of muscle soreness and recovery of muscle function as dependent variables. Articles were excluded if subjects did not include runners, if the interventions included PBC instead of WBC, and if both muscle performance and perceived muscle soreness were not assessed within the study. Results: Two of the four articles revealed that WBC was significantly more effective than treatment interventions such as far-infrared radiation and passive recovery at reducing perceived levels of muscle soreness and restoring muscle power and endurance following simulated trail runs and high-intensity interval running, respectively. One of the four articles revealed no significant difference between WBC and passive recovery in terms of reducing perceived muscle soreness and restoring muscle power following sprint intervals. One of the four articles revealed that WBC had a harmful effect compared to CWI and passive recovery on both perceived muscle soreness and recovery of muscle strength and power following a marathon. Discussion/Conclusion: Though there was no consensus in terms of WBC’s effectiveness at treating exercise-induced muscle damage following running compared to other interventions, it seems as though WBC may at least have a time-dependent positive effect on muscle soreness and recovery following high-intensity interval runs and endurance running, marathons excluded. More research needs to be conducted in order to determine the most effective way to implement WBC as a recovery method for exercise-induced muscle damage, including the optimal temperature, timing, duration, and frequency of treatment.

Keywords: cryotherapy, physical therapy intervention, physical therapy, whole body cryotherapy

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Authors: Hanan Bin Nakhi, Asaad M. Albadrawi, Maged Al Shahat, ‎Entesar Mandani

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Background:‎ Kawasaki disease (KD) is one of the most common vasculitis of childhood. ‎It is considered the leading cause of acquired heart disease in children. The ‎peak age of occurrence is 6 to 24 months, with 80% of affected children being ‎less than 5 years old. There are only a few reports of KD in infants younger ‎than 6 months. Infants had a higher incidence of atypical KD and of coronary ‎artery complications. This case report from Kuwait will reinforce considering ‎atypical KD in case of sepsis like condition with negative cultures and ‎unresponding to systemic antibiotics. Early diagnosis allows early treatment ‎with intravenous immune globulin (IVIG) and so decreases the incidence of ‎cardiac aneurysm.‎ Case Report:‎ A 2 month old female infant, product of full term normal delivery to ‎consanguineous parents, presented with fever and poor feeding. She was ‎admitted and treated as urinary tract infection as her urine routine revealed ‎pyurea. The baby continued to have persistent fever and hypoactivity inspite ‎of using intravenous antibiotics. Latter, she developed non purulent ‎conjunctivitis, skin mottling, oedema of the face / lower limb and was treated ‎in intensive care unit as a case of septic shock. In spite of her partial general ‎improvement, she continued to look unwell, hypoactive and had persistent ‎fever. Septic work up, metabolic, and immunologic screen were negative. KD ‎was suspected when the baby developed polymorphic erythematous rash and ‎noticed to have peeling of skin at perianal area and periangular area of the ‎fingers of the hand and feet. IVIG was given in dose of 2 gm/kg/day in single ‎dose and aspirin 100 mg/kg/day in four divided doses. The girl showed marked ‎clinical improvement. The fever subsided dramatically and the level acute ‎phase reactant markedly decreased but the platelets count increased to ‎‎1600000/mm3. Echo cardiography showed mild dilatation of mid right ‎coronary artery. Aspirin was continued in a dose of 5 mg/kg/d till repeating ‎cardiac echo. ‎Conclusion:‎ A high index of suspicion of KD must be maintained in young infants with ‎prolonged unexplained fever. Accepted criteria should be less restrictive to ‎allow early diagnosis of a typical KD in infants less than 6 months of age. ‎Timely appropriate treatment with IVIG is essential to avoid severe coronary ‎sequels.‎

Keywords: Kawasaki disease, atypical Kawasaki disease, infantile Kawasaki disease, hypo activity‎ ‎

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Authors: Alice Civera, Mattia Cattaneo, Michele Meoli, Stefano Paleari

