Search results for: flood risk communication

Authors: Tetyana Kendzerska, David T. Zhu, Michael Pugliese, Douglas Manuel, Mohsen Sadatsafavi, Marcus Povitz, Therese A. Stukel, Teresa To, Shawn D. Aaron, Sunita Mulpuru, Melanie Chin, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Andrea S. Gershon

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The impact of the COVID-19 pandemic on the management of ambulatory care sensitive conditions (ACSCs) remains unknown. To compare observed and expected (projected based on previous years) trends in all-cause mortality and healthcare use for ACSCs in the first year of the pandemic (March 2020 - March 2021). A population-based study using provincial health administrative data.General adult population (Ontario, Canada). Monthly all-cause mortality, and hospitalizations, emergency department (ED) and outpatient visit rates (per 100,000 people at-risk) for seven combined ACSCs (asthma, COPD, angina, congestive heart failure, hypertension, diabetes, and epilepsy) during the first year were compared with similar periods in previous years (2016-2019) by fitting monthly time series auto-regressive integrated moving-average models. Compared to previous years, all-cause mortality rates increased at the beginning of the pandemic (observed rate in March-May 2020 of 79.98 vs. projected of 71.24 [66.35-76.50]) and then returned to expected in June 2020—except among immigrants and people with mental health conditions where they remained elevated. Hospitalization and ED visit rates for ACSCs remained lower than projected throughout the first year: observed hospitalization rate of 37.29 vs. projected of 52.07 (47.84-56.68); observed ED visit rate of 92.55 vs. projected of 134.72 (124.89-145.33). ACSC outpatient visit rates decreased initially (observed rate of 4,299.57 vs. projected of 5,060.23 [4,712.64-5,433.46]) and then returned to expected in June 2020. Reductions in outpatient visits for ACSCs at the beginning of the pandemic combined with reduced hospital admissions may have been associated with temporally increased mortality—disproportionately experienced by immigrants and those with mental health conditions. The Ottawa Hospital Academic Medical Organization

Keywords: COVID-19, chronic disease, all-cause mortality, hospitalizations, emergency department visits, outpatient visits, modelling, population-based study, asthma, COPD, angina, heart failure, hypertension, diabetes, epilepsy

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Authors: Ghadeer Aly, Yasmeen Hanafy

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The way we research travel options and decide where to go has substantially changed in the digital age. Atypical search engines like social networking sites like TikTok have evolved, influencing the preferences of various generations. The influence of TikTok use as a search engine for choosing travel locations and its effect on a country's destination branding are both examined in this study. The study specifically focuses on the comparative preferences and actions of Generations Y and Z within the Egyptian community, shedding light on how these generations interact with travel related TikTok content and how it influences their perceptions of various destinations. It also investigates how TikTok Accounts use tourism branding techniques to promote a country's tourist destination. The investigation of how social media platforms are changing as unconventional search engines has theoretical relevance. This study can advance our knowledge of how digital platforms alter information-seeking behaviors and affect the way people make decisions. Furthermore, investigating the relationship between TikTok video and destination branding might shed light on the intricate interplay between social media, perceptions of locations, and travel preferences, enhancing theories about consumer behavior and communication in the digital age. Regarding the methodology of the research, the study is conducted in two stages: first, both generations are polled, and from the results, the top three destinations are chosen to be subjected to content analysis. As for the research's theoretical framework, it incorporates the tourism destination branding model as well as the conceptual model of nation branding. Through the use of the survey as a quantitative approach and the qualitative content analysis, the research will rely on both quantitative and qualitative methods. When it comes to the theoretical framework, both the Nation Branding Model and the Tourism Branding Model can offer useful frameworks for analyzing and comprehending the dynamics of using TikTok as a search engine to choose travel destinations, especially in the context of Generation Y and Generation Z in the Egyptian community. Additionally, the sample will be drawn specifically from both Gen-Y and Gen-Z. 100 members of Gen Z and 100 members of Gen Y will be chosen from TikTok users and followers of travel-related accounts, and the sample for the content analysis will be chosen based on the survey's results.

