Search results for: precision public health

Authors: Nivedita Paul

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The changing character of marriage be it arranged marriage, love marriage, polygamy, informal unions, all signify different gender relations in everyday lives. Marriages in India are part and parcel of the kinship and cultural practices. Arranged marriage is still the dominant form of marriage where spouse selection is the initiative and decision of the parents; but its form is changing, as women are now actively participating in spouse selection but with parental consent. Spouse selection related decision making is important because marriage as an institution brings social change and gender inequality; especially in a women’s life as marriages in India are mostly patrilocal. Moreover, the amount of say in spouse selection can affect a woman’s reproductive rights, domestic violence issues, household resource allocation, communication possibilities with the spouse/husband, marital life, etc. The present study uses data from Indian Human Development Survey II (2011-12) which is a nationally representative multitopic survey that covers 41,554 households. Currently, married women of age group 15-49 in their first marriage; whose year of marriage is from 1970s to 2000s have been taken for the study. Based on spouse selection experiences, the sample of women has been divided into three marriage categories-self, semi and family arranged. Women in self arranged or love marriage is the sole decision maker in choosing the partner, in semi arranged marriage or arranged marriage with consent both parents and women together take the decision, whereas in family arranged or arranged marriage without consent only parents take the decision. The main aim of the study is to find the relationship between spouse selection experiences and women’s autonomy in India. Decision making in economic matters, child and health related decision making, mobility and access to resources are taken to be proxies of autonomy. Method of ordinal regression has been used to find the relationship between spouse selection experiences and autonomy after marriage keeping other independent variables as control factors. Results show that women in semi arranged marriage have more decision making power regarding financial matters of the household, health related matters, mobility and accessibility to resources, when compared to women in family, arranged marriages. For freedom of movement and access to resources women in self arranged marriage have the highest say or exercise greatest power. Therefore, greater participation of women (even though not absolute control) in spouse selection may lead to greater autonomy after marriage.

Keywords: arranged marriage, autonomy, consent, spouse selection

Procedia PDF Downloads 138

Authors: Cláudia Patrocínio, Beatriz Fernandes, Ana Filipa Pires

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Background: Mirror therapy (MT) is used to improve motor function after stroke. During MT, a mirror is placed between the two upper limbs (UL), thus reflecting movements of the non- affected side as if it were the affected side. Objectives: The aim of this review is to analyze the evidence on the effec.tiveness of MT in the recovery of UL function in population with post chronic stroke. Methods: The literature search was carried out in PubMed, ISI Web of Science, and PEDro database. Inclusion criteria: a) studies that include individuals diagnosed with stroke for at least 6 months; b) intervention with MT in UL or comparing it with other interventions; c) articles published until 2023; d) articles published in English or Portuguese; e) randomized controlled studies. Exclusion criteria: a) animal studies; b) studies that do not provide a detailed description of the intervention; c) Studies using central electrical stimulation. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Studies with < 4 on PEDro scale were excluded. Eighteen studies met all the inclusion criteria. Main results and conclusions: The quality of the studies varies between 5 and 8. One article compared muscular strength training (MST) with MT vs without MT and four articles compared the use of MT vs conventional therapy (CT), one study compared extracorporeal shock therapy (EST) with and without MT and another study compared functional electrical stimulation (FES), MT and biofeedback, three studies compared MT with Mesh Glove (MG) or Sham Therapy, five articles compared performing bimanual exercises with and without MT and three studies compared MT with virtual reality (VR) or robot training (RT). The assessment of changes in function and structure (International Classification of Functioning, Disability and Health parameter) was carried out, in each article, mainly using the Fugl Meyer Assessment-Upper Limb scale, activity and participation (International Classification of Functioning, Disability and Health parameter) were evaluated using different scales, in each study. The positive results were seen in these parameters, globally. Results suggest that MT is more effective than other therapies in motor recovery and function of the affected UL, than these techniques alone, although the results have been modest in most of the included studies. There is also a more significant improvement in the distal movements of the affected hand than in the rest of the UL.

Keywords: physical therapy, mirror therapy, chronic stroke, upper limb, hemiplegia

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Authors: Fathi Abid, Bilel Kaffel

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The olive tree, the olive harvest during winter season and the production of olive oil better known by professionals under the name of the crushing operation have interested institutional traders such as olive-oil offices and private companies such as food industry refining and extracting pomace olive oil as well as export-import public and private companies specializing in olive oil. The major problem facing producers of olive oil each winter campaign, contrary to what is expected, it is not whether the harvest will be good or not but whether the sale price will allow them to cover production costs and achieve a reasonable margin of profit or not. These questions are entirely legitimate if we judge by the importance of the issue and the heavy complexity of the uncertainty and competition made tougher by a high level of indebtedness and the experience and expertise of speculators and producers whose objectives are sometimes conflicting. The aim of this paper is to study the formation mechanism of olive oil prices in order to learn about speculators’ behavior and expectations in the market, how they contribute by their industry knowledge and their financial alliances and the size the financial challenge that may be involved for them to build private information hoses globally to take advantage. The methodology used in this paper is based on two stages, in the first stage we study econometrically the formation mechanisms of olive oil price in order to understand the market participant behavior by implementing ARMA, SARMA, GARCH and stochastic diffusion processes models, the second stage is devoted to prediction purposes, we use a combined wavelet- ANN approach. Our main findings indicate that olive oil market participants interact with each other in a way that they promote stylized facts formation. The unstable participant’s behaviors create the volatility clustering, non-linearity dependent and cyclicity phenomena. By imitating each other in some periods of the campaign, different participants contribute to the fat tails observed in the olive oil price distribution. The best prediction model for the olive oil price is based on a back propagation artificial neural network approach with input information based on wavelet decomposition and recent past history.

Keywords: olive oil price, stylized facts, ARMA model, SARMA model, GARCH model, combined wavelet-artificial neural network, continuous-time stochastic volatility mode

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Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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Authors: Suganya Chandrababu, Dhundy Bastola

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Like in the gut, the subgingival microbiota plays a crucial role in oral hygiene, health, and cariogenic diseases. Human activities like diet, antibiotics, and periodontal treatments alter the bacterial communities, metabolism, and functions in the oral cavity, leading to a dysbiotic state and changes in the plaques of orthodontic patients. Fixed periodontal appliances hinder oral hygiene and cause changes in the dental plaques influencing the subgingival microbiota. However, the microbial species’ diversity and complexity pose a great challenge in understanding the taxa’s community distribution patterns and their role in oral health. In this research, we analyze the subgingival microbial samples from individuals with fixed dental appliances (metal/clear) using an in silico approach. We employ exploratory hypothesis-driven multivariate and regression analysis to shed light on the microbial community and its functional fluctuations due to dental appliances used and identify risks associated with complex disease phenotypes. Our findings confirm the changes in oral microbiota composition due to the presence and type of fixed orthodontal devices. We identified seven main periodontic pathogens, including Bacteroidetes, Actinobacteria, Proteobacteria, Fusobacteria, and Firmicutes, whose abundances were significantly altered due to the presence and type of fixed appliances used. In the case of metal braces, the abundances of Bacteroidetes, Proteobacteria, Fusobacteria, Candidatus saccharibacteria, and Spirochaetes significantly increased, while the abundance of Firmicutes and Actinobacteria decreased. However, in individuals With clear braces, the abundance of Bacteroidetes and Candidatus saccharibacteria increased. The highest abundance value (P-value=0.004 < 0.05) was observed with Bacteroidetes in individuals with the metal appliance, which is associated with gingivitis, periodontitis, endodontic infections, and odontogenic abscesses. Overall, the bacterial abundances decrease with clear type and increase with metal type of braces. Regression analysis further validated the multivariate analysis of variance (MANOVA) results, supporting the hypothesis that the presence and type of the fixed oral appliances significantly alter the bacterial abundance and composition.

