Search results for: public health risks

Authors: Kaoutar Chbihi, Aziza Menouni, Emilie Hardy, Matteo Creta, Nathalie Grova, An Van Nieuwenhuyse, Lode Godderis, Samir El Jaafari, Radu-Corneliu Duca

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Industrial products and materials are often treated with additional compounds like brominated flame retardants (BFRs) and heavy metals in order to prevent their ignition, increase their functionality and improve their performance like electrical conductivity. Consequently, this could potentially expose children to harmful chemicals through indoor dust and through hand-to-mouth or toy-chewing behaviors. The aim of this study was to assess the exposure of Moroccan children aged 5-11 years to BFRs and heavy metal elements and investigate their impacts on the epigenetic profile, namely through global DNA methylation modifications. First, parents were asked to answer a questionnaire on children’s lifestyle, then blood and urine samples were collected from (n= 93) children, following the ethical guidelines, for biomonitoring and DNA methylation analysis, using a set of solid phase extraction (SPE), LC-MS/MS, GC-MS/MS and ICP/MS techniques. BFRs were detected in 54.84% of samples with a median concentration of 0.01 nmol/mL (range: 0.004-0.051 nmol/mL), while metal elements were detected in more than 90% of samples. No association was found between BFRs and global DNA methylation, unlike metal element levels that showed significant variations with global DNA methylation biomarkers, namely 5-mdC, 5-OH-mdC and N⁶-mA levels. To conclude, Moroccan children could be significantly exposed to flame retardant compounds and heavy metal elements through several routes, such as dust or equipment usage and are therefore susceptible to the adverse health effects that could be linked with such chemicals. Further research is required to assess the exposure to environmental pollutants among the Moroccan population in order to protect Moroccan health and prevent the incidence of diseases.

Keywords: biomonitoring, children, DNA methylation, epigenetics, flame retardants, heavy metals, Morocco

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Authors: Anthony R. Townsend, Robyn L. Fasser

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This research project provides an interpretative phenomenological analysis of a proposed conceptual model of parenting ability that has been designed to offer recommendations to guide intervention in child custody evaluations in South Africa. A recent review of the literature on child custody evaluations reveals that while there have been significant and valuable shifts in the capacity of the legal system aided by mental health professionals in understanding children and family dynamics, there remains a conceptual gap regarding the nature of parenting ability. With a view to addressing this paucity of a theoretical basis for considering parenting ability, this research project reviews a dimensional model for the assessment of parenting ability by conceiving parenting ability as a combination of good parenting and parental fitness. This model serves as a conceptual framework to guide child-custody evaluation and refine intervention in such cases to better meet the best interests of the child in a manner that bridges the professional gap between parties, legal entities, and mental health professionals. Using a model of good parenting as a point of theoretical departure, this model incorporates both intra-psychic and interpersonal attributes and behaviours of parents to form an impression of parenting ability and identify areas for potential enhancement. This research, therefore, hopes to achieve the following: (1) to provide nuanced descriptions of parents’ parenting ability; (2) to describe parents’ parenting potential; (3) to provide a parenting assessment tool for investigators in forensic family matters that will enable more useful recommendations and interventions; (4) to develop a language of consensus for investigators, attorneys, judges and parents, in forensic family matters, as to what comprises parenting ability and how this can be assessed; and (5) that all of the aforementioned will serve to advance the best interests of the children involved in such litigious matters. The evaluative promise and post-assessment prospects of this model are illustrated through three interlinking data sets: (1) the results of interviews with South African psychologists about the model, (2) retrospective analysis of care and contact evaluation reports using the model to determine if different conclusions or more specific recommendations are generated with its use and (3) the results of an interview with a psychologist who piloted this model by using it in care and contact evaluation.

Keywords: alienation, attachment, best interests of the child, care and contact evaluation, children’s act (38 of 2005), child custody evaluation, civil forensics, gatekeeping, good parenting, good-enough parenting, health professions council of South Africa, family law, forensic mental healthcare practitioners, parental fitness, parenting ability, parent management training, parenting plan, problem-determined system, psychotherapy, support of other child-parent relationship, voice of the child

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Authors: Abdullah Alnutayfat, Alexander Sutin

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One of the most important types of renewable energy resources is wind energy which can be produced by wind turbines. The blades of the wind turbine are exposed to the pressure of the harsh environment, which causes a significant issue for the wind power industry in terms of the maintenance cost and failure of blades. One of the reliable methods for blade inspection is the vibroacoustic structural health monitoring (SHM) method which examines information obtained from the structural vibrations of the blade. However, all vibroacoustic SHM techniques are based on comparing the structural vibration of intact and damaged structures, which places a practical limit on their use. Methods for nonlinear vibroacoustic SHM are more sensitive to damage and cracking and do not need to be compared to data from the intact structure. This paper presents the Vibro-Acoustic Modulation (VAM) method based on the modulation of high-frequency (probe wave) by low-frequency loads (pump wave) produced by the blade rotation. The blade rotation alternates bending stress due to gravity, leading to crack size variations and variations in the blade resonance frequency. This method can be used with the classical SHM vibration method in which the blade is excited by piezoceramic actuator patches bonded to the blade and receives the vibration response from another piezoceramic sensor. The VAM modification of this method analyzes the spectra of the detected signal and their sideband components. We suggest the VAM model as the simple mechanical oscillator, where the parameters of the oscillator (resonance frequency and damping) are varied due to low-frequency blade rotation. This model uses the blade vibration parameters and crack influence on the blade resonance properties from previous research papers to predict the modulation index (MI).

