Search results for: critical frequency

Authors: Kever Gomes, Rosana Martins

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The use of environmental indicators is today an important strategy for analyzing the sustainability of agricultural systems. Despite of the considerable importance of family agriculture for Brazilian economy, sustainable agricultural practices are still weakly known, and the known ones, underused. Currently, economic aspects of the relationship between man and nature lead to the destruction of natural ecosystems, which justifies the urgent need for dissemination and usage of new sustainable production techniques. The study shows the agro-social and social-cultural trajectory of the farmers and hypothesis are advanced on what would imply the adoption of agroforestry systems in family agriculture. This study aimed to investigate aspects related to the perception of sustainable agriculture, especially on agroforestry systems in farms of farmers from Distrito Federal-Brazil. Agro-social characteristics of farmers were systematized considering their perceptions about agroforestry systems for the preparation of proposal for a program of Environmental Services Payment, intended for families who are involved in the various activities of home gardens. This study used qualitative methodological approaches of quantitative research, using descriptive exploratory research. To get the necessary elements for the intended analysis, interviews were conducted at 40 heads of households of which 15 were men and 25 women. The results were analyzed using descriptive statistics, having been considered in the analysis the frequency, consistency, coherence and originality of responses. It was found that the lack of financial resources and lack of technical assistance are limiting factors for the dissemination and use of sustainable agricultural practices. Considering the great number of species found for the main categories of use, it can be inferred that the home gardens play important functions for the interviewed families, contributing for the food and medicine production destined for the consumption by the families themselves, and also playing an important esthetic function thanks to the variety of their ornamental plants. The wealth of these home gardens may be related to the rural origin and to the culture of the owners, who still keep a cultivation tradition. It was found that the products obtained from the home gardens contributed for the diet’s variety of the informants, representing a promising potential for the improvement of the population alimentation. The study reached the conclusion over the need to motivate the interest of these farmers to seek information and resources to enable the implementation of Agroforestry projects, including the recovery of areas in their properties, even those distinct from their backyards. The study shows the agro-social and social-cultural trajectory of the farmers and hypothesis are advanced on what would imply the adoption of agroforestry systems in family agriculture.

Keywords: agro-biodiversity, natural conservation, silviculture, urban agriculture

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Authors: Dr. Dionysis Panos Dpt. Communication, Internet Studies Cyprus University of Technology

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The widespread use of New Media and particularly Social Media, through fixed or mobile devices, has changed in a staggering way our perception about what is “intimate" and "safe" and what is not, in interpersonal communication and social relationships. The distribution of self and identity-related information in communication now evolves under new and different conditions and contexts. Consequently, this new framework forces us to rethink processes and mechanisms, such as what "exposure" means in interpersonal communication contexts, how the distinction between the "private" and the "public" nature of information is being negotiated online, how the "audiences" we interact with are understood and constructed. Drawing from an interdisciplinary perspective that combines sociology, communication psychology, media theory, new media and social networks research, as well as from the empirical findings of a longitudinal comparative research, this work proposes an integrative model for comprehending mechanisms of personal information management in interpersonal communication, which can be applied to both types of online (Computer-Mediated) and offline (Face-To-Face) communication. The presentation is based on conclusions drawn from a longitudinal qualitative research study with 458 new media users from 24 countries for almost over a decade. Some of these main conclusions include: (1) There is a clear and evidenced shift in users’ perception about the degree of "security" and "familiarity" of the Web, between the pre- and the post- Web 2.0 era. The role of Social Media in this shift was catalytic. (2) Basic Web 2.0 applications changed dramatically the nature of the Internet itself, transforming it from a place reserved for “elite users / technical knowledge keepers" into a place of "open sociability” for anyone. (3) Web 2.0 and Social Media brought about a significant change in the concept of “audience” we address in interpersonal communication. The previous "general and unknown audience" of personal home pages, converted into an "individual & personal" audience chosen by the user under various criteria. (4) The way we negotiate the nature of 'private' and 'public' of the Personal Information, has changed in a fundamental way. (5) The different features of the mediated environment of online communication and the critical changes occurred since the Web 2.0 advance, lead to the need of reconsideration and updating the theoretical models and analysis tools we use in our effort to comprehend the mechanisms of interpersonal communication and personal information management. Therefore, is proposed here a new model for understanding the way interpersonal communication evolves, based on a revision of social penetration theory.

Keywords: new media, interpersonal communication, social penetration theory, communication exposure, private information, public information

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Authors: Albert Amagyei, Julia Carroll, Amanda R. Amorim Adegboye, Laura Strumidlo, Rosie Kneafsey

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Introduction: Classroom-based learning has persisted as the mainstream model of pre-registration nurse education. This model is often rigid, teacher-centered, and unable to support active learning and the practical learning needs of nursing students. Health Education England (HEE), a public body of the Department of Health and Social Care, hypothesises that blended learning (BL) programmes may address health system and nursing profession challenges, such as nursing shortages and lack of digital expertise, by exploring opportunities for providing predominantly online, remote-access study which may increase nursing student recruitment, offering alternate pathways to nursing other than the traditional classroom route. This study will provide evidence for blended learning strategies adopted in nursing education as well as examine nursing student learning experiences concerning the challenges and opportunities related to using blended learning within nursing education. Objective: This review will explore the challenges and opportunities of BL within pre-registration nurse education from the student's perspective. Methods: The search was completed within five databases. Eligible studies were appraised independently by four reviewers. The JBI-convergent segregated approach for mixed methods review was used to assess and synthesize the data. The study’s protocol has been registered with the International Register of Systematic Reviews with registration number// PROSPERO (CRD42023423532). Results: Twenty-seven (27) studies (21 quantitative and 6 qualitative) were included in the review. The study confirmed that BL positively impacts nursing students' learning outcomes, as demonstrated by the findings of the meta-analysis and meta-synthesis. Conclusion: The review compared BL to traditional learning, simulation, laboratory, and online learning on nursing students’ learning and programme outcomes as well as learning behaviour and experience. The results show that BL could effectively improve nursing students’ knowledge, academic achievement, critical skills, and clinical performance as well as enhance learner satisfaction and programme retention. The review findings outline that students’ background characteristics, BL design, and format significantly impact the success of the BL nursing programme.

Keywords: nursing student, blended learning, pre-registration nurse education, online learning

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Authors: Farzaneh Badinlou, Reza Kormi-Nouri, Monika Knopf, Kamal Kharrazi

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When we teach, we have two critical elements at our disposal to help students: learning styles as well as testing styles. There are many different ways in which educators can effectively teach their students; verbal learning and experience-based learning. Lecture as a form of verbal learning style is a traditional arrangement in which teachers are more active and share information verbally with students. In experienced-based learning as the process of through, students learn actively through hands-on learning materials and observing teachers or others. Meanwhile, standard testing or assessment is the way to determine progress toward proficiency. Teachers and instructors mainly use essay (requires written responses), multiple choice questions (includes the correct answer and several incorrect answers as distractors), or open-ended questions (respondents answers it with own words). The current study focused on exploring an effective teaching style and testing methods as the function of age over school ages. In the present study, totally 410 participants were selected randomly from four grades (2ⁿᵈ, 4ᵗʰ, 6ᵗʰ, and 8ᵗʰ). Each subject was tested individually in one session lasting around 50 minutes. In learning tasks, the participants were presented three different instructions for learning materials (learning by doing, learning by observing, and learning by listening). Then, they were tested via different standard assessments as free recall, cued recall, and recognition tasks. The results revealed that generally students remember more of what they do and what they observe than what they hear. The age effect was more pronounced in learning by doing than in learning by observing, and learning by listening, becoming progressively stronger in the free-recall, cued-recall, and recognition tasks. The findings of this study indicated that learning by doing and free recall task is more age sensitive, suggesting that both of them are more strategic and more affected by developmental differences. Pedagogically, these results denoted that learning by modeling and engagement in program activities have the special role for learning. Moreover, the findings indicated that the multiple-choice questions can produce the best performance for school-aged children but is less age-sensitive. By contrast, the essay as essay can produce the lowest performance but is more age-sensitive. It will be very helpful for educators to know that what types of learning styles and test methods are most effective for students in each school grade.