Keywords: oral microbiota, statistical analysis, fixed or-thodontal appliances, bacterial abundance, multivariate analysis, regression analysis

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Authors: A. Tamimi, S. Greatrex-White, A. Narayanasamy

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Background: Spirituality has been increasingly acknowledged in the nursing literature as an important element of holistic patient care. To date there have been numerous studies investigating the meaning of spirituality in Western cultures. Spirituality in Middle Eastern countries however remains under-researched. We will present a study which aimed to address this gap. Aim: The study aimed to explore how spirituality manifests in the lives of Jordanian End Stage Renal Failure (ESRF) patients. Methodology and Method: A hermeneutic phenomenological approach was adopted informed by the philosophy of Martin Heidegger. Participants (n=27) were recruited from four different dialysis units: in a public hospital, a private hospital, an educational hospital and a refugee’s hospital in Jordan. Data was collected through in-depth unstructured interviews. Data Analysis: Analysis was guided by the tenets of hermeneutic phenomenology namely: gaining immediate sense of what was said both during and after each interview, transcribing data verbatim, translating interviews into the English language, intensive reading and re-reading, seeking meaning units by line to line coding, developing situated structures (how spirituality was manifest in each text), developing a general structure from the individual situated structures (how the phenomenon ‘spirituality’ comes into being). Findings: Three major themes emerged from analysis: Religion, Relationships and Desperation. We will argue that a ‘secular’ concept of spirituality had no meaning for the participants in the study. Spirituality is fundamentally part of religion and vice versa. Discussion: The findings may have consequences for the use of spirituality in multi-cultural settings in Western countries. Additionally, findings highlighted an important emphasis on the practice of spirituality, often underestimated in previous literature for Arab-Muslim Jordanian patients. Conclusion: The study findings contribute to the existing gap in knowledge regarding how Arab-Muslim Jordanian ESRF patients experience spirituality during their illness. It provides valuable insights into the importance of spirituality for this patient group and suggests how nurses, educators and policy makers might help address ESRF patients’ spiritual needs and provide appropriate spiritual care. We suggest the findings may have relevance beyond the Jordanian context in educating nurses’ on the importance of appreciating the religious dimension of spirituality.

Keywords: spirituality, nursing, muslim, Jordan

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Authors: Joshua Fogel, Rivka Herzog

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Although direct-to-consumer prescription medication advertisements (DTCA) are viewed or heard in many venues, there does not appear to be any research for internet social media DTCA. We study the association of traditional media DTCA and digital media DTCA including internet social media of YouTube, Facebook, and Twitter with three different outcomes. There was one intentions outcome and two different behavior outcomes. The intentions outcome was the agreement level for seeking additional information about a prescription medication after seeing a DTCA. One behavior outcome was the agreement level for obtaining additional information about a prescription medication after seeing a DTCA. The other behavior outcome was the frequency level for obtaining additional information about a prescription medication after seeing a DTCA. Surveys were completed by 635 college students. Predictors included demographic variables, theory of planned behavior variables, health variables, and advertisements seen or heard. Also, in the behavior analyses, additional predictors of intentions and sources for seeking additional prescription drug information were included. Multivariate linear regression analyses were conducted. We found that increased age was associated with increased behavior, women were associated with increased intentions, and Hispanic race/ethnicity was associated with decreased behavior. For the theory of planned behavior variables, increased attitudes were associated with increased intentions, increased social norms were associated with increased intentions and behavior, and increased intentions were associated with increased behavior. Very good perceived health was associated with increased intentions. Advertisements seen in spam mail were associated with decreased intentions. Advertisements seen on traditional or cable television were associated with decreased behavior. Advertisements seen on television watched on the internet were associated with increased behavior. The source of seeking additional information of reading internet print content was associated with increased behavior. No internet social media advertisements were associated with either intentions or behavior. In conclusion, pharmaceutical brand managers and marketers should consider these findings when tailoring their DTCA advertising campaigns and directing their DTCA advertising budget towards young adults such as college students. They need to reconsider the current approach for traditional television DTCA and also consider dedicating a larger advertising budget toward internet television DTCA. Although internet social media is a popular place to advertise, the financial expenditures do not appear worthwhile for DTCA when targeting young adults such as college students.

Keywords: brand managers, direct-to-consumer advertising, internet, social media

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Authors: Oktia Woro Kasmini Handayani, Bambang Budi Raharjo, Efa Nugroho, Bertakalswa Hermawati

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Obesity prevalence and severe malnutrition in Indonesia has increased from 2007 to 2013. The utilization of local resources in nutritional program planning can be used to program efficiency and to reach the goal. The aim of this research is to plan a nutrition program based on local resources for urban fringe areas in a developing country. This research used a qualitative approach, with a focus on local resources including social capital, social system, cultural system. The study was conducted in Mijen, Central Java, as one of the urban fringe areas in Indonesia. Purposive and snowball sampling techniques are used to determine participants. A total of 16 participants took part in the study. Observation, interviews, focus group discussion, SWOT analysis, brainstorming and Miles and Huberman models were used to analyze the data. We have identified several local resources, such as the contributions from nutrition cadres, social organizations, social financial resources, as well as the cultural system and social system. The outstanding contribution of nutrition cadres is the participation and creativity to improve nutritional status. In addition, social organizations, like the role of the integrated health center for children (Pos Pelayanan Terpadu), can be engaged in the nutrition program planning. This center is supported by House of Nutrition to assist in nutrition program planning, and provide social support to families, neighbors and communities as social capitals. The study also reported that cultural systems that show appreciation for well-nourished children are a better way to improve the problem of balanced nutrition. Social systems such as teamwork and mutual cooperation can also be a potential resource to support nutritional programs and overcome associated problems. The impact of development in urban areas such as the introduction of more green areas which improve the perceived status of local people, as well as new health services facilitated by people and companies, can also be resources to support nutrition programs. Local resources in urban fringe areas can be used in the planning of nutrition programs. The expansion of partnership with all stakeholders, empowering the community through optimizing the roles of nutrition care centers for children as our recommendation with regard to nutrition program planning.