Keywords: wind turbine blades, damaged detection, vibro-acoustic structural health monitoring, vibro-acoustic modulation

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Authors: Aimite Jorge, Leenekela Usebiu

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In recent years the International Community has seen a rise of what can be termed as ‘actio popularis”;that is to say lawsuits brought by third parties in the interest of the public or the world community as a whole, such as in cases of genocide and terrorism prosecutions under international law. It is equally clear that under current globalized world the effect of multinational activities on the environment is often felt beyond the borders of the territories where they operate. Equally true is the fact that the correspondence of citizens self-determination with national government is increasingly upset by the increasing willingness of states to share some ‘sovereign powers’ in order to address new economic, environmental and security interdependencies. The ‘unbundling’ of functional governance from fixed territories sees continuously citizens give up their formal approval of key decisions in exchange for a more remote, indirect say in supra-national or international decision-making bodies. The efforts to address a growing transnational flow of ecological harm are at the forefront of such indirect transformations, as evidenced by a proliferation of multilateral environmental agreements (MEAs) over the past three decades. However, unlike the defence of the global commons in cases of terrorism and genocide, there is still to be a clear application of action popularis in the case of environment, despite acknowledgement that the effect of the activities of several multinationals on the environment is as destructive to the global commons as genocide or terrorism are. Thus, this paper looking at specific cases of harmful degradation of the environment by certain multinationals transcending national boundaries, argues that it is high-time for a serious consideration of the application of the actio-popularis to environmental concerns. Although it is acknowledged that in international environmental law the challenge to reach a “critical mass” of recognition and support for an ‘actio-popularis’ for environment damage is particularly demanding, it is worth the try.

Keywords: actio popularis in environment law, global commons, transnational environmental damage, law and environment

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Authors: Partha Sarathi Mondal, Srabani Sanyal

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Different geomorphic agents produce a different landforms pattern. Similarly rivers also have a distinct and diverse landforms pattern. And even, within a river course different and distinct assemblage of landforms i.e. morphological variability are seen. These morphological variability are produced by different river processes. Channel and floodplain morphology helps to interpret river processes. Consequently morphological variability can be used as an important tool for assessing river processes, hydrological connectivity and river health, which will help us to draw inference about river processes and therefore, management of river health. The present study is documented on West Rapti river, a trans-boundary river flowing through Nepal and India, from its source to confluence with Ghaghra river in India. The river shows a significant morphological variability throughout its course. The present study tries to find out factors and processes responsible for the morphological variability of the river and in which way it can be applied in river management practices. For this purpose channel and floodplain morphology of West Rapti river was mapped as accurately as possible and then on the basis of process-form interactions, inferences are drawn to understand factors of morphological variability. The study shows that the valley setting of West Rapti river, in the Himalayan region, is confined and somewhere partly confined whereas, channel of the West Rapti river is single thread in most part of Himalayan region and braided in valley region. In the foothill region valley is unconfined and channel is braided, in middle part channel is meandering and valley is unconfined, whereas, channel is anthropogenically altered in the lower part of the course. Due to this the morphology of West Rapti river is highly diverse. These morphological variability are produced by different geomorphic processes. Therefore, for any river management it is essential to sustain these morphological variability so that the river could not cross the geomorphic threshold and environmental flow of the river along with the biodiversity of riparian region is maintained.

Keywords: channel morphology, environmental flow, floodplain morphology, geomorphic threshold

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Authors: Charlotte Williams

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Yale University Professor Hiram Bingham’s discovery of Machu Picchu in 1911 spurred an international interest in the Inca Empire, and with it, a dispute with the Peruvian government over who had rightful jurisdiction and curatorship over Inca history. By 2011, the Peruvian government initiated a legal battle for the return of artifacts that Bingham had removed from Machu Picchu, successfully returning them not to the site of Machu Picchu, but to Cusco, employing the rationale that the ancient Inca capital housed descendants of the Inca empire. This conflation of the past and present can be traced to a largely unanalyzed study that accompanied Bingham’s expedition: an ethnographic analysis of Inca descendants, which at the time portrayed indigenous Peruvian Andean peoples as remnants of a lost civilization, using Cusco as an assumed repository for people with 'Inca' characteristics. This study draws from the original Yale Peruvian Expedition archives, the Cusco Library archives, and in-depth interviews with curators of the Inca Museum and Machu Picchu Museum to analyze both the political conflict that emerged as a reaction to the ethnographic study, and how the study articulated with an inflating tourism market attempting to define what it meant to be Inca to an international public. The construction of the modern Inca as both directors of tourism management and purveyors of their archaeological material culture points to a unique case in which modern Peruvian citizens could claim heritage to an Inca past despite a lack of recognition as a legally defined group. The result has far-reaching implications, since Bingham’s artifacts returned not necessarily to a traditional nation-state, but to an imagined one, broadening the conditions under which informal repatriations can occur.

Keywords: archaeology of memory, imagined communities, Incanismo, repatriation

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Authors: Aarthi Mariappan, Janani Selvaraj, P. B. Harathi, M. Prashanthi Devi

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Anthropogenic modification of the urban environment has largely increased in the recent years in order to sustain the growing human population. Intense industrial activity, permanent and high traffic on the roads, a developed subterranean infrastructure network, land use patterns are just some specific characteristics. Every day, the urban environment is polluted by more or less toxic emissions, organic or metals wastes discharged from specific activities such as industrial, commercial, municipal. When these eventually deposit into the soil, the physical and chemical properties of the surrounding soil is changed, transforming it into a human exposure indicator. Metals are non-degradable and occur cumulative in soil due to regular deposits are a result of permanent human activity. Due to this, metals are a contaminant factor for soil when persistent over a long period of time and a possible danger for inhabitant’s health on prolonged exposure. Metals accumulated in contaminated soil may be transferred to humans directly, by inhaling the dust raised from top soil, or by ingesting, or by dermal contact and indirectly, through plants and animals grown on contaminated soil and used for food. Some metals, like Cu, Mn, Zn, are beneficial for human’s health and represent a danger only if their concentration is above permissible levels, but other metals, like Pb, As, Cd, Hg, are toxic even at trace level causing gastrointestinal and lung cancers. In urban areas, metals can be emitted from a wide variety of sources like industrial, residential, commercial activities. Our study interrogates the spatial distribution of heavy metals in soil in relation to their permissible levels and their association with the health risk to the urban population in Coimbatore, India. Coimbatore region is a high cancer risk zone and case records of gastro intestinal and respiratory cancer patients were collected from hospitals and geocoded in ArcGIS10.1. The data of patients pertaining to the urban limits were retained and checked for their diseases history based on their diagnosis and treatment. A disease map of cancer was prepared to show the disease distribution. It has been observed that in our study area Cr, Pb, As, Fe and Mg exceeded their permissible levels in the soil. Using spatial overlay analysis a relationship between environmental exposure to these potentially toxic elements in soil and cancer distribution in Coimbatore district was established to show areas of cancer risk. Through this, our study throws light on the impact of prolonged exposure to soil contamination in soil in the urban zones, thereby exploring the possibility to detect cancer risk zones and to create awareness among the exposed groups on cancer risk.

