Search results for: comfort talk

Authors: Stephanie Nihan, Jayson M. Fadrigalan, Pyay P. San, Steven M. Santos, Weihui Li

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People of all ages who use wheelchairs are left with the inconvenience of not having an easy way to take their vital signs. Typically, patients are required to visit the hospital in order to take the vital signs. VitalGO is a wheel chair system that equipped with medical devices to take vital signs and then transmit data to a mobile application for convenient, long term health monitoring. The vital signs include oxygen saturation, heart rate, and blood pressure, breathing rate and body temperature. Oxygen saturation and heart rate are monitored through pulse oximeter. Blood pressure is taken through a radar sensor. Breathing rate is derived through thoracic impedance while body temperature is measured through an infrared thermometer. The application receives data through bluetooth and stores in a database for review in a simple graphical interface. The application will have the ability to display this data over various time intervals such as a day, week, month, 3 months, 6 months and a year. The final system for the mobile app can also provide an interface for both the user and their physician(s) to record notes or keep record of daily symptoms that a patient might be having. The user’s doctor will be granted access by the user to view the patient information for assistance with a more accurate diagnosis. Also, this wheelchair accessory conveniently includes a foldable table/desk as somewhere to place an electronic device that may be used to access the app. The foldable table will overall contribute to the wheelchair user’s increased comfort and will give them somewhere to place food, a book, or any other form of entertainment that would normally be hard to juggle on their lap.

Keywords: wheel chair, vital sign, mobile application, telemedicine

Procedia PDF Downloads 331

Authors: Nirupama Sam

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COVID-19, the greatest pandemic since the turn of the century, presents several issues for urban planners, the most significant of which is determining appropriate mitigation techniques for creating pandemic-friendly and resilient public spaces. The study is conducted in four stages. The first stage consisted of literature reviews to examine the evolution and transformation of public spaces during pandemics throughout history and the role of public spaces during pandemic outbreaks. The second stage is to determine the factors that influence the success of public spaces, which was accomplished by an analysis of current literature and case studies. The influencing factors are categorized under comfort and images, uses and activity, access and linkages, and sociability. The third stage is to establish the priority of identified factors for which a questionnaire survey of stakeholders is conducted and analyzing of certain factors with the help of GIS tools. COVID-19 has been in effect in India for the last two years. Kerala has the highest daily COVID-19 prevalence due to its high population density, making it more susceptible to viral outbreaks. Despite all preventive measures taken against COVID-19, Kerala remains the worst-affected state in the country. Finally, two live case studies of the hardest-hit localities, namely Subhash bose park and Napier Museum park in the Ernakulam and Trivandrum districts of Kerala, respectively, were chosen as study areas for the survey. The responses to the questionnaire were analyzed using SPSS for determining the weights of the influencing factors. The spatial success of the selected case studies was examined using the GIS interpolation model. Following the overall assessment, the fourth stage is to develop strategies and guidelines for planning public spaces to make them more efficient and robust, which further leads to improved quality, safety and resilience to future pandemics.

Keywords: urban design, public space, covid-19, post-pandemic, public spaces

Procedia PDF Downloads 137

Authors: Mona Maria Mombeck

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Social participation in heterogeneous classrooms is one of the main goals in inclusive education. Children with special educational needs (SEN) and children with learning difficulties, or behavioural problems not diagnosed as SEN, are more likely to be excluded by other children than others. It is proven that the presence of dogs, as well as contact with dogs, increases the likelihood of positive social behaviour between humans. Therefore, animal-assisted pedagogy may be presumed to be a constructive way of inclusive teaching and facing the challenges of social inclusion in school classes. This study investigates the presence of a friendly dog in heterogeneous groups of pupils in order to evaluate the influence of dogs on facets of social participation of children in school. 30 German pupils, aged from 10 to 14, in four classes were questioned about their social participation before and after they were educated for a year in school with animal-assisted-pedagogy, using the problem-concerned interview method. In addition, the post-interview includes some general questions about the putative differences or similarities of being educated with and without a dog. The interviews were analysed with the qualitative-content-analysis using QDA software. The results showed that a dog has a positive impact on the atmosphere, student relationships, and well-being in class. Regarding the atmosphere, the pupils mainly argued that the improvement was caused by taking into account the dog’s well-being, respecting the dog-related rules, and by emotional self-regulation. It can be supposed that children regard the rules concerning the dog as more relevant to them than rules, not concerning the dog even if they require the same behaviour and goal. Furthermore, a dog has a positive impact on emotional self-regulation and, therefore, on pupil’s behaviour in class and the atmosphere. In terms of the statements about relationships, the dog’s presence was mainly seen to provide both a unifying aim and a uniting topic to talk about. The improved well-being was described as a feeling of joy and peace of mind. Moreover, the teacher was evaluated as more friendly and trustworthy after animal-assisted teaching. Nevertheless, animal-assisted pedagogy can, rarely, cause problems as well, such as jealousy, distraction, or concerns about the well-being of the dog. The study could prove the relevance of animal-assisted pedagogy for facing the challenges of social participation in inclusive education.

Keywords: animal-assisted-pedagogy, inclusive education, human-animal-interactions, social participation

Procedia PDF Downloads 115

Authors: Kadhim Alabady

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Purpose: Mental health problems affect women and men equally, but some are more common among women. To Provide a baseline of the current picture of major mental health challenges among women in Dubai. which can then be used to measure the impact of interventions or service development. Method: We have used mixed methods evaluation approaches. This was used to increase the validity of findings by using a variety of data collection techniques. We have integrated qualitative and quantitative methods in this piece of work. Conducting the two approaches is to explore issues that might not be highlighted enough through one method. Results: The key findings are: The prevalence of people who suffer from different types of mental disorders remains largely unknown, many women are unwilling to seek professional help because of lack of awareness or the stigma attached to it. -It is estimated there were around 2,928–4,392 mothers in Dubai (2014) suffering from postnatal depression of which 858–1,287, early intervention can be effective. -The system for managing health care for women with mental illness is fragmented and contains gaps and duplications. -It is estimated 1,029 girl aged 13–19 years affected with anorexia nervosa and there would be an estimated 1,029 girl aged 13–19 years affected with anorexia nervosa. Recommendations: -Work is required with primary health care in order to identify women with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. -It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions that are not routinely collected to get a clear sense of what is needed and to assist decision and policy making in getting a complete picture on what services are required. -Emergency Mental Health Care – there is a need for a crisis response team to respond to emergencies in the community. -Continuum of care – a significant gap in the services for women once they diagnosed with mental disorder.