Keywords: developing country, local resources, nutrition program, urban fringe

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Authors: Sandeep Nath

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There are good stresses and bad stresses. To tell the difference, recognize early signs of stress, and label stress conditions correctly, we need to understand stress triggers and the mechanism of stress as it arises. By understanding this through mindfulness of body, mind, and spirit, we can be prepared to prevent harmful stress from escalating and ruining health; physical, mental, and emotional. We can also prepare others/peers to be stress-free. The understanding of this is available in a form closest to our natural being, in ancient oriental wisdom, and is brought together as actionable habits in the movement called RENEWALism. The constructs of RENEWALism Habits are detailed in this paper, and case studies presented of how mindfulness has equipped individuals with both capability and capacity to handle their situations and environments despite the odds.

Keywords: habits, mindfulness, renewalism, stress

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Authors: Katarzyna Pawęska, Aleksandra Bawiec, Ewa Burszta-Adamiak, Wiesław Fiałkiewicz

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The water shortage becomes a serious problem not only in African and Middle Eastern countries, but also recently in the European Union. Scarcity of water means that not all agricultural, industrial and municipal needs will be met. When the annual availability of renewable freshwater per capita is less than 1,700 cubic meters, countries begin to experience periodic or regular water shortages. The phenomenon of water stress is the result of an imbalance between the constantly growing demand for water and its availability. The constant development of industry, population growth, and climate changes make the situation even worse. The search for alternative water sources and independent supplies is becoming a priority for many countries. Data enabling the assessment of country’s condition regarding water resources, water consumption, water price, wastewater volume, forecasted climate changes e.g. temperature, precipitation, are scattered and their interpretation by common entrepreneurs may be difficult. For this purpose, a digital tool has been developed to support decisions related to the implementation of water and wastewater re-use systems, as a result of an international research project “Framework for organizational decision-making process in water reuse for smart cities” (SMART-WaterDomain) funded under the EIG-CONCERT Japan call on Smart Water Management for Sustainable Society. The developed geo-visualization tool graphically presents, among others, data about the capacity of wastewater treatment plants and the volume of water demand in the private and public sectors for Poland, Germany, and the Czech Republic. It is expected that such a platform, extended with economical water management data and climate forecasts (temperature, precipitation), will allow in the future independent investigation and assessment of water use rate and wastewater production on the local and regional scale. The tool is a great opportunity for small business owners, entrepreneurs, farmers, local authorities, and common users to analyze the impact of climate change on the availability of water in the regions of their business activities. Acknowledgments: The authors acknowledge the support of the Project Organisational Decision Making in Water Reuse for Smart Cities (SMART- WaterDomain), funded by The National Centre for Research and Development and supported by the EIG-Concert Japan.

Keywords: circular economy, digital tool, geo-visualization, wastewater re-use

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Authors: G. A. Gevorgyan, A. S. Mamyan, L. G. Stepanyan, L. R. Hambaryan

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Bacterio- and phytoplankton growth rates in 'Yerevanyan lich' reservoir and the Hrazdan river in Yerevan city, Armenia were investigated in April and June-August, 2015. Phytoplankton sampling and analysis were performed by the standard methods accepted in hydrobiological studies. The quantitative analysis of aerobic, coliform and E. coli bacteria is done by the 'RIDA COUNT' medium sheets (coated with ready-to-use culture medium). The investigations showed that the insufficient management of household discharges in Yerevan city caused the organic and fecal pollution of the Hrazdan river in this area which in turn resulted in an increase in bacterial count and increased sanitary and pathogenic risks to the environment and human health. During the investigation in April, the representatives of diatom algae prevailed quantitatively in the coastal area of 'Yerevanyan lich' reservoir, nevertheless, a significant change in the phytoplankton community in June occurred: due to green algae bloom in the reservoir, the quantitative parameters of phytoplankton increased significantly. This was probably conditioned by a seasonal increase in the water temperature in the conditions of the sufficient concentration of nutrients. However, a succession in phytoplankton groups during July-August occurred, and a dominant group (according to quantitative parameters) in the phytoplankton community was changed as follows: green algae-diatom algae-blue-green algae. Rapid increase in the quantitative parameters of diatom and blue-green algae in the reservoir may have been conditioned by increased organic matter level resulted from green algae bloom. Algal bloom in 'Yerevanyan lich' reservoir caused changes in phytoplankton community and an increase in bacterioplankton count not only in the reservoir but also in the Hrazdan river sites located in the downstream from the reservoir. Thus, the insufficient management of urban discharges and aquatic ecosystems in Yerevan city led to unfavorable changes in water quality and microbial and phytoplankton communities in “Yerevanyan lich” reservoir and the Hrazdan river which in turn caused increased sanitary and pathogenic risks to the environment and human health.

Keywords: algal bloom, bacterioplankton, phytoplankton, Hrazdan river, Yerevanyan lich reservoir

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Authors: Kuei-Yu Chien, Nai-Wen Kan, Wan-Chun Wu, Guo-Dong Ma, Shu-Chen Chen

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Purpose: The purpose of this study was to investigate the responses of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), rating of perceived exertion (RPE) and lactate following continued high-intensity interval exercise in water and on land. The results of studies can be an exercise program design reference for health care and fitness professionals. Method: A total of 20 volunteer postmenopausal women was included in this study. The inclusion criteria were: duration of menopause > 1 year; and sedentary lifestyle, defined as engaging in moderate-intensity exercise less than three times per week, or less than 20 minutes per day. Participants need to visit experimental place three times. The first time visiting, body composition was performed and participant filled out the questionnaire. Participants were assigned randomly to the exercise environment (water or land) in second and third time visiting. Water exercise testing was under water of trochanter level. In continuing jump testing, each movement consisted 10-second maximum volunteer jump for two sets. 50% heart rate reserve dynamic resting (walking or running) for one minute was within each set. SBP, DBP, HR, RPE of whole body/thigh (RPEW/RPET) and lactate were performed at pre and post testing. HR, RPEW, and RPET were monitored after 1, 2, and 10 min of exercise testing. SBP and DBP were performed after 10 and 30 min of exercise testing. Results: The responses of SBP and DBP after exercise testing in water were higher than those on land. Lactate levels after exercise testing in water were lower than those on land. The responses of RPET were lower than those on land post exercise 1 and 2 minutes. The heart rate recovery in water was faster than those on land at post exercise 5 minutes. Conclusion: This study showed water interval jump exercise induces higher cardiovascular responses with lower RPE responses and lactate levels than on-land jumps exercise in postmenopausal women. Fatigue is one of the major reasons to obstruct exercise behavior. Jump exercise could enhance cardiorespiratory fitness, the lower-extremity power, strength, and bone mass. There are several health benefits to the middle to older adults. This study showed that water interval jumping could be more relaxed and not tried to reach the same land-based cardiorespiratory exercise intensity.