Keywords: tiktok, nation image, egyptian community, tourism branding

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Authors: Filipa Cruz, Grecia P. Matos

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An Inexhaustible Will of Infinite is ongoing practice-based research focused on a psychophysiological conception of body and on the creative will that seeks to examine the possibility of art being simultaneously a pacifier and an intensifier in a physiological artistic production. This is a study where philosophy and art converge in a commentary on the affection of the concept of will to power in the art world through Nietzsche’s commentaries, through the analysis of case studies and a reflection arising from artistic practice. Through Nietzsche, it is sought to compare concepts that communicate with the artistic practice since creation is an intensification and engenders perspectives. It is also a practice highly embedded in the body, in the non-verbal, in the physiology of art and in the coexistence between the sensorial and the thought. It is questioned if the physiology of art could be thought of as a thinking-feeling with no primacy of the thought over the sensorial. Art as a manifestation of the will to power participates in a comprehension of the world. In this article, art is taken as a privileged way of communication – implicating corporeal-sensorial-conceptual – and of connection between humans. Problematized is the dream and the drunkenness as intensifications and expressions of life’s comprehension. Therefore, art is perceived as suggestion and invention, where the artistic intoxication breaks limits in the experience of life, and the artist, dominated by creative forces, claims, orders, obeys, proclaims love for life. The intention is also to consider how one can start from pain to create and how one can generate new and endless artistic forms through nightmares, daydreams, impulses, intoxication, enhancement, intensification in a plurality of subjects and matters. It is taken into consideration the fact that artistic creation is something that is intensified corporeally, expanded, continuously generated and acting on bodies. It is inextinguishable and a constant movement intertwining Apollonian and Dionysian instincts of destruction and creation of new forms. The concept of love also appears associated with conquering, that, in a process of intensification and drunkenness, impels the artist to generate and to transform matter. Just like a love relationship, love in Nietzsche requires time, patience, effort, courage, conquest, seduction, obedience, and command, potentiating the amplification of knowledge of the other / the world. Interlacing Nietzsche's philosophy, not with Modern Art, but with Contemporary Art, it is argued that intoxication, will to power (strongly connected with the creative will) and love still have a place in the artistic production as creative agents.

Keywords: artistic creation, body, intensification, psychophysiology, will to power

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Authors: Ahmet Ozcan, Onder Alparslan, Anil Sezgin, Omer Cetin

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The use of unmanned systems for different purposes has become very popular over the past decade. Expectations from these systems have also shown an incredible increase in this parallel. But meeting the demands of the tasks are often not possible with the usage of a single unmanned vehicle in a mission, so it is necessary to use multiple autonomous vehicles with different abilities together in coordination. Therefore the usage of the same type of vehicles together as a swarm is helped especially to satisfy the time constraints of the missions effectively. In other words, it allows sharing the workload by the various numbers of homogenous platforms together. Besides, it is possible to say there are many kinds of problems that require the usage of the different capabilities of the heterogeneous platforms together cooperatively to achieve successful results. In this case, cooperative working brings additional problems beyond the homogeneous clusters. In the scenario presented as an example problem, it is expected that an autonomous ground vehicle, which is lack of its position information, manage to perform point-to-point navigation without losing its way in a previously unknown labyrinth. Furthermore, the ground vehicle is equipped with very limited sensors such as ultrasonic sensors that can detect obstacles. It is very hard to plan or complete the mission for the ground vehicle by self without lost its way in the unknown labyrinth. Thus, in order to assist the ground vehicle, the autonomous air drone is also used to solve the problem cooperatively. The autonomous drone also has limited sensors like downward looking camera and IMU, and it also lacks computing its global position. In this context, it is aimed to solve the problem effectively without taking additional support or input from the outside, just benefiting capabilities of two autonomous vehicles. To manage the point-to-point navigation in a previously unknown labyrinth, the platforms have to work together coordinated. In this paper, cooperative work of heterogeneous unmanned systems is handled in an applied sample scenario, and it is mentioned that how to work together with an autonomous ground vehicle and the autonomous flying platform together in a harmony to take advantage of different platform-specific capabilities. The difficulties of using heterogeneous multiple autonomous platforms in a mission are put forward, and the successful solutions are defined and implemented against the problems like spatially distributed tasks planning, simultaneous coordinated motion, effective communication, and sensor fusion.