Keywords: mental health, depression, schizophrenia, women

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Authors: Odeh Regina Comfort, Angelina Okewu Ogwuche

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The study investigated transformational leadership style of principal and conflict management in secondary schools in North Central Nigeria. A descriptive survey design was adopted. The population of the study comprised 34,473 teachers in 1949 public secondary schools in the study area. Proportionate stratified random sampling and simple random sampling techniques were used to select 39 public secondary schools and 689 respondents, respectively, for the study. The researcher utilized a self-structured questionnaire titled 'Influence of Transformational Leadership Style Questionnaire (ITLSQ)'. Face and content validity were ensured. The reliability index of 0.86 was obtained through Cronbach alpha statistics. The instrument was a modified Likert rating scale of Very High Extent (4), High Extent (3), Low Extent (2) and Very Low Extent (1). Mean, and standard deviation were used to answer 2 research questions, while chi-square goodness of fit was used to test the 2 hypotheses at 0.05 level of significance. The results among others indicate: that intellectual stimulation and individualized components of transformational leadership style of principal in public secondary schools in the study area have significant influence on conflict management in secondary schools. Based on the results, it was recommended that principals of secondary schools should be encouraged to practice the intellectual stimulation component of transformational leadership style that would help to consider teachers' levels of knowledge to decide what suits them to reach high levels of attainment thereby minimizing conflict in school settings; also transformational leadership should be taught to all people at all levels of secondary school especially that which pertains to individualized consideration to have a positive impact on the overall performance of teachers and this would help to minimize conflict in schools.

Keywords: conflict management, individualized consideration, intellectual stimulation, transformational leadership style

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Authors: Syed Ahmed Salman

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Ethicality is essential in our daily activities, including personal and commercial activities. This is evidenced by referring to the historical development of the corporate governance and ethical guidelines. The first corporate governance guideline, i.e. Cadbury Report from U.K. focuses the responsibility of board members towards the shareholders only. Gradually, realising the need to take care of the society and community, stakeholders are now concerns of business entities. Consequently, later codes of corporate governance started extending the responsibility to the other stakeholders in addition to the shareholders. One prevailing corporate governance theory, i.e. stakeholder theory, has been widely used in the research to explore the effects of business entities on society. In addition, the Global Reporting Initiative (GRI) is the leading organisation which promotes social care from businesses for sustainable development. Conventionally, history shows that ethics is key to the long term success of businesses. Many organisations, societies, and regulators give full attention and consideration to ethics. Several countries have introduced ethical codes of conduct to direct trade activities. Similarly, Islam and other religions prohibit the practice of interest, uncertainty, and gambling because of its unethical nature. These prohibited practices are not at all good for the society, business, and any organisation especially as it is detrimental to the well-being of society. In order to avoid unethicality in the finance industry, Shari’ah scholars come out with the idea of Islamic finance which is free from the prohibited elements from the Islamic perspective. It can also be termed ethical finance. This paper highlights how Takaful as one of the Islamic finance products offers fair and just products to the contracting parties and the society. Takaful is framed based on ethical guidelines which are extracted from Shari’ah principles and divine sources such as the Quran and Sunnah. Takaful products have been widely offered all over the world, including in both Muslim and non-Muslim countries. It seems that it is gaining acceptance regardless of religion. This is evidence that Takaful is being accepted as an ethical financial product.

Keywords: ethics, insurance, Islamic finance, religion and takaful

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Authors: Laura G. Caixeta, Maico R. Severino

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One of the biggest challenges that the industries find nowadays is to incorporate sustainability practices into its operations. The Green Supply Chain Management (GSCM) concept assists industries in such incorporation. For the full application of this concept is important that enterprises of a same supply chain have the GSCM practices coordinated among themselves. Note that this type of analyses occurs on the context of developed countries and sectors considered big impactors (as automotive, mineral, among others). The propose of this paper is to analyze as the GSCM concepts are applied on the Brazilian animal nutrition industries. The method used was the Case Study. For this, it was selected a supply chain relationship composed by animal nutrition products manufacturer (Enterprise A) and its supplier of animal waste, such as blood, viscera, among others (Enterprise B). First, a literature review was carried out to identify the main GSCM practices. Second, it was done an individual analysis of each one selected enterprise of the application of GSCM concept. For the observed practices, the coordination of each practice in this supply chain was studied. And, it was developed propose of GSCM applications for the practices no observed. The findings of this research were: a) the systematization of main GSCM practices, as: Internal Environment Management, Green Consumption, Green Design, Green Manufacturing, Green Marketing, Green Packaging, Green Procurement, Green Recycling, Life Cycle Analysis, Consultation Selection Method, Environmental Risk Sharing, Investment Recovery, and Reduced Transportation Time; b) the identification of GSCM practices on Enterprise A (7 full application, 3 partial application and 3 no application); c) the identification of GSCM practices on Enterprise B (2 full application, 2 partial application and 9 no application); d) the identification of how is the incentive and the coordination of the GSCM practices on this relationship by Enterprise A; e) proposals of application and coordination of the others GSCM practices on this supply chain relationship. Based on the study, it can be concluded that its possible apply GSCM on animal nutrition industries, and when occurs the motivation on the application of GSCM concepts by a supply chain echelon, these concepts are deployed for the others supply chain echelons by the coordination (orchestration) of the first echelon.