Keywords: interval exercise, power, recovery, fatigue

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Authors: Krzysztof J. Czarnocki, F. Silveira, E. Czarnocka, K. Szaniawska

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Research background: Problems related to the occupational health and decreasing level of safety occur commonly in the construction industry. Important factor in the occupational safety in construction industry is scaffold use. All scaffolds used in construction, renovation, and demolition shall be erected, dismantled and maintained in accordance with safety procedure. Increasing demand for new construction projects unfortunately still is linked to high level of occupational accidents. Therefore, it is crucial to implement concrete actions while dealing with scaffolds and risk assessment in construction industry, the way on doing assessment and liability of assessment is critical for both construction workers and regulatory framework. Unfortunately, professionals, who tend to rely heavily on their own experience and knowledge when taking decisions regarding risk assessment, may show lack of reliability in checking the results of decisions taken. Purpose of the article: The aim was to indicate crucial parameters that could be modeling with Risk Assessment Model (RAM) use for improving both building enterprise productivity and/or developing potential and safety climate. The developed RAM could be a benefit for predicting high-risk construction activities and thus preventing accidents occurred based on a set of historical accident data. Methodology/Methods: A RAM has been developed for assessing risk levels as various construction process stages with various work trades impacting different spheres of enterprise activity. This project includes research carried out by teams of researchers on over 60 construction sites in Poland and Portugal, under which over 450 individual research cycles were carried out. The conducted research trials included variable conditions of employee exposure to harmful physical and chemical factors, variable levels of stress of employees and differences in behaviors and habits of staff. Genetic modeling tool has been used for developing the RAM. Findings and value added: Common types of trades, accidents, and accident causes have been explored, in addition to suitable risk assessment methods and criteria. We have found that the initial worker stress level is more direct predictor for developing the unsafe chain leading to the accident rather than the workload, or concentration of harmful factors at the workplace or even training frequency and management involvement.

Keywords: safety climate, occupational health, civil engineering, productivity

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Authors: Mary M. Park

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Hollywood has had a long and enduring history of showcasing the United States military to civilian audiences, and the portrayals of soldiers in films have had a definite impact on the civilian perception of the US military. The growing gap between the civilian population and the military in the US has led to certain stereotypes of military personnel to proliferate, especially in the area of militarized masculinity, which has often been harmful to the psychological and spiritual wellbeing of military personnel. Examining Hollywood's portrayal of soldiers can serve to enhance our understanding of how civilians may be influenced in their perception of military personnel. Moreover, it can provide clues as to how male military personnel may also be influenced by Hollywood films as they form their own military identity. The post 9/11 era has seen numerous high budget films lionizing a particular type of soldier, the 'warrior-hero', who adheres to a traditional form of hegemonic masculinity and exhibits traits such as physical strength, bravery, stoicism, and an eagerness to fight. This paper examines how the portrayal of the 'warrior-hero' perpetuates a negative stereotype that soldiers are a blend of superheroes and emotionless robots and, therefore, inherently different from civilians. This paper examines the portrayal of militarized masculinity in three of the most successful war films of the post-9/11 era; Black Hawk Down (2001), The Hurt Locker (2008), and American Sniper (2014). The characters and experiences of the soldiers depicted in these films are contrasted with the lived experiences of soldiers during the Iraq and Afghanistan wars. Further, there is an analysis of popular films depicting ancient warriors, such as Troy (2004) and 300 (2007), which were released during the early years of the War on Terror. This paper draws on the concept of hegemonic militarised masculinity by leading scholars and feminist international relations theories on militarized masculinity. This paper uses veteran testimonies collected from a range of public sources, as well as previous studies on the link between traditional masculinity and war-related mental illness. This paper concludes that the seemingly exclusive portrayal of soldiers as 'warrior-heroes' in films in the post-9/11 era is misleading and damaging to civil-military relations and that the reality of the majority of soldiers' experiences is neglected in Hollywood films. As civilians often believe they are being shown true depictions of the US military in Hollywood films, especially in films that portray real events, it is important to find the differences between the idealized fictional 'warrior-heroes' and the reality of the soldiers on the ground in the War on Terror.

Keywords: civil-military relations, gender studies, militarized masculinity, social pyschology

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Authors: Yasmin A. M. Ferreira, Ana C. K. Pelissari, Sofia De C. F. Vicente, Raquel M. Da S. Campos, Deborah C. L. Masquio, Lian Tock, Lila M. Oyama, Flavia C. Corgosinho, Valter T. Boldarine, Ana R. Dâmaso

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The prevalence of overweight and obesity is growing around the world and currently considered a global epidemic. Food and nutrition are essential requirements for promoting health and protecting non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate the inflammation and oxidative stress in obese individuals. Few studies have investigated the dietary Inflammation Factor Rating (IFR) in obese adolescents. The IFR was developed to characterize an individual´s diet on anti- to pro-inflammatory score. This evaluation contributes to investigate the effects of inflammatory diet in metabolic profile in several individual conditions. Objectives: The present study aims to investigate the effects of a multidisciplinary weight loss therapy on inflammation factor rating and cardiometabolic risk in obese adolescents. Methods: A total of 26 volunteers (14-19 y.o) were recruited and submitted to 20 weeks interdisciplinary therapy allied to health education website- Ciclo do Emagrecimento®, including clinical, nutritional, psychological counseling and exercise training. The body weight was monitored weekly by self-report and photo. The adolescents answered a test to evaluate the knowledge of the topics covered in the videos. A 24h dietary record was applied at the baseline and after 20 weeks to assess the food intake and to calculate IFR. A negative IFR suggests that diet may have inflammatory effects and a positive IFR indicates an anti-inflammatory effect. Statistical analysis was performed using the program STATISTICA version 12.5 for Windows. The adopted significant value was α ≤ 5 %. Data normality was verified with the Kolmogorov Smirnov test. Data were expressed as mean±SD values. To analyze the effects of intervention it was applied test t. Pearson´s correlations test was performed. Results: After 20 weeks of treatment, body mass index (BMI), body weight, body fat (kg and %), abdominal and waist circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. Moreover, it was found an improvement of inflammation factor rating from -427,27±322,47 to -297,15±240,01, suggesting beneficial effects of nutritional counselling. Considering the correlations analysis, it was found that pro-inflammatory diet is associated with increase in the BMI, very low-density lipoprotein cholesterol (VLDL), triglycerides, insulin and insulin resistance index (HOMA-IR); while an anti-inflammatory diet is associated with improvement of HDL-c and insulin sensitivity Check index (QUICKI). Conclusion: The 20-week blended multidisciplinary therapy was effective to reduce body weight, anthropometric circumferences and improve inflammatory markers in obese adolescents. In addition, our results showed that an increase in inflammatory profile diet is associated with cardiometabolic parameters, suggesting the relevance to stimulate anti-inflammatory diet habits as an effective strategy to treat and control of obesity and related comorbidities. Financial Support: FAPESP (2017/07372-1) and CNPq (409943/2016-9)

Keywords: cardiometabolic risk, inflammatory diet, multidisciplinary therapy, obesity

