Search results for: social assessment of territory
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14479

Search results for: social assessment of territory

5839 Patients in Opioid Maintenance Programs: Psychological Features that Predict Abstinence

Authors: Janaina Pereira, Barbara Gonzalez, Valentina Chitas, Teresa Molina

Abstract:

Intro: The positive impact of opioid maintenance programs on the health of heroin addicts, and on public health in general, has been widely recognized, namely on the prevalence reduction of infectious diseases as HIV, and on the social reintegration of this population. Nevertheless, a part of patients in these programs cannot remain heroin abstinent, or has relapses, during the treatment. Method: Thus, this cross-sectional research aims at analyzing the relation between a set of psychological and psychosocial variables, which have been associated with the onset of heroin use, and assess if they are also associated with absence of abstinence in participants in an opioid maintenance program. A total of 62 patients, aged between 26 and 58 years old (M= 40.87, DP= 7.39) with a time in opioid maintenance program between 1 and 10 years (M= 5.42, DP= 3.05), 77.4% male and 22.6% female, participated in this research. To assess the criterion variable (heroin use) we used the mean value of positive results in urine tests during the participation in the program, weighted according to the number of months in program. The predictor variables were the coping strategies, the dispositional sensation seeking, and the existence of Posttraumatic stress disorder (PTSD). Results: The results showed that only 33.87% of the patients were totally abstinent of heroin use since the beginning of the program, and the absence of abstinence, as the number of positive heroin tests, was primarily predicted by less proactive coping, and secondarily by a higher level of sensation seeking. 16.13% of the sample fulfilled diagnosis criteria for PTSD, and 67.74 % had at least one traumatic experience throughout their lives. The total of PTSD symptoms had a positive correlation with the number of physical health problems, and with the lack of professional occupation. These results have several implications for the clinical practice in this field, and we suggest the promotion of proactive coping strategies should integrate these opioid maintenance programs, as they represent the tendency to face future events as challenges and opportunities, being positively related to positive results on several fields. The early identification of PTSD in the participants, before entering the opioid maintenance programs, would be important as it is related to negative features that hinder social reintegration, Finally, to identify individuals with a sensation seeking profile would be relevant, not only because they face a higher risk of relapse, but also because the therapeutical approaches should not ignore this dispositional feature in the alternatives they propose to the patients.

Keywords: opioid maintenance programs, proactive coping, PTSD, sensation seeking

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5838 Factors Affecting the Success of Premarital Screening Service in Middle Eastern Islamic Countries

Authors: Wafa Al Jabri

Abstract:

Background: In Middle Eastern Islamic Countries (MEICs), there is a high prevalence of genetic blood disorders (GBDs), particularly sickle cell disease and thalassemia. The GBDs are considered a major public health concern, especially with the increase in affected populations along with the associated psychological, social, and financial cost of management. Despite the availability of premarital screening services (PSS) that aim to identify the asymptomatic carriers of GBDs and provide genetic counseling to couples in order toreduce the prevalence of these diseases; yet, the success rate of PSS is very low due to religious and socio-cultural concerns. Purpose: This paper aims to highlight the factors that affect the success of PSS in MEICs. Methods: A literature review of articles located in CINAHL, PubMed, SCOPUS, and MedLinewas carried out using the following terms: “premarital screening,” “success,” “effectiveness,” and “ genetic blood disorders.” Second, a hand search of the reference lists and Google searches were conducted to find studies that did not exist in the primary database searches. Only studies which are conducted in MEICs countries and published in the last five years were included. Studies that were not published in English were excluded. Results: Fourteen articles were included in the review. The results showed that PSS in most of the MEICs was successful in achieving its objective of identifying high-risk marriages; however, the service failed to meetitsultimate goal of reducing the prevalence of GBDs. Various factors seem to hinder the success of PSS, including poor public awareness, late timing of the screening, culture and social stigma, religious beliefs, availability of prenatal diagnosis and therapeutic abortion, emotional factors, and availability of genetic counseling services. However, poor public awareness, late timing of the screening, and unavailability of adequate counseling services were the most common barriers identified. Conclusion: Overcoming the identified barriers by providing effective health education programs, offering the screening test to young adults at an earlier stage, and tailoring the genetic counseling would be crucial steps to provide a framework for an effective PSS in MEICs.

Keywords: premarital screening, success, effectiveness, and genetic blood disorders

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5837 Assimilating Multi-Mission Satellites Data into a Hydrological Model

Authors: Mehdi Khaki, Ehsan Forootan, Joseph Awange, Michael Kuhn

Abstract:

Terrestrial water storage, as a source of freshwater, plays an important role in human lives. Hydrological models offer important tools for simulating and predicting water storages at global and regional scales. However, their comparisons with 'reality' are imperfect mainly due to a high level of uncertainty in input data and limitations in accounting for all complex water cycle processes, uncertainties of (unknown) empirical model parameters, as well as the absence of high resolution (both spatially and temporally) data. Data assimilation can mitigate this drawback by incorporating new sets of observations into models. In this effort, we use multi-mission satellite-derived remotely sensed observations to improve the performance of World-Wide Water Resources Assessment system (W3RA) hydrological model for estimating terrestrial water storages. For this purpose, we assimilate total water storage (TWS) data from the Gravity Recovery And Climate Experiment (GRACE) and surface soil moisture data from the Advanced Microwave Scanning Radiometer for the Earth Observing System (AMSR-E) into W3RA. This is done to (i) improve model estimations of water stored in ground and soil moisture, and (ii) assess the impacts of each satellite of data (from GRACE and AMSR-E) and their combination on the final terrestrial water storage estimations. These data are assimilated into W3RA using the Ensemble Square-Root Filter (EnSRF) filtering technique over Mississippi Basin (the United States) and Murray-Darling Basin (Australia) between 2002 and 2013. In order to evaluate the results, independent ground-based groundwater and soil moisture measurements within each basin are used.