Keywords: soil contamination, cancer risk, spatial analysis, India

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Authors: Paula Paulino, Alzira Matias, Ana Margarida Veiga Simão

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Self-regulated learning (SRL) directs students in analyzing proposed tasks, setting goals and designing plans to achieve those goals. The literature has suggested a metacognitive strategy for goal attainment known as Mental Contrasting with Implementation Intentions (MCII). This strategy involves Mental Contrasting (MC), in which a significant goal and an obstacle are identified, and Implementation Intentions (II), in which an "if... then…" plan is conceived and operationalized to overcome that obstacle. The present study proposes to assess the MCII process and whether it promotes students’ commitment towards learning goals during school tasks in sciences subjects. In this investigation, we intended to study the MCII strategy in a systemic context of the classroom. Fifty-six students from middle school and secondary education attending a public school in Lisbon (Portugal) participated in the study. The MCII strategy was explicitly taught in a procedure that included metacognitive modeling, guided practice and autonomous practice of strategy. A mental contrast between a goal they wanted to achieve and a possible obstacle to achieving that desire was instructed, and then the formulation of plans in order to overcome the obstacle identified previously. The preliminary results suggest that the MCII metacognitive strategy, applied to the school context, leads to more sophisticated reflections, the promotion of learning goals and the elaboration of more complex and specific self-regulated plans. Further, students achieve better results on school tests and worksheets after strategy practice. This study presents important implications since the MCII has been related to improved outcomes and increased attendance. Additionally, MCII seems to be an innovative process that captures students’ efforts to learn and enhances self-efficacy beliefs during learning tasks.

Keywords: implementation intentions, learning goals, mental contrasting, metacognitive strategy, self-regulated learning

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Authors: Ayedun Hassan, Ayadi Odunayo Peter

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The ancient city of Abeokuta has been supplied with pipe borne water since 1911, yet, a continuous increase in population and unplanned city expansion makes water a very precious and scarce commodity. The government reserved areas (GRA’s) are well planned, and public water supply is available; however, the sub-urban areas consist of scattered structures with individuals trying to source water by digging wells and boreholes. The geology of the city consists of basement rock which makes digging wells and boreholes very difficult. The present study was conducted to assess the risk arising from the consumption of toxic elements in the groundwater of Abeokuta, Ogun State, Nigeria. Forty-five groundwater samples were collected from nine different areas of Abeokuta and analyzed for physicochemical parameters and toxic elements. The physicochemical parameters were determined using standard methods, while the toxic elements were determined using Inductively Coupled Plasma-Mass Spectrometer (ICP/MS). Ninety-six percent (96%) of the water sample has pH < 6.5, and 11% has conductivity > 250 µSCm⁻¹ limits in drinking water as recommended by WHO. Seven percent (7%) of the samples have Pb concentration >10 µgL⁻¹ while 75% have Al concentration >200 µgL⁻¹ recommended by WHO. The order for risk of cancer from different area of Abeokuta are Cd²⁺ > As³⁺ > Pb²⁺ > Cr⁶⁺ for Funaab, Camp and Obantoko; As³⁺ > Cd²⁺ > Pb²⁺ > Cr⁶⁺ for Ita Osin, Isale Igbein, Ake and Itoku; Cd²⁺ >As > Cr⁶⁺ > Pb²⁺ for Totoro; Pb²⁺ > Cd²⁺ > As³⁺ > Cr⁶⁺ for Idiaba. The order of non-cancer hazard index (HI) calculated for groundwater of Abeokuta City are Cd²⁺ > As³⁺ > Mn²⁺ > Pb²⁺ > Ni²⁺ and were all greater than one, which implies susceptibility to other illnesses. The sources of these elements are the rock and inappropriate waste disposal method, which leached the elements into the groundwater. A combination of sources from food will accumulate these elements in the human body system. Treatment to remove Al and Pb is necessary, while the method of water distribution should be reviewed to ensure access to potable water by the residents.

Keywords: Abeokuta, groundwater, Nigeria, risk

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Authors: Raif Parlakkaya, Mustafa Nihat Demirci, Mehmet Nuri Salur

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Environmental pollution has detrimental effects on the quality of our life and its scope has reached such an extent that measures are being taken both at the national and international levels to reduce, prevent and mitigate its impact on social, economic and political spheres. Therefore, awareness of environmental problems has been increasing among stakeholders and accordingly among companies. It is seen that corporate reporting is expanding beyond environmental performance. Primary purpose of publishing an environmental report is to provide specific audiences with useful, meaningful information. This paper is intended to analyze the extent and qualification of environmental disclosures of Turkish publicly quoted firms and see how it varies from one sector to another. The data for the study were collected from annual activity reports of companies, listed on the corporate governance index (BIST-XKURY) of Istanbul Stock Exchange. Content analysis was the research methodology used to measure the extent of environmental disclosure. Accordingly, 2015 annual activity reports of companies that carry out business in some particular fields were acquired from Capital Market Board, websites of Public Disclosure Platform and companies’ own websites. These reports were categorized into five main aspects: Environmental policies, environmental management systems, environmental protection and conservation activities, environmental awareness and information on environmental lawsuits. Subsequently, each component was divided into several variables related to what each firm is supposed to disclose about environmental information. In this context, the nature and scope of the information disclosed on each item were assessed according to five different ways (N.I: No Information; G.E.: General Explanations; Q.E.: Qualitative Detailed Explanations; N.E.: Quantitative (numerical) Detailed Explanations; Q.&N.E.: Both Qualitative and Quantitative Explanations).