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Authors: Teemu Saressalo

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This article examines the evolution of the Israel Defence Forces’ information operation activities during an eight-year timespan from the 2006 war with Hezbollah to more recent operations such as Pillar of Defence and Protective Edge. To this end, the case study will show a change in the Israel Defence Forces’ activities in the information domain. In the 2006 war with Hezbollah in Lebanon, Israel inflicted enormous damage on the Lebanese infrastructure, leaving more than 1,200 people dead and 4,400 injured. Casualties among Hezbollah, Israel’s main adversary, were estimated to range from 250 to 700 fighters. Damage to the Lebanese infrastructure was estimated at over USD 2.5bn, with almost 2,000 houses and buildings damaged and destroyed. Even this amount of destruction did not force Hezbollah to yield and while both sides were claiming victory in the war, Israel paid a heavier price in political backlashes and loss of reputation, mainly due to failures in the media and the way in which the war was portrayed and perceived in Israel and abroad. Much of this can be credited to Hezbollah’s efficient use of the media, and Israel’s failure to do so. Israel managed the next conflict it was engaged in completely differently – it had learnt its lessons and built up new ways to counter its adversary’s propaganda and media operations. In Operation Cast Lead at the turn of 2009, Hamas, Israel’s adversary and Gaza’s dominating faction, was not able to utilize the media in the same way that Hezbollah had. By creating a virtual and physical barrier around the Gaza Strip, Israel almost totally denied its adversary access to the worldwide media, and by restricting the movement of journalists in the area, Israel could let its voice be heard above all. The operation Cast Lead began with a deception operation, which caught Hamas totally off guard. The 21-day campaign left the Gaza Strip devastated, but did not cause as much protest in Israel during the operation as the 2006 war did, mainly due to almost total Israeli dominance in the information dimension. The most important outcome from the Israeli perspective was the fact that Operation Cast Lead was assessed to be a success and the operation enjoyed domestic support along with support from many western nations, which had condemned Israeli actions in the 2006 war. Later conflicts have shown the same tendency towards virtually total dominance in the information domain, which has had an impact on target audiences across the world. Thus, it is clear that well-planned and conducted information operations are able to shape public opinion and influence decision-makers, although Israel might have been outpaced by its rivals.

Keywords: Hamas, Hezbollah, information operations, Israel Defence Forces

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Authors: Emilio Galdeano-Gómez, Ángeles Godoy-Durán, Juan C. Pérez-Mesa, Laura Piedra-Muñoz

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Eco-efficiency is receiving ever-increasing interest as an indicator of sustainability, as it links environmental and economic performances in productive activities. In agriculture, these indicators and their determinants prove relevant due to the close relationships in this activity between the use of natural resources, which is generally limited, and the provision of basic goods to society. In this context, various analyses have focused on eco-efficiency by considering individual family farms as the basic production unit. However, not only must the measure of efficiency be taken into account, but also the existence of a series of factors which constitute socio-economic, political-institutional, and environmental determinants. Said factors have been studied to a lesser extent in the literature. The present work analyzes eco-efficiency at a micro level, focusing on small-scale family farms as the main decision-making units in horticulture in southeast Spain, a sector which represents about 30% of the fresh vegetables produced in the country and about 20% of those consumed in Europe. The objectives of this study are a) to obtain a series of eco-efficiency indicators by estimating several pressure ratios and economic value added in farming, b) to analyze the influence of specific social, economic and environmental variables on the aforementioned eco-efficiency indicators. The present work applies the method of Data Envelopment Analysis (DEA), which calculates different combinations of environmental pressures (water usage, phytosanitary contamination, waste management, etc.) and aggregate economic value. In a second stage, an analysis is conducted on the influence of the socio-economic and environmental characteristics of family farms on the eco-efficiency indicators, as endogeneous variables, through the use of truncated regression and bootstrapping techniques, following Simar-Wilson methodology. The results reveal considerable inefficiency in aspects such as waste management, while there is relatively little inefficiency in water usage and nitrogen balance. On the other hand, characteristics, such as product specialization, the adoption of quality certifications and belonging to a cooperative do have a positive impact on eco-efficiency. These results are deemed to be of interest to agri-food systems structured on small-scale producers, and they may prove useful to policy-makers as regards managing public environmental programs in agriculture.

Keywords: data envelopment analysis, eco-efficiency, family farms, horticulture, socioeconomic features

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Authors: Kingsley Agyapong

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Research conducted in recent years has delved into the concept of patient-perceived value within the context of co-creation, particularly in the realm of doctor-patient interactions within healthcare settings. However, existing scholarly discourse lacks exploration regarding the emergence of patient-derived value in the co-creation process, specifically within encounters involving patients and stakeholders such as doctors, nurses, pharmacists, and other healthcare professionals. This study aims to fill this gap by elucidating the perspectives of patients regarding the value they derive from their interactions with multiple stakeholders in the delivery of healthcare services. The fieldwork was conducted at a university clinic located in Ghana. Data collection procedures involved conducting 20 individual interviews with key informants on distinct value accrued from co-creation practices and interactions with stakeholders. The key informants consisted of patients receiving care at the university clinic during the Malaria Treatment Process. Three themes emerged from both the existing literature and the empirical data collected. The first theme, labeled as "patient value needs in co-creation," encapsulates elements such as communication effectiveness, interpersonal interaction quality, treatment efficacy, and enhancements to the overall quality of life experienced by patients during their interactions with healthcare professionals. The second theme, designated as "services that enhance patients' experience in value co-creation," pertains to patients' perceptions of services that contribute favourably to co-creation experiences, including initiatives related to health promotion and the provision of various in-house services that patients deem pertinent for augmenting their overall experiences. The third theme, titled "Challenges in the co-creation of patients' value," delineates obstacles encountered within the co-creation process, including health professionals' challenges in effectively following up with patients scheduled for review and prolonged waiting times for healthcare delivery. This study contributes to the patients' perceptions of value within the co-creation process during their interactions with service providers, particularly healthcare professionals. By gaining a deeper insight into this process, healthcare providers can enhance the delivery of patient-centered care, thereby leading to improved healthcare outcomes. The study further offers managerial implications derived from its findings, providing actionable insights for healthcare managers and policymakers aiming to optimize patient value creation in healthcare services. Furthermore, it suggests avenues for future research endeavors within healthcare settings.

Keywords: patient, healthcare, co-creation, malaria

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Authors: V. L. M. F. Capellini, A. P. P. M. Maturana, N. C. M. Brondino, M. B. C. L. B. M. Peixoto, A. J. Broughton

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A paradigm shift is a process. The process of implementing inclusive education, a system constructed to support all learners, requires planning, identification, experimentation, and evaluation. In this vein, the purpose of the present study was to evaluate the capacity of one Brazilian state school systems to provide special education students with a quality inclusive education. This study originated at the behest of concerned families of students with special needs who filed complaints with the Municipality of Bauru, São Paulo. These families claimed, 1) children with learning differences and educational needs had not been identified for services, and 2) those who had been identified had not received sufficient specialized educational assistance (SEA) in schools across the City of Bauru. Hence, the Office of Civil Rights for the state of São Paulo (Ministério Público de São Paulo) summoned the local higher education institution, UNESP, to design a research study to investigate these allegations. In this exploratory study, descriptive data were gathered from all elementary and middle schools including 58 state schools and 17 city schools, for a total of 75 schools overall. Data collection consisted of each school's annual strategic action plan, surveys and interviews with all school stakeholders to determine their perceptions of the inclusive education available to students with Special Education Needs (SEN). The data were collected as one of four stages in a larger study which also included field observations of a focal students' experience and a continuing education course for all teachers and administrators in both state and city schools. For the purposes of this study, the researchers were interested in understanding the perceptions of school staff, parents, and students across all schools. Therefore, documents and surveys from 75 schools were analyzed for adherence to federal legislation guaranteeing students with SEN the right to special education assistance within the regular school setting. Results shows that while some schools recognized the legal rights of SEN students to receive special education, the plans to actually deliver services were absent. In conclusion, the results of this study revealed both school staff and families have insufficient planning and accessibility resources, and the schools have inadequate infrastructure for full-time support to SEN students, i.e., structures and systems to support the identification of SEN and delivery of services within schools of Bauru, SP. Having identified the areas of need, the city is now prepared to take next steps in the process toward preparing all schools to be inclusive.