Keywords: data assimilation, GRACE, AMSR-E, hydrological model, EnSRF

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5836 The Gender Dialectic in Mothers and Daughters’ Relationships

Authors: Ronit Even Zahav

Abstract:

Objectives: Mother-daughter relationships are often portrayed as one of the most constitutive ties that shape women's identities throughout their lives. Yet, to the best of author’s knowledge, only few studies examine mother-daughter relationships in adulthood in the context of cross-cultural transition. Most of them focus on the mother-daughter relationship among one origin group. Hence, the existing knowledge about these relationships in adulthood, in the context of intercultural transition and encounters between different cultures, remain limited. Based on a critical feminist approach critical and cultural perspectives the current study focuses on a cross-cultural comparison of adult mother-daughter relationships among three groups of origin: Ethiopia, Russia, and Israel. The study aimed to: Explore the voices of women participating in a mother-daughter discourse in the context of gender and ethnicity; examine the differences in the mother-daughter relationship through number of factors (e.g. expectations of similarity and difference, perceptions of gender roles, gender identity, emotional closeness, sharing and stress) and finally, to develop a gender informed tool for understanding the gender dialectic in mother-daughter relationship in the context of cross cultural transitions. Method: 37 dyads of mothers and adult daughters participated in a qualitative study. A semi-structured interview was conducted that included questions about socio-demographic characteristics, language proficiency, social distance, closeness, emotional stress, and expectations of similarity and difference in mother-daughter relationships. Results: Analysis of the findings yielded three relationship patterns of gender dialectic and expectations of similarity and difference that characterize the groups of origin. Ethiopian mothers reported more sharing their daughters, fewer expectations of similarity, and felt more stress in the relationship compered to women from the two other origin groups. Conclusions: The study highlighted the impact of intercultural transition and social exclusion on mother-daughter relationships in adulthood in the context of the gender dialectic and women’s status in society. The presentation will explore the findings that were brought up by participants. The discussion will focus on the practices related to gender dialectic and intersecting inequalities regarding diverse groups and discuss gender development reducing inequalities and promoting empowerment to transform oppressive conditions.

Keywords: gender informed perspectives, gender dialectic, mother-daughter relationships, multiculturalism

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5835 Genome-Wide Assessment of Putative Superoxide Dismutases in Unicellular and Filamentous Cyanobacteria

Authors: Shivam Yadav, Neelam Atri

Abstract:

Cyanobacteria are photoautotrophic prokaryotes able to grow in diverse ecological habitats, originated 2.5 - 3.5 billion years ago and brought oxygenic photosynthesis. Since then superoxide dismutases (SODs) acquired great significance due to their ability to catalyze detoxification of byproducts of oxygenic photosynthesis, i.e. superoxide radicals. Sequence information from several cyanobacterial genomes offers a unique opportunity to conduct a comprehensive comparative analysis of the superoxide dismutases family. In the present study, we extracted information regarding SODs from species of sequenced cyanobacteria and investigated their diversity, conservation, domain structure, and evolution. 144 putative SOD homologues were identified. SODs are present in all cyanobacterial species reflecting their significant role in survival. However, their distribution varies, fewer in unicellular marine strains whereas abundant in filamentous nitrogen-fixing cyanobacteria. Motifs and invariant amino acids typical in eukaryotic SODs were conserved well in these proteins. These SODs were classified into three major families according to their domain structures. Interestingly, they lack additional domains as found in proteins of other family. Phylogenetic relationships correspond well with phylogenies based on 16S rRNA and clustering occurs on the basis of structural characteristics such as domain organization. Similar conserved motifs and amino acids indicate that cyanobacterial SODs make use of a similar catalytic mechanism as eukaryotic SODs. Gene gain-and-loss is insignificant during SOD evolution as evidenced by absence of additional domain. This study has not only examined an overall background of sequence-structure-function interactions for the SOD gene family but also revealed variation among SOD distribution based on ecophysiological and morphological characters.

Keywords: comparative genomics, cyanobacteria, phylogeny, superoxide dismutases

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5834 Evaluation of Research in the Field of Energy Efficiency and MCA Methods Using Publications Databases

Authors: Juan Sepúlveda

Abstract:

Energy is a fundamental component in sustainability, the access and use of this resource is related with economic growth, social improvements, and environmental impacts. In this sense, energy efficiency has been studied as a factor that enhances the positive impacts of energy in communities; however, the implementation of efficiency requires strong policy and strategies that usually rely on individual measures focused in independent dimensions. In this paper, the problem of energy efficiency as a multi-objective problem is studied, using scientometric analysis to discover trends and patterns that allow to identify the main variables and study approximations related with a further development of models to integrate energy efficiency and MCA into policy making for small communities.

Keywords: energy efficiency, MCA, scientometric, trends

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5833 Ports and Airports: Gateways to Vector-Borne Diseases in Portugal Mainland

Authors: Maria C. Proença, Maria T. Rebelo, Maria J. Alves, Sofia Cunha

Abstract:

Vector-borne diseases are transmitted to humans by mosquitos, sandflies, bugs, ticks, and other vectors. Some are re-transmitted between vectors, if the infected human has a new contact when his levels of infection are high. The vector is infected for lifetime and can transmit infectious diseases not only between humans but also from animals to humans. Some vector borne diseases are very disabling and globally account for more than one million deaths worldwide. The mosquitoes from the complex Culex pipiens sl. are the most abundant in Portugal, and we dispose in this moment of a data set from the surveillance program that has been carried on since 2006 across the country. All mosquitos’ species are included, but the large coverage of Culex pipiens sl. and its importance for public health make this vector an interesting candidate to assess risk of disease amplification. This work focus on ports and airports identified as key areas of high density of vectors. Mosquitoes being ectothermic organisms, the main factor for vector survival and pathogen development is temperature. Minima and maxima local air temperatures for each area of interest are averaged by month from data gathered on a daily basis at the national network of meteorological stations, and interpolated in a geographic information system (GIS). The range of temperatures ideal for several pathogens are known and this work shows how to use it with the meteorological data in each port and airport facility, to focus an efficient implementation of countermeasures and reduce simultaneously risk transmission and mitigation costs. The results show an increased alert with decreasing latitude, which corresponds to higher minimum and maximum temperatures and a lower amplitude range of the daily temperature.