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Despite the fact that more equal access to higher education has been an objective public policy for several decades, little is known about the effectiveness of alternative means for achieving such goal. Indeed, nowadays, high level of graduate population can be observed both in countries with the high and low level of fees, or high and low level of public expenditure in higher education. This paper surveys the extant literature providing some background on the economic concepts of the higher education market, and reviews key determinants of demand and supply. A theoretical model of aggregate demand and supply of higher education is derived, with the aim to facilitate the understanding of the challenges in today’s higher education systems, as well as the opportunities for development. The model is validated on some exemplary case studies describing the different relationship between the level of public investment and levels of graduate population and helps to derive general implications. In addition, using a two-stage least squares model, we build a macroeconomic model of supply and demand for European higher education. The model allows interpreting policies shifting either the supply or the demand for higher education, and allows taking into consideration contextual conditions with the aim of comparing divergent policies under a common framework. Results show that the same policy objective (i.e., increasing graduate population) can be obtained by shifting either the demand function (i.e., by strengthening student aid) or the supply function (i.e., by directly supporting higher education institutions). Under this theoretical perspective, the level of tuition fees is irrelevant, and empirically we can observe high levels of graduate population in both countries with high (i.e., the UK) or low (i.e., Germany) levels of tuition fees. In practice, this model provides a conceptual framework to help better understanding what are the external conditions that need to be considered, when planning a policy for increasing graduate population. Extrapolating a policy from results in different countries, under this perspective, is a poor solution when contingent factors are not addressed. The second implication of this conceptual framework is that policies addressing the supply or the demand function needs to address different contingencies. In other words, a government aiming at increasing graduate population needs to implement complementary policies, designing them according to the side of the market that is interested. For example, a ‘supply-driven’ intervention, through the direct financial support of higher education institutions, needs to address the issue of institutions’ moral hazard, by creating incentives to supply higher education services in efficient conditions. By contrast, a ‘demand-driven’ policy, providing student aids, need to tackle the students’ moral hazard, by creating an incentive to responsible behavior.

Keywords: graduates, higher education, higher education policies, tuition fees

Procedia PDF Downloads 147

Authors: Salvana P. M. Costa, Tarcyla A. Gomes, Giovanna C. R. M. Schver, Leslie R. M. Ferraz, Cristovão R. Silva, Magaly A. M. Lyra, Danilo A. F. Fonte, Larissa A. Rolim, Amanda C. Q. M. Vieira, Miracy M. Albuquerque, Pedro J. Rolim-neto

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Efavirenz (EFV) is considered one of the most widely used anti-HIV drugs. However, it is classified as a drug class II (poorly soluble, highly permeable) according to the biopharmaceutical classification system, presenting problems of absorption in the gastrointestinal tract and thereby inadequate bioavailability for its therapeutic action. This study aimed to overcome these barriers by developing and obtaining solid dispersions (SD) in order to increase the EFZ bioavailability. For the development of SD with EFV, theoretical and practical studies were initially performed. Thus, there was a choice of a carrier to be used. For this, it was analyzed the various criteria such as glass transition temperature of the polymer, intra- and intermolecular interactions of hydrogen bonds between drug and polymer, the miscibility between the polymer and EFV. The choice of the obtainment method of the SD came from the analysis of which method is the most consolidated in both industry and literature. Subsequently, the choice of drug and carrier concentrations in the dispersions was carried out. In order to obtain DS to present the drug in its amorphous form, as the DS were obtained, they were analyzed by X-ray diffraction (XRD). SD are more stable the higher the amount of polymer present in the formulation. With this assumption, a SD containing 10% of drug was initially prepared and then this proportion was increased until the XRD showed the presence of EFV in its crystalline form. From this point, it was not produced SD with a higher concentration of drug. Thus, it was allowed to select PVP-K30, PVPVA 64 and the SOLUPLUS formulation as carriers, once it was possible the formation of hydrogen bond between EFV and polymers since these have hydrogen acceptor groups capable of interacting with the donor group of the drug hydrogen. It is worth mentioning also that the films obtained, independent of concentration used, were presented homogeneous and transparent. Thus, it can be said that the EFV is miscible in the three polymers used in the study. The SD and Physical Mixtures (PM) with these polymers were prepared by the solvent method. The EFV diffraction profile showed main peaks at around 2θ of 6,24°, in addition to other minor peaks at 14,34°, 17,08°, 20,3°, 21,36° and 25,06°, evidencing its crystalline character. Furthermore, the polymers showed amorphous nature, as evidenced by the absence of peaks in their XRD patterns. The XRD patterns showed the PM overlapping profile of the drug with the polymer, indicating the presence of EFV in its crystalline form. Regardless the proportion of drug used in SD, all the samples showed the same characteristics with no diffraction peaks EFV, demonstrating the behavior amorphous products. Thus, the polymers enabled, effectively, the formation of amorphous SD, probably due to the potential hydrogen bonds between them and the drug. Moreover, the XRD analysis showed that the polymers were able to maintain its amorphous form in a concentration of up to 80% drug.