Keywords: animal nutrition industries, coordination, green supply chain management, supply chain management, sustainability

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Authors: Ghulam Hussain, Herrington Lee, Comfort Paul, Jones Richard

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Background: To determine the functional limitations of the lower limbs or readiness to return to sport, most rehabilitation programs use some form of testing; however, it is still unknown what the pass criteria is. This study aims to investigate the differences between the dominant and non-dominant leg performances across several lower limb tasks, which are hop tests, two-dimensional (2D) frontal plane projection angle (FPPA) tests, and isokinetic muscle tests. This study also provides the reference values for the limb symmetry index (LSI) for the hop and isokinetic muscle strength tests. Twenty recreationally active participants were recruited, 11 males and 9 females (age 23.65±2.79 years; height 169.9±3.74 cm; and body mass 74.72±5.81 kg. All tests were undertaken on the dominant and non-dominant legs. These tests are (1) Hop tests, which include horizontal hop for distance and crossover hop tests, (2) Frontal plane projection angle (FPPA): 2D capturing from two different tasks, which are forward hop landing and squatting, and (3) Isokinetic muscle strength tests: four different muscles were tested: quadriceps, hamstring, ankle plantar flexor, and hip extensor muscles. The main outcome measurements were, for the (1) hop tests: maximum distance was taken when undertaking single/crossover hop for distance using a standard tape measure, (2) for the FPPA: the knee valgus angle was measured from the maximum knee flexion position using a single 2D camera, and (3) for the isokinetic muscle strength tests: three different variables were measured: peak torque, peak torque to body weight, and the total work to body weight. All the muscle strength tests have been applied in both concentric and eccentric muscle actions at a speed of 60°/sec. This study revealed no differences between the dominant and non-dominant leg performance, and 85% of LSI was achieved by the majority of the subjects in both hop and isokinetic muscle tests, and; therefore, one leg’s hop performance can define the other.

Keywords: 2D FPPA, hop tests, isokinetic testing, LSI

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Authors: Hanan. Al Chaghouri, Mohammad Azad Malik, P. John Thomas, Paul O’Brien

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The process of assembling metal nanoparticles at the interface of two liquids has received a great interest over the past few years due to a wide range of important applications and their unusual properties compared to bulk materials. We present a low cost, simple and cheap synthesis of metal nanoparticles, core/shell structures and semiconductors followed by assembly of these particles between immiscible liquids. The aim of this talk is divided to three parts: firstly, to describe the achievement of a closed loop recycling for producing cadmium sulphide as powders and/or nanostructured thin films for solar cells or other optoelectronic devices applications by using a different chain length of commercially available secondary amines of dithiocarbamato complexes. The approach can be extended to other metal sulphides such as those of Zn, Pb, Cu, or Fe and many transition metals and oxides. Secondly, to synthesis significantly cheaper magnetic particles suited for the mass market. Ni/NiO nanoparticles with ferromagnetic properties at room temperature were among the smallest and strongest magnets (5 nm) were made in solution. The applications of this work can be applied to produce viable storage devices and the other possibility is to disperse these nanocrystals in solution and use it to make ferro-fluids which have a number of mature applications. The third part is about preparing and assembling of submicron silver, cobalt and nickel particles by using polyol methods and liquid/liquid interface, respectively. Noble metal like gold, copper and silver are suitable for plasmonic thin film solar cells because of their low resistivity and strong interactions with visible light waves. Silver is the best choice for solar cell application since it has low absorption losses and high radiative efficiency compared to gold and copper. Assembled cobalt and nickel as films are promising for spintronic, magnetic and magneto-electronic and biomedics.

Keywords: assembling nanoparticles, liquid/liquid interface, thin film, core/shell, solar cells, recording media

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Authors: Ilirian Laçi, Alketa Spahiu

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Big strums of thyroid glandule observed by a simple viewing can be witnessed in everyday life. Medical cabinets evidence patients withpalpablenodes of thyroid glandule, mainly nodes of the size of 10 millimeters. Further, more cases which have resulted in negative under palpation have resulted in positive at ultrasound examination. Therefore, the use of ultrasound for diagnosing has increased the number of patients with nodes of thyroid glandule in the last couple of decades in all countries, Albania included. Thus, there has been evidence of an increased number of patients affected by this pathology, where female patients dominate. Demographically, the capital shows high numbers due to the high population, but of interest is the high incidence of those areas distanced from the sea. While regarding related pathologies, no significant link was evidenced, an element of ancestry was evident in the nodes of the thyroid glandule. When we talk of nodes of the thyroid glandule, we should consider hyperplasia, neoplasia, and inflammatory diseases that cause nodes of the thyroid glandule. This increase parallels the world’s increase of the incidence of thyroid glandule, with malign cases, which are at about 5% and are not depended on size. Given the numbers, with most thyroid glandule nodes being benign, the main objective of the examination of the nodes was the determination of benign and malign cases to avoid undue surgery. Subject of this study were 212 patients that underwent fine-needle aspiration (FNA) under ultrasound guidance at the Medical University Center of Tirana. All the patients came to the Mother Teresa University Hospital from public and private hospitals and other polyclinics. These patients had an ultrasound examination before visiting the Center of Nuclear Medicine for a scintigraph of thyroid glandule in the period September 2016 and September 2017. To correlate, all patients had been examined via ultrasound of the thyroid glandule prior to the scintigraph. The ultrasound included evaluation of the number of nodes, their size, their solid, cystic, or solid-cystic structure, echogenicity according to the gray scale, the presence of calcification, the presence of lymph nodes, the presence of adenopathy, and the correlation of the cytology results from the Laboratory of Pathological Anatomy of Medical University Center of Tirana.

Keywords: thyroid nodes, fine needle aspiration, ultrasound, scintigraphy

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Authors: Farida Habib, Haya Alfozan, Eman Miligi, Najla Alotaibi

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Background: Women’s satisfaction with maternity services, especially care during labor and birth, has become highly significant to healthcare providers, administrators, and policymakers. Purpose: The aims of this study were to assess maternal satisfaction regarding the quality of care during labor and to compare the level of maternal satisfaction between women who delivered by physicians and those delivered by midwives. Methodology: A descriptive, cross-sectional, correlational design was used. A convenient sample of 180 low-risk cases of immediate postpartum women who delivered at King Abdul-Aziz medical city was recruited. Women whose babies were diagnosed with serious health problems were excluded from the study. Data were collected using a self-administered questionnaire. The validity and reliability of the questionnaire were ensured. The questionnaire included three parts, namely: demographics data, medical history, and obstetrical history, and the last part is the satisfaction assessment tool. Ethical confederations were ensured. Maternal satisfaction during labor was classified in terms of health care, health workers' communication, and the environment. Results: Regarding health care, women were highly satisfied with care received from nurse (M = 4.21 + 0.88), medical care received (M = 4.17 + 0.79), and comfort techniques (M = 4.04 + 0.91). Regarding health workers' communication, women were highly satisfied with the provider to treat with dignity and respect (M = 4.03 + 0.91) and orientation to the toilet, bathroom, washing area (M = 4.00 + 0.93). Regarding the environment, women were highly satisfied with the experience of their baby's birth (M = 4.18 + 0.98) and supplies with drugs and supplies (M = 4.09 + 0.97). There was no statistically significant difference in maternal satisfaction between women who delivered by physicians and those delivered by midwives. Conclusion: Women were generally satisfied with their labor and delivery experience. There was no difference in maternal satisfaction on the labor process between women who delivered by physicians and those delivered by midwives.