Keywords: human health, risk assessment, risk management, vector-borne diseases

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5832 Discussion of Blackness in Wrestling

Authors: Jason Michael Crozier

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The wrestling territories of the mid-twentieth century in the United States are widely considered the birthplace of modern professional wrestling, and by many professional wrestlers, to be a beacon of hope for the easing of racial tensions during the civil rights era and beyond. The performers writing on this period speak of racial equality but fail to acknowledge the exploitation of black athletes as a racialized capital commodity who suffered the challenges of systemic racism, codified by a false narrative of aspirational exceptionalism and equality measured by audience diversity. The promoters’ ability to equate racial and capital exploitation with equality leads to a broader discussion of the history of Muscular Christianity in the United States and the exploitation of black bodies. Narratives of racial erasure that dominate the historical discourse when examining athleticism and exceptionalism redefined how blackness existed and how physicality and race are conceived of in sport and entertainment spaces. When discussing the implications of race and professional wrestling, it is important to examine the role of promotions as ‘imagined communities’ where the social agency of wrestlers is defined and quantified based on their ‘desired elements’ as a performer. The intentionally vague nature of this language masks a deep history of racialization that has been perpetuated by promoters and never fully examined by scholars. Sympathetic racism and the omission of cultural identity are also key factors in the limitations and racial barriers placed upon black athletes in the squared circle. The use of sympathetic racism within professional wrestling during the twentieth century defined black athletes into two distinct categorizations, the ‘black savage’ or the ‘black minstrel’. Black wrestlers of the twentieth century were defined by their strength as a capital commodity and their physicality rather than their knowledge of the business and in-ring skill. These performers had little agency in their ability to shape their own character development inside and outside the ring. Promoters would often create personas that heavily racialized the performer by tying them to a regional past or memory, such as that of slavery in the deep south using dog collar matches and adoring black characters in chains. Promoters softened cultural memory by satirizing the historic legacy of slavery and the black identity.

Keywords: sympathetic racism, social agency, racial commodification, stereotyping

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5831 Assessment of Ocular Morbidity, Knowledge and Barriers to Access Eye Care Services among the Children Live in Offshore Island, Bangladesh

Authors: Abir Dey, Shams Noman

Abstract:

Introduction: Offshore Island is the remote and isolated area from the terrestrial mainland. They are deprived of their needs. The children from an offshore island are usually underserved in the case of health care because it is a remote area where the health care systems are quite poor compared to mainland. So, the proper information is required for appropriate planning to reduce underlying causes behind visual deprivation among the surviving children of the Offshore Island. Purpose: The purpose of this study was to determine ocular morbidities, knowledge, and barriers of eye care services among children in an Offshore Island. Methods: The study team visited, and all data were collected from different rural communities at Sandwip Upazila, Chittagong district for screening the children aged 5-16 years old by doing spot examination. The whole study was conducted in both qualitative and quantitative methods. To determine ocular status of children, examinations were done under skilled Ophthalmologists and Optometrists. A focus group discussion was held. The sample size was 490. It was a community based descriptive study and the sampling method was purposive sampling. Results: In total 490 children, about 56.90% were female and 43.10% were male. Among them 456 were school-going children (93.1%) and 34 were non-school going children (6.9%). In this study the most common ocular morbidity was Allergic Conjunctivitis (35.2%). Other mentionable ocular morbidities were Refractive error (27.7%), Blepharitis (13.8%), Meibomian Gland Dysfunction (7.5%), Strabismus (6.3%) and Amblyopia (6.3%). Most of the non-school going children were involved in different types of domestic work like farming, fishing, etc. About 90.04% children who had different ocular abnormalities could not attend to the doctor due to various reasons. Conclusions: The ocular morbidity was high in rate on the offshore island. Eye health care facility was also not well established there. Awareness should be raised about necessity of maintaining hygiene and eye healthcare among the island people. Timely intervention through available eye care facilities and management can reduce the ocular morbidity rate in that area.

Keywords: morbidities, screening, barriers, offshore island, knowledge

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5830 Independent Encryption Technique for Mobile Voice Calls

Authors: Nael Hirzalla

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The legality of some countries or agencies’ acts to spy on personal phone calls of the public became a hot topic to many social groups’ talks. It is believed that this act is considered an invasion to someone’s privacy. Such act may be justified if it is singling out specific cases but to spy without limits is very unacceptable. This paper discusses the needs for not only a simple and light weight technique to secure mobile voice calls but also a technique that is independent from any encryption standard or library. It then presents and tests one encrypting algorithm that is based of frequency scrambling technique to show fair and delay-free process that can be used to protect phone calls from such spying acts.

Keywords: frequency scrambling, mobile applications, real-time voice encryption, spying on calls

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5829 Combination of Diane-35 and Metformin to Treat Early Endometrial Carcinoma in PCOS Women with Insulin Resistance

Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

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Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

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5828 Effects of Web-Enabled Sculpture Package on Colleges of Education Students’ Psychomotor Ability in Fine Arts in South-West, Nigeria

Authors: Ibrahim A. Kareem, Sina O. Ayelaagbe

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This study investigated the effects of web-enabled Sculpture package on Colleges of Education students’ psychomotor level in Fine Arts in South-west, Nigeria. The objectives of this study were to: (i) determine the effect of web-enabled Sculpture package on Fine Arts Students’ performance; (ii) find out the effect of ability levels on Fine Arts Students’ performance and (iii) ascertain the interaction effect of treatment and ability levels on Fine Arts Students’ performance. The study was quasi-experimental design. A total of 48 Fine Arts Students participated in the study. There were 26 students in experimental and 22 for the control. The respondents were purposively sampled from Adeyemi College of Education, Ondo and Federal College of Education (Special) Oyo. Sculpture Achievement Test, Sculpture Skill Test and Sculpture ‘on the Spot’ Skill Assessment Instrument were validated by experts while Pearson’s Product Moment Correlation (PPMC) statistics was used to analyse the instrument while the remaining two instruments were subjected to Cronbach alpha statistics. Data were analysed using t-test and ANCOVA were used to test the hypotheses at 0.05 level of significance. The findings of the study revealed that: (i) Fine Arts Students’ in the experimental group performed significantly better than the control group; (ii) there was a significant difference among high, medium and low ability levels mean scores of Fine Arts Students’ performance in Colleges of Education; (iii) there was no significant interaction effect of treatment and ability levels on the mean scores of Fine Arts Students’ performance in Colleges of Education and. The study concluded that Fine Arts Students exposed to web-enabled Sculpture package performed better than those taught using the conventional method. Based on the study it was recommended that lecturers in Colleges of Education should endeavour to adapt and utilise web-enabled Sculpture package for teaching sculpture.