Keywords: experience-based learning, learning style, school-aged children, testing methods, verbal learning

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Authors: Michael Lognoul

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In April 2021, the European Commission released its AI Act Proposal, which is the first policy proposal at the European Union level to target AI systems comprehensively, in a horizontal manner. This Proposal notably aims to achieve an ecosystem of trust in the European Union, based on the respect of fundamental rights, regarding AI. Among many other requirements, the AI Act Proposal aims to impose several generic transparency obligationson all AI systems to the benefit of natural persons facing those systems (e.g. information on the AI nature of systems, in case of an interaction with a human). The Proposal also provides for more stringent transparency obligations, specific to AI systems that qualify as high-risk, to the benefit of their users, notably on the characteristics, capabilities, and limitations of the AI systems they use. Against that background, this research firstly presents all such transparency requirements in turn, as well as related obligations, such asthe proposed obligations on record keeping. Secondly, it focuses on a legal analysis of their scope of application, of the content of the obligations, and on their practical implications. On the scope of transparency obligations tailored for high-risk AI systems, the research notably notes that it seems relatively narrow, given the proposed legal definition of the notion of users of AI systems. Hence, where end-users do not qualify as users, they may only receive very limited information. This element might potentially raise concern regarding the objective of the Proposal. On the content of the transparency obligations, the research highlights that the information that should benefit users of high-risk AI systems is both very broad and specific, from a technical perspective. Therefore, the information required under those obligations seems to create, prima facie, an adequate framework to ensure trust for users of high-risk AI systems. However, on the practical implications of these transparency obligations, the research notes that concern arises due to potential illiteracy of high-risk AI systems users. They might not benefit from sufficient technical expertise to fully understand the information provided to them, despite the wording of the Proposal, which requires that information should be comprehensible to its recipients (i.e. users).On this matter, the research points that there could be, more broadly, an important divergence between the level of detail of the information required by the Proposal and the level of expertise of users of high-risk AI systems. As a conclusion, the research provides policy recommendations to tackle (part of) the issues highlighted. It notably recommends to broaden the scope of transparency requirements for high-risk AI systems to encompass end-users. It also suggests that principles of explanation, as they were put forward in the Guidelines for Trustworthy AI of the High Level Expert Group, should be included in the Proposal in addition to transparency obligations.

Keywords: aI act proposal, explainability of aI, high-risk aI systems, transparency requirements

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Authors: Marcio Emilio Dos Santos, Kelly C. F. Dos Santos

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Caregivers of patients diagnosed with ASD are subjected to high stress situations due to the complexity and multiple levels of daily activities that require the organization of events, behaviors and socioemotional situations, such as immediate decision making and in public spaces. The cognitive and emotional requirement needed to fulfill this caregiving role exceeds the regular cultural process that adults receive in their process of preparation for conjugal and parental life. Therefore, in many cases, caregivers present a high level of overload, poor capacity to organize and mediate the development process of the child or patient about their care. Aims: Improvement in the cognitive and emotional capacities related to the caregiver function, allowing the reduction of the overload, the feeling of incompetence and the characteristic level of stress, developing a more organized conduct and decision making more oriented towards the objectives and procedural gains necessary for the integral development of the patient with diagnosis of ASD. Method: The study was performed with 20 relatives, randomly selected from a total of 140 patients attended. The family members were submitted to the Wechsler Adult Intelligence Scale III intelligence test and the Family assessment Management Measure (FaMM) questionnaire as a previous evaluation. Therapeutic activity in a small group of family members or caregivers, with weekly frequency, with a minimum workload of two hours, using the Feuerstein Instrumental Enrichment Cognitive Development Program - Feuerstein Instrumental Enrichment for ten months. Reapplication of the previous tests to verify the gains obtained. Results and Discussion: There is a change in the level of caregiver overload, improvement in the results of the Family assessment Management Measure and highlight to the increase of performance in the cognitive aspects related to problem solving, planned behavior and management of behavioral crises. These results lead to the discussion of the need to invest in the integrated care of patients and their caregivers, mainly by enabling cognitively to deal with the complexity of Autism. This goes beyond the simple therapeutic orientation about adjustments in family and school routines. The study showed that when the caregiver improves his/her capacity of management, the results of the treatment are potentiated and there is a reduction of the level of the caregiver's overload. Importantly, the study was performed for only ten months and the number of family members attended in the study (n = 20) needs to be expanded to have statistical strength.

Keywords: caregiver overload, cognitive development program ASD caregivers, feuerstein instrumental enrichment, family assessment management measure

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Authors: Bruno Baptista, Andreia S. R. Oliveira, Patricia V. Mendonca, Jorge F. J. Coelho, Fani Sousa

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Drug delivery systems are designed to allow adequate protection and controlled delivery of drugs to specific locations. These systems aim to reduce side effects and control the biodistribution profile of drugs, thus improving therapeutic efficacy. This study involved the synthesis of polymeric nanoparticles, based on amphiphilic diblock copolymers, comprising a biocompatible, poly (oligo (ethylene oxide) methyl ether methacrylate (POEOMA) as hydrophilic segment and a pH-sensitive block, the poly (2-diisopropylamino)ethyl methacrylate) (PDPA). The objective of this work was the development of polymeric pH-responsive nanoparticles to encapsulate and carry small RNAs as a model to further develop non-coding RNAs delivery systems with therapeutic value. The responsiveness of PDPA to pH allows the electrostatic interaction of these copolymers with nucleic acids at acidic pH, as a result of the protonation of the tertiary amine groups of this polymer at pH values below its pKa (around 6.2). Initially, the molecular weight parameters and chemical structure of the block copolymers were determined by size exclusion chromatography (SEC) and nuclear magnetic resonance (1H-NMR) spectroscopy, respectively. Then, the complexation with small RNAs was verified, generating polyplexes with sizes ranging from 300 to 600 nm and with encapsulation efficiencies around 80%, depending on the molecular weight of the polymers, their composition, and concentration used. The effect of pH on the morphology of nanoparticles was evaluated by scanning electron microscopy (SEM) being verified that at higher pH values, particles tend to lose their spherical shape. Since this work aims to develop systems for the delivery of non-coding RNAs, studies on RNA protection (contact with RNase, FBS, and Trypsin) and cell viability were also carried out. It was found that they induce some protection against constituents of the cellular environment and have no cellular toxicity. In summary, this research work contributes to the development of pH-sensitive polymers, capable of protecting and encapsulating RNA, in a relatively simple and efficient manner, to further be applied on drug delivery to specific sites where pH may have a critical role, as it can occur in several cancer environments.