Keywords: environmental accounting, disclosure, corporate governance, content analysis

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Authors: Hengameh Hosseini

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Design of large healthcare facilities – such as hospitals, multi-service line clinics, and nursing facilities - that can accommodate patients with wide-ranging disabilities is a challenging endeavor and one that is poorly understood among healthcare facility managers, administrators, and executives. An even less-understood extension of this problem is the implications of weakly or insufficiently accommodative design of facilities for healthcare workers in physically-intensive jobs who may also suffer from a range of disabilities and who are therefore at increased risk of workplace accident and injury. Combine this reality with the vast range of facility types, ages, and designs, and the problem of universal accommodation becomes even more daunting and complex. In this study, we focus on the implication of facility design for healthcare workers suffering with low vision who also have physically active jobs. The points of difficulty are myriad and could span health service infrastructure, the equipment used in health facilities, and transport to and from appointments and other services can all pose a barrier to health care if they are inaccessible, less accessible, or even simply less comfortable for people with various disabilities. We conduct a series of surveys and interviews with employees and administrators of 7 facilities of a range of sizes and ownership models in the Northeastern United States and combine that corpus with in-facility observations and data collection to identify five major points of failure common to all the facilities that we concluded could pose safety threats to employees with vision impairments, ranging from very minor to severe. We determine that lack of design empathy is a major commonality among facility management and ownership. We subsequently propose three methods for remedying this lack of empathy-informed design, to remedy the dangers posed to employees: the use of an existing open-sourced Augmented Reality application to simulate the low-vision experience for designers and managers; the use of a machine learning model we develop to automatically infer facility shortcomings from large datasets of recorded patient and employee reviews and feedback; and the use of a computer vision model fine tuned on images of each facility to infer and predict facility features, locations, and workflows, that could again pose meaningful dangers to visually impaired employees of each facility. After conducting a series of real-world comparative experiments with each of these approaches, we conclude that each of these are viable solutions under particular sets of conditions, and finally characterize the range of facility types, workforce composition profiles, and work conditions under which each of these methods would be most apt and successful.

Keywords: artificial intelligence, healthcare workers, facility design, disability, visually impaired, workplace safety

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Authors: Sun-Young Jang, Sung-Ah Kim, Dongyoun Shin

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The Intelligent transportation system is essential to build smarter cities. Machine learning based transportation prediction could be highly promising approach by delivering invisible aspect visible. In this context, this research aims to make a prototype model that predicts transportation network by using big data and machine learning technology. In detail, among urban transportation systems this research chooses bus system.  The research problem that existing headway model cannot response dynamic transportation conditions. Thus, bus delay problem is often occurred. To overcome this problem, a prediction model is presented to fine patterns of bus delay by using a machine learning implementing the following data sets; traffics, weathers, and bus statues. This research presents a flexible headway model to predict bus delay and analyze the result. The prototyping model is composed by real-time data of buses. The data are gathered through public data portals and real time Application Program Interface (API) by the government. These data are fundamental resources to organize interval pattern models of bus operations as traffic environment factors (road speeds, station conditions, weathers, and bus information of operating in real-time). The prototyping model is designed by the machine learning tool (RapidMiner Studio) and conducted tests for bus delays prediction. This research presents experiments to increase prediction accuracy for bus headway by analyzing the urban big data. The big data analysis is important to predict the future and to find correlations by processing huge amount of data. Therefore, based on the analysis method, this research represents an effective use of the machine learning and urban big data to understand urban dynamics.

Keywords: big data, machine learning, smart city, social cost, transportation network

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Authors: Arwin Malabanan, Carl Chester Ragudo, Jerome Tadiosa, John Dee Mangoba, Eric Augustus Tingatinga, Romeo Eliezer Longalong

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Concrete hollow blocks (CHB) are the most commonly used masonry block for walls in residential houses, school buildings and public buildings in the Philippines. During the recent 2013 Bohol earthquake (Mw 7.2), it has been proven that CHB walls are very vulnerable to severe external action like strong ground motion. In this paper, a numerical model of CHB structures is proposed, and seismic behavior of CHB houses is presented. In modeling, the Rigid Body Spring-Discrete Element method (RBS-DEM)) is used wherein masonry blocks are discretized into rigid elements and connected by nonlinear springs at preselected contact points. The shear and normal stiffness of springs are derived from the material properties of CHB unit incorporating the grout and mortar fillings through the volumetric transformation of the dimension using material ratio. Numerical models of reinforced and unreinforced walls are first subjected to linearly-increasing in plane loading to observe the different failure mechanisms. These wall models are then assembled to form typical model masonry houses and then subjected to the El Centro and Pacoima earthquake records. Numerical simulations show that the elastic, failure and collapse behavior of the model houses agree well with shaking table tests results. The effectiveness of the method in replicating failure patterns will serve as a basis for the improvement of the design and provides a good basis of strengthening the structure.

Keywords: concrete hollow blocks, discrete element method, earthquake, rigid body spring model

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Authors: Salah Al-Ali

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The role of technology transfer in technical and vocational education is significant since lecturers, trainers, and students can obtain the updated knowledge, skills, and attitudes that are currently being practiced by local and international businesses and industries. Technology transfer can indeed close the gap between what is being learned and practiced in technical and vocational institutions and the world of work. However, the success of technology transfer in technical and vocational education perspectives would depend entirely on the quality of management. It is their responsibility when signing an agreement with internal or external providers of technology, to include calluses that enable academic staff in related specialty to interact positively and freely with the supplier of technology. In other terms, ensuring no clear or hidden restriction is imposed by the supplier of technology to acquire the know-how and know-why that are embedded in the agreement. In this paper, I present some of the empirical results and observations which describe the interactions between the supplier of technology (Electrical Engineering System) and the recipient of the technology (PAAE&T) in the field of technology transfer. In another word, whether the PAAE&T have taken the opportunity while building its new headquarter, the transfer of technology from the supplier of an electrical engineering system to its academic staff in its various Electrical Engineering Academic Departments at the PAAE&T colleges and institutions. The paper argues that, for effective and efficient transfer of technology, the recipient (PAAE&T) must ensure that the agreement with the supplier of the Electrical Engineering System must include calluses that would allow the PAAE&T academic staff in its various Electrical Engineering Academic Departments in its various colleges and institutions to acquire the technology embedded in the agreement. The paper concludes that the transfer of technology and the building of a local scientific and technical infrastructure must be viewed by Kuwaiti decision-makers as complementary to one another. Thus, reducing, to great extent, the level of dependence on expatriates, particularly in the essential sectors of the economy.