Keywords: maternity, satisfaction, labor, delivery

Procedia PDF Downloads 189

Authors: Rana Sameeh

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The city is the greatest symbol of human civilization and has been built for safety and comfort. However, uncontrolled urban growth caused some anonymous and unsightly images of the cities such as unused or abandoned spaces. When social interaction is missed in a public space it means the public space is lost since public spaces reflect the social life and interaction of people. Accordingly; this space became one of the most meaningless parts of the cities and has broken the continuity of the urban fabric. Lost urban spaces are the leftover unstructured landscape within the urban fabric. They are generally the unrecognized urban areas that are in need of redesign, since they have a great value that can add to their surrounding urban context. The research significance lies within the importance of urban open spaces, their value and their impact on the urban fabric. The research also addresses the reuse and reclamation of lost urban spaces in order to increase the percentage of green areas along the urban fabric, provide urban open spaces, develop a sustainable approach towards urban landscape and enhance the quality of the public open space and user experience. In addition, the reuse of lost space will give it the identity and function it lacks while also providing places for presence, spending time and observing. Creating continuity in a broken urban fabric represents an exploratory process in the relationship between infrastructure and the urban fabric and seeks to establish an architectural solution to leftover space within the city. In doing so, the research establishes a framework (criteria) for adaptive reuse of lost urban space throughout inductive and deductive methodology, analytical methodology; by analyzing some relevant examples and similar cases of lost spaces and finally through field methodology; by applying the achieved criteria on a case study in Alexandria and carrying on SWOT analysis and evaluation of the potentials of this case study.

Keywords: adaptive reuse, lost urban space, quality of public open space, urban fabric

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Authors: Oumaima Khlifati, Khadija Baba

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Pavement distress is the main factor responsible for the deterioration of road structure durability, damage vehicles, and driver comfort. Transportation agencies spend a high proportion of their funds on pavement monitoring and maintenance. The auscultation of pavement distress was based on the manual survey, which was extremely time consuming, labor intensive, and required domain expertise. Therefore, the automatic distress detection is needed to reduce the cost of manual inspection and avoid more serious damage by implementing the appropriate remediation actions at the right time. Inspired by recent deep learning applications, this paper proposes an algorithm for automatic road distress detection and classification using on the Deep Convolutional Neural Network (DCNN). In this study, the types of pavement distress are classified as transverse or longitudinal cracking, alligator, pothole, and intact pavement. The dataset used in this work is composed of public asphalt pavement images. In order to learn the structure of the different type of distress, the DCNN models are trained and tested as a multi-label classification task. In addition, to get the highest accuracy for our model, we adjust the structural optimization hyper parameters such as the number of convolutions and max pooling, filers, size of filters, loss functions, activation functions, and optimizer and fine-tuning hyper parameters that conclude batch size and learning rate. The optimization of the model is executed by checking all feasible combinations and selecting the best performing one. The model, after being optimized, performance metrics is calculated, which describe the training and validation accuracies, precision, recall, and F1 score.

Keywords: distress pavement, hyperparameters, automatic classification, deep learning

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Authors: Divya Ramaseshan

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The indigenous beauty of a space supported by its local context is unmatchable. India, known to be a hub for varied cultural significance, has one of the best uses of vernacularism. This paper focuses on the traditional houses present in Thirumayilai, Mylapore, one of the oldest and most populous cities in Chennai. The Mylapore houses are known for their Agraharam style with thinnai, courtyard, and sloping roof characteristics. These homes had a combined influence of Indian, Islamic as well as Neo-classical architecture in their design. The design of the houses reflects the lives of Brahmin communities which have almost vanished from sight now. According to the growing demands of local residents as well as urbanization, many houses have been renovated. Some of those structures have been conserved in certain streets showcasing their historical identity. Other structures have either been demolished or redesigned based on people’s needs. Those structures have been identified and studied to understand the comparative features that have been changed. Many of those were in direct relevance to the city’s climate, family size, socializing habits, and local materials. Being a temple town, Mylapore has contour variations sloping towards various water bodies. These factors have been considered for building homes as well. The study aims to list down the possible design guidelines that could be effective in today’s construction field. The pros and cons are analyzed, and the respective methodologies are framed. Our modern construction technologies have brought in the best visual aesthetics in a short frame of time, but the serene touch of teak wood, walking through paved stones, daydreaming in the sunlit courtyards, and chitchatting in porticos are always cherished. Architects around the world are trying hard to achieve such appreciated design elements in upcoming projects with the best use of modern technology. This will also improvise people’s mental health in the comfort of their homes.

Keywords: Agraharam, Mylapore, traditional, vernacularism

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Authors: Nindyo Cahyo Kresnanto, Muhamad Willdan, Wika Harisa Putri

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Gunungkidul is one of the emerging tourism industry areas in Yogyakarta Province, Indonesia. This article describes how GIS can predict the development of tourism potential in Gunungkidul. The tourism sector in Gunungkidul Regency contributes 3.34% of the total gross regional domestic product and is the economic sector with the highest growth with a percentage of 18.37% in the post-Covid-19 period. This contribution makes researchers consider that several tourist sites need to be explored more to increase regional economic development gradually. This research starts by collecting spatial data from tourist locations tourists want to visit in Gunungkidul Regency based on survey data from 571 respondents. Then the data is visualized with ArcGIS software. This research shows an overview of tourist destinations interested in travellers depicted from the lowest to the highest from the data visualization. Based on the data visualization results, specific tourist locations potentially developed to influence the surrounding economy positively. The visualization of the data displayed is also in the form of a desire line map that shows tourist travel patterns from the origin of the tourist to the destination of the tourist location of interest. From the desire line, the prediction of the path of tourist sites with a high frequency of transportation activity can figure out. Predictions regarding specific tourist location routes that high transportation activities can burden can consider which routes will be chosen. The route also needs to be improved in terms of capacity and quality. The goal is to provide a sense of security and comfort for tourists who drive and positively impact the tourist sites traversed by the route.