Keywords: drug delivery systems, pH-responsive polymers, POEOMA-b-PDPA, small RNAs

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Authors: Zanele Ntshidi, Sebinasi Dzikiti, Dominic Mazvimavi

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South Africa is a dry country and yet it is ranked as the 8th largest exporter of fresh apples (Malus Domestica) globally. Prime apple producing regions are in the Eastern and Western Cape Provinces of the country where all the fruit is grown under irrigation. Climate change models predict increasingly drier future conditions in these regions and the frequency and severity of droughts is expected to increase. For the sustainability and growth of the fruit industry it is important to minimize non-beneficial water losses from the orchard floor. The aims of this study were firstly to compare the water use of cover crop species used in South African orchards for which there is currently no information. The second aim was to investigate how orchard water use (evapotranspiration) was partitioned into beneficial (tree transpiration) and non-beneficial (orchard floor evaporation) water uses for micro-sprinkler irrigated orchards with different canopy covers. This information is important in order to explore opportunities to minimize non-beneficial water losses. Six cover crop species (four exotic and two indigenous) were grown in 2 L pots in a greenhouse. Cover crop transpiration was measured using the gravimetric method on clear days. To establish how water use was partitioned in orchards, evapotranspiration (ET) was measured using an open path eddy covariance system, while tree transpiration was measured hourly throughout the season (October to June) on six trees per orchard using the heat ratio sap flow method. On selected clear days, soil evaporation was measured hourly from sunrise to sunset using six micro-lysimeters situated at different wet/dry and sun/shade positions on the orchard floor. Transpiration of cover crops was measured using miniature (2 mm Ø) stem heat balance sap flow gauges. The greenhouse study showed that exotic cover crops had significantly higher (p < 0.01) average transpiration rates (~3.7 L/m2/d) than the indigenous species (~ 2.2 L/m²/d). In young non-bearing orchards, orchard floor evaporative fluxes accounted for more than 60% of orchard ET while this ranged from 10 to 30% in mature orchards with a high canopy cover. While exotic cover crops are preferred by most farmers, this study shows that they use larger quantities of water than indigenous species. This in turn contributes to a larger orchard floor evaporation flux. In young orchards non-beneficial losses can be minimized by adopting drip or short range micro-sprinkler methods that reduce the wetted soil fraction thereby conserving water.

Keywords: evapotranspiration, sap flow, soil evaporation, transpiration

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Authors: Chiu-Wen Chang, I-Yun Chang, Wei-Ting Chen, Hui-Ping Ho, Chao-Ying Pan, Joh-Jong Huang

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Dengue is a ‘community disease’ or ‘environmental disease’, as long as the environment exist suitable container (including natural and artificial) for mosquito breeding, once the virus invade will lead to the dengue epidemic. Surveillance of vector density is critical to effective infectious disease control and play an important role in monitoring the dynamics of mosquitoes in community, such as mosquito species, density, distribution area. The objective of this study was to examine the relationship in vector density survey (Breteau index, Adult index, House index, Container index, and Larvae index) form 2014 to 2016 in Kaohsiung City and evaluate the effects of introducing the Breeding Elimination and Appraisal Team (hereinafter referred to as BEAT) as an intervention measure on eliminating dengue vector breeding site started from May 2016. BEAT were performed on people who were suspected of contracting dengue fever, a surrounding area measuring 50 meters by 50 meters was demarcated as the emergency prevention and treatment zone. BEAT would perform weekly vector mosquito inspections and vector mosquito inspections in regions with a high Gravitrap index and assign a risk assessment index to each region. These indices as well as the prevention and treatment results were immediately reported to epidemic prevention-related units every week. The results indicated that, vector indices from 2014 to 2016 showed no statistically significant differences in the Breteau index, adult index, and house index (p > 0.05) but statistically significant differences in the container index and larvae index (p <0.05). After executing the integrated elimination work, container index and larvae index are statistically significant different from 2014 to 2016 in the (p < 0.05). A post hoc test indicated that the container index of 2014 (M = 12.793) was significantly higher than that of 2016 (M = 7.631), and that the larvae index of 2015 (M = 34.065) was significantly lower than that of 2014 (M = 66.867). The results revealed that effective vector density surveillance could highlight the focus breeding site and then implement the immediate control action (BEAT), which successfully decreased the vector density and the risk of dengue epidemic.

Keywords: Breteau index, dengue control, monitoring method, vector density

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Authors: A. Mostaani, M. P. Pereira, B. F. Rolfe

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The increasing application of Advanced High Strength Steel (AHSS) in the automotive industry to fulfill crash requirements has introduced higher levels of wear in stamping dies and parts. Therefore, understanding wear behaviour in sheet metal forming is of great importance as it can help to reduce the high costs currently associated with tool wear. At the contact between the die and the sheet, the tips of hard tool asperities interact with the softer sheet material. Understanding the deformation that occurs during this interaction is important for our overall understanding of the wear mechanisms. For these reasons, the scratching of a perfectly plastic material by a rigid indenter has been widely examined in the literature; with finite element modelling (FEM) used in recent years to further understand the behaviour. The ‘wear mode diagram’ has been commonly used to classify the deformation regime of the soft work-piece during scratching, into three modes: ploughing, wedge formation, and cutting. This diagram, which is based on 2D slip line theory and upper bound method for perfectly plastic work-piece and rigid indenter, relates different wear modes to attack angle and interfacial strength. This diagram has been the basis for many wear studies and wear models to date. Additionally, it has been concluded that galling is most likely to occur during the wedge formation mode. However, there has been little analysis in the literature of how the material behaviour and deformation conditions associated with metal forming processes influence the wear behaviour. Therefore, the first aim of this work is first to use a commercial FEM package (Abaqus/Explicit) to build a 3D model to capture wear modes during scratching with indenters with different attack angles and different interfacial strengths. The second goal is to utilise the developed model to understand how wear modes might change in the presence of bulk deformation of the work-piece material as a result of the metal forming operation. Finally, the effect of the work-piece material properties, including strain hardening, will be examined to understand how these influence the wear modes and wear behaviour. The results show that both strain hardening and substrate deformation can change the critical attack angle at which the wedge formation regime is activated.

Keywords: finite element, pile-up, scratch test, wear mode

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Authors: A. P. Pashkov

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The number of environmental factors that adversely affect children's health is growing every year; their combination in each territory is different. The contribution of socio-economic factors to the health status of the younger generation is increasing. It is the child’s body that is most sensitive to changes in environmental conditions, responding to this with a deterioration in health. Over the past years, scientists have determined the influence of environmental factors and the incidence of children. Currently, there is a tendency to study regional characteristics of the interaction of a combination of environmental factors with the child's body. The aim of the work was to identify trends in the primary non-infectious morbidity of the children of the Altai Territory as a unique region that combines territories with different levels of environmental quality indicators, as well as to assess the effect of atmospheric air, drinking water and socio-economic indicators on the incidence of children in the region. An unfavorable tendency has been revealed in the region for incidence of such nosological groups as neoplasms, including malignant ones, diseases of the endocrine system, including obesity and thyroid disease, diseases of the circulatory system, digestive diseases, diseases of the genitourinary system, congenital anomalies, and respiratory diseases. Between some groups of diseases revealed a pattern of geographical distribution during mapping and a significant correlation. Some nosologies have a relationship with socio-economic indicators for an integrated assessment: circulatory system diseases, respiratory diseases (direct connection), endocrine system diseases, eating disorders, and metabolic disorders (feedback). The analysis of associations of the incidence of children with average annual concentrations of substances that pollute the air and drinking water showed the existence of reliable correlation in areas of critical and intense degree of environmental quality. This fact confirms that the population living in contaminated areas is subject to the negative influence of environmental factors, which immediately affects the health status of children. The results obtained indicate the need for a detailed assessment of the influence of environmental factors on the incidence of children in the regional aspect, the formation of a database, and the development of automated programs that can predict the incidence in each specific territory. This will increase the effectiveness, including economic of preventive measures.