Keywords: vocational and technical education, technology transfer, enhancing indigenous capabilities, Kuwait

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Authors: Chung Gun Lee

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Objectives: Certain life change events were shown to have strong effects on physical activity-related behavior, but more research is needed to investigate the longer-term effects of different life change events on physical activity-related behaviors. The purpose of this study is to examine the effect of experiencing physically or non-physically forced sexual activity on sports participation from adolescence to young adulthood. Methods: This study used the National Longitudinal Study of Adolescent Health (Add Health) data. Group-based trajectory modeling was utilized to examine the effect of experiencing sexual assault on trajectories of sports participation from adolescence to young adulthood. Results: Male participants were divided into three trajectory groups (i.e., Low-stable, High-decreasing, and High-stable) and female participants were divided into two trajectory groups (i.e., Low-stable and High-decreasing). The main finding of this study is that women who experienced non-physically forced sexual activity significantly decreases sports participation throughout the trajectory in ‘High-decreasing group.’ The effect of non-physically forced sexual activity on women’s sports participation was considerably weakened and became insignificant after including psychological depression in the model as a potential mediator. Discussion: Special attention should be paid to sport participation among women victims of non-physically forced sexual activity. Further studies are needed to examine other potential mediators in addition to psychological depression when examining the effect of non-physically forced sexual activity on sport participation in women.

Keywords: adolescent, group-based trajectory modeling, sexual assault, young adult

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Authors: Kalsoom Rani

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Tobacco contains nicotine, which causes addiction to many toxic chemicals. In the world, people consume it in the form of smoke, chew, and sniffing, smoke of it is composed of almost 7000 active chemicals, which are very harmful to human health as well as for eye health, inhalation of tobacco smoke and fumes can accelerate and cause many blinding eye diseases. Dry eye and smoking have not been covered extensively in researches; more studies are required to unveil the relationship between smoking and dry eye. This study was conducted to determine the quantity and quality of tears in smokers. 60 subjects participated in the study, which was divided into two groups on the basis of consumption of cigarettes per day with age matched non smokers of 15-50 years. All participants have gone through a study based questioner, eye examination, and diagnostic 'Dry Eye Tests' for evaporative tears evaluation and measurement of basal tear secretion. Subjects were included in the criteria of 10 cigarettes per day with a minimum duration of 1 year; passive smokers for control groups were excluded. The study was carried out in a Medina Teaching Hospital, Faisalabad, Pakistan, ophthalmology department for the duration of 8 months. Mean values for tear break up time (TBUT), was reported 10sec with SD of +3.74 in controlled group, 5sec with SD + 2.32 in smokers and 4sec SD +3.77 heavy smokers in right eye (RE) and left eye (LE) 10.35sec with SD of +3.88 in controlled 5sec with SD + 2.3 in smokers and much reduced TBUT in heavy smokers was 3.85sec SD+2.20. Smoking has a very strong association with TRUT with a significance of P=.00 both eyes. Mean Schirmer-I value of the subjects was reported 12.6mm with SD + 8.37 in RE and 12.59mm with SD + 8.96 LE. The mean Schirmer-II test value was reported in the right, and left eye with a mean value for control was 20.23mm with SD + 8.93, 20.75mm with SD + 8.84 respectively, and in Smokers 9.90mm with SD + 5.74, and 10.07mm with SD + 6.98, and in heavy smokers 7.7mm, SD + 3.22 and 6.9, SD + 3.50 mm, association with smoking showed p=.001 in RE and .003 in LE. Smoking has deteriorated effect on both evaporative tear and aqueous tear secretion and causing symptoms of dry eye burning, itching, redness, and watering with epithelial cell damage.

Keywords: tear break-up time, basal tear secretion, smokers, dry eye

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Authors: Mamta Jat

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Background: The increased longevity has resulted in the increase in the percentage of the global population aged 60 years or over. With this “demographic transition” towards ageing, “epidemiologic transition” is also taking place characterised by growing share of non-communicable diseases in the overall disease burden. So, many of the older adults are ageing with chronic disease and high levels of frailty which often results in lower levels of quality of life. Although frailty may be increasingly common in older adults, prevention or, at least, delay the onset of late-life adverse health outcomes and disability is necessary to maintain the health and functional status of the ageing population. This is an effort using SAGE data to assess levels of frailty and its socio-demographic correlates and its relation with quality of life in LMICs of India, China, Ghana, Mexico, Russia and South Africa in a comparative perspective. Methods: The data comes from multi-country Study on Global AGEing and Adult Health (SAGE), consists of nationally representative samples of older adults in six low and middle-income countries (LMICs): China, Ghana, India, Mexico, the Russian Federation and South Africa. For our study purpose, we will consider only 50+ year’s respondents. The logistic regression model has been used to assess the correlates of frailty. Multinomial logistic regression has been used to study the effect of frailty on QOL (quality of life), controlling for the effect of socio-economic and demographic correlates. Results: Among all the countries India is having highest mean frailty in males (0.22) and females (0.26) and China with the lowest mean frailty in males (0.12) and females (0.14). The odds of being frail are more likely with the increase in age across all the countries. In India, China and Russia the chances of frailty are more among rural older adults; whereas, in Ghana, South Africa and Mexico rural residence is protecting against frailty. Among all countries china has high percentage (71.46) of frail people in low QOL; whereas Mexico has lowest percentage (36.13) of frail people in low QOL.s The risk of having low and middle QOL is significantly (p<0.001) higher among frail elderly as compared to non–frail elderly across all countries with controlling socio-demographic correlates. Conclusion: Women and older age groups are having higher frailty levels than men and younger aged adults in LMICs. The mean frailty scores demonstrated a strong inverse relationship with education and income gradients, while lower levels of education and wealth are showing higher levels of frailty. These patterns are consistent across all LMICs. These data support a significant role of frailty with all other influences controlled, in having low QOL as measured by WHOQOL index. Future research needs to be built on this evolving concept of frailty in an effort to improve quality of life for frail elderly population, in LMICs setting.