Keywords: tourism development, GIS and survey, transportation, potential desire line

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Authors: Mahdiyeh Zafaranchi

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With rapid development of urbanization and improvement of living standards in the world, energy consumption and carbon emissions of the building sector are expected to increase in the near future; because of that, energy-saving issues have become more important among the engineers. Besides, the building sector is a major contributor to energy consumption and carbon emissions. The concept of efficient building appeared as a response to the need for reducing energy demand in this sector which has the main purpose of shifting from standard buildings to low-energy buildings. Although energy-saving should happen in all steps of a building during the life cycle (material production, construction, demolition), the main concept of efficient energy building is saving energy during the life expectancy of a building by using passive and active systems, and should not sacrifice comfort and quality to reach these goals. The main aim of this study is to investigate passive strategies (do not need energy consumption or use renewable energy) to achieve energy-efficient buildings. Energy retrofit measures were explored by eQuest software using a case study as a base model. The study investigates predictive accuracy for the major factors like thermal transmittance (U-value) of the material, windows, shading devices, thermal insulation, rate of the exposed envelope, window/wall ration, lighting system in the energy consumption of the building. The base model was located in Istanbul, Turkey. The impact of eight passive parameters on energy consumption had been indicated. After analyzing the base model by eQuest, a final scenario was suggested which had a good energy performance. The results showed a decrease in the U-values of materials, the rate of exposing buildings, and windows had a significant effect on energy consumption. Finally, savings in electric consumption of about 10.5%, and gas consumption by about 8.37% in the suggested model were achieved annually.

Keywords: efficient building, electric and gas consumption, eQuest, Passive parameters

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Authors: Miroslav Dumbrovsky

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The paper deals with impacts of climate change with the main emphasis on land degradation, agriculture and forestry management in the landscape. Land degradation, due to adverse effect of farmers activities, as a result of inappropriate conventional technologies, was a major issue in the Czech Republic during the 20th century and will remain for solving in the 21st century. The importance of land degradation is very high because of its impact on crop productivity and many other adverse effects. Land degradation through soil degradation is causing losses on crop productivity and quality of the environment, through decreasing quality of soil and water (especially water resources). Negative effects of conventional farming practices are increased water erosion, as well as crusting and compaction of the topsoil and subsoil. Soil erosion caused by water destructs the soil’s structure, reduces crop productivity due to deterioration in soil physical and chemical properties such as infiltration rate, water-holding capacity, loss of nutrients needed for crop production, and loss of soil carbon. Water erosion occurs on fields with row crops (maize, sunflower), especially during the rainfall period from April to October. Recently there is a serious problem of greatly expanded production of biofuels and bioenergy from field crops. The result is accelerated soil degradation. The damages (on and off- site) are greater than the benefits. An effective soil conservation requires an appropriate complex system of measures in the landscape. They are also important to continue to develop new sophisticated methods and technologies for decreasing land degradation. The system of soil conservation solving land degradation depend on the ability and the willingness of land users to apply them. When we talk about land degradation, it is not just a technical issue but also an economic and political issue. From a technical point of view, we have already made many positive steps, but for successful solving the problem of land degradation is necessary to develop suitable economic and political tools to increase the willingness and ability of land users to adopt conservation measures.

Keywords: land degradation, soil erosion, soil conservation, climate change

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Wen Hsin Hsu, Pin Lin

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Objective: Thirst discomfort is the most common yet often overlooked symptom in patients in the intensive care unit (ICU), with an incidence rate of 69.8%. If not properly cared for, it can easily lead to irritability, affect sleep quality, and increase the incidence of delirium, thereby extending the length of hospital stay. Research points out that the sensation of coldness is an effective strategy to alleviate thirst. Using a combined care approach for thirst can prolong the sensation of coldness in the mouth and reduce thirst discomfort. Therefore, it needs to be further analyzed and its effectiveness reviewed. Methods: This study uses systematic literature review and meta-analysis methodologies and searched databases including PubMed, MEDLINE, EMBASE, Cochrane, CINAHL, and two Chinese databases (CEPS and CJTD) based on keywords. JBI was used to appraise the quality of the literature. RevMen 5.4 software package was used, and Fix Effect Model was applied for data analysis. We selected experimental articles, including those in English and Chinese, that met the inclusion and exclusion criteria. Three research articles were included in total, with a sample size of 416 people. Two were randomized controlled trials, and one was a quasi-experimental design. Results: The results show that the combined care for thirst, which includes ice water spray or oral swab wipes, menthol mouthwash, and lip balm, can significantly relieve thirst intensity MD=-1.36 (3 studies, 95% CI (-1.77, -0.95), p <0.001) and thirst distress MD=-0.71 (2 studies, 95% CI (-1.32, -0.10), p =0.02). Therefore, it is recommended that medical staff identify high-risk groups for thirst early on. Implications for Practice: For patients who cannot eat orally, providing combined care for thirst can increase oral comfort and improve the quality of care.