Keywords: incidence of children, regional features, socio-economic factors, environmental factors

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Authors: Aisha Alshdefat, Lina Shakman

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Objective: With environmental sustainability (ES) emerging as a critical concern due to its global impact, higher education institutions play a vital role in promoting ES through curricula and campus operations. This study examines the perceptions, attitudes, and behaviors related to ES among students at Sultan Qaboos University, aiming to identify areas for improved integration of sustainability practices in higher education. Design: A descriptive cross-sectional survey was conducted with 300 students from Sultan Qaboos University using an online questionnaire as the primary data collection instrument. The survey assessed six key areas: awareness, concern, attitude, willingness to participate, current behaviors, and recommendations for enhancing campus sustainability initiatives. Data was analyzed using SPSS Version 23, employing Pearson’s correlation, chi-square, and Fisher's exact test to explore associations among key variables. Findings: Preliminary analysis reveals that 68% of participants are familiar with core ES concepts, including the Sustainable Development Goals (SDGs), with high levels of concern expressed regarding environmental issues. However, only 47% reported active involvement in campus-led ES initiatives, highlighting an engagement gap. Over 70% of respondents indicated that sustainability should be a university policy priority, and 62% expressed willingness to participate in additional ES-related programs. Despite this interest, 58% advocated for more courses on sustainability within their curriculum, suggesting that current offerings are insufficient. Statistical analysis identified a significant positive correlation between ES awareness levels and willingness to engage in sustainable practices (p < 0.05). These findings emphasize the need for enhanced institutional efforts, including targeted programs and curriculum integration, to foster a more sustainability-focused culture among students. Conclusion: The results underscore that while there is a strong foundational awareness of ES among students, greater institutional support is essential to translate this awareness into actionable engagement. Integrating sustainability more fully into academic programs and campus life could substantially advance students’ involvement and commitment to environmental stewardship.

Keywords: environmental sustainability, higher education, students, perceptions, Sultan Qaboos University.

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Authors: Bilge Ozel

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Cities are high-complex living organisms and are subjects to continuous transformations produced by the stress that derives from changing conditions. Today the metropolises are seen like “development engines” of the countries and accordingly they become the centre of better living conditions that encourages demographic growth which constitutes the main reason of the changes. Indeed, the potential for economic advancement of the cities directly represents the economic status of their countries. The term of “resilience”, which sees the changes as natural processes and represents the flexibility and adaptability of the systems in the face of changing conditions, becomes a key concept for the development of urban transformation policies. The term of “resilience” derives from the Latin word ‘resilire’, which means ‘bounce’, ‘jump back’, refers to the ability of a system to withstand shocks and still maintain the basic characteristics. A resilient system does not only survive the potential risks and threats but also takes advantage of the positive outcomes of the perturbations and ensures adaptation to the new external conditions. When this understanding is taken into the urban context - or rather “urban resilience” - it delineates the capacity of cities to anticipate upcoming shocks and changes without undergoing major alterations in its functional, physical, socio-economic systems. Undoubtedly, the issue of coordinating the urban systems in a “resilient” form is a multidisciplinary and complex process as the cities are multi-layered and dynamic structures. The concept of “urban transformation” is first launched in Europe just after World War II. It has been applied through different methods such as renovation, revitalization, improvement and gentrification. These methods have been in continuous advancement by acquiring new meanings and trends over years. With the effects of neoliberal policies in the 1980s, the concept of urban transformation has been associated with economic objectives. Subsequently this understanding has been improved over time and had new orientations such as providing more social justice and environmental sustainability. The aim of this research is to identify the most applied urban transformation methods in Turkey and its main reasons of being selected. Moreover, investigating the lacking and limiting points of the urban transformation policies in the context of “urban resilience” in a comparative way with European interventions. The emblematic examples, which symbolize the breaking points of the recent evolution of urban transformation concepts in Europe and Turkey, are chosen and reviewed in a critical way.

Keywords: resilience, urban dynamics, urban resilience, urban transformation

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Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said

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Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.

Keywords: intensive care unit, mortality, nosocomial infection, risk factors

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Authors: Wilfred Emmannuel Dzasu, Sani Usman Kunya, Inuwa Yusuf Mohammed, Moses Jonathan Gambo

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The research aimed at investigating and identifying the strategies for enhancing access to microfinance for housing provision in the informal sector of North East Nigeria, with a focus on addressing the critical issue of housing poverty and lack of access to affordable housing finance among low-income households in the informal sector. The study employed an exploratory sequential mixed method design, combining both qualitative and quantitative data collection and analysis techniques. In the qualitative phase, 12 participants from microfinance institutions (MFIs) in four selected states (Adamawa, Bauchi, Gombe, and Taraba) were interviewed. The interviews were conducted using an interview guide with open-ended questions and were recorded with the consent of the respondents. In the quantitative phase, a survey strategy was adopted to collect data from 500 questionnaires distributed to informal sector workers (ISWs) in the study area. A total of 350 questionnaires were returned, representing a 70.0% response rate. The most preferred strategy for improving access to housing microfinance among ISWs is aggressive awareness of housing financing options by MFIs, with a mean score of 4.213; the most important strategy for improving access to housing microfinance among MFIs is close monitoring and adequate supervision of housing loan beneficiaries by MFIs, with a mean score of 4.675. The study identified several government-related strategies that are necessary for enhancing access to housing microfinance, including the provision of grants and subsidized intervention funds for housing, improvement in infrastructures to aid housing developments, and adequate measures for checking inflation/price fluctuation of building materials. The study also identified several MFI-related strategies that are necessary for enhancing access to housing microfinance, including deliberate expansion in the capital bases of MFIs, adequate training and capacity development of MFIs staff on relevant skills in housing micro-financing, and introduction of loan products that suit the incremental building needs of informal sector workers. Overall, the study highlights the need for a combination of government-related and MFI-related strategies to enhance access to microfinance for housing provision in the informal sector of North East Nigeria.