Keywords: Keywords: Ageing, elderly, frailty, quality of life

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Authors: Manar Al-Ateeq

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The building construction industry plays a major role in the economy of the word and the state of Kuwait. This paper evaluates existing new civil site engineers, describes a new system for improvement and insures the importance of prequalifying and developing for new engineers. In order to have a strong base in engineering, educational institutes and workplaces should be responsible to continuously train engineers and update them with new methods and techniques in engineering. As to achieve that, school of engineering should constantly update computational resources to be used in the professions. A survey was prepared for graduated Engineers based on stated objectives to understand the status of graduate engineers in both the public and private sector. Interviews were made with different sectors in Kuwait, and several visits were made to different training centers within different workplaces in Kuwait to evaluate training process and try to improve it. Virtual Reality (VR) technology could be applied as a complement to three-dimensional (3D) modeling, leading to better communication whether in job training, in education or in professional practice. Techniques of 3D modeling and VR can be applied to develop the models related to the construction process. The 3D models can support rehabilitation design as it can be considered as a great tool for monitoring failure and defaults in structures; also it can support decisions based on the visual analyses of alternative solutions. Therefore, teaching computer-aided design (CAD) and VR techniques in school will help engineering students in order to prepare them to site work and also will assist them to consider these technologies as important supports in their later professional practice. This teaching technique will show how the construction works developed, allow the visual simulation of progression of each type of work and help them to know more about the necessary equipment needed for tasks and how it works on site.

Keywords: three dimensional modeling (3DM), civil engineers (CE), professional practice (PP), virtual reality (VR)

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Authors: Laurent Bellemare

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After the showcase of traditional Indonesian performing arts at the Vancouver Expo 1986, Canadian universities inherited sets of Indonesian gamelan orchestras and soon began offering courses for music students interested in learning these diverse traditions. Among them, Université de Montréal was offered two sets of Balinese orchestras, a novelty that allowed a community of Montreal gamelan enthusiasts to form and engage with this music. A few generations later, a large body of archives have amassed, framing the history of this niche community’s achievements. This data, scattered in public and private archive collections, comes in various formats: Digital Audio Tape, audio cassettes, Video Home System videotape, digital files, photos, reel-to-reel audiotape, posters, concert programs, letters, TV shows, reports and more. Attempting to study these documents in order to unearth a chronology of gamelan in Montreal has proven to be challenging since no suitable platform for preservation, storage, and research currently exists. These files are, therefore, hard to find due to their decentralized locations. Additionally, most of the documents in older formats have yet to be digitized. In the case of recent digital files, such as pictures or rehearsal recordings, their locations can be even messier and their quantity overwhelming. Aside from the basic issue of choosing a suitable repository platform, questions of legal rights and methodology arise. For posterity, these documents should nonetheless be digitized, organized, and stored in an easily accessible online repository. This paper aims to underline the various challenges encountered in the early stages of such a project as well as to suggest ways of overcoming the obstacles to a thorough archival investigation.

Keywords: archival work, archives, Balinese gamelan, Canada, Gamelan, Indonesia, Javanese gamelan, Montreal

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Authors: Sıla Uzkul

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As a requirement of human rights and children's rights, the basic condition of inclusive education is that it covers all children. However, the reforms made in the context of education in Turkey and around the world include a limited level of inclusiveness. Generally, the inclusiveness mentioned is for individuals who need special education. Educational reforms superficially state that differences are tolerated, but these differences are extremely limited and often do not include sexual orientation. When we look at the education modules of the Ministry of National Education within the scope of inclusive education in Turkey, there are children with special needs, bilingual children, children exposed to violence, children under temporary protection, children affected by migration and terrorism, and children affected by natural disasters. No training modules or inclusion terms regarding sexual orientations could be found. This research aimed to understand the perspectives of research assistants working in the preschool education department regarding sexual orientations within the scope of inclusive education. Six research assistants working in the preschool teaching department at a public university in Ankara (Turkey) participated in this qualitative research study. Participants were determined by typical case sampling, which is one of the purposeful sampling methods. The data of this research was obtained through a "survey consisting of open-ended questions". Raw data from the surveys were analyzed and interpreted using the "content analysis technique" (Yıldırım & Şimşek, 2005). During the data analysis process, the data from the participants were first numbered, then all the data were read, and content analysis was performed, and possible themes, categories, and codes were extracted. The opinions of the participants in the research regarding sexual orientations in inclusive education are presented under three main headings within the scope of the research questions. These are: (a) their views on inclusive education, (b) their views on sexual orientations (c) their views on sexual orientations in the preschool period.

Keywords: sexual orientation, inclusive education, child rights, preschool education

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Authors: Noemi Schneider, Richard Blaese, Pietro Morandi, Brigitte Liebig

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While women are increasingly frequent among the founders of innovative companies and advanced researchers in many university research institutes today, they are still an exception among initiators of research-based spin-offs. This also applies to countries such as Switzerland, which does have a leading position in international innovation rankings. Starting from a gender-sensitive neo-institutionalist perspective, this paper examines formal and non-formal institutional framework conditions for academic spin-offs at Swiss universities of applied sciences. This field, which stresses vocational education and practice-oriented research, seems to conserve the gender gap in the area of establishing research-based spin-offs spin-off rates strongly. The analysis starts from a survey conducted in 2017 and 2018 at all seven public universities of applied sciences in Switzerland as well as on an evaluation of expert interviews performed with heads of start-up centers, where also spin-offs from universities of applied sciences get support. The results show the mechanisms, which contribute to gender gaps in academic entrepreneurship in higher education. University's female employees have hardly been discovered as target groups. Thus, only 10.5% of universities of applied sciences offer specific support measures for women in academia. And only 1 out of 7 universities of applied sciences offer mentoring programs for female entrepreneurs while in addition there are no financial resources available to support female founders in academia. Moreover, the awareness of the gender gap in academic entrepreneurship is low among founding commissioners. A consistent transfer strategy might be key for bringing in line the formal and non-formal preconditions relevant for the formation of research-based spin-offs and for providing an effective incentive structure to promote women.