Keywords: thirst bundle care, intensive care units, meta-analysis, ice water spray, menthol

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Authors: H. M. D. Prabhashana Herath, M. D. Anuradha Wickramasinghe, A. M. C. Kalpani Polgolla, R. A. C. Prasad Ranasinghe, M. Anusha Wijewardane

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The demand for thermal comfort in buildings in hot and humid climates increases progressively. In general, buildings in hot and humid climates spend more than 60% of the total energy cost for the functionality of the air conditioning (AC) system. Hence, it is required to install energy efficient AC systems or integrate energy recovery systems for both new and/or existing AC systems whenever possible, to reduce the energy consumption by the AC system. Integrate a Rotary Thermal Wheel as the energy recovery device of an existing AC system has shown very promising with attractive payback periods of less than 5 years. A rotary thermal wheel can be located in the Air Handling Unit (AHU) of a central AC system to recover the energy available in the return air stream. During this study, a sensitivity analysis was performed using a CFD (Computational Fluid Dynamics) software to determine the optimum design parameters (i.e., rotary speed and parameters of the matrix profile) of a rotary thermal wheel for hot and humid climates. The simulations were performed for a sinusoidal matrix geometry. Variation of sinusoidal matrix parameters, i.e., span length and height, were also analyzed to understand the heat exchanging performance and the induced pressure drop due to the air flow. The results show that the heat exchanging performance increases when increasing the wheel rpm. However, the performance increment rate decreases when increasing the rpm. As a result, it is more advisable to operate the wheel at 10-20 rpm. For the geometry, it was found that the sinusoidal geometries with lesser spans and higher heights have higher heat exchanging capabilities. Considering the sinusoidal profiles analyzed during the study, the geometry with 4mm height and 3mm width shows better performance than the other combinations.

Keywords: air conditioning, computational fluid dynamics, CFD, energy recovery, heat exchangers

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Authors: Beatriz Mella Lira, Karla Yohannessen, Robin Hickman

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The aim of the paper is recognising inequalities through the self-assessment of health-related factors, in the context of daily mobilities in Santiago de Chile. Human capabilities will be used as the theoretical basis for the recognition and assessment of these factors regarding the functioning (what people are currently able to do) and capabilities (what people want to achieve and what is valuable for them), reflecting differences across social groups and among types of transport users. The self-assessment of health-related factors considers perceptions of stress, physical effort, proximity to other transport users, pollution, safety, and comfort. The types of transport users are classified as: private (cars, taxis, colectivos, motos), public (buses and metro) and active (bicycles and walking). The methodology follows a capability-based questionnaire, which was applied in different areas of Santiago de Chile, considering concepts extracted from the human capabilities list. The self-assessment of these health-related factors examines the context of peoples’ mobilities for performing their daily activities, considering socioeconomic differences as income, age, gender, disabilities, residence location and primary mode choice. The paper uses Relative Importance Index (RII) for weighting the relative influence or valuation of the factors. The respondents were asked to rate the importance of each factor on a scale from 1 to 5, in an ascending order of importance. The results suggest that these health-related factors impact not just the perceptions of users, but their well-being and their propensity for achieving their capabilities and the things they value in life. The paper is focused on the development of an applicable approach, measuring factors that should be included in transport project appraisal, as a more comprehensive and complementary method.

Keywords: active transport, health, human capabilities, Santiago de Chile, transport inequalities, transportation planning, urban planning

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Authors: Homa Hedayat

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Public spaces have been a central concern of urban planners for centuries but have been neglected for a long time. In the modernist planning, the focus has been on the requirements of cars rather than the needs and expectations of pedestrians, and therefore, cities have lost many qualities. Urban public space is a space within the city area which is accessible to all people and is the ground for their activity. People’s public life occurs in urban public spaces in a complex set of forms and functions. These spaces must facilitate diverse behavior, uses, and activities such as shopping, walking, conversation, entertainment, relaxation or even passing the time during festivities and events. One of the public spaces is the surrounding space of public transportation stations. Subway stations, although potentially encompass many different groups of people accommodate few social interactions. Making the surrounding areas of subway stations pedestrian-oriented, potentially increases the socialization capacity. The Sadeghieh Subway Station can be considered as the most important subway station in Tehran, which on the one hand is the rail port of Tehran's western entrance, and on the other is the port for railway journeys inside the city. The main concern of this study is to assess the success or failure of the interventions made by the municipality for changing the surrounding area of the Sadeghieh Subway Station into a pedestrian-oriented space and examine the amount of the area's improvement into a desirable space. The method used in this study is surveying, in which the data were collected using a questionnaire and interview. The study's population is all people who use Sadeghieh Subway, and the sample size for the study was 140 subjects. Using parametric one-sample t-test, we found improvement in factors such as transportation, security, pedestrian infrastructure, vitality and climate comfort. However, there was no improvement in mix use, recreational activity, readability.

Keywords: public space, public transportation stations, pedestrian-oriented space, socialization

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Authors: Amir Sattari, Mac Panah, Naeim Rashidfarokhi

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To enhance the mixing of fluid in a rectangular enclosure with a circular inlet and outlet, an energy-efficient approach is further investigated through computational fluid dynamics (CFD). Particle image velocimetry (PIV) measurements help confirm that the pulsation of the inflow velocity improves the mixing performance inside the enclosure considerably without increasing energy consumption. In this study, multiple CFD simulations with different turbulent models were performed. The results obtained were compared with experimental PIV results. This study investigates small-scale representations of flow patterns in a ventilated rectangular room. The objective is to validate the concept of an energy-efficient ventilation strategy with improved thermal comfort and reduction of stagnant air inside the room. Experimental and simulated results confirm that through pulsation of the inflow velocity, strong secondary vortices are generated downstream of the entrance wall-jet. The pulsatile inflow profile promotes a periodic generation of vortices with stronger eddies despite a relatively low inlet velocity, which leads to a larger boundary layer with increased kinetic energy in the occupied zone. A real-scale study was not conducted; however, it can be concluded that a constant velocity inflow profile can be replaced with a lower pulsated flow rate profile while preserving the mixing efficiency. Among the turbulent CFD models demonstrated in this study, SST-kω is most advantageous, exhibiting a similar global airflow pattern as in the experiments. The detailed near-wall velocity profile is utilized to identify the wall-jet instabilities that consist of mixing and boundary layers. The SAS method was later applied to predict the turbulent parameters in the center of the domain. In both cases, the predictions are in good agreement with the measured results.