Keywords: finanace, microfinance, housing, North East Nigeria

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Authors: Joe Kallas

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It is now widely accepted that the preservation of cultural heritage must go beyond simple restoration and renovation actions. While some historic monuments have been preserved for millennia, many of them, less important or simply neglected because of lack of money, have disappeared. As a result, the adaptation of monuments and archaeological sites to new functions allow them to 'survive'. Temporary activities or 'ephemeral' re-use, are increasingly recognized as a means of vitalization of deprived areas and enhancement of historic sites that became obsolete. They have the potential to increase economic and cultural value while making the best use of existing resources. However, there are often conservation and preservation issues related to the implementation of this type of re-use, which can also threaten the integrity and authenticity of archaeological sites and monuments if they have not been properly managed. This paper aims to get a better knowledge of the ephemeral re-use of heritage, and more specifically the subject of the incorporation of the festival phenomenon within the monuments and archaeological sites in Lebanon, a topic that is not yet studied enough. This paper tried to determine the elements that compose it, in order to analyze this phenomenon and to trace its good practices, by comparing international study cases to important national cases: the International Festival of Baalbek, the International Festival of Byblos and the International Festival of Beiteddine. Various factors have been studied and analyzed in order to best respond to the main problematic of this paper: 'How can we preserve the integrity of sites and monuments after the integration of an ephemeral function? And what are the preventive conservation measures to be taken when holding festivals in archaeological sites with fragile structures?' The impacts of the technical problems were first analyzed using various data and more particularly the effects of mass tourism, the integration of temporary installations, sound vibrations, the effects of unstudied lighting, until the mystification of heritage. Unfortunately, the DGA (General Direction of Antiquities in Lebanon) does not specify any frequency limit for the sound vibrations emitted by the speakers during musical festivals. In addition, there is no requirement from its part regarding the installations of the lighting systems in the historic monuments and no monitoring is done in situ, due to the lack of awareness of the impact that could be generated by such interventions, and due to the lack of materials and tools needed for the monitoring process. The study and analysis of the various data mentioned above led us to the elaboration of the main objective of this paper, which is the establishment of a list of recommendations. This list enables to define various preventive conservation measures to be taken during the holding of the festivals within the cultural heritage sites in Lebanon. We strongly hope that this paper will be an awareness document to start taking into consideration several factors previously neglected, in order to improve the conservation practices in the archaeological sites and monuments during the incorporation of the festival phenomenon.

Keywords: archaeology, authenticity, conservation, cultural heritage, festival, historic sites, integrity, monuments, tourism

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Authors: Umut Tuğlu Karslı

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While, port function had a major role during the antiquity and medieval times, it has started to lose its significance in 19th century. In many port cities, while heavy industrial functions and ports have been moved out of the former port districts, the resulting derelict spaces have been transformed to new waterfront quarters to accommodate commercial, tourism, cultural, residential and public uses. Primary aim of these operations is to revitalize abandoned spaces of historical potential and re-establish a relationship between the city and the coast. Karakoy Port, field of this study, located in the Bosphorus, was surrounded by the city centre in time due to the transformation of urban functions, and as a result it has lost its former significance. While Karakoy has 24 hours lively residential and commercial uses in old times; in early 1980s, became a district of mechanical, plumbing and electronic parts suppliers during the day and a place for homeless at night. Today, activities for revitalization of this region continue in two forms and scales. First of these activities is the "planned transformation projects," which also includes the most important one “Galataport project”, and the second one is "spontaneous transformation," which consists of individual interventions. Galataport project that based on the idea of arranging the area specifically for tourists was prepared in 2005 and became a topic of tremendous public debate. On the other hand, the "spontaneous transformation" that is observed in the Karakoy District starts in 2004 with the foundation of “Istanbul Modern Museum”. Istanbul Modern, the first contemporary arts museum of the city, allowed the cultural integration of old naval warehouses of the port to the daily life. Following this adaptive reuse intervention, the district started to accommodate numerous art galleries, studios, café-workshops and design stores. In this context, this paper briefly examines revitalization studies in obsolete port regions, analyzes the planned and ongoing socio-spatial transformations in the specific case of Karakoy under the subjects of "planned transformation projects" and "spontaneous transformation", and realizes a critical review of the sustainability of the proposals on how to reinstate the district in the active life of Istanbul.

Keywords: port cities, socio-spatial transformation, urban regeneration, urban revitalization

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Authors: Sandra Maria Cerqueira Da Silva

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The construction of the material world involves a series of social power relations. These relations, in a way, can dictate, shape, judge and drive the profiles of so-called ‘ideal’ individuals. Gender relations, as power relations, are defined based on hierarchies, obediences and inequalities, and male domination seems, with few exceptions, to be rooted in every society around the world. The profile of the Brazilian woman, beyond patriarchal and market determinations, is strongly subjected to media products. Women are, numerically, the majority in Brazilian society. The social indicators point to slight advances in terms of years of study and professional qualification, as well as access to the job market; yet, differences in opportunity and conditions — often explained though the ‘unquestionable’ cultural rancidness argument — still hinder women’s ability to reach and keep job positions. These unequalities are also visible in everyday interactions and in gender relations, and they become greater once race is added to the analysis. For a black woman, her racial origins may play a part in determining the construction of her gender roles. In these terms, there is need to investigate the racial character of the sexual differences within a larger social proccess of naturalization and justification of cultural hierarchies. Thus, the goal of this study is to identify and discuss the media-built image of black women in Brazil. Furthermore, it is necessary to seek views different than those of the ruling classes. The study uses a qualitative approach based on the feminist standpoint, which intends to hold women’s experiences as central. The body of the research — images taken from the Internet — was treated through critical content analysis. The results show that in Brazil the profile of black women, beyond the machist and sexist generalizations, objectifies them or sees them as servants, always at the disposal of non-blacks. It is necessary to overcome the history of this nation, always considering the contribution of these women to the growth and development of places and societies. This can be done through the acknowledgement and highlighting of the few black women who were able to overcome the many barriers in their path and reach leadership position in the country. There are still many important challenges in the way of finding affirmative policies and reaching a more equal society in terms of gender and race; a serious and firm political commitment seems sine qua non.

Keywords: black woman, feminist standpoint, markings, objectification

Procedia PDF Downloads 272

Authors: J. Woźniak-Holecka, T. Holecki, S. Jaruga

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Spa treatment is an important area of the health care system in Poland due to the increasing needs of the population and the context of historical conditions for this form of therapy. It extends the range of financing possibilities of the outlets and increases the potential of spa services, which is very important in the context of demographic and epidemiological changes. The main advantages of spa treatment services include its relatively wide availability, low risk of side effects, good patient tolerance, long-lasting curative effect and a relatively low cost. In addition, patients should be provided with a proper diet and enable participation in health education and health promotion classes aimed at health problems consistent with the treatment profile. Challenges for global health care systems include a sharp increase in spending on benefits, dynamic development of health technologies and growing social expectations. This requires extending the competences of health resort facilities for health promotion. Within each type of health resort institutions in Poland, nutritional education services are implemented, aimed at creating and consolidating proper eating habits. Choosing the right diet can speed up recovery or become one of the methods to alleviate the symptoms of chronic diseases. During spa treatment patient learns the principles of rational nutrition and adequate dietotherapy to his diseases. The aim of the project is to assess the frequency and quality of nutritional education provided to patients in health resort facilities in a nationwide perspective. The material for the study will be data obtained as part of an in-depth interview conducted among Heads of Nutrition Departments of selected institutions. The use of nutritional education in a health resort may be an important goal of implementing the state health policy as a useful tool to reduce the risk of diet-related diseases. Recognizing nutritional education in health resort institutions as a type of full-value health service can be effective system support for health policy, including seniors, due to demographic changes currently occurring in the Polish population. Furthermore, it is necessary to increase the interest and motivation of patients to follow the recommendations of nutritional education, because it will bring tangible benefits for the long-term effects of therapy and care should be taken for the form and methodology of nutrition education implemented in health resort institutions. Finally it is necessary to construct an educational offer in terms of selected groups of patients with the highest health needs: the elderly and the disabled. In conclusion, it can be said that the system of nutritional education implemented in polish health resort institutions should be subjected to global changes and strong systemic correction.