Keywords: gender, science-based spin-off, universities of applied sciences, knowledge transfer strategy

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Authors: Y. P. Raghavendra Babu

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Electrocution is a common cause of morbidity and mortality as electricity is an indispensible part of today’s World. Deaths due to electrocution which are witnessed do not pose a problem at the manner and cause of death. However un-witnessed deaths can raise suspicion of manner of death. A case of fatal electrocution is reported here which was diagnosed to be accidental in manner with the help of reconstruction of events by proper investigation.

Keywords: electrocution, manner of death, reconstruction of events, health information

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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Authors: Nuria Rubio, María Campo, Joana Ruiz, Paola Vecino

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Renewable energies have been proposed for some years as a solution to the ecological crisis caused by traditional fuels. The installation of solar parks for electricity production is therefore necessary for a transition to cleaner energy. Additionally, spaces occupied by solar parks can be ideal places for biodiversity promotion consisting in controlled areas allowing free transit of numerous animal species in absence of phytosanitary products or other substances commonly used in rural areas. The main objective of this project is increasing local biodiversity. Secondary objectives include the installation of beehives with Apis mellifera iberiensis swarms (native honeybee species), the monitoring and periodic evaluation of the state of health and demographic progression of these swarms and study of biodiversity increase in these areas, mainly due to the presence of Apis mellifera iberiensis. Prior to bee-hives installation, a preliminary study of the area is carried out to quantify floral load, biocenosis and geo-climatological characteristics of the area of study for determining the optimal number of hives for the benefit of the local ecosystem. Once beehives set up, the bee-swarms health status is monitored and evaluated quarterly using monitoring systems. Parameters studies are weight, humidity inside the hive, external and internal temperature, and sound inside the hive. Furthermore, a biodiversity study of the area was conducted by direct observation and quantification of species (S) in the area of bee-foraging (1 km around the beehives). A great diversity of species has been detected in the area of study. Therefore, the population of Apis mellifera iberiensis is not displacing other pollinators in the area, on the contrary, results show that it is contributing to the pollination of the different plant species enhancing wild bees’ biodiversity.

Keywords: biodiversity, honeybee, pollination, solar park

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Authors: Mahmoud Abdel Hameed Shahin

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Job demands that are incompatible with an employee's skills, resources, or needs cause unpleasant emotional and physical reactions known as job stress. Nurses offer care in hospital emergency rooms all around the world, and since they operate in such a dynamic and unpredictable setting, they are constantly under pressure. It has been discovered that job stress has harmful impacts on nurses' health as well as their capacity to handle the demands of their jobs. The purpose of this study was to evaluate the level of job stress experienced by the emergency department nurses at King Fahad Specialist Hospital in Buraidah City, Saudi Arabia. In October 2021, a cross-sectional descriptive study was conducted. 80 nurses were conveniently selected for the study, the bulk of them worked at King Fahad Specialist Hospital's emergency department. An electronic questionnaire with a sociodemographic data sheet and a job stress scale was given to the participating nurses after ethical approval was received from the Ministry of Health's representative bodies. Using SPSS Version 26, both descriptive and inferential statistics were employed to analyze and tabulate the acquired data. According to the findings, the factors that contributed to the most job stress in the clinical setting were having an excessive amount of work to do and working under arbitrary deadlines, whereas the factors that contributed to the least stress were receiving the proper recognition or rewards for good work. In the emergency room of King Fahad Specialist Hospital, nurses had a moderate level of stress (M=3.32 ± 0.567/5). Based on their experience, emergency nurses' levels of job stress varied greatly, with nurses with less than a year of experience notably experiencing the lowest levels of job stress. The amount of job stress did not differ significantly based on the emergency nurses' age, nationality, gender, marital status, position, or level of education. The causes and impact of stress on emergency nurses should be identified and alleviated by hospitals through the implementation of interventional programs.

Keywords: emergency nurses, job pressure, Qassim, Saudi Arabia, job stress

Procedia PDF Downloads 184

Authors: Danah Al-Selahi, Sulaiman Al-Ghunaim, Bashayer Sadiq, Fatma Al-Otaibi, Ali Ameen

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In light of recent changes affecting the Oil & Gas Industry, optimization measures have become imperative for all companies globally, including Kuwait Oil Company (KOC). To keep abreast of the dynamic market, a detailed Integrated Asset Plan (IAP) was developed to drive optimization across the organization, which was facilitated through the in-house developed software “Well Inventory Data Entry” (WIDE). This comprehensive and integrated approach enabled centralization of all planned asset components for better well planning, enhancement of performance, and to facilitate continuous improvement through performance tracking and midterm forecasting. Traditionally, this was hard to achieve as, in the past, various legacy methods were used. This paper briefly describes the methods successfully adopted to meet the company’s objective. IAPs were initially designed using computerized spreadsheets. However, as data captured became more complex and the number of stakeholders requiring and updating this information grew, the need to automate the conventional spreadsheets became apparent. WIDE, existing in other aspects of the company (namely, the Workover Optimization project), was utilized to meet the dynamic requirements of the IAP cycle. With the growth of extensive features to enhance the planning process, the tool evolved into a centralized data-hub for all asset-groups and technical support functions to analyze and infer from, leading WIDE to become the reference two-year operational plan for the entire company. To achieve WIDE’s goal of operational efficiency, asset-groups continuously add their parameters in a series of predefined workflows that enable the creation of a structured process which allows risk factors to be flagged and helps mitigation of the same. This tool dictates assigned responsibilities for all stakeholders in a method that enables continuous updates for daily performance measures and operational use. The reliable availability of WIDE, combined with its user-friendliness and easy accessibility, created a platform of cross-functionality amongst all asset-groups and technical support groups to update contents of their respective planning parameters. The home-grown entity was implemented across the entire company and tailored to feed in internal processes of several stakeholders across the company. Furthermore, the implementation of change management and root cause analysis techniques captured the dysfunctionality of previous plans, which in turn resulted in the improvement of already existing mechanisms of planning within the IAP. The detailed elucidation of the 2 year plan flagged any upcoming risks and shortfalls foreseen in the plan. All results were translated into a series of developments that propelled the tool’s capabilities beyond planning and into operations (such as Asset Production Forecasts, setting KPIs, and estimating operational needs). This process exemplifies the ability and reach of applying advanced development techniques to seamlessly integrated the planning parameters of various assets and technical support groups. These techniques enables the enhancement of integrating planning data workflows that ultimately lay the founding plans towards an epoch of accuracy and reliability. As such, benchmarks of establishing a set of standard goals are created to ensure the constant improvement of the efficiency of the entire planning and operational structure.