Keywords: fine art, psychomotor, sculpture, web-enabled

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5827 'Sit Down, Breathe, and Feel What?' Bringing a Contemplative Intervention into a Public Urban Middle School

Authors: Lunthita M. Duthely, John T. Avella, John Ganapati Coleman

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For as many as one in three adolescents living in the United States, the adolescent years is a period of low well-being and mental health challenges—from depressive symptoms to mild to moderate psychological diagnoses. Longitudinal population health studies demonstrated that these challenges persist in young adulthood, and beyond. The positive psychology (PS) approach is a more preventative approach to well-being, which contrasts the traditional, deficits approach to curing mental illness. The research among adult populations formed the basis for PS studies among adolescents. The empirical evidence for the effectiveness of PS interventions exists for both adult and youth populations. Positive Psychology interventions target individuals’ strengths, such as hope and optimism, and positive emotions, such as gratitude. Positive psychology interventions such as increasing gratitude, proved effective in many outcomes among youth, including psychological, social, and academically-related outcomes. Although gratitude-inducing studies have been conducted for the past decade in the United States, few studies have been conducted among samples of urban youth, particularly youth of diverse cultural backgrounds. For nearly two decades, the secular practice of meditation has been tested among adults and more recently among youth, focused mostly among clinical samples. The field of Contemplative Sciences explores practices such as Hatha Yoga, Tai Chi, and Meditation, as preventative practices among children and adolescents. A more recent initiative is to explore Contemplative Practices in the school environment. Contemplative Practices yield a variety of positive outcomes, including academic, social, psychological, physiological, and neurological changes among children and adolescents. Again, few studies were conducted among adolescents of diverse cultural backgrounds. The purpose of this doctoral dissertation research study was to test a gratitude-meditation intervention among middle school students attending a public charter school, located in an urban region of Metropolitan Miami. The objective of this presentation is to summarize the challenges and success of bringing a positive psychology and meditation intervention into an urban middle school. Also, the most recent findings on positive psychology and meditation interventions conducted in school environments will be presented as well.

Keywords: adolescents, contemplative intervention, gratitude, secular meditation, positive psychology, school engagement, Sri Chinmoy

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5826 Environmental Awareness and Community Outreach: A Case Study of Speak Up World Foundation

Authors: Akshita Gaba, Ria P. Dey, Sanya Karotiya, Smrijanee Dash, Soni Gupta

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This research paper explores the significance of environmental awareness and community outreach initiatives undertaken by the Speak Up World Foundation; a non-profit organization founded in 2021. The study delves into the historical context of environmental issues, identifies the driving factors contributing to environmental degradation, and outlines tasks undertaken by the foundation to promote environmental consciousness. The paper also highlights the impact of these efforts on the community and emphasizes the need for continued dedication to ensure sustainable coexistence with our environment.

Keywords: environment, social service, organization, degradation, survey

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5825 Chinese Tourists's Behaviors towards Travel and Shopping in Bangkok

Authors: Sasitorn Chetanont

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The objectives of this study are to study Chinese tourist’s Behaviors towards travel and shopping in Bangkok. The research methodology was a quantitative research. The sample of this research was 400 Chinese tourists in Bangkok chosen by the accidental sampling and the purposive sampling. Inferential Statistics Analysis by using the Chi-square statistics. As for the results of this study the researcher found that differences between personal, social and cultural information, i.e., gender, age, place of residence, educational level, occupation, income, family, and main objectives of tourism with behaviors of Chinese tourists in Bangkok towards travel and shopping in Bangkok.

Keywords: tourists’ behavior, Chinese tourists, travelling, expenses in travels

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5824 Vulnerability Assessment of Healthcare Interdependent Critical Infrastructure Coloured Petri Net Model

Authors: N. Nivedita, S. Durbha

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Critical Infrastructure (CI) consists of services and technological networks such as healthcare, transport, water supply, electricity supply, information technology etc. These systems are necessary for the well-being and to maintain effective functioning of society. Critical Infrastructures can be represented as nodes in a network where they are connected through a set of links depicting the logical relationship among them; these nodes are interdependent on each other and interact with each at other at various levels, such that the state of each infrastructure influences or is correlated to the state of another. Disruption in the service of one infrastructure nodes of the network during a disaster would lead to cascading and escalating disruptions across other infrastructures nodes in the network. The operation of Healthcare Infrastructure is one such Critical Infrastructure that depends upon a complex interdependent network of other Critical Infrastructure, and during disasters it is very vital for the Healthcare Infrastructure to be protected, accessible and prepared for a mass casualty. To reduce the consequences of a disaster on the Critical Infrastructure and to ensure a resilient Critical Health Infrastructure network, knowledge, understanding, modeling, and analyzing the inter-dependencies between the infrastructures is required. The paper would present inter-dependencies related to Healthcare Critical Infrastructure based on Hierarchical Coloured Petri Nets modeling approach, given a flood scenario as the disaster which would disrupt the infrastructure nodes. The model properties are being analyzed for the various state changes which occur when there is a disruption or damage to any of the Critical Infrastructure. The failure probabilities for the failure risk of interconnected systems are calculated by deriving a reachability graph, which is later mapped to a Markov chain. By analytically solving and analyzing the Markov chain, the overall vulnerability of the Healthcare CI HCPN model is demonstrated. The entire model would be integrated with Geographic information-based decision support system to visualize the dynamic behavior of the interdependency of the Healthcare and related CI network in a geographically based environment.