Keywords: health care system, nutritional education, public health, spa and treatment

Procedia PDF Downloads 114

Authors: Iman Jabbar

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Within the scope of professionalism and in order to compete with the modern world, teachers, are expected to develop their teaching skills and activities in addition to their professional knowledge. At the college level, the teacher should be able to face classroom challenges through his engagement with the learning situation to understand the students and their needs. In our field of TESOL, the role of the English teacher is no longer restricted to teaching English texts, but rather he should endeavor to enhance the students’ skills such as communication and critical analysis. Within the literature of professionalism, there are certain strategies and tools that an English teacher should adopt to develop his competence and performance. Reflective practice, which is an exploratory process, is one of these strategies. Another strategy contributing to classroom development is motivation. It is crucial in students’ learning as it affects the quality of learning English in the classroom in addition to determining success or failure as well as language achievement. This is a qualitative study grounded on interpretive perspectives of teachers and students regarding the process of professional development. This study aims at (a) understanding how teachers at the college level conceptualize reflective practice and motivation inside EFL classroom, and (b) exploring the methods and strategies that they implement to practice reflection and motivation. This study and is based on two questions: 1. How do EFL teachers perceive and view reflection and motivation in relation to their teaching and professional development? 2. How can reflective practice and motivation be developed into practical strategies and actions in EFL teachers’ professional context? The study is organized into two parts, theoretical and practical. The theoretical part reviews the literature on the concept of reflective practice and motivation in relation to professional development through providing certain definitions, theoretical models, and strategies. The practical part draws on the theoretical one, however; it is the core of the study since it deals with two issues. It involves the research design, methodology, and methods of data collection, sampling, and data analysis. It ends up with an overall discussion of findings and the researcher's reflections on the investigated topic. In terms of significance, the study is intended to contribute to the field of TESOL at the academic level through the selection of the topic and investigating it from theoretical and practical perspectives. Professional development is the path that leads to enhancing the quality of teaching English as a foreign or second language in a way that suits the modern trends of globalization and advanced technology.

Keywords: professional development, motivation, reflection, learning

Procedia PDF Downloads 450

Authors: Oubelkacem Yacine, El Bast Hassan, El Bakkali Abdelmajid, Lamhasni Taibi, Ettakni Mahmoud, Ait Lyazidi Saadia, Haddad Mustapha, Ben-Ncer Abdelouahed, El Ferrane Mohammed, Boufarra Abdelkrim

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The present work relates to an on-site and completely non-invasive investigation of one of the most famous west Mediterranean Torah Scroll housed at the National Library of the Kingdom of Morocco. The scroll is 26 m long and consists of 143 parchment sheets of 59 cm x 19 cm, exhibiting only black writings; it is of unknown age. The artifact has been restored by the curator staff of the library. The investigation exploring separately the parchment support and the writing black ink aims at: i) the examination of the parchment conservation/degradation state, ii) the identification of the black ink and iii) the identification of the parchment handcrafting materials. For this purpose, the analyses have been based on combining all of elemental XRF and structural Raman, ATR-FT Infrared Red and Fiber Optical Reflectance spectroscopies, in addition to chroma-metric and pH measurements. pH measurements showing values around 6.5 are in concordance with the absence of any visual corrosion related to the parchment acidity. However, on the basis of the relative intensities and frequency shift of amid I (AI) and amid II (AII) vibrational bands of the collagen, ATR-FTIR spectra revealed diffuse hydrolysis and gelatinization of the parchment writing support; diffuse and non-homogeny degradation by gelatinization has been also confirmed by the IG gelatinization index deduced from the NIR bands on the FOR spectra. This IG index, defined as the ratio I (6860 cm-1) / I (6685 cm-1), ranges in the interval 0.98 – 1 and highlights collagen degradation at the molecular level. Sequentially Shifted Excitation Raman measurements (SSERS) crossed to X-ray fluorescence (XRF) ones on the black writings revealed that the black ink used is an iron-copper gall one, while FOR spectra are typical of pure metal gall inks. These later reflectance measurements exclude, thus, any intentional addition of carbon black to the ink recipe. Moreover, no lead white had been used while pre-drawing the writing lines. On another side, ATR-FTIR measurements highlighted the presence of oxalates as ink degradation products. Considering the parchment handcrafting, the combination of XRF and ATR-FTIR measurements led to the assumption that this writing support had been prepared according to ancient Middle East practices; the parchment infrared fingerprint seems identical to that of the Dead Sea scroll. The present multi-technical analyses are the first ones performed on an ancient Judaic written parchment of Morocco; it is under furthering. The investigation will be extended to other parchments belonging to the Jewish Cultural Heritage Museum of Morocco in Casablanca.

Keywords: torah scroll, parchment, black ink, non-invasive analyses, XRF/ATR-FTIR/RAMAN/FORS

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Authors: A. Yousuf, M. Iqbal, A. Mir, S. Aziz

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This study deals with the women’s right to land for gender equality. Economic Transformation Initiative, Gilgit-Baltistan (ETI-GB), an ambitious program supported by International Fund for Agricultural Development United Nation (IFAD, UN), aims to strengthen land reforms process in disputed area of Gilgit-Baltistan (GB) Pakistan, that is taking place first time in the history. This project is a brick to build the foundation of land reforms and land policies in GB. The ETI-GB provides substantive support to government of GB in developing policy measures and initiatives to promote women’s right to have and to own land is kind of unconventional step in a very traditional society. It would be interesting to have discussion and document the people’s response regarding this project. The study has used mixed method for data collection. For qualitative data, content analysis is used to have a thorough understanding of different types of land reforms across the globe particularly in South Asia. Theoretical understanding of the literature is essential which provides the basis why land reforms are important and how far it plays an important role when it comes to eliminating inequality. Focused group discussion was carried out for verification and triangulation of data. For quantitative, survey was conducted to take responses from the people of the region and analyzed. The program is implemented in Ghizer district of GB. 2340 households were identified as beneficiaries of newly developed land. Among them, 2285 were men households, and 55 were women households. There is a significant difference between men and women households. In spite of great difference, it is a great achievement of the donor that in history of GB, first time women are going to be entitled to land ownership. GB is a patriarchal society, many social factors like cultural, religious play role for gender inequality. In developing countries, such as Pakistan, the awareness of land property rights has not been given proper attention to gender equality development frameworks. It is argued that land property rights of women have not been taken into mainstream policymaking in the development of nation building process. Consequently, this has generated deprivation of women’s property rights, low income level, lack of education and poor health. This paper emphasises that there should have proper land property right of women in Gilgit-Baltistan Pakistan, provided that the gender empowerment could be increased in terms of women’s property rights.