Keywords: unmanned systems, heterogeneous autonomous vehicles, coordination, task planning

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Authors: P. Pérez-Martín, G. Pedrós, P. Martínez-Jiménez, M. Varo-Martínez

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In recent decades, family habits related to children’s displacements to school have changed, increasing motorized travels against active modes. This entails a major negative impact on the urban environment, road safety in cities and the physical and psychological development of children. One of the more common actions used to reverse this trend is Walking School Bus (WSB), which consists of a predefined adult-scorted pedestrian route to school with several stops along the path where schoolchildren are collected. At Tirso de Molina School in Cordoba (Spain), a new ICT-based methodology to deploy WSB has been tested. A mobile app that allows the geoposition of the group, the notification of the arrival and real-time communication between the WSB participants have been presented to the families in order to organize and register the daily participation. After an initial survey to know the travel mode and the spatial distribution of the interested families, three WSB routes have been established and the families have been trained in the app usage. During nine weeks, 33 children have joined the WSB and their parents have accompanied the groups in turns. A high recurrence in the attendance has been registered. Through a final survey, participants have valued highly the tool and the methodology designed, emphasizing as most useful features of the mobile app: notifications system, chat and real-time monitoring. It has also been found that the tool has had a major impact on the degree of confidence of parents regarding the autonomous on foot displacement of their children to school. Moreover, 37,9% of the participant families have reported a total or partial modal shift from car to walking, and the benefits more reported are an increment of the parents available time and less problems in the travel to school daily organization. As a consequence, It has been proved the effectiveness of this user-centric innovative ICT-based methodology to reduce the levels of private car drop offs, minimize barriers of time constraints, volunteer recruitment, and parents’ safety concerns, while, at the same time, increase convenience and time savings for families. This pilot study can offer guidance for community coordinated actions and local authority interventions to support sustainable school travel outcomes.

Keywords: active travel, mobile app, sustainable mobility, urban transportation planning, walking school bus

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Authors: Bahar Hazal Yalçınkaya, Bayram Yılmaz, Mustafa Özilgen

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Brain information transmission in the neuronal network occurs in the form of electrical signals. Neural work transmits information between the neurons or neurons and target cells by moving charged particles in a voltage field; a fraction of the energy utilized in this process is dissipated via entropy generation. Exergy loss and entropy generation models demonstrate the inefficiencies of the communication along the dendritic trees. In this study, neurons of 4 different animals were analyzed with one dimensional cable model with N=6 identical dendritic trees and M=3 order of symmetrical branching. Each branch symmetrically bifurcates in accordance with the 3/2 power law in an infinitely long cylinder with the usual core conductor assumptions, where membrane potential is conserved in the core conductor at all branching points. In the model, exergy loss and entropy generation rates are calculated for each branch of equivalent cylinders of electrotonic length (L) ranging from 0.1 to 1.5 for four different dendritic branches, input branch (BI), and sister branch (BS) and two cousin branches (BC-1 & BC-2). Thermodynamic analysis with the data coming from two different cat motoneuron studies show that in both experiments nearly the same amount of exergy is lost while generating nearly the same amount of entropy. Guinea pig vagal motoneuron loses twofold more exergy compared to the cat models and the squid exergy loss and entropy generation were nearly tenfold compared to the guinea pig vagal motoneuron model. Thermodynamic analysis show that the dissipated energy in the dendritic tress is directly proportional with the electrotonic length, exergy loss and entropy generation. Entropy generation and exergy loss show variability not only between the vertebrate and invertebrates but also within the same class. Concurrently, single action potential Na⁺ ion load, metabolic energy utilization and its thermodynamic aspect contributed for squid giant axon and mammalian motoneuron model. Energy demand is supplied to the neurons in the form of Adenosine triphosphate (ATP). Exergy destruction and entropy generation upon ATP hydrolysis are calculated. ATP utilization, exergy destruction and entropy generation showed differences in each model depending on the variations in the ion transport along the channels.