Keywords: inclusion, school, special education, special needs

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Authors: Yuanyuan Song

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Background: As we all know, culture plays a pivotal role in the realm of education, influencing study perceptions and outcomes. Nevertheless, there remains a need to delve into how culture specifically impacts the perception of courses. Therefore, the impact of culture on students' perceptions and academic performance is explored in this study. Drawing from cultural constructionism and conflict theories, it is posited that when students hailing from diverse cultures and backgrounds converge in the same classroom, their perceptions of course content may diverge significantly. This study seeks to unravel the tangible disparities and ascertain how cultural nuances shape students' perceptions of classroom content when encountering diverse cultural contexts within the same learning environment. Methodology: Given the diverse cultural backgrounds of students within the US, this study draws upon data collected from a course offered by a US college. In pursuit of answers to these inquiries, a qualitative approach was employed, involving semi-structured interviews conducted in a college-level science class in the US during 2023. The interviews encompassed approximately nine questions, spanning demographic particulars, cultural backgrounds, science learning experiences, academic outcomes, and more. Participants were exclusively drawn from science-related majors, with each student originating from a distinct cultural context. All participants were undergraduates, and most of them were from eighteen to twenty-five years old, totaling six students who attended the class and willingly participated in the interviews. The duration of each interview was approximately twenty minutes. Results: The findings gleaned from the interview data underscore the notable impact of varying cultural contexts on students' perceptions. This study argues that female science students, for instance, are influenced by gender dynamics due to the predominant male presence in science majors, creating an environment where female students feel reticent about expressing themselves in public. Students of East Asian origin exhibit a stronger belief in the efficacy of personal efforts when contrasted with their North American counterparts. Minority students indicated that they grapple with integration into the predominantly white mainstream society, influencing their eagerness to engage in classroom activities that are conducted by white professors. All of them emphasized the importance of learning science.

Keywords: multiculture education, educational sociology, educational equality, STEM education

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Authors: Imelda Albert Gisip, Tarisah T. Z. Taman

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In Asia, particularly in Malaysia, women entrepreneurs contribute substantially to economic growth. This paper presents a review of women entrepreneurs’ program, focusing on Creating Millionaires among Young Women Entrepreneurs (CREAM@YWE) program in Sabah Malaysia, which aims to accelerate entrepreneurship among young women in Sabah Malaysia. Entrepreneurs are seen as essential for growth, job creation, and social progress, and the virtues of small business for Sabah Maju Jaya (SMJ), the Sabah state government Sabah State development plan for the year 2021-2025. SMJ guides the direction of the government's policies and programs, further guiding the implementation in a planned and strategic manner to achieve targets and goals that coincide with the development needs of the state. One of the government’s agendas is to put more effort into ensuring that women entrepreneurs are well supported and enhanced. Thus, The CreaM@YWE Program was developed in 2018 with the main objective is to produce competitive young women entrepreneurs in Sabah and achieve "millionaire" status. CreaM@YWE Program is an innovation process specifically developed to accelerate the entrepreneurship sector, particularly for women entrepreneurs in Sabah, by incorporating strategic partnerships and collaborations with government agencies and industry players. Being the first of its kind in Sabah, the novelty of this project is providing a supportive ecosystem, including six months of intensive courses guided through "hands-holding”, collaborations with strategic partners, and easy access to government assistance. Since its inception, the program has significantly impacted society’s wellbeing, particularly in empowering young women entrepreneurs in Sabah for the past six years, and has produced many successful women entrepreneurs with “millionaire” status. Generally, improving the women’s enterprise sector in Malaysia needs an overall environment that provides development opportunities for women entrepreneurs, including access to resources and support services. Since achieving the goal of women's entrepreneurship policy requires effective partnerships and inclusiveness, Cream @YWE Program has managed to practice these in assisting small entrepreneurs among young women in Sabah in accessing public goods and business opportunities. This proves that achieving women’s economic empowerment requires sound policies, a holistic approach, and long-term commitment. Thus, this paper presents how the Cream@YWE Program has been supporting Sabah young women entrepreneurs by reforming the business environment to help create opportunities for women while addressing the few existing gender-specific hurdles.

Keywords: young, women, entrepreneurs, Sabah, Malaysia

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Authors: Marcio Freire Cruz, Naoaki Ono, Shigehiko Kanaya, Carlos Arthur Mattos Teixeira Cavalcante

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The systems that record patient care information, known as Electronic Medical Record (EMR) and those that monitor vital signs of patients, such as heart rate, body temperature, and blood pressure have been extremely valuable for the effectiveness of the patient’s treatment. Several kinds of research have been using data from EMRs and vital signs of patients to predict illnesses. Among them, we highlight those that intend to predict, classify, or, at least identify patterns, of sepsis illness in patients under vital signs monitoring. Sepsis is an organic dysfunction caused by a dysregulated patient's response to an infection that affects millions of people worldwide. Early detection of sepsis is expected to provide a significant improvement in its treatment. Preceding works usually combined medical, statistical, mathematical and computational models to develop detection methods for early prediction, getting higher accuracies, and using the smallest number of variables. Among other techniques, we could find researches using survival analysis, specialist systems, machine learning and deep learning that reached great results. In our research, patients are modeled as points moving each hour in an n-dimensional space where n is the number of vital signs (variables). These points can reach a sepsis target point after some time. For now, the sepsis target point was calculated using the median of all patients’ variables on the sepsis onset. From these points, we calculate for each hour the position vector, the first derivative (velocity vector) and the second derivative (acceleration vector) of the variables to evaluate their behavior. And we construct a prediction model based on a Long Short-Term Memory (LSTM) Network, including these derivatives as explanatory variables. The accuracy of the prediction 6 hours before the time of sepsis, considering only the vital signs reached 83.24% and by including the vectors position, speed, and acceleration, we obtained 94.96%. The data are being collected from Medical Information Mart for Intensive Care (MIMIC) Database, a public database that contains vital signs, laboratory test results, observations, notes, and so on, from more than 60.000 patients.