Keywords: amorphous form, Efavirenz, solid dispersions, solubility

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Authors: Mariam Tsitsagi, Ana Berdzenishvili

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Rainfall intensity change is one of the main indicators of climate change. It has a great influence on agriculture as one of the main factors causing soil erosion. Splash and sheet erosion are one of the most prevalence and harmful for agriculture. It is invisible for an eye at first stage, but the process will gradually move to stream cutting erosion. Our study provides the assessment of rainfall erosivity potential with the use of modern research methods in Kakheti region. The region is the major provider of wheat and wine in the country. Kakheti is located in the eastern part of Georgia and characterized quite a variety of natural conditions. The climate is dry subtropical. For assessment of the exact rate of rainfall erosion potential several year data of rainfall with short intervals are needed. Unfortunately, from 250 active metro stations running during the Soviet period only 55 of them are active now and 5 stations in Kakheti region respectively. Since 1936 we had data on rainfall intensity in this region, and rainfall erosive potential is assessed, in some old papers, but since 1990 we have no data about this factor, which in turn is a necessary parameter for determining the rainfall erosivity potential. On the other hand, researchers and local communities suppose that rainfall intensity has been changing and the number of haily days has also been increasing. However, finding a method that will allow us to determine rainfall erosivity potential as accurate as possible in Kakheti region is very important. The study period was divided into three sections: 1936-1963; 1963-1990 and 1990-2015. Rainfall erosivity potential was determined by the scientific literature and old meteorological stations’ data for the first two periods. And it is known that in eastern Georgia, at the boundary between steppe and forest zones, rainfall erosivity in 1963-1990 was 20-75% higher than that in 1936-1963. As for the third period (1990-2015), for which we do not have data of rainfall intensity. There are a variety of studies, where alternative ways of calculating the rainfall erosivity potential based on lack of data are discussed e.g.based on daily rainfall data, average annual rainfall data and the elevation of the area, etc. It should be noted that these methods give us a totally different results in case of different climatic conditions and sometimes huge errors in some cases. Three of the most common methods were selected for our research. Each of them was tested for the first two sections of the study period. According to the outcomes more suitable method for regional climatic conditions was selected, and after that, we determined rainfall erosivity potential for the third section of our study period with use of the most successful method. Outcome data like attribute tables and graphs was specially linked to the database of Kakheti, and appropriate thematic maps were created. The results allowed us to analyze the rainfall erosivity potential changes from 1936 to the present and make the future prospect. We have successfully implemented a method which can also be use for some another region of Georgia.