Keywords: ATP utilization, entropy generation, exergy loss, neuronal information transmittance

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Authors: Soheila Sadeghi

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In the dynamic landscape of project management, scope changes are an inevitable reality that can significantly impact project performance. These changes, whether initiated by stakeholders, external factors, or internal project dynamics, can lead to cost overruns and schedule delays. Accurately predicting the consequences of these changes is crucial for effective project control and informed decision-making. This study aims to develop predictive models to estimate the impact of scope changes on project cost and schedule using machine learning techniques. The research utilizes a comprehensive dataset containing detailed information on project tasks, including the Work Breakdown Structure (WBS), task type, productivity rate, estimated cost, actual cost, duration, task dependencies, scope change magnitude, and scope change timing. Multiple machine learning models are developed and evaluated to predict the impact of scope changes on project cost and schedule. These models include Linear Regression, Decision Tree, Ridge Regression, Random Forest, Gradient Boosting, and XGBoost. The dataset is split into training and testing sets, and the models are trained using the preprocessed data. Cross-validation techniques are employed to assess the robustness and generalization ability of the models. The performance of the models is evaluated using metrics such as Mean Squared Error (MSE) and R-squared. Residual plots are generated to assess the goodness of fit and identify any patterns or outliers. Hyperparameter tuning is performed to optimize the XGBoost model and improve its predictive accuracy. The feature importance analysis reveals the relative significance of different project attributes in predicting the impact on cost and schedule. Key factors such as productivity rate, scope change magnitude, task dependencies, estimated cost, actual cost, duration, and specific WBS elements are identified as influential predictors. The study highlights the importance of considering both cost and schedule implications when managing scope changes. The developed predictive models provide project managers with a data-driven tool to proactively assess the potential impact of scope changes on project cost and schedule. By leveraging these insights, project managers can make informed decisions, optimize resource allocation, and develop effective mitigation strategies. The findings of this research contribute to improved project planning, risk management, and overall project success.

Keywords: cost impact, machine learning, predictive modeling, schedule impact, scope changes

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Authors: Faizan Sultan

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Non-government organizations (NGOs) in Pakistan have the potential to deliver services such as health, education, and rural development through targeting the most vulnerable communities of society. Having this significant importance, NGOs are facing numerous challenges in service delivery. So, there is a need to identify the challenges NGOs face in community development, particularly post-conflict development. The current study has analyzed the social and political constraints in development projects in the post-conflict region of the Swat district of Khyber Pakhtunkhwa. The objectives of this study are “What are the social and political constraints faced by the nongovernmental organizations in the implementation of development aid Projects in post-conflict development of Swat and to examine the challenges in coordination mechanism between government departments, NGOs, and community in reconstruction activities”. This research is based upon both the quantitative and qualitative data that is being gathered from the NGO representatives, government officials, and community members who were involved in post-conflict development interventions in the Swat region. A purposive sampling technique was used to select respondents from the community members/activists (25 in number) and government and NGO officials (10 in number). Based on analysis against our objectives, NGOs have faced numerous constraints such as Insecurity, Negative Perceptions about NGOs, restrictions on women's mobility, government policies and regulations, lack of coordination and networking, trust deficit, and political interference while implementing their project interventions. These findings concluded that constraints have affected project implementation to a greater extent, including women's participation, involvement of marginalized populations, and equal distribution of resources. In the Swat region, NGOs cannot openly discuss sensitive projects such as human rights, gender-based projects, or women empowerment as these issues are very sensitive to the local community due to their cultural values. The community may not allow their females to go outside their homes as this region is a male-dominated society. Similarly, lack of communication and poor networking for the arrangements of the project meetings were also the major constraints.