Keywords: dynamic analysis, long short-term memory, prediction, sepsis

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Authors: Giovanni Duran Polo

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Demonstrate the importance of the stages such as Information, Diagnosis, Management, and Intervention is fundamental to have a historical, live, and quality inhabited center. One of the major actions to take is to promote the concept of the management of a historic center with harmonious development. For that, concerned actors should strengthen the concept that said historic center may be the neighborhood of all and for all. The centers of historical cities, presented as any other urban area, social, environmental issues etc; yet they get added value that have no other city neighborhoods. The equity component, either by the urban plan, or environmental quality offered properties of architectural, landscape or some land uses are the differentiating element, while the tool that makes them attractive face pressure exerted by new housing developments or shopping centers. That's why through the experience of working in historical centers, they are declared the actions in heritage areas. This paper will show how the encounter with each of these places are trying to take the phases of information, to gather all the data needed to be closer to the territory with specific data, diagnosis; which allowed the actors to see what state they were, felt how the heart is related to the rest of the city, show what problems affected the situation and what potential it had to compete in a global market. Also, to discuss the importance of the organization, as it is legal and normative basis for it have an order and a concept, when you know what can and what cannot, in an area where the citizen has many myth or history, when he wanted to intervene in protected buildings. It is also appropriate to show how it could develop the intervention phase, where the shares on the tangible elements and intervention for the protection of the heritage property are executed. The management is the final phase which will carry out all that was raised on paper, it's time to orient, explain, persuade, promote, and encourage citizens to take care of the heritage. It is profitable and also an obligation and it is not an insurmountable burden. It has to be said this is the time to pull all the cards to make the historical center and heritage becoming more alive today. It is the moment to make it more inhabited and to transformer it into a quality place, so citizens will cherish and understand the importance of such a place. Inhabited historical centers, endowments and equipment required, with trade quality, with constant cultural offer, with well-preserved buildings and tidy, modern and safe public spaces are always attractive for tourism, but first of all, the place should be conceived for citizens, otherwise everything will be doomed to failure.

Keywords: development, diagnosis, heritage historic center, intervention, management, patrimony

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Authors: Othman Saleh Al-Razgan

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Obesity establishes an epidemic along with an array of comorbidities and this call for careful clinical assessment, to identify causal factors and comprehensive management. In Kuwait, this epidemic reflects the progressive, socio-economic and age-related issues, along with the shift of nutrition from traditional to modern-style. The current research attempts to narrate the obesity and related health issues in Kuwait, with a special emphasis on the magnitude of the issue in Kuwait, nutrition transition over the past three decades, change in life-style, and possible solution for this issue.

Keywords: clinical assessment, comorbidities, obesity, socio-economic

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Authors: Seyda Can, Meryem Unulu

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Objective: Breast milk is the most fundamental nutritional element for the healthy growth and development of newborns as they supply all the necessary components. Various obstacles such as diseases of mother and child, allergies of the baby, and insufficient breastmilk affect breast-feeding adversely. The wet nursery or breast milk banking is the most important source in providing the nutrients closest to the ideal for the newborn. Despite increasing opinions about its benefits, breast milk banking practice is controversial because of reasons such as ethical problems, traditional beliefs and attitudes, security concerns of families and lack of knowledge. It is thought that the results of this study will create the data for studies to raise the awareness of the society regarding wet nursery, and milk banks. Method: The study was planned and performed in descriptive type. The population of the study consists of mothers that gave birth between October-November 2017 in a public hospital in Turkey, and the sample consisted of 205 mothers chosen by improbable sampling method from the population and accepted to participate in the study. While gathering data, a survey consisting of 33 questions designed to determine the socio-demographic characteristics and their views on wet nursery and breast milk banking. Written ethical committee and institution permit was taken. Before the interview, participants were informed about the purpose and content of the study and oral permit was taken. Result: When the distribution of 205 mothers according to their individual characteristics, it was detected that their age average was 28,16±5,23 and 63,4 of mothers (n=130) had normal delivery. It was determined that clear majority of mothers, 75,6% (n=155) had no breast-feeding problems and 75,1% (n=154) fed the baby only with breast milk. It was detected that 18,5% (n=38) would accept a stranger to be a wet nurse and 60% (n=123) would donate milk if there is a breast milk bank. It was detected 33,2 % (n=68) of participant mothers want to make use of breast milk bank if there is a situation that prevents breast feeding, 38,5 % (n=79) of mothers think breast milk bank would be problematic religiously. Statistical difference was detected between the educational status of women and the rate of wanting breast milk bank practice. As the educational status of mothers increased, their rate of wanting breast milk bank practice increased. Conclusion: It is essential that every baby is breastfed by its mother primarily. However, when this is not possible, in order to implement wet nursery and breast milk banking as an extension of national breast-feeding policy, regulations need to be made and worries should be eased. Also, organizing training programs are also really important to raise awareness of the society and mothers.

Keywords: breast feeding, breast milk, milk banks, wet nursery

Procedia PDF Downloads 153

Authors: Peter Ecke

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This research presents insights from a questionnaire study and autobiographic narrative analyses about the language and cultural backgrounds, challenges, interests, and needs, as well as perceptions about bilingualism and language learning of undergraduate students at a Public University in the southwestern United States. Participants were 650 students, enrolled in college-level general education courses, entitled “Becoming multilingual: Learning and maintaining two or more languages” between 2020 and 2024. Data were collected via pre- and post-course questionnaires administered online through the Qualtrix XM platform and complemented with analyses of excerpts from autobiographical narratives that students produced as part of the course assignments. Findings, for example, show that course participants have diverse linguistic backgrounds. The five most frequently reported L1s were English (about 50% of course participants), Spanish, Arabic, Mandarin, and Korean (in that order). The five most frequently reported L2s were English, Spanish, French, ASL, Japanese, German, and Mandarin (in that order). Participants also reported on their L2, L3, L4, and L5 if applicable. Most participants (over 60%) rated themselves bilingual or multilingual whereas 40% considered themselves to be monolingual or foreign language learners. Only about half of the participants reported feeling very or somewhat comfortable with their language skills, but these reports changed somewhat from the pre- to the post-course survey. About half of participants were mostly interested in learning how to effectively learn a foreign language. The other half of participants reported being most curious about learning about themselves as bi/multilinguals, (re)learning a language used in childhood, learning how to bring up a child as a bi/multilingual or learning about people who speak multiple languages (distributed about evenly). Participants’ comments about advantages and disadvantages of being bilingual remained relatively stable but their agreement with common myths about bilingualism and language learning changed from the pre- to the post-course survey. Students’ reflections in the autobiographical narratives and comments in (institutionally administered) anonymous course evaluations provided additional data on students’ concerns about their current language skills and uses as well as their perceptions about learning outcomes and the usefulness of the general education course for their current and future lives. It is hoped that the presented findings and discussion will spark interest among colleagues in offering similar courses as a resource for college students (and possibly other audiences), including those from migrant, indigenous, multilingual, and multicultural communities to contribute to a more harmonious bilingualism and well-being of college students who are or inspire to become bi-or multilingual.