Keywords: erosivity potential, Georgia, GIS, Kakheti, rainfall

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Authors: Narjis Kahtoon

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The issue of the wage discrimination on the basis of gender and social problem has been a significant research problem for several decades. Whereas lots of have explored reasons for the persistence of an inequality in the wages of male and female, none has successfully explained away the entire differentiation. The wage discrimination on the basis of gender and social problem of working women is a global issue. Although inequality in political and economic and social make-up of countries all over the world, the gender wage discrimination, and social constraint is present. The aim of the research is to examine the gender wage discrimination and social constraint from an international perspective and to determine whether any pattern exists among cultural dimensions of a country and the man and women remuneration gap in Readymade Garment Sector of Pakistan. Population growth rate is significant indicator used to explain the change in population and play a crucial point in the economic development of a country. In Pakistan, readymade garment sector consists of small, medium and large sized firms. With an estimated 30 percent of the workforce in textile- Garment is females’. Readymade garment industry is a labor intensive industry and relies on the skills of individual workers and provides highest value addition in the textile sector. In the Garment sector, female workers are concentrated in poorly paid, labor-intensive down-stream production (readymade garments, linen, towels, etc.), while male workers dominate capital- intensive (ginning, spinning and weaving) processes. Gender wage discrimination and social constraint are reality in Pakistan Labor Market. This research allows us not only to properly detect the size of gender wage discrimination and social constraint but to also fully understand its consequences in readymade garment sector of Pakistan. Furthermore, research will evaluated this measure for the three main clusters like Lahore, Karachi, and Faisalabad. These data contain complete details of male and female workers and supervisors in the readymade garment sector of Pakistan. These sources of information provide a unique opportunity to reanalyze the previous finding in the literature. The regression analysis focused on the standard 'Mincerian' earning equation and estimates it separately by gender, the research will also imply the cultural dimensions developed by Hofstede (2001) to profile a country’s cultural status and compare those cultural dimensions to the wage inequalities. Readymade garment of Pakistan is one of the important sectors since its products have huge demand at home and abroad. These researches will a major influence on the measures undertaken to design a public policy regarding wage discrimination and social constraint in readymade garment sector of Pakistan.

Keywords: gender wage differentials, decomposition, garment, cultural

Procedia PDF Downloads 194

Authors: Qing Wu, Xuchun Ye, Kirsten Corazzini

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Objective: It is increasingly recognized that patients’ rational and meaningful engagement in healthcare could make important contributions to their health care and safety management. However, recent evidence indicated that patients' actual roles in healthcare didn’t match their desired roles, and many patients reported a less active role than desired, which suggested that patient engagement in healthcare may be influenced by various factors. This study aimed to analyze influencing factors on patient engagement and explore the influence mechanism, which will be expected to contribute to the strategy development of patient engagement in healthcare. Methods: On the basis of analyzing the literature and theory study, the research framework was developed. According to the research framework, a cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale, Facilitation of Patient Involvement Scale and Wake Forest Physician Trust Scale, and other influencing factor related scales. A convenience sample of 580 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province, and Zhejiang Province. Results: The results of the cross-sectional survey indicated that the mean score for the patient engagement behavior was (4.146 ± 0.496), and the mean score for the willingness was (4.387 ± 0.459). The level of patient engagement behavior was inferior to their willingness to be involved in healthcare (t = 14.928, P ＜ 0.01). The influencing mechanism model of patient engagement in healthcare was constructed by the path analysis. The path analysis revealed that patient attitude toward engagement, patients’ perception of facilitation of patient engagement and health literacy played direct prediction on the patients’ willingness of engagement, and standard estimated values of path coefficient were 0.341, 0.199, 0.291, respectively. Patients’ trust in physician and the willingness of engagement played direct prediction on the patient engagement, and standard estimated values of path coefficient were 0.211, 0.641, respectively. Patient attitude toward engagement, patients’ perception of facilitation and health literacy played indirect prediction on patient engagement, and standard estimated values of path coefficient were 0.219, 0.128, 0.187, respectively. Conclusions: Patients engagement behavior did not match their willingness to be involved in healthcare. The influencing mechanism model of patient engagement in healthcare was constructed. Patient attitude toward engagement, patients’ perception of facilitation of engagement and health literacy posed indirect positive influence on patient engagement through the patients’ willingness of engagement. Patients’ trust in physician and the willingness of engagement had direct positive influence on the patient engagement. Patient attitude toward engagement, patients’ perception of physician facilitation of engagement and health literacy were the factors influencing the patients’ willingness of engagement. The results of this study provided valuable evidence on guiding the development of strategies for promoting patient rational and meaningful engagement in healthcare.