Keywords: automation, integration, value, communication

Procedia PDF Downloads 140

Authors: Osman Zorbaz, Selen Demirtas-Zorbaz, Ozlem Ulas

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The factors that cause adolescents to drop out school were several. One of the frameworks about school dropout focuses on the contextual factors around the adolescents whereas the other one focuses on individual factors. It can be said that both factors are important equally. In this study, both adolescent’s individual factors (anti-social behaviors, academic success) and contextual factors (parent academic involvement, parent academic support, number of siblings, living with parent) were examined in the term of school dropout. The study sample consisted of 346 high school students in the public schools in Ankara who continued their education in 2015-2016 academic year. One hundred eighty-five the students (53.5%) were girls and 161 (46.5%) were boys. In addition to this 118 of them were in ninth grade, 122 of them in tenth grade and 106 of them were in eleventh grade. Multiple regression and one-way ANOVA statistical methods were used. First, it was examined if the data meet the assumptions and conditions that are required for regression analysis. After controlling the assumptions, regression analysis was conducted. Parent academic involvement, parent academic support, number of siblings, anti-social behaviors, academic success variables were taken into the regression model and it was seen that parent academic involvement (t=-3.023, p < .01), anti-social behaviors (t=7.038, p < .001), and academic success (t=-3.718, p < .001) predicted school dropout whereas parent academic support (t=-1.403, p > .05) and number of siblings (t=-1.908, p > .05) didn’t. The model explained 30% of the variance (R=.557, R2=.300, F5,345=30.626, p < .001). In addition to this the variance, results showed there was no significant difference on high school students school dropout levels according to living with parents or not (F2;345=1.183, p > .05). Results discussed in the light of the literature and suggestion were made. As a result, academic involvement, academic success and anti-social behaviors will be considered as an important factors for preventing school drop-out.

Keywords: adolescents, anti-social behavior, parent academic involvement, parent academic support, school dropout

Procedia PDF Downloads 271

Authors: Peifang Hsieh

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The prevention of child abuse has aroused serious concerns in Taiwan because of the disparity between the increasing amount of reported child abuse cases that doubled over the past decade and the scarcity of social workers. New Taipei city, with the most population in Taiwan and over 70% of its 4 million citizens are migrant families in which the needs of children can be easily neglected due to insufficient support from relatives and communities, sees urgency for a social support system, by preemptively identifying and outreaching high-risk families of child abuse, so as to offer timely assistance and preventive measure to safeguard the welfare of the children. Big data analysis is the inspiration. As it was clear that high-risk families of child abuse have certain characteristics in common, New Taipei city decides to consolidate detailed background information data from departments of social affairs, education, labor, and health (for example considering status of parents’ employment, health, and if they are imprisoned, fugitives or under substance abuse), to cross-reference for accurate and prompt identification of the high-risk families in need. 'The Service Center for High-Risk Families' (SCHF) was established to integrate data cross-departmentally. By utilizing the machine learning 'random forest method' to build a risk prediction model which can early detect families that may very likely to have child abuse occurrence, the SCHF marks high-risk families red, yellow, or green to indicate the urgency for intervention, so as to those families concerned can be provided timely services. The accuracy and recall rates of the above model were 80% and 65%. This prediction model can not only improve the child abuse prevention process by helping social workers differentiate the risk level of newly reported cases, which may further reduce their major workload significantly but also can be referenced for future policy-making.

Keywords: child abuse, high-risk families, big data analysis, risk prediction model

Procedia PDF Downloads 131

Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Renata Karina Reis, Soraia Assad Nasbine Rabeh, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira e Silva, Sheila Araújo Teles

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Context and significance: Nursing team professionals faced challenges in combating the COVID-19 pandemic around the world. They were subjected to exhausting workloads and prolonged use of Personal Protective Equipment. Using N95 masks for long periods of time can cause skin changes. In this context, health professionals who worked on the front lines of fighting the pandemic were more exposed to possible physical and psychological changes. Objective: The aim of the study was to analyze the factors associated with skin lesions resulting from the use of N95 masks among nursing team professionals. Method: The study was carried out in all regions of Brazil from October to December 2020, with professionals from the nursing team who worked in health care during the COVID-19 pandemic. Participants were recruited via social media, and information was collected electronically and stored on the Survey Monkey platform. Descriptive statistics were used to characterize the sample, association tests (Chi-square), with a statistical significance level of p < 0.05. Factors associated with skin lesions resulting from the use of an N95 mask were determined by Binary Logistic Regression, with a significance level of 5% (α = 0.05). Results: 8,405 nursing professionals participated in the study, 5,492 nurses (65.3%), 2,747 nursing technicians (32.7%), and 7,084 females (84.3%). Female nursing team professionals were 1.4 times more likely to develop skin lesions due to the use of N95 masks when compared to males (OR 1.4 [CI95% 1.22 – 1.59] p < 0.001). The following protective factors were identified: nursing technician (ORA 0.608 [CI95% 0.43 – 0.86] p = 0.005) and not having provided assistance in field hospitals for COVID-19 (0.73 [CI95% 0.65-0.81] p<0.000). Conclusion: It was concluded that female nursing team professionals were more likely to have skin changes related to the use of N95 masks. The need for intervention studies is emphasized in order to explore measures to prevent these types of injuries. Descritores: Nursing professionals; COVID-19; SARS-CoV-2; Brazil.

Keywords: nursing professionals, COVID-19, SARS-CoV-2, Brazil

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Authors: Bill D. Geis

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Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

Procedia PDF Downloads 66