Keywords: critical infrastructure interdependency, hierarchical coloured petrinet, healthcare critical infrastructure, Petri Nets, Markov chain

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5823 Building Data Infrastructure for Public Use and Informed Decision Making in Developing Countries-Nigeria

Authors: Busayo Fashoto, Abdulhakeem Shaibu, Justice Agbadu, Samuel Aiyeoribe

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Data has gone from just rows and columns to being an infrastructure itself. The traditional medium of data infrastructure has been managed by individuals in different industries and saved on personal work tools; one of such is the laptop. This hinders data sharing and Sustainable Development Goal (SDG) 9 for infrastructure sustainability across all countries and regions. However, there has been a constant demand for data across different agencies and ministries by investors and decision-makers. The rapid development and adoption of open-source technologies that promote the collection and processing of data in new ways and in ever-increasing volumes are creating new data infrastructure in sectors such as lands and health, among others. This paper examines the process of developing data infrastructure and, by extension, a data portal to provide baseline data for sustainable development and decision making in Nigeria. This paper employs the FAIR principle (Findable, Accessible, Interoperable, and Reusable) of data management using open-source technology tools to develop data portals for public use. eHealth Africa, an organization that uses technology to drive public health interventions in Nigeria, developed a data portal which is a typical data infrastructure that serves as a repository for various datasets on administrative boundaries, points of interest, settlements, social infrastructure, amenities, and others. This portal makes it possible for users to have access to datasets of interest at any point in time at no cost. A skeletal infrastructure of this data portal encompasses the use of open-source technology such as Postgres database, GeoServer, GeoNetwork, and CKan. These tools made the infrastructure sustainable, thus promoting the achievement of SDG 9 (Industries, Innovation, and Infrastructure). As of 6th August 2021, a wider cross-section of 8192 users had been created, 2262 datasets had been downloaded, and 817 maps had been created from the platform. This paper shows the use of rapid development and adoption of technologies that facilitates data collection, processing, and publishing in new ways and in ever-increasing volumes. In addition, the paper is explicit on new data infrastructure in sectors such as health, social amenities, and agriculture. Furthermore, this paper reveals the importance of cross-sectional data infrastructures for planning and decision making, which in turn can form a central data repository for sustainable development across developing countries.

Keywords: data portal, data infrastructure, open source, sustainability

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5822 The Impact of the Length of Time Spent on the Street on Adjustment to Homelessness

Authors: Jakub Marek, Marie Vagnerova, Ladislav Csemy

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Background: The length of time spent on the street influences the degree of adjustment to homelessness. Over the years spent sleeping rough, homeless people gradually lose the ability to control their lives and their return to mainstream society becomes less and less likely. Goals: The aim of the study was to discover whether and how men who have been sleeping rough for more than ten years differ from those who have been homeless for four years or less. Methods: The research was based on a narrative analysis of in-depth interviews focused on the respondent’s entire life story, i.e. their childhood, adolescence, and the period of adulthood preceding homelessness. It also asked the respondents about how they envisaged the future. The group under examination comprised 51 homeless men aged 37 – 54. The first subgroup contained 29 men who have been sleeping rough for 10 – 21 years, the second group contained 22 men who have been homeless for four years or less. Results: Men who have been sleeping rough for more than ten years had problems adapting as children. They grew up in a problematic family or in an institution and acquired only a rudimentary education. From the start they had problems at work, found it difficult to apply themselves, and found it difficult to hold down a job. They tend to have high-risk personality traits and often a personality disorder. Early in life they had problems with alcohol or drugs and their relationships were unsuccessful. If they have children, they do not look after them. They are reckless even in respect of the law and often commit crime. They usually ended up on the street in their thirties. Most of this subgroup of homeless people lack motivation and the will to make any fundamental change to their lives. They identify with the homeless community and have no other contacts. Men who have been sleeping rough for four years or less form two subgroups. There are those who had a normal childhood, attended school and found work. They started a family but began to drink, and as a consequence lost their family and their job. Such men end up on the street between the ages of 35 and 40. And then there are men who become homeless after the age of 40 because of an inability to cope with a difficult situation, e.g. divorce or indebtedness. They are not substance abusers and do not have a criminal record. Such people can be offered effective assistance to return to mainstream society by the social services because they have not yet fully self-identified with the homeless community and most of them have retained the necessary abilities and skills. Conclusion: The length of time a person has been homeless is an important factor in respect of social prevention. It is clear that the longer a person is homeless, the worse are their chances of being reintegrated into mainstream society.

Keywords: risk factors, homelessness, chronicity, narrative analysis

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5821 Equality in Higher Education: A Library and Learning Collaborative Project to Support Teachers

Authors: Ika Jorum

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The aim of this collaborative project was to develop library support that contributes in a long-term way to a technical university’s work on increased equality in education. The background was an assessment made by the Higher Education Authority that showed the need for improvement regarding equality in several programs at the university. The university’s Vice President for equality and Vice President for sustainability announced funds for projects that supported the improvement of equality in education. The library was granted funding for a one-year project that aimed both to support teachers in order to embed equality in education and to support the library staff and improve the organization’s own work. The part of the project that was directed to teachers was performed as activities in different areas and forms, such as acquisition and collections, teaching, exhibitions and book discussions. Besides the activities and support that was offered to teachers, the education team had journal clubs in order to develop and embed equality in their own teaching. The part that was directed to library staff and management was performed as workshops in collaboration with Equality Office in order to identify areas where the library could make improvements on work with equality and inclusion. The expectation was that the activities would be well attended since the project team had got indications that the content would be relevant. The outcome of this project was that some activities turned out to be more attended than others and what is expected to be found relevant, for example, a workshop on information searching from a gender and equality perspective for teachers, might still not attract participants. On the other hand, Ph.D. students and students participated in the book discussions and wanted them to continue after the project had ended. Results will be shared both on what was successful and what was challenging. Some reflections will be given on what can be done to attract participants to activities in the area of gender equality that is most likely relevant for the expected attendants and how results from a project on gender equality can be integrated into an organization’s daily work.