Keywords: CFD, PIV, pulsatile inflow, ventilation, wall-jet

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Authors: Hanan. Al Chaghouri, Mohammad Azad Malik, P. John Thomas, Paul O’Brien

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The process of assembling metal nanoparticles at the interface of two liquids has received a great deal of attention over the past few years due to a wide range of important applications and their unusual properties as compared to bulk materials. We present a low cost, simple and cheap synthesis of metal nanoparticles, core/shell structures and semiconductors followed by assembly of these particles between immiscible liquids. The aim of this talk is divided to three parts: Firstly, to describe the achievement of a closed loop recycling for producing cadmium sulfide as powders and/or nanostructured thin films for solar cells or other optoelectronic devices applications by using a different chain length of commercially available secondary amines of dithiocarbamato complexes. The approach can be extended to other metal sulfides such as those of Zn, Pb, Cu, or Fe and many transition metals and oxides. Secondly, to synthesis significantly cheaper magnetic particles suited for the mass market. Ni/NiO nanoparticles with ferromagnetic properties at room temperature were among the smallest and strongest magnets (5 nm) were made in solution. The applications of this work can be to produce viable storage devices and the other possibility is to disperse these nanocrystals in solution and use it to make ferrofluids which have a number of mature applications. The third part is about preparing and assembling of submicron silver, cobalt and nickel particles by using polyol methods and liquid/liquid interface, respectively. Coinage metals like gold, copper and silver are suitable for plasmonic thin film solar cells because of their low resistivity and strong interactions with visible light waves. Silver is the best choice for solar cell application since it has low absorption losses and high radiative efficiency compared to gold and copper. Assembled cobalt and nickel as films are promising for spintronic, magnetic and magneto-electronic and biomedics.

Keywords: metal nanoparticles, core/shell structures and semiconductors, ferromagnetic properties, closed loop recycling, liquid/liquid interface

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Authors: Raimo P. Hämäläinen, Juha Törmänen, Esa Saarinen

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Systems thinking has been acknowledged as an important approach in the strategy and management literature ever since the seminal works of Ackhoff in the 1970´s and Senge in the 1990´s. The early literature was very much focused on structures and organizational dynamics. Understanding systems is important but making improvements also needs ways to understand human behavior in systems. Peter Senge´s book The Fifth Discipline gave the inspiration to the development of the concept of Systems Intelligence. The concept integrates the concepts of personal mastery and systems thinking. SI refers to intelligent behavior in the context of complex systems involving interaction and feedback. It is a competence related to the skills needed in strategy and the environment of modern industrial engineering and management where people skills and systems are in an increasingly important role. The eight factors of Systems Intelligence have been identified from extensive surveys and the factors relate to perceiving, attitude, thinking and acting. The personal self-evaluation test developed consists of 32 items which can also be applied in a peer evaluation mode. The concept and test extend to organizations too. One can talk about organizational systems intelligence. This paper reports the results of an extensive survey based on peer evaluation. The results show that systems intelligence correlates positively with professional performance. People in a managerial role score higher in SI than others. Age improves the SI score but there is no gender difference. Top organizations score higher in all SI factors than lower ranked ones. The SI-tests can also be used as leadership and management development tools helping self-reflection and learning. Finding ways of enhancing learning organizational development is important. Today gamification is a new promising approach. The items in the SI test have been used to develop an interactive card game following the Topaasia game approach. It is an easy way of engaging people in a process which both helps participants see and approach problems in their organization. It also helps individuals in identifying challenges in their own behavior and in improving in their SI.

Keywords: gamification, management competence, organizational learning, systems thinking

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Authors: Barbara Klimek

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Wolves are one of the most misrepresented species in literature and the media. They’re often portrayed as vicious, man-eating beasts whose main life goal is to hunt and kill people. Many movie directors use wolves as their main characters in different types of films, especially horror, thriller and science fiction movies to create gore and fear. This, in turn, results in people being afraid of wolves and wanting to destroy them. Such cultural creations caused wolves being stalked, abused and killed by people and in many areas they were completely destroyed. This paper analyzes the representations of wolves in the chosen films in the four main portrayed aspects: 1. the overall picture – true versus false, positive versus negative, based on stereotypes or realistic, displaying wolf behavior typical of the species or fake 2. subjectivity – how humans treat and talk about the animals – as subjects or as objects 3. animal welfare – how humans treat wolves and nature, are the human – animal relations positive and appropriate or negative and abusive 4. empathy – are human characters shown to co-feel the suffering with the wolves, do they display signs of empathy towards the animals, do the animals empathize with humans? The detailed analysis of the text and pictures presented in the chosen films concludes that wolves are especially misrepresented in the movies. Their behavior is shown as fake and negative, based on stereotypes and myths, the human – animal relations are shown mainly as negative where people fear the animals and hunt them and wolves stalk, follow, attack and kill humans. It shows that people do not understand the needs of these animals and are unable to show empathy towards them. The article will discuss the above-mentioned study results in detail and will present many examples. Animal representations in cultural creations, including film have a great impact on how people treat particular species of animals. The media shape people’s attitudes, what in turn results in people either respecting and protecting the animals or fearing, disliking and destroying the particular species.

Keywords: film, movies, representations, wolves

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Authors: Abimbola Akintounde

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Supporting the social and emotional needs of young adolescents has become an emergent concern for schools around the world. Yet educators remain in a dilemma regarding the optimum approach for integrating social and emotional learning (SEL) into their content area instruction. The purpose of this study was to explore the perception of secondary students regarding their schoolwide SEL interventions. Twenty-four International Baccalaureate students in a final year mathematics course at an American Public Secondary School near Washington D. C. were randomly selected for participation in this study via an online electronic survey. The participants in this study used Likert-scale items to rate the effectiveness of the socio-emotional and character development programs being implemented at their schools. Respondents also ranked their preferred mode of delivery of social and emotional support programs. About 71% of the teenagers surveyed preferred SEL support rendered via interactive team-building activities and games, 42% of the high school students in the study ranked focus group discussions as their preferred format for SEL interventions, while only 13% of the respondents in the study regarded lectures and presentations as their preferred mode of SEL delivery. About one-fourth of the study participants agreed that explicit instruction was critical to enhancing students’ wellness, 79% agreed that SEL programs should foster less teacher talk, while 88% of the students indicated that student engagement was critical to their mental health. Eighty percent of the teenagers surveyed decried that the focus of their school-wide social and emotional programs was poorly prioritized. About two-thirds of the students agreed that social justice and equity issues should be embedded in their schools’ advisory programs. More than half of the respondents agitated for strategies for managing stress and their school workload. About 54% of the respondents also clamored for SEL programs that reinforce emotion regulation and coping strategies for anxiety. Based on the findings of this study, recommendations were proffered for best practices in the design and implementation of effective learner-friendly social and emotional development interventions.