Keywords: autobiographic narratives, general education university course, harmonious bilingualism and well-being, multilingualism, questionnaire study

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Authors: Pin Yu Chen, Puay Chuan Lee, Yu Jen Loo, Ju Xia Zhang, Deborah Teo, Jack Wei Chieh Tan, Biauw Chi Ong

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Background: Synchronous communication, such as telephone calls, remains the standard communication method between nurses and other healthcare professionals in Singapore public hospitals despite advances in asynchronous technological platforms, such as instant messaging. Although miscommunication is one of the most common causes of lapses in patient care, there is a scarcity of research characterizing baseline inter-professional healthcare communications in a hospital setting due to logistic difficulties. Objective: This study aims to characterize the frequency and patterns of communication behaviours among healthcare professionals. Methods: The one-week observational study was conducted on Monday through Sunday at the nursing station of a cardiovascular medicine and cardiothoracic surgery inpatient ward at the National Heart Centre Singapore. Subjects were shadowed by two physicians for sixteen hours or consecutive morning and afternoon nursing shifts. Communications were logged and characterized by type, duration, caller, and recipient. Results: A total of 1,023 communication events involving the attempted use of the common telephones at the nursing station were logged over a period of one week, corresponding to a frequency of one event every 5.45 minutes (SD 6.98, range 0-56 minutes). Nurses initiated the highest proportion of outbound calls (38.7%) via the nursing station common phone. A total of 179 face-to-face communications (17.5%), 362 inbound calls (35.39%), 481 outbound calls (47.02%), and 1 emergency alert (0.10%) were captured. Average response time for task-oriented communications was 159 minutes (SD 387.6, range 86-231). Approximately 1 in 3 communications captured aimed to clarify patient-related information. The total duration of time spent on synchronous communication events over one week, calculated from total inbound and outbound calls, was estimated to be a total of 7 hours. Conclusion: The results of our study showed that there is a significant amount of time spent on inter-professional healthcare communications via synchronous channels. Integration of patient-related information and use of asynchronous communication channels may help to reduce the redundancy of communications and clarifications. Future studies should explore the use of asynchronous mobile platforms to address the inefficiencies observed in healthcare communications.

Keywords: healthcare communication, healthcare management, nursing, qualitative observational study

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Authors: Sheila S. Silang

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This research seeks to make an impact analysis on multiple intelligence as the basis for differentiated classroom instruction in TLE. It will also address the felt need of how TLE subject could be taught effectively exhausting all the possible means.This study seek the effect of giving different instruction according to the ability of the students in the following objectives: 1. student’s technological skills enhancement, 2. learning potential improvements 3. having better linkage between school and community in a need for soliciting different learning devices and materials for the learner’s academic progress. General Luna, Quezon is composed of twenty seven barangays. There are only two public high schools. We are aware that K-12 curriculum is focused on providing sufficient time for mastery of concepts and skills, develop lifelong learners, and prepare graduates for tertiary education, middle-level skills development, employment, and entrepreneurship. The challenge is with TLE offerring a vast area of specializations, how would Multiple Intelligence play its vital role as basis in classroom instruction in acquiring the requirement of the said curriculum? 1.To what extent do the respondent students manifest the following types of intelligences: Visual-Spatial, Body-Kinesthetic, Musical, Interpersonal, Intrapersonal, Verbal-Linguistic, Logical-Mathematical and Naturalistic. What media should be used appropriate to the student’s learning style? Visual, Printed Words, Sound, Motion, Color or Realia 3. What is the impact of multiple intelligence as basis for differentiated instruction in T.L.E. based on the following student’s ability? Learning Characteristic and Reading Ability and Performance 3. To what extent do the intelligences of the student relate with their academic performance? The following were the findings derived from the study: In consideration of the vast areas of study of TLE, and the importance it plays in the school curriculum coinciding with the expectation of turning students to technologically competent contributing members of the society, either in the field of Technical/Vocational Expertise or Entrepreneurial based competencies, as well as the government’s concern for it, we visualize TLE classroom teachers making use of multiple intelligence as basis for differentiated classroom instruction in teaching the subject .Somehow, multiple intelligence sample such as Linguistic, Logical-Mathematical, Bodily-Kinesthetic, Interpersonal, Intrapersonal, and Spatial abilities that an individual student may have or may not have, can be a basis for a TLE teacher’s instructional method or design.

Keywords: education, multiple, differentiated classroom instruction, impact analysis

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Authors: Marcela Dávalos López

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In Mexico, the distribution of hygienistarchitecture during the 20th century had different rhythms. The culmination of the urban hygiene system (from sewers to showers, passing through garbage collection) forced neighbors and citizens to participate in the common welfare. This turned the urban references and dissociated the ways of living and led to comfort and health. However, the contrast between two Mexicancities, Cuernavaca and Mexico City shows us very different cultural practices regarding the use of hygienicarchitectures: in the first, thenature of its deepravines marked the destiny of residential architecture, while in Mexico City, state participation alteredthelandscape and homogenized the architectural models of domestic and intímate spaces.

Keywords: Cultural Practices, Dissociated Ways To Comfort, Hygiene Architecture , Mexico

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Authors: Marco Ferretti, Marcello Risitano, Maria Cristina Pietronudo, Lina Ozturk

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A green port is the result of a sustainable long-term strategy adopted by an entire port infrastructure, therefore by the set of actors involved in port activities. The strategy aims to realise the development of sustainable port infrastructure focused on the reduction of negative environmental impacts without jeopardising economic growth. Green technology represents the core tool to implement sustainable solutions, however, they are not a magic bullet. Ports have always been integrated in the local territory affecting the environment in which they operate, therefore, the sustainable strategy should fit with the entire local systems. Therefore, adopting a sustainable strategy means to know how to involve and engage a wide stakeholders’ network (industries, production, markets, citizens, and public authority). The existing research on the topic has not well integrated this perspective with those of sustainability. Research on green ports have mixed the sustainability aspects with those on the maritime industry, neglecting dynamics that lead to the development of the green port phenomenon. We propose an analysis of green ports adopting the lens of ecosystem studies in the field of management. The ecosystem approach provides a way to model relations that enable green solutions and green practices in a port ecosystem. However, due to the local dimension of a port and the port trend on innovation, i.e., sustainable innovation, we draw to a specific concept of ecosystem, those on local innovation systems. More precisely, we explore if a green port is a local innovation system engaged in developing sustainable innovation with a large impact on the territory or merely an innovation adopter. To address this issue, we adopt a comparative case study selecting two innovative ports in Europe: Rotterdam and Genova. The case study is a research method focused on understanding the dynamics in a specific situation and can be used to provide a description of real circumstances. Preliminary results show two different approaches in supporting sustainable innovation: one represented by Rotterdam, a pioneer in competitiveness and sustainability, and the second one represented by Genoa, an example of technology adopter. The paper intends to provide a better understanding of how sustainable innovations are developed and in which manner a network of port and local stakeholder support this process. Furthermore, it proposes a taxonomy of green ports as developers and adopters of sustainable innovation, suggesting also best practices to model relationships that enable the port ecosystem in applying a sustainable strategy.

Keywords: green port, innovation, sustainability, local innovation systems

Procedia PDF Downloads 106