Keywords: national disaster management authority, millennium development goals, provincial disaster management authority, provincial reconstruction, rehabilitation and settlement authority

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Authors: Guler Duru Asiret, Cemile Kutmec Yilmaz, Gulcan Bagcivan, Tugce Turten Kaymaz

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This descriptive study was conducted to determine the relationship between caregiver burden and life satisfaction who give home care to elderly individuals. The sample was recruited from the internal medicine unit and palliative unit of a state hospital located in Turkey on June 2016-2017. The study sample consisted of 231 primary caregiver family member, who met the eligibility criteria and agreed to participate in the study. The inclusion criteria were as follows: inpatient’s caregiver, primary caregiver for at least 3 months, at least 18 years of age, no communication problem or mental disorder. Data were gathered using an Information Form prepared by the researchers based on previous literature, the Zarit Burden Interview (ZBI), and the Satisfaction with Life Scale (SWLS). The data were analyzed using IBM SPSS Statistics software version 20.0 (SPSS, Chicago, IL). The descriptive characteristics of the participant were analyzed using number, percentage, mean and standard deviation. The suitability of normal distribution of scale scores was analyzed using Kolmogorov-Smirnov and Shapiro-Wilk test. Relationships between scales were analyzed using Spearman’s rank-correlation coefficient. P values less than 0.05 were considered to be significant. The average age of the caregivers was 50.11±13.46 (mean±SD) years. Of the caregivers, 76.2% were women, 45% were primary school graduates, 89.2% were married, 38.1% were the daughters of their patients. Among these, 52.4% evaluated their income level to be good. Of them, 53.6% had been giving care less than 2 years. The patients’ average age was 77.1±8.0 years. Of the patients, 55.8% were women, 56.3% were illeterate, 70.6% were married, and 97.4% had at least one chronic disease. The mean Zarit Burden Interview score was 35.4±1.5 and the Satisfaction with Life Scale score was 20.6±6.8. A negative relationship was found between the patients’ score average on the ZBI, and on the SWLS (r= -0.438, p=0.000). The present study determined that the caregivers have a moderate caregiver burden and the life satisfaction. And the life satisfaction of caregivers decreased as their caregiver burden increase. In line with the results obtained from the research, it is recommended that to increase the effectiveness of discharge training, to arrange training and counseling programs for caregivers to cope with the problems they experienced, to monitor the caregivers at regular intervals and to provide necessary institutional support.

Keywords: caregiver burden, family caregivers, nurses, satisfaction

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Authors: Obiageli Helen Ezeh, Chuks Clement Ezeh

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Background: It is estimated that more than 330 million persons are living with HIV-infection globally and in Nigeria about 3.4 persons are living with the infection, with an annual death rate of 180,000. Psychological morbidity often accompany chronic illnesses and may be associated with substance abuse, poor health seeking behavior and adherence to treatment program; it may worsen existing health problems and the overall quality of life. Until the burden is effectively identified, intervention cannot be planned. Until there is a cure, the goal is to manage and cope effectively with HIV-infection. Little if any studies have been done in this area in the North West geo-political zone of Nigeria. The study would help to identify high risk groups and prevent the progression and spread of the infection. Aim: To identify HIV-infected persons with psychological morbidity, accessing HIV- clinic at Shika Hospital, Zaria, Kaduna State; and analyze their socio-demographic profile. Methods: A cross sectional descriptive study was carried out to assess and analyze the socio-demographic characteristics of HIV-infected persons attending Shika hospital Zaria Nigeria, who screened positive for psychological morbidity. A total of 109 HIV-infected persons receiving HAART at Shika clinic, Zaria, Kaduna State, Nigeria, were administered questionnaires, the General Health Questionnaire (GHQ-12)measuring psychological morbidity and socio-demographic data. The participants ranged in age between 18 and 75 years. Results: Data were analyzed using SPSS software 15. Both descriptive and inferential Statistics were performed on the data. Results indicate a total prevalent rate of psychological morbidity of 78 percent among participants. Of this, about 16.2 percent were severely distressed, 25.1 percent moderately distressed and 36.7percent were mildly distressed. More females (65 percent of those with psychological morbidity) were found to be distressed than their male (55 percent) counterparts. It was (44 percent) for patients whose HIV-infection was of relatively shorter duration(2-4 years) than those of longer duration(5-9 years; and 10 years/above). The age group (21-30 years) was the most affected (35 percent). The rate was also 55 percent for Christians and 45 percent for Muslims. For married patients with partners it was 20 percent and for singles 30 percent; for the widowed (12 percent) and divorced (38 percent). At the level of tribal/ethnic groups, it was 13 percent for Ibos, 22 percent for Yorubas, 27 percent for Hausas and 33 percent for all the other minority tribes put together. Conclusion/Recommendation: The study has been able to identify the presence of psychological morbidity among HIV-infected persons as high and analyze the socio-demographic factors associated with it as significant. Periodic screening of HIV-infected persons for psychological morbidity and psychosocial intervention was recommended.