Keywords: SEL, math anxiety, student support, emotion regulation, social awareness, self awareness, self management, relationship building

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Authors: Marinel Dayawon

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Student participation in classroom activities is vital in the teaching- learning the process as it develops self-confidence, social relationships and good academic performance of students. It is the teacher’s empathetic manner and creativity to create solutions that encourage teamwork and mutual support while dropping the academic competition within the class that hinder every shy student to walk with courage and talk with conviction because they consider their ideas, weak, as compared to the bright students. This study aimed to explore the different design thinking strategies that will change the mindset of shy students in classroom activities, maximizing their participation in all given tasks while sharing their views through ideation and providing them a wider world through compromise agreement within the members of the group, sensitivity to one’s idea, thus, arriving at a collective decision in the development of a prototype that indicates improvement in their classroom involvement. The study used the qualitative type of research. Triangulation is done through participant observation, focus group discussion and interview, documented through photos and videos. The respondents were the second- year Bachelor of Secondary Education students of the Institute of Teacher Education at Isabela State University- Cauayan City Campus. The result of the study revealed that reticent students when involved in game activities through a slap and tap method, writing their clustered ideas, using sticky notes is excited in sharing ideas as it doesn’t use oral communication. It is also observed after three weeks of using the design thinking strategies; shy students volunteer as secretary, rapporteur or group leader in the team- building activities as it represents the ideas of the heterogeneous group, removing the individual identity of the ideas. Superior students learned to listen to the ideas of the reticent students and involved them in the prototyping process of designing a remediation program for high school students showing reticence in the classroom, making their experience as a benchmark. The strategies made a 360- degrees transformation of the shy students, producing their journal log, in their journey to being open. Thus, faculty members are now adopting the design thinking approach.

Keywords: design thinking activities, qualitative, reticent students, Isabela, Philippines

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Authors: Huang Chiung Chiu

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This article is about the nursing experience of assisting an outpatient with premature menopause, osteoporosis and sarcopenia through a multi-discipline care model. The nursing period is from September 22nd, 2020, to December 7th, 2020, collecting data through interviews with the patient, observation, and physical assessment. It was found that the main health problems were insufficient nutrition, less physical need, insomnia, and potentially dangerous falls. As an outpatient nurse, the author observed that in recent years, the age group of women with premature menopause, osteoporosis and sarcopenia had shifted downward. Integrated multi-disciplinary interventions were provided upon the initial diagnosis of osteoporosis and sarcopenia. Under the outpatient care setting, the collaborative team works between the doctors, nutritionists, osteoporosis educators, rehabilitates, physical therapists and other specialized teams were applied to provide individualized, integrated multi-disciplinary care. Through empathy and the establishment of attentive care, companionship and trust, we discussed care plans and treatment guidelines with the case, providing accurate, complete disease information and feedback education to strengthen the patient’s knowledge and motivation for exercise. Nursing guidance regarding the dietary nutrition and adjustment of daily routine was provided to increase the self-care ability, improve the health problems of muscle weakness and insomnia, and prevent falls. For patients with postmenopausal osteoporosis and sarcopenia, it is recommended that the nurses coordinate the multi-discipline integrated care model, adjust patients’ lifestyle and diet, and establish a regular exercise plan so that the cases can be evaluated holistically to improve the quality of care and physical and mental comfort.

Keywords: multi-discipline care model, premature menopause, osteoporosis, sarcopenia, insomnia

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Authors: Silvia Platania, Martina Morando, Giuseppe Santisi

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Introduction: In the last thirty years, there is constant talk of sustainable consumption and a "transition" of consumer lifestyles towards greater awareness of consumer choices (United Nation, 1992). The 2019 coronavirus (COVID-19) epidemic that has hit the world population since 2020 has had significant consequences in all areas of people's lives; individuals have been forced to change their behaviors, to redefine their owngoals, priorities, practices, and lifestyles, to rebuild themselves in the new situation dictated by the pandemic. Method(Participants and procedure ): The data were collected through an online survey; moreover, we used convenience sampling from the general population. The participants were 669 Italians consumers (Female= 514, 76.8%; Male=155, 23.2%) that choice sustainability brands, aged between 18 and 65 years (Mₐ𝓰ₑ = 35.45; Standard Deviation, SD = 9.51).(Measure ): The following measures were used: The Muncy–Vitell Consumer Ethics Scale; Attitude Toward Business Scale; Perceived Consumer Effectiveness Scale; Consumers Perception on Sustainable Brand Attitudes. Results: Preliminary analyses were conducted to test our model. Pearson's bivariate correlation between variables shows that all variables of our model correlate significantly and positively, PCE with CPSBA (r = .56, p <.001). Furthermore, a CFA, according to Harman's single-factor test, was used to diagnose the extent to which common-method variance was a problem. A comparison between the hypothesised model and a model with one factor (with all items loading on a unique factor) revealed that the former provided a better fit for the data in all the CFA fit measures [χ² [6, n = 669] = 7.228, p = 0.024, χ² / df = 1.20, RMSEA = 0.07 (CI = 0.051-0.067), CFI = 0.95, GFI = 0.95, SRMR = 0.04, AIC = 66.501; BIC = 132,150). Next, amulti mediation was conducted to test our hypotheses. The results show that there is a direct effect of PCE on ethical consumption behavior (β = .38) and on ATB (β = .23); furthermore, there is a direct effect on the CPSBA outcome (β = .34). In addition, there is a mediating effect by ATB (C.I. =. 022-.119, 95% interval confidence) and by CES (C.I. =. 136-.328, 95% interval confidence). Conclusion: The spread of the COVID-19 pandemic has affected consumer consumption styles and has led to an increase in online shopping and purchases of sustainable products. Several theoretical and practical considerations emerge from the results of the study.

Keywords: decision making, sustainability, pandemic, multimediation model

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