Keywords: equality, higher education, critical information literacy, collaboration

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5820 Challenges of Management of Subaortic Membrane in a Young Adult Patient: A Case Review and Literature Review

Authors: Talal Asif, Maya Kosinska, Lucas Georger, Krish Sardesai, Muhammad Shah Miran

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This article presents a case review and literature review focused on the challenges of managing subaortic membranes (SAM) in young adult patients with mild aortic regurgitation (AR) or aortic stenosis (AS). The study aims to discuss the diagnosis of SAM, imaging studies used for assessment, management strategies in young patients, the risk of valvular damage, and the controversy surrounding prophylactic resection in mild AR. The management of SAM in adults poses challenges due to limited treatment options and potential complications, necessitating further investigation into the progression of AS and AR in asymptomatic SAM patients. The case presentation describes a 40-year-old male with muscular dystrophy who presented with symptoms and was diagnosed with SAM. Various imaging techniques, including CT chest, transthoracic echocardiogram (TTE), and transesophageal echocardiogram (TEE), were used to confirm the presence and severity of SAM. Based on the patient's clinical profile and the absence of surgical indications, medical therapy was initiated, and regular outpatient follow-up was recommended to monitor disease progression. The discussion highlights the challenges in diagnosing SAM, the importance of imaging studies, and the potential complications associated with SAM in young patients. The article also explores the management options for SAM, emphasizing surgical resection as the definitive treatment while acknowledging the limited success rates of alternative approaches. Close monitoring and prompt intervention for complications are crucial in the management of SAM. The concluding statement emphasizes the need for further research to explore alternative treatments for SAM in young patients.

Keywords: subaortic membrane, management, case report, literature review, aortic regurgitation, aortic stenosis, left ventricular outflow obstruction, guidelines, heart failure

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5819 Identification of Ideal Plain Sufu (Fermented Soybean Curds) Based on Ideal Profile Method and Assessment of the Consistency of Ideal Profiles Obtained from Consumers

Authors: Yan Ping Chen, Hau Yin Chung

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The Ideal Profile Method (IPM) is a newly developed descriptive sensory analysis conducted by consumers without previous training. To perform this test, both the perceived and the ideal intensities from the judgements of consumers on products’ attributes, as well as their hedonic ratings were collected for formulating an ideal product (the most liked one). In addition, Ideal Profile Analysis (IPA) was conducted to check the consistency of the ideal data at both the panel and consumer levels. In this test, 12 commercial plain sufus bought from Hong Kong local market were tested by 113 consumers according to the IPM, and rated on 22 attributes. Principal component analysis was used to profile the perceived and the ideal spaces of tested products. The consistency of ideal data was then checked by IPA. The result showed that most consumers shared a common ideal. It was observed that the sensory product space and the ideal product space were structurally similar. Their first dimensions all opposed products with intense fermented related aroma to products with less fermented related aroma. And the predicted ideal profile (the estimated liking score around 7.0 in a 9.0-point scale) got higher hedonic score than the tested products (the average liking score around 6.0 in a 9.0-point scale). For the majority of consumers (95.2%), the stated ideal product considered as a potential ideal through checking the R2 coefficient value. Among all the tested products, sample-6 was the most popular one with consumer liking percentage around 30%. This product with less fermented and moldy flavour but easier to melt in mouth texture possessed close sensory profile according to the ideal product. This experiment validated that data from untrained consumers could be guided as useful information. Appreciated sensory characteristics could be served as reference in the optimization of the commercial plain sufu.

Keywords: ideal profile method, product development, sensory evaluation, sufu (fermented soybean curd)

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5818 Active Ageing a Way Forward to Healthy Ageing Among the Rural Elderly Women

Authors: Hannah Evangeline Sangeetha

Abstract:

Ageing is an inevitable change in the life span of an individual. India’s old age population has increased from 19 million in 1947 to 100 million in the 21st century. The United Nations World Population ageing reports that the grey population has immensely increased from 9.2% in 1990 to 11.7 % in 2013, and it’s expected to triple by the year 2050 growing from 737 million to over 2 billion persons 60 years of age and older. Ageing is a period of physical, mental and social decline which brings a host of challenges to the individual and the family. Hence it requires attention at the micro, mezzo and the macro levels of the society. The concepts of healthy and successful aging are being used to help people to change their negative attitude towards aging. This perspective is important to make people realize their potentialities to bring about a change in the minds of senior citizens as well as the society. The objective of this study was to understand the level of active ageing among the rural elderly women and its impact on the quality of life. 330 elderly women from 12 villages of Sriperumbudur associated with the Mobile medical care of Help age India were interviewed using census method. The study revealed the following findings; most respondents in this study were young old between the age group of 60 to 75 years. All the three major religious groups were represented, 85.5percent were Hindus. Majority of the respondents 73.3percent had no education. It was interesting to know that majority of the respondents were self reliant (83.94 percent) and 82.73 percent of them very independent and took care of them by themselves (activities of daily living) without any support from their families. 76.9 percent of the senior women worked based on their competencies, 75.5 percent of them were involved in plenty of activities everyday including their occupation and household chores, which enabled them to be physically active. The chi square values that there is a significant association between the overall active ageing score, religion &number of members in the family. The other demographic variables like age, occupation, income marital status, age at marriage, number of children in the family and Socio –Economic Status were not significantly associated with the overall active aging score. The p-value 0.032 showed Social network and being self-reliant are significantly associated. The study surprisingly shows that most women enjoyed freedom and Independence in their family which is a positive indicator of active ageing.

Keywords: active ageing, quality of life, independence, self reliance

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5817 Assessment of Groundwater Chemistry and Quality Characteristics in an Alluvial Aquifer and a Single Plane Fractured-Rock Aquifer in Bloemfontein, South Africa

Authors: Modreck Gomo

Abstract:

The evolution of groundwater chemistry and its quality is largely controlled by hydrogeochemical processes and their understanding is therefore important for groundwater quality assessments and protection of the water resources. A study was conducted in Bloemfontein town of South Africa to assess and compare the groundwater chemistry and quality characteristics in an alluvial aquifer and single-plane fractured-rock aquifers. 9 groundwater samples were collected from monitoring boreholes drilled into the two aquifer systems during a once-off sampling exercise. Samples were collected through low-flow purging technique and analysed for major ions and trace elements. In order to describe the hydrochemical facies and identify dominant hydrogeochemical processes, the groundwater chemistry data are interpreted using stiff diagrams and principal component analysis (PCA), as complimentary tools. The fitness of the groundwater quality for domestic and irrigation uses is also assessed. Results show that the alluvial aquifer is characterised by a Na-HCO3 hydrochemical facie while fractured-rock aquifer has a Ca-HCO3 facie. The groundwater in both aquifers originally evolved from the dissolution of calcite rocks that are common on land surface environments. However the groundwater in the alluvial aquifer further goes through another evolution as driven by cation exchange process in which Na in the sediments exchanges with Ca2+ in the Ca-HCO3 hydrochemical type to result in the Na-HCO3 hydrochemical type. Despite the difference in the hydrogeochemical processes between the alluvial aquifer and single-plane fractured-rock aquifer, this did not influence the groundwater quality. The groundwater in the two aquifers is very hard as influenced by the elevated magnesium and calcium ions that evolve from dissolution of carbonate minerals which typically occurs in surface environments. Based on total dissolved levels (600-900 mg/L), groundwater quality of the two aquifer systems is classified to be of fair quality. The negative potential impacts of the groundwater quality for domestic uses are highlighted.