Keywords: socio-demographics, psychological morbidities, HIV-Infection, HAART

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Authors: Svetlana Kostrubina, Anastasia Prokopeva

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This research presents a comprehensive study of the word formation processes in computer terminology within English and Russian languages and provides listeners with a system of exercises for training these skills. The originality is that this study focuses on a comparative approach, which shows both general patterns and specific features of English and Russian computer terms word formation. The key point is the system of exercises development for training computer terminology based on Bloom’s taxonomy. Data contain 486 units (228 English terms from the Glossary of Computer Terms and 258 Russian terms from the Terminological Dictionary-Reference Book). The objective is to identify the main affixation models in the English and Russian computer terms formation and to develop exercises. To achieve this goal, the authors employed Bloom’s Taxonomy as a methodological framework to create a systematic exercise program aimed at enhancing students’ cognitive skills in analyzing, applying, and evaluating computer terms. The exercises are appropriate for various levels of learning, from basic recall of definitions to higher-order thinking skills, such as synthesizing new terms and critically assessing their usage in different contexts. Methodology also includes: a method of scientific and theoretical analysis for systematization of linguistic concepts and clarification of the conceptual and terminological apparatus; a method of nominative and derivative analysis for identifying word-formation types; a method of word-formation analysis for organizing linguistic units; a classification method for determining structural types of abbreviations applicable to the field of computer communication; a quantitative analysis technique for determining the productivity of methods for forming abbreviations of computer vocabulary based on the English and Russian computer terms, as well as a technique of tabular data processing for a visual presentation of the results obtained. a technique of interlingua comparison for identifying common and different features of abbreviations of computer terms in the Russian and English languages. The research shows that affixation retains its productivity in the English and Russian computer terms formation. Bloom’s taxonomy allows us to plan a training program and predict the effectiveness of the compiled program based on the assessment of the teaching methods used.

Keywords: word formation, affixation, computer terms, Bloom's taxonomy

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Authors: Elizabeth B. Katana, Brenda N. Simbwa, Josephine Namayanja, Bob O. Amodan, Edirisa J. Nsubuga, Eva A. O. Laker