Keywords: gender equality, women right to land ownership, property rights, women empowerment

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Authors: Seval Kula-Kartal

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Developing students’ reading comprehension skills is an aim that is difficult to accomplish and requires to follow long-term and systematic teaching and assessment processes. In these processes, teachers need tools to provide guidance to them on what reading comprehension is and which comprehension skills they should develop. Due to a lack of clear and evidence-based frameworks defining reading comprehension skills, especially in Turkiye, teachers and students mostly follow various processes in the classrooms without having an idea about what their comprehension goals are and what those goals mean. Since teachers and students do not have a clear view of comprehension targets, strengths, and weaknesses in students’ comprehension skills, the formative feedback processes cannot be managed in an effective way. It is believed that detecting and defining influential comprehension skills may provide guidance both to teachers and students during the feedback process. Therefore, in the current study, some of the reading comprehension frameworks that define comprehension skills operationally were examined. The aim of the study is to develop a simple and clear framework that can be used by teachers and students during their teaching, learning, assessment, and feedback processes. The current study is qualitative research in which documents related to reading comprehension skills were analyzed. Therefore, the study group consisted of recourses and frameworks which made big contributions to theoretical and operational definitions of reading comprehension. A content analysis was conducted on the resources included in the study group. To determine the validity of the themes and sub-categories revealed as the result of content analysis, three educational assessment experts were asked to examine the content analysis results. The Fleiss’ Cappa coefficient revealed that there is consistency among themes and categories defined by three different experts. The content analysis of the reading comprehension frameworks revealed that comprehension skills could be examined under four different themes. The first and second themes focus on understanding information given explicitly or implicitly within a text. The third theme includes skills used by the readers to make connections between their personal knowledge and the information given in the text. Lastly, the fourth theme focus on skills used by readers to examine the text with a critical view. The results suggested that fundamental reading comprehension skills can be examined under four themes. Teachers are recommended to use these themes in their reading comprehension teaching and assessment processes. Acknowledgment: This research is supported by Pamukkale University Scientific Research Unit within the project, whose title is Developing A Reading Comprehension Rubric.

Keywords: reading comprehension, assessing reading comprehension, comprehension taxonomies, educational assessment

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Authors: Wanwadee Neamsakul

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VARK learning style is an effective method of learning that could enhance all skills of the students like visual (V), auditory (A), read/write (R), and kinesthetic (K). This learning style benefits the students in terms of professional competencies, critical thinking and lifelong learning which are the desirable characteristics of the nursing students. This study aimed to develop a model of teaching and learning clinical practicum at postpartum ward for nursing students by using VARK learning styles, and evaluate the nursing students’ opinions about the developmental model. A methodology used for this study was research and development (R&D). The model was developed by focus group discussion with five obstetric nursing instructors who have experiences teaching Maternal Newborn and Midwifery I subject. The activities related to practices in the postpartum (PP) ward including all skills of VARK were assigned into the matrix table. The researcher asked the experts to supervise the model and adjusted the model following the supervision. Subsequently, it was brought to be tried out with the nursing students who practiced on the PP ward. Thirty third year nursing students from one of the northern Nursing Colleges, Academic year 2015 were purposive sampling. The opinions about the satisfaction of the model were collected using a questionnaire which was tested for its validity and reliability. Data were analyzed using descriptive statistics. The developed model composed of 27 activities. Seven activities were developed as enhancement of visual skills for the nursing students (25.93%), five activities as auditory skills (18.52%), six activities as read and write skills (22.22%), and nine activities as kinesthetic skills (33.33%). Overall opinions about the model were reported at the highest level of average satisfaction (mean=4.63, S.D=0.45). In the aspects of visual skill (mean=4.80, S.D=0.45) was reported at the highest level of average satisfaction followed by auditory skill (mean=4.62, S.D=0.43), read and write skill (mean=4.57, S.D=0.46), and kinesthetic skill (mean=4.53, S.D=0.45) which were reported at the highest level of average satisfaction, respectively. The nursing students reported that the model could help them employ all of their skills during practicing and taking care of the postpartum women and newborn babies. They could establish self-confidence while providing care and felt proud of themselves by the benefits of the model. It can be said that using VARK learning style to develop the model could enhance both nursing students’ competencies and positive attitude towards the nursing profession. Consequently, they could provide quality care for postpartum women and newborn babies effectively in the long run.

Keywords: model, nursing students, postpartum ward, teaching and learning clinical practicum

Procedia PDF Downloads 148

Authors: Ling-Lang Huang

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Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

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Authors: Xiaoyu Sun

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In recent years, the rapid development of Artificial Intelligence (AI) has extensively promoted medicine, pharmaceutical, and other related fields. The medical research and development of artificial intelligence by scientific and commercial organizations are on the fast track. The ethics review is one of the critical procedures of registration to get the products approved and launched. However, the SOPs for ethics review is not enough to guide the healthy and rapid development of artificial intelligence in healthcare in China. Ethical Review Measures for Biomedical Research Involving Human Beings was enacted by the National Health Commission of the People's Republic of China (NHC) on December 1st, 2016. However, from a legislative design perspective, it was neither updated timely nor in line with the trends of AI international development. Therefore, it was great that NHC published a consultation paper on the updated version on March 16th, 2021. Based on the most updated laws and regulations in the States and EU, and in-depth-interviewed 11 subject matter experts in China, including lawmakers, regulators, and key members of ethics review committees, heads of Regulatory Affairs in SaMD industry, and data scientists, several suggestions were proposed on top of the updated version. Although the new version indicated that the Ethics Review Committees need to be created by National, Provincial and individual institute levels, the review authorities of different levels were not clarified. The suggestion is that the precise scope of review authorities for each level should be identified based on Risk Analysis and Management Model, such as the complicated leading technology, gene editing, should be reviewed by National Ethics Review Committees, it will be the job of individual institute Ethics Review Committees to review and approve the clinical study with less risk such as an innovative cream to treat acne. Furthermore, to standardize the research and development of artificial intelligence in healthcare in the age of AI, more clear guidance should be given to data security in the layers of data, algorithm, and application in the process of ethics review. In addition, transparency and responsibility, as two of six principles in the Rome Call for AI Ethics, could be further strengthened in the updated version. It is the shared goal among all countries to manage well and develop AI to benefit human beings. Learned from the other countries who have more learning and experience, China could be one of the most advanced countries in artificial intelligence in healthcare.

Keywords: biomedical research involving human beings, data security, ethics committees, ethical review, medical artificial intelligence

Procedia PDF Downloads 166

Authors: Johan Buermans, Kristel Crombé, Niek Desmet, Laura Dittrich, Andrei Goriaev, Yurii Kovtun, Daniel López-Rodriguez, Sören Möller, Per Petersson, Maja Verstraeten