Keywords: alluvial aquifer, fractured-rock aquifer, groundwater quality, hydrogeochemical processes

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5816 Assessment the Infiltration of the Wastewater Ponds and Its Impact on the Water Quality of Pleistocene Aquifer at El Sadat City Using 2-D Electrical Resistivity Tomography and Water Chemistry

Authors: Abeer A. Kenawy, Usama Massoud, El-Said A. Ragab, Heba M. El-Kosery

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2-D Electrical Resistivity Tomography (ERT) and hydrochemical study have been conducted at El Sadat industrial city. The study aims to investigate the area around the wastewater ponds to determine the possibility of water percolation from the wastewater ponds to the Pleistocene aquifer and to inspect the effect of this seepage on the groundwater chemistry. Pleistocene aquifer is the main groundwater reservoir in this area, where El Sadat city and its vicinities depend totally on this aquifer for water supplies needed for drinking, agricultural, and industrial activities. In this concern, seven ERT profiles were measured around the wastewater ponds. Besides, 10 water samples were collected from the ponds and the nearby groundwater wells. The water samples have been chemically analyzed for major cations, anions, nutrients, and heavy elements. Also, the physical parameters (pH, Alkalinity, EC, TDS) of the water samples were measured. Inspection of the ERT sections shows that they exhibit lower resistivity values towards the water ponds and higher values in opposite sides. In addition, the water table was detected at shallower depths at the same sides of lower resistivity. This could indicate a wastewater infiltration to the groundwater aquifer near the oxidation ponds. Correlation of the physical parameters and ionic concentrations of the wastewater samples with those of the groundwater samples indicates that; the ionic levels are randomly varying and no specific trend could be obtained. In addition, the wastewater samples shows some ionic levels lower than those detected in other groundwater samples. Besides, the nitrate level is higher in samples taken from the cultivated land than the wastewater samples due to the over using of nitrogen fertilizers. Then, we can say that the infiltrated water from wastewater ponds are not the main controller of the groundwater chemistry in this area, but rather the variable ionic concentrations could be attributed to local, natural, and anthropogenic processes.

Keywords: El Sadat city, ERT, hydrochemistry, percolation, wastewater ponds

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5815 Quality Assessment of Hollow Sandcrete Blocks in Minna, Nigeria

Authors: M. Abdullahi, S. Sadiku, Bashar S. Mohammed, J. I. Aguwa

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The properties of hollow sandcrete blocks produced in Minna, Nigeria are presented. Sandcrete block is made of cement, water and sand bound together in certain mix proportions. For the purpose of this work, fifty (50) commercial sandcrete block industries were visited in Minna, Nigeria to obtain block samples and aggregates used for the manufacture, and to also take inventory of the mix composition and the production process. Sieve analysis tests were conduction on the soil sample from various block industries to ascertain their quality to be used for block making. The mix ratios were also investigated. Five (5) nine inches (9’’ or 225mm) blocks were obtained from each block industry and tested for dimensional compliance and compressive strength. The result of test shows that the grading of the sand falls within the limit required by BS 882: 1990. The sand particles generally satisfy the grading requirement of overall grading and also fall in at least one of the classification of coarse grading, medium grading or fine grading. This clearly indicates that the quality of the aggregates used for the production of sandcrete blocks in Minna, Nigeria are of good quality in terms of grading and workable mix can easily be achieved to obtain high quality product. Physical examinations of the block sizes show slight deviation from the standard requirement in NIS 87:2000. Compressive strength of hollow sandcrete blocks in range of 0.12 N/mm2 to 0.54 N/mm2 was obtained which is below the recommendable value of 3.45 N/mm2 for load bearing hollow sandcrete blocks. This indicates that these blocks are below the standard for load-bearing sandcrete blocks and cannot be used as load bearing walling units. The mix composition also indicated low cement content resulting in low compressive strength. Most of the commercial block industries visited do not take curing very serious. Water were only sprinkled ones or twice before the blocks were stacked and made readily available for sale. It is recommended that a mix ratio of 1:4 to 1:6 should be used for the production of sandcrete blocks and proper curing practice should be adhered to. Blocks should also be cured for 14 days before making them available for consumers.

Keywords: compressive strength, dimensions, mix proportions, sandcrete blocks

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5814 Nursing Experience in Improving Physical and Mental Well-Being of a Patient with Premature Menopause Osteoporosis and Sarcopenia in Nursing-Led Multi-Discipline Care

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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5813 Investigation of Ductile Failure Mechanisms in SA508 Grade 3 Steel via X-Ray Computed Tomography and Fractography Analysis

Authors: Suleyman Karabal, Timothy L. Burnett, Egemen Avcu, Andrew H. Sherry, Philip J. Withers

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SA508 Grade 3 steel is widely used in the construction of nuclear pressure vessels, where its fracture toughness plays a critical role in ensuring operational safety and reliability. Understanding the ductile failure mechanisms in this steel grade is crucial for designing robust pressure vessels that can withstand severe nuclear environment conditions. In the present study, round bar specimens of SA508 Grade 3 steel with four distinct notch geometries were subjected to tensile loading while capturing continuous 2D images at 5-second intervals in order to monitor any alterations in their geometries to construct true stress-strain curves of the specimens. 3D reconstructions of X-ray computed tomography (CT) images at high-resolution (a spatial resolution of 0.82 μm) allowed for a comprehensive assessment of the influences of second-phase particles (i.e., manganese sulfide inclusions and cementite particles) on ductile failure initiation as a function of applied plastic strain. Additionally, based on 2D and 3D images, plasticity modeling was executed, and the results were compared to experimental data. A specific ‘two-parameter criterion’ was established and calibrated based on the correlation between stress triaxiality and equivalent plastic strain at failure initiation. The proposed criterion demonstrated substantial agreement with the experimental results, thus enhancing our knowledge of ductile fracture behavior in this steel grade. The implementation of X-ray CT and fractography analysis provided new insights into the diverse roles played by different populations of second-phase particles in fracture initiation under varying stress triaxiality conditions.