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Background: Understanding stakeholders’ perceptions towards the implementation of a mass vaccination campaign is important to ensure the design of better strategies to address challenges. We explored stakeholders’ perceptions of the implementation of a nationwide door-to-door mass vaccination campaign for the oral polio vaccine (nOPV2) in Uganda for the two rounds that occurred in January and November 2022. Methods: A qualitative study was conducted among stakeholders who participated in the campaign implementation from 8 districts in Uganda using random sampling. We conducted 46 In-depth interviews lasting 30 – 40 minutes with 6 national/central supervisors, 12 district, 14 sub-county, and 14 parish-level supervisors. Stakeholders were asked about their experiences in the campaign implementation, including challenges faced and their opinions of the campaign impact and use of the door-to-door strategy. Data were analyzed thematically in line with the major campaign activities. Results: Most of the stakeholders were primarily concerned about poor planning, inadequate training of vaccination teams, community resistance including schools, challenges with recruitment and teaming of vaccinators, poor and delayed payments, lack of logistics and motivation for vaccination teams, the timing of the activities and implementing amidst COVID-19 and Ebola. The stakeholders believed that the first round was not well planned and implemented, while the second round was leveraged in their previous experiences. On the other hand, some positive experiences were noted with regard to communication, advocacy and mobilization, vaccine delivery and distribution, district readiness assessments, and cold chain management. Conclusion: This study identified many challenges that were faced in the implementation of the door-to-door mass campaign for nOPV2 in Uganda. This study identified that more needs to be done to improve door-to-door mass campaigns with a focus on motivating the implementers. These findings highlight the need for conducting performance reviews, improved planning, especially routine updates and verification of target populations and training in microplanning, and adequate mapping of community resistance to inform the implementation of future mass campaigns.

Keywords: mass polio vaccination campaigns, door-to-door strategy, stakeholders' perceptions, implementation challenges

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Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

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Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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Authors: Nicholas McNamara, John Brookes, Michael Williams, Manish Mathew, Elizabeth Brookes, Tristan Yan, Paul Bannon

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Objective: Pericardial effusions are an uncommon but potentially fatal complication after cardiac surgery. The goal of this study was to describe the incidence and risk factors associated with the development of pericardial effusion requiring drainage after coronary artery bypass graft surgery (CABG). Methods: A retrospective analysis was undertaken using prospectively collected data. All adult patients who underwent CABG at our institution between 1st January 2017 and 31st December 2018 were included. Pericardial effusion was diagnosed using transthoracic echocardiography (TTE) performed for clinical suspicion of pre-tamponade or tamponade. Drainage was undertaken if considered clinically necessary and performed via a sub-xiphoid incision, pericardiocentesis, or via re-sternotomy at the discretion of the treating surgeon. Patient demographics, operative characteristics, anticoagulant exposure, and postoperative outcomes were examined to identify those variables associated with the development of pericardial effusion requiring drainage. Tests of association were performed using the Fischer exact test for dichotomous variables and the Student t-test for continuous variables. Logistic regression models were used to determine univariate predictors of pericardial effusion requiring drainage. Results: Between January 1st, 2017, and December 31st, 2018, a total of 408 patients underwent CABG at our institution, and eight (1.9%) required drainage of pericardial effusion. There was no difference in age, gender, or the proportion of patients on preoperative therapeutic heparin between the study and control groups. Univariate analysis identified preoperative atrial arrhythmia (37.5% vs 8.8%, p = 0.03), reduced left ventricular ejection fraction (47% vs 56%, p = 0.04), longer cardiopulmonary bypass (130 vs 84 min, p < 0.01) and cross-clamp (107 vs 62 min, p < 0.01) times, higher drain output in the first four postoperative hours (420 vs 213 mL, p <0.01), postoperative atrial fibrillation (100% vs 32%, p < 0.01), and pleural effusion requiring drainage (87.5% vs 12.5%, p < 0.01) to be associated with development of pericardial effusion requiring drainage. Conclusion: In this study, the incidence of pericardial effusion requiring drainage was 1.9%. Several factors, mainly related to preoperative or postoperative arrhythmia, length of surgery, and pleural effusion requiring drainage, were identified to be associated with developing clinically significant pericardial effusions. High clinical suspicion and low threshold for transthoracic echo are pertinent to ensure this potentially lethal condition is not missed.