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The International Thermonuclear Experimental Reactor (ITER) will rely on three sources of external heating to produce and sustain a plasma; Neutral Beam Injection (NBI), Ion Cyclotron Resonance Heating (ICRH), and Electron Cyclotron Resonance Heating (ECRH). ECRH is a way to heat the electrons in a plasma by resonant absorption of electromagnetic waves. The energy of the electrons is transferred indirectly to the ions by collisions. The electron cyclotron heating system can be directed to deposit heat in particular regions in the plasma (https://www.iter.org/mach/Heating). Electron Cyclotron Resonance Heating (ECRH) at the fundamental resonance in X-mode is limited by a low cut-off density. Electromagnetic waves cannot propagate in the region between this cut-off and the Upper Hybrid Resonance (UHR) and cannot reach the Electron Cyclotron Resonance (ECR) position. Higher harmonic heating is hence preferred in heating scenarios nowadays to overcome this problem. Additional power deposition mechanisms can occur above this threshold to increase the plasma density. This includes collisional losses in the evanescent region, resonant power coupling at the UHR, tunneling of the X-wave with resonant coupling at the ECR, and conversion to the Electron Bernstein Wave (EBW) with resonant coupling at the ECR. A more profound knowledge of these deposition mechanisms can help determine the optimal plasma production scenarios. Several ECRH experiments are performed on the TOroidally MAgnetized System (TOMAS) to identify the conditions for Electron Bernstein Wave (EBW) heating. Density and temperature profiles are measured with movable Triple Langmuir Probes in the horizontal and vertical directions. Measurements of the forwarded and reflected power allow evaluation of the coupling efficiency. Optical emission spectroscopy and camera images also contribute to plasma characterization. The influence of the injected power, magnetic field, gas pressure, and wave polarization on the different deposition mechanisms is studied, and the contribution of the Electron Bernstein Wave is evaluated. The TOMATOR 1D hydrogen-helium plasma simulator numerically describes the evolution of current less magnetized Radio Frequency plasmas in a tokamak based on Braginskii’s legal continuity and heat balance equations. This code was initially benchmarked with experimental data from TCV to determine the transport coefficients. The code is used to model the plasma parameters and the power deposition profiles. The modeling is compared with the data from the experiments.

Keywords: electron Bernstein wave, Langmuir probe, plasma characterization, TOMAS

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Authors: Md Monirul Islam, Shahaduz Zaman, Mosarraf H. Sarker

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Context: Medical waste management (MWM) is a critical sector in Bangladesh due to its impact on human health and the environment. There is a need to assess the current policies and identify the role of policy actors in the policy formulation and implementation process. Research Aim: The study aimed to evaluate the role of policy actors in the medical waste management policy-making process in Bangladesh, identify policy gaps, and provide actionable recommendations for improvement. Methodology: The study adopted a qualitative research method and conducted key informant interviews. The data collected were analyzed using the thematic coding approach through Atlas.ti software. Findings: The study found that policies are formulated at higher administrative levels and implemented in a top-down approach. Higher-level institutions predominantly contribute to policy development, while lower-level institutions focus on implementation. However, due to negligence, ignorance, and lack of coordination, medical waste management receives insufficient attention from the actors. The study recommends the need for immediate strategies, a comprehensive action plan, regular policy updates, and inter-ministerial meetings to enhance medical waste management practices and interventions. Theoretical Importance: The research contributes to evaluating the role of policy actors in medical waste management policymaking and implementation in Bangladesh. It identifies policy gaps and provides actionable recommendations for improvement. Data Collection: The study used key informant interviews as the data collection method. Thirty-six participants were interviewed, including influential policymakers and representatives of various administrative spheres. Analysis Procedures: The data collected was analyzed using the inductive thematic analysis approach. Question Addressed: The study aimed to assess the role of policy actors in medical waste management policymaking and implementation in Bangladesh. Conclusion: In conclusion, the study provides insights into the current medical waste management policy in Bangladesh, the role of policy actors in policy formulation and implementation, and the need for improved strategies and policy updates. The findings of this study can guide future policy-making efforts to enhance medical waste management practices and interventions in Bangladesh.

Keywords: key informant, medical waste management, policy maker, qualitative study

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Authors: M. A. Hafiz, P. T. Matevenga

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Micro-level machining of metals is a developing field which has shown to be a prospective approach to produce features on the parts in the range of a few to a few hundred microns with acceptable machining quality. It is known that the mechanics (i.e. the material removal mechanism) of micro-machining and conventional machining have significant differences due to the scaling effects associated with tool-geometry, tool material and work piece material characteristics. Shape memory alloys (SMAs) are those metal alloys which display two exceptional properties, pseudoelasticity and the shape memory effect (SME). Nickel-titanium (NiTi) alloys are one of those unique metal alloys. NiTi alloys are known to be difficult-to-cut materials specifically by using conventional machining techniques due to their explicit properties. Their high ductility, high amount of strain hardening, and unusual stress–strain behaviour are the main properties accountable for their poor machinability in terms of tool wear and work piece quality. The motivation of this research work was to address the challenges and issues of micro-machining combining with those of machining of NiTi alloy which can affect the desired performance level of machining outputs. To explore the significance of range of cutting conditions on surface roughness and tool wear, machining tests were conducted on NiTi. Influence of different cutting conditions and cutting tools on surface and sub-surface deformation in work piece was investigated. Design of experiments strategy (L9 Array) was applied to determine the key process variables. The dominant cutting parameters were determined by analysis of variance. These findings showed that feed rate was the dominant factor on surface roughness whereas depth of cut found to be dominant factor as far as tool wear was concerned. The lowest surface roughness was achieved at the feed rate of equal to the cutting edge radius where as the lowest flank wear was observed at lowest depth of cut. Repeated machining trials have yet to be carried out in order to observe the tool life, sub-surface deformation and strain induced hardening which are also expecting to be amongst the critical issues in micro machining of NiTi. The machining performance using different cutting fluids and strategies have yet to be studied.

Keywords: nickel titanium, micro-machining, surface roughness, machinability

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Authors: Matthias Stange

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Building Information Modelling (BIM) is one of the most promising methods in the building design process and plays an important role in the digitalization of the Architectural, Engineering, and Construction (AEC) Industry. The application of BIM is seen as the key enabler for increasing productivity in the construction industry. The model-based collaboration using the BIM method is intended to significantly reduce cost increases, schedule delays, and quality problems in the planning and construction of buildings. Numerous qualitative studies based on expert interviews support this theory and report perceived benefits from the use of BIM in terms of achieving project objectives related to cost, schedule, and quality. However, there is a large research gap in analysing quantitative data collected from real construction projects regarding the actual benefits of applying BIM based on representative sample size and different application regions as well as different project typologies. In particular, the influence of the project-related BIM maturity level is completely unexplored. This research project examines primary data from 105 construction projects worldwide using quantitative research methods. Projects from the areas of residential, commercial, and industrial construction as well as infrastructure and hydraulic engineering were examined in application regions North America, Australia, Europe, Asia, MENA region, and South America. First, a descriptive data analysis of 6 independent project variables (BIM maturity level, application region, project category, project type, project size, and BIM level) were carried out using statistical methods. With the help of statisticaldata analyses, the influence of the project-related BIM maturity level on 6 dependent project variables (deviation in planning time, deviation in construction time, number of planning collisions, frequency of rework, number of RFIand number of changes) was investigated. The study revealed that most of the benefits of using BIM perceived through numerous qualitative studies have not been confirmed. The results of the examined sample show that the application of BIM did not have an improving influence on the dependent project variables, especially regarding the quality of the planning itself and the adherence to the schedule targets. The quantitative research suggests the conclusion that the BIM planning method in its current application has not (yet) become a recognizable increase in productivity within the planning and construction process. The empirical findings indicate that this is due to the overall low level of BIM maturity in the projects of the examined sample. As a quintessence, the author suggests that the further implementation of BIM should primarily focus on an application-oriented and consistent development of the project-related BIM maturity level instead of implementing BIM for its own sake. Apparently, there are still significant difficulties in the interweaving of people, processes, and technology.

Keywords: AEC-process, building information modeling, BIM maturity level, project results, productivity of the construction industry

Procedia PDF Downloads 73