Keywords: healthcare, patient engagement, influencing factor, the mechanism

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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Introduction: An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavored to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learners. Aim: Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Methods: Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Results: Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. Discussion: After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Conclusion: Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: ethics, medical student, doubt, medical education, faith

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Authors: Santhani M. Selveindran

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Background: Natural disasters are traumatic global events that are becoming increasing more common, with significant psychosocial impact on survivors. This impact results not only in psychosocial distress but, for many, can lead to psychosocial disorders and chronic psychopathology. While there are currently available interventions that seek to prevent and treat these psychosocial sequelae, their effectiveness is uncertain. The evidence-base is emerging with more primary studies evaluating the effectiveness of various psychosocial interventions for survivors of natural disasters, which remains to be synthesized. Aim of Review: To identify, critically appraise and synthesize the current evidence-base on the effectiveness of psychosocial interventions in preventing or treating Post-Traumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and/or Generalized Anxiety Disorder (GAD) in adults and children who are survivors of natural disasters. Methods: A protocol was developed as a guide to carry out this review. A systematic search was conducted in eight international electronic databases, three grey literature databases, one dissertation and thesis repository, websites of six humanitarian and non-governmental organizations renowned for their work on natural disasters, as well as bibliographic and citation searching for eligible articles. Papers meeting the specific inclusion criteria underwent quality assessment using the Downs and Black checklist. Data were extracted from the included papers and analysed by way of narrative synthesis. Results: Database and website searching returned 3777 papers where 31 met the criteria for inclusion. Additional 2 papers were obtained through bibliographic and citation searching. Methodological quality of most papers was fair. Twenty-five studies evaluated psychological interventions, five, social interventions whereas three studies evaluated ‘mixed’ psychological and social interventions. All studies, irrespective of methodological quality, reported post-intervention reductions in symptom scores for PTSD, depression and/or anxiety and where assessed, reduced diagnosis of PTSD and MDD, and produced improvements in self-efficacy and quality of life. Statistically significant results were seen in 27 studies. However, three studies demonstrated that the evaluated interventions may not have been very beneficial. Conclusions: The overall positive results suggest that any psychosocial interventions are favourable and should be delivered to all natural disaster survivors, irrespective of age, country, and phase of disaster. Yet, heterogeneity and methodological shortcomings of the current evidence-base makes it difficult to draw definite conclusions needed to formulate categorical guidance or frameworks. Further, rigorously conducted research is needed in this area, although the feasibility of such, given the context and nature of the problem, is also recognized.

Keywords: psychosocial interventions, natural disasters, survivors, effectiveness

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Authors: Bill Wang, Paul Childerhouse, Yuanfei Kang

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Purpose: The research is to extend resource orchestration theory (ROT) into supply chain management (SCM) area to investigate the dyadic relationships at both individual and organizational levels in supply chain integration (SCI). Also, we try to explore the interaction mechanism between inter-personal relationships (IPRs) and inter-organizational (IORs) during the whole SCI process. Methodology/approach: The research employed an exploratory multiple case study approach of four New Zealand companies. The data was collected via semi-structured interviews with top, middle, and lower level managers and operators from different departments of both suppliers and customers triangulated with company archival data. Findings: The research highlights the important role of both IPRs and IORs in the whole SCI process. Both IPRs and IORs are valuable, inimitable resources but IORs are formal and exterior while IPRs are informal and subordinated. In the initial stage of SCI process, IPRs are seen as key resources antecedents to IOR building while three IPRs dimensions work differently: personal credibility acts as an icebreaker to strengthen the confidence forming IORs, and personal affection acts as a gatekeeper, whilst personal communication expedites the IORs process. In the maintenance and development stage, IORs and IPRs interact each other continuously: good interaction between IPRs and IORs can facilitate SCI process while the bad interaction between IPRs can damage the SCI process. On the other hand, during the life-cycle of SCI process, IPRs can facilitate the formation, development of IORs while IORs development can cultivate the ties of IPRs. Out of the three dimensions of IPRs, Personal communication plays a more important role to develop IORs than personal credibility and personal affection. Originality/value: This research contributes to ROT in supply chain management literature by highlighting the interaction of IPRs and IORs in SCI. The intangible resources and capabilities of three dimensions of IPRs need to be orchestrated and nurtured to achieve efficient and effective IORs in SCI. Also, IPRs and IORs need to be orchestrated in terms of breadth, depth, and life-cycle of whole SCI process. Our study provides further insight into the rarely explored inter-personal level of SCI. Managerial implications: Our research provides top management with further evidence of the significance roles of IPRs at different levels when working with trading partners. This highlights the need to actively manage and develop these soft IPRs skills as an intangible competitive resource. Further, the research identifies when staff with specific skills and connections should be utilized during the different stages of building and maintaining inter-organizational ties. More importantly, top management needs to orchestrate and balance the resources of IPRs and IORs.