Keywords: ductile fracture, two-parameter criterion, x-ray computed tomography, stress triaxiality

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5812 Measurement and Monitoring of Graduate Attributes via iCGPA Implementation and ACADEMIA Programming: UNIMAS Case Study

Authors: Shanti Faridah Salleh, Azzahrah Anuar, Hamimah Ujir, Rohana Sapawi, Wan Hashim Wan Ibrahim, Noraziah Abdul Wahab, Majina Sulaiman, Raudhah Ahmadi, Al-Khalid Othman, Johari Abdullah

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Integrated Cumulative Grade Point Average or iCGPA is an evaluation and reporting system that represents a comprehensive development of students’ achievement in their academic programs. Universiti Malaysia Sarawak, UNIMAS has started its implementation of iCGPA in 2016. iCGPA is driven by the Outcome-Based Education (OBE) system that has been long integrated into the higher education in Malaysia. iCGPA is not only a tool to enhance the OBE concept through constructive alignment but it is also an integrated mechanism to assist various stakeholders in making decisions or planning for program improvement. The outcome of this integrated system is the reporting of students’ academic performance in terms of cognitive (knowledge), psychomotor (skills), and affective (attitude) of which the students acquire throughout the duration of their study. The iCGPA reporting illustrates the attainment of student’s attribute in the eight domains of learning outcomes listed in the Malaysian Qualifications Framework (MQF). This paper discusses on the implementation of iCGPA in UNIMAS on the policy and strategy to direct the whole university to implement the iCGPA. The steps and challenges in integrating the exsting Outcome-Based Education and utilising iCGPA as a tool to quantify the students’ achievement are also highlighted in this paper. Finally, the ACADEMIA system, which is a dedicated centralised program ensure the implementation of iCGPA is a success has been developed. This paper discusses the structure and the analysis of ACADEMIA program and concludes the analysis made on the improvement made on the implementation of constructive alignment in all 40 programs involves in iCGPA implementation.

Keywords: constructive alignment, holistic graduates, mapping of assessment, programme outcome

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5811 The Conceptualization of Patient-Centered Care in Latin America: A Scoping Review

Authors: Anne Klimesch, Alejandra Martinez, Martin HäRter, Isabelle Scholl, Paulina Bravo

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Patient-centered care (PCC) is a key principle of high-quality healthcare. In Latin America, research on and promotion of PCC have taken place in the past. However, thorough implementation of PCC in practice is still missing. In Germany, an integrative model of patient-centeredness has been developed by synthesis of diverse concepts of PCC. The model could serve as a point of reference for further research on the implementation of PCC. However, it is predominantly based on research from Europe and North America. This scoping review, therefore, aims to accumulate research on PCC in Latin America in the past 15 years and analyse how PCC has been conceptualized. The resulting overview of PCC in Latin America will be a foundation for a subsequent study aiming at the adaptation of the integrative model of patient-centeredness to the Latin American health care context. Scientific databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, Web of Science, SCIELO, Redalyc.) will be searched, and reference and citation tracking will be performed. Studies will be included if they were carried out in Latin America, investigated PCC in any clinical and community setting (public and private), and were published in English, Spanish, French, or Portuguese since 2006. Furthermore, any theoretical framework or conceptual model to guide how PCC is conceptualized in Latin America will be included. Two reviewers will be responsible for the identification of articles, screening of records, and full-text assessment. The results of the scoping review will be used in the development of a mixed-methods study with the aim to understand the needs for PCC, as well as barriers and facilitators in Latin America. Based on the outcomes, the integrative model of PCC will be translated to Spanish and adapted to the Latin American context. The integrative model will enable the dissemination of the concept of PCC in Latin America and will provide a common ground for further research on the topic. The project will thereby make an important contribution to an evidence-based implementation of PCC in Latin America.

Keywords: conceptual framework, integrative model of PCC, Latin America, patient-centered care

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5810 Indicators and Sustainability Dimensions of the Mediterranean Diet

Authors: Joana Margarida Bôto, Belmira Neto, Vera Miguéis, Manuela Meireles, Ada Rocha

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The Mediterranean diet has been recognized as a sustainable model of living with benefits for the environment and human health. However, a complete assessment of its sustainability, encompassing all dimensions and aspects, to our best knowledge, has not yet been realized. This systematic literature review aimed to fill this gap by identifying and describing the indicators used to assess the sustainability of the Mediterranean diet, looking at several dimensions, and presenting the results from their application. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines methodology was used, and searches were conducted in PubMed, Scopus, Web of Science, and GreenFile. There were identified thirty-two articles evaluating the sustainability of the Mediterranean diet. The environmental impact was quantified in twenty-five of these studies, the nutritional quality was evaluated in seven studies, and the daily cost of the diet was assessed in twelve studies. A total of thirty-three indicators were identified and separated by four dimensions of sustainability, specifically, the environmental dimension (ten indicators, namely carbon, water, and ecological footprint), the nutritional dimension (eight indicators, namely Health score and Nutrient Rich Food Index), the economic dimension (one indicator, the dietary cost), the sociocultural dimension (six indicators – with no results). Only eight of the studies used combined indicators. The Mediterranean diet was considered in all articles as a sustainable dietary pattern with a lower impact than Western diets. The carbon footprint ranged between 0.9 and 6.88 kg CO₂/d per capita, the water footprint between 600 and 5280 m³/d per capita, and the ecological footprint between 2.8 and 53.42 m²/d per capita. The nutritional quality was high, obtaining 122 points using the Health score and 12.95 to 90.6 points using the Nutrient Rich Food Index. The cost of the Mediterranean diet did not significantly differ from other diets and varied between 3.33 and 14.42€/d per capita. A diverse approach to evaluating the sustainability of the Mediterranean diet was found.

Keywords: Mediterranean diet, sustainability, environmental indicators, nutritional indicators

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