Keywords: coronary artery bypass, pericardial effusion, pericardiocentesis, tamponade, sub-xiphoid drainage

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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

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Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

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Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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Authors: Mohamed Aljarallah, Mohamed Nurullah, George Saridakis

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This paper aims and objectives are to investigate how the structural change of the financial regulatory bodies affect the financial supervision and how the regulators can design such a structure with taking into account; the Central Bank, the conduct of business and the prudential regulators, it will also consider looking at the structure of the international regulatory bodies and what barriers are found. There will be five questions to be answered; should conduct of business and prudential regulation be separated? Should the financial supervision and financial stability be separated? Should the financial supervision be under the Central Bank? To what extent the politician should intervene in changing the regulatory and supervisory structure? What should be the regulatory and supervisory structure when there is financial conglomerate? Semi structure interview design will be applied. This research sample selection contains a collective of financial regulators and supervisors from the emerged and emerging countries. Moreover, financial regulators and supervisors must be at a senior level at their organisations. Additionally, senior financial regulators and supervisors would come from different authorities and from around the world. For instance, one of the participants comes from the International Bank Settlements, others come from European Central Bank, and an additional one will come from Hong Kong Monetary Authority and others. Such a variety aims to fulfil the aims and objectives of the research and cover the research questions. The analysis process starts with transcription of the interview, using Nvivo software for coding, applying thematic interview to generate the main themes. The major findings of the study are as follow. First, organisational structure changes quite frequently if the mandates are not clear. Second, measuring structural change is difficult, which makes the whole process unclear. Third, effective coordination and communication are what regulators looking for when they change the structure and that requires; openness, trust, and incentive. In addition to that, issues appear during the event of crisis tend to be the reason why the structure change. Also, the development of the market sometime causes a change in the regulatory structure. And, some structural change occurs simply because of the international trend, fashion, or other countries' experiences. Furthermore, when the top management change the structure tends to change. Moreover, the structure change due to the political change, or politicians try to show they are doing something. Finally, fear of being blamed can be a driver of structural change. In conclusion, this research aims to provide an insight from the senior regulators and supervisors from fifty different countries to have a clear understanding of why the regulatory structure keeps changing from time to time through a qualitative approach, namely, semi-structure interview.

Keywords: financial regulation bodies, financial regulatory structure, global financial regulation, financial crisis

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Authors: Johan Esbach

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The entrepreneur has traditionally been defined through various historical lenses, emphasising individual traits, risk-taking, speculation, innovation and firm creation. However, these definitions often fail to address the dynamic nature of the modern entrepreneurial functions, which respond to unpredictable uncertainties and transition to routine management as certainty is achieved. This paper proposes a revised definition, positioning the entrepreneur as a dynamic function rather than a human construct, that emerges to address specific uncertainties in economic systems, but fades once uncertainty is resolved. By examining historical definitions and its limitations, including the works of Cantillon, Say, Schumpeter, and Knight, this paper identifies a gap in literature and develops a generalised definition for the entrepreneur. The revised definition challenges conventional thought by shifting focus from static attributes such as alertness, traits, firm creation, etc., to a dynamic role that includes reliability, adaptation, scalability, and adaptability. The methodology of this paper employs a mixed approach, combining theoretical analysis and case study examination to explore the dynamic nature of the entrepreneurial function in relation to uncertainty. The selection of case studies includes companies like Airbnb, Uber, Netflix, and Tesla, as these firms demonstrate a clear transition from entrepreneurial uncertainty to routine certainty. The data from the case studies is then analysed qualitatively, focusing on the patterns of entrepreneurial function across the selected companies. These results are then validated using quantitative analysis, derived from an independent survey. The primary finding of the paper will validate the entrepreneur as a dynamic function rather than a static, human-centric role. In considering the transition from uncertainty to certainty in companies like Airbnb, Uber, Netflix, and Tesla, the study shows that the entrepreneurial function emerges explicitly to address market, technological, or social uncertainties. Once these uncertainties are resolved and a certainty in the operating environment is established, the need for the entrepreneurial function ceases, giving way to routine management and business operations. The paper emphasises the need for a definitive model that responds to the temporal and contextualised nature of the entrepreneur. In adopting the revised definition, the entrepreneur is positioned to play a crucial role in the reduction of uncertainties within economic systems. Once the uncertainties are addressed, certainty is manifested in new combinations or new firms. Finally, the paper outlines policy implications for fostering environments that enables the entrepreneurial function and transition theory.

Keywords: dynamic function, uncertainty, revised definition, transition

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