Keywords: case study, inter-organizational relationships, inter-personal relationships, resource orchestration, supply chain integration

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Authors: Anjula Negi, D. T. V. Raghu Ramaswamy, Rajneesh Sareen

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Road infrastructure is emphatically one of the top most critical infrastructure to the Indian economy. Road network in the country of around 3.3 million km is the second largest in the world. Nationwide statistics released by Ministry of Road, Transport and Highways reveal that every minute an accident happens and one death every 3.7 minutes. This reported scale in terms of safety is a matter of grave concern, and economically represents a national loss of 3% to the GDP. Union Budget 2016-17 has allocated USD 12 billion annually for development and strengthening of roads, an increase of 56% from last year. Thus, highlighting the importance of roads as critical infrastructure. National highway alone represent only 1.7% of the total road linkages, however, carry over 40% of traffic. Further, trends analysed from 2002 -2011 on national highways, indicate that in less than a decade, a 22 % increase in accidents have been reported, but, 68% increase in death fatalities. Paramount inference is that accident severity has increased with time. Over these years many measures to increase road safety, lessening damage to physical assets, reducing vulnerabilities leading to a build-up for resilient road infrastructure have been taken. In the context of national highway development program, policy makers proposed implementation of around 20 % of such road length on PPP mode. These roads were taken up on high-density traffic considerations and for qualitative implementation. In order to understand resilience impacts and safety parameters, enshrined in various PPP concession agreements executed with the private sector partners, such highway specific projects would be appraised. This research paper would attempt to assess such safety measures taken and the possible reasons behind an increase in accident severity through these PPP case study projects. Delving further on safety features to understand policy measures adopted in these cases and an introspection on reasons of severity, whether an outcome of increased speeds, faulty road design and geometrics, driver negligence, or due to lack of discipline in following lane traffic with increased speed. Assessment exercise would study these aspects hitherto to PPP and post PPP project structures, based on literature review and opinion surveys with sectoral experts. On the way forward, it is understood that the Ministry of Road, Transport and Highway’s estimate for strengthening the national highway network is USD 77 billion within next five years. The outcome of this paper would provide an understanding of resilience measures adopted, possible options for accessible and safe road network and its expansion to policy makers for possible policy initiatives and funding allocation in securing critical infrastructure.

Keywords: national highways, policy, PPP, safety

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Authors: A. Drapeaux, S. Aviles, E. Garfoot

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Stem cell injections are a promising alternative treatment for hip osteoarthritis. Current literature has focused on short-term outcomes for both knee and hip osteoarthritis; however, there is a significant gap for longitudinal benefits for hip OA and limited firm conclusions due to small sample sizes. The purpose of this prospective study was to determine longitudinal changes in pain, function, and radiographs following bone marrow concentrate injection (BMAC) into the osteoarthritic hip joint. Methods: A prospective, cross-sectional study was conducted over the course of 12 months at an orthopedic practice. The study recruited 15 osteoarthritic pre-surgical hips with mild to moderate osteoarthritic severity who were scheduled to undergo hip arthroscopy. Data was collected at both pre-operative and post-operative time frames. Data collected included: hip radiographs, i-HOT-33 questionnaire data, BMAC autologous volume, and demographics. Questionnaire data was captured using Qualtrics XM software, and participants were sent an anonymous link at the following time frames: pre-operative, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Radiographic changes and BMAC volume were collected and reviewed by an orthopedic surgeon and sent to the primary investigator. Data was exported and analyzed in IBM-SPSS. Results: A total of 15 hips from 15 participants (mean age: 49, gender: 50% males, 50% females, BMI: 29.7) were used in the final analysis. Summative i-HOT 33 mean scores significantly changed between pre-operative status and 2-6 weeks post-operative status (p <.001) and pre-operative status and 3-6 months post-operative status (p <.001). There were no significant changes between other post-operative phases or between pre-operative status and 12 months post-operative. Significant improvements were found between summative i-HOT 33 mean (p<.001), daily pain (p<.001), daily sitting (p=.02), daily distance walked (p =.003), and daily limp (p=0.03) and post-operative status (2-6 weeks). No significant differences between demographic variables (gender, age, tobacco use, or diabetes) and i-HOT 33 summative mean scores. Discussion/Implications: The purpose of this study was to determine longitudinal changes in pain and function following a hip joint bone marrow concentrate injection. Results indicate that participants experience a significant improvement in pain and function between pre-operative and 2-6 weeks and 3-6 months post-injection. Participants also self-reported a significant change in average daily pain with sitting and walking between pre-operation and 2-6 weeks post-operative. This study includes a larger sample size of hip osteoarthritis cases; however, future research is warranted to include random controlled trials with a larger sample size.

Keywords: adult stem cell, orthopedics, osteoarthritis (hip), patient outcome assessment

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Authors: Ilona Buchem, Carolin Gellner

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Over the last few years, the call for the support of senior learners in the development of their digital literacy has become prevalent, mainly due to the progression towards ageing societies paired with advances in digitalisation in all spheres of life, including e-health and electronic patient record (EPA). While major research efforts in supporting senior learners in developing digital literacy have been invested so far in e-learning focusing on knowledge acquisition and cognitive tasks, little research exists in learning models which target virtual mentoring and coaching with the help of pedagogical agents and address the social dimensions of learning. Research from studies with students in the context of formal education has already provided methods for designing intelligent virtual agents in support of personalised learning. However, this research has mostly focused on cognitive skills and has not yet been applied to the context of mentoring/coaching of senior learners, who have different characteristics and learn in different contexts. In this paper, we describe how insights from previous research can be used to develop an intelligent virtual learning coach (agent) for senior learners with a focus on building the social relationship between the agent and the learner and the key task of the agent to socialize learners to the larger context of digital literacy with a focus on electronic health records. Following current approaches to mentoring and coaching, the agent is designed not to enhance and monitor the cognitive performance of the learner but to serve as a trusted friend and advisor, whose role is to provide one-to-one guidance and support sharing of experiences among learners (peers). Based on literature review and synopsis of research on virtual agents and current coaching/mentoring models under consideration of the specific characteristics and requirements of senior learners, we describe the design framework which was applied to design an intelligent virtual learning coach as part of the e-learning system for digital literacy of senior learners in the ePA-Coach project founded by the German Ministry of Education and Research. This paper also presents the results from the evaluation study, which compared the use of the first prototype of the virtual learning coach designed according to the design framework with a voice narration in a multimedia learning environment with senior learners. The focus of the study was to validate the agent design in the context of the persona effect (Lester et al., 1997). Since the persona effect is related to the hypothesis that animated agents are perceived as more socially engaging, the study evaluated possible impacts of agent coaching in comparison with voice coaching on motivation, engagement, experience, and digital literacy.

Keywords: virtual learning coach, virtual mentor, pedagogical agent, senior learners, digital literacy, electronic health records

Procedia PDF Downloads 100

Authors: Hila Levi

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Respect for human rights is a fundamental element of the European Union's (EU) identity and law. Surprisingly, however, the protection of human rights has been significantly restricted in the austerity programs ordered by the International Monetary Fund (IMF), the European Central Bank (ECB) and the European Commission (EC) (often labeled 'the Troika') in return for financial aid to the crisis-hit countries. This paper focuses on the role of the ECB in the crisis management. While other international financial institutions, such as the IMF or the World Bank, may opt to neglect human rights obligations, one might expect a greater respect of human rights from the ECB, which is bound by the EU Charter of Fundamental Rights. However, this paper argues that ECB officials made no significant effort to protect human rights or strike an adequate balance between competing financial and human rights needs while coping with the crisis. ECB officials were preoccupied with the need to stabilize the economy and prevent a collapse of the Eurozone, and paid only marginal attention to human rights concerns in the design and implementation of Troikas' programs. This paper explores the role of Organizational Culture (OC) in explaining this marginalization. While International Relations (IR) research on Intergovernmental Organizations (IGOs) behavior has traditionally focused on external interests of powerful member states, and on national and economic considerations, this study focuses on particular institutions' internal factors and independent processes. OC characteristics have been identified in OC literature as an important determinant of organizational behavior. This paper suggests that cultural characteristics are also vital for the examination of IGOs, and particularly for understanding the ECB's behavior during the crisis. In order to assess the OC of the ECB and the impact it had on its policies and decisions during the Eurozone crisis, the paper uses the results of numerous qualitative interviews conducted with high-ranking officials and staff members of the ECB involved in the crisis management. It further reviews primary sources of the ECB (such as ECB statutes, and the Memoranda of Understanding signed between the crisis countries and the Troika), and secondary sources (such as the report of the UN High Commissioner for Human Rights on Austerity measures and economic, social, and cultural rights). It thus analyzes the interaction between the ECBs culture and the almost complete absence of human rights considerations in the Eurozone crisis resolution scheme. This paper highlights the importance and influence of internal ideational factors on IGOs behavior. From a more practical perspective, this paper may contribute to understanding one of the obstacles in the process of human rights implementation in international organizations, and provide instruments for better protection of social and economic rights.

Keywords: European central bank, eurozone crisis, intergovernmental organizations, organizational culture

Procedia PDF Downloads 137

Authors: Shreyas S. Hegde, Anindya Deb, Suresh Nagesh

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Computational bio-mechanics is developing rapidly as a non-invasive tool to assist the medical fraternity to help in both diagnosis and prognosis of human body related issues such as injuries, cardio-vascular dysfunction, atherosclerotic plaque etc. Any system that would help either properly diagnose such problems or assist prognosis would be a boon to the doctors and medical society in general. Recently a lot of work is being focused in this direction which includes but not limited to various finite element analysis related to dental implants, skull injuries, orthopedic problems involving bones and joints etc. Such numerical solutions are helping medical practitioners to come up with alternate solutions for such problems and in most cases have also reduced the trauma on the patients. Some work also has been done in the area related to the use of computational fluid mechanics to understand the flow of blood through the human body, an area of hemodynamics. Since cardio-vascular diseases are one of the main causes of loss of human life, understanding of the blood flow with and without constraints (such as blockages), providing alternate methods of prognosis and further solutions to take care of issues related to blood flow would help save valuable life of such patients. This project is an attempt to use computational fluid dynamics (CFD) to solve specific problems related to hemodynamics. The hemodynamics simulation is used to gain a better understanding of functional, diagnostic and theoretical aspects of the blood flow. Due to the fact that many fundamental issues of the blood flow, like phenomena associated with pressure and viscous forces fields, are still not fully understood or entirely described through mathematical formulations the characterization of blood flow is still a challenging task. The computational modeling of the blood flow and mechanical interactions that strongly affect the blood flow patterns, based on medical data and imaging represent the most accurate analysis of the blood flow complex behavior. In this project the mathematical modeling of the blood flow in the arteries in the presence of successive blockages has been analyzed using CFD technique. Different cases of blockages in terms of percentages have been modeled using commercial software CATIA V5R20 and simulated using commercial software ANSYS 15.0 to study the effect of varying wall shear stress (WSS) values and also other parameters like the effect of increase in Reynolds number. The concept of fluid structure interaction (FSI) has been used to solve such problems. The model simulation results were validated using in vivo measurement data from existing literature

Keywords: computational fluid dynamics, hemodynamics, blood flow, results validation, arteries

Procedia PDF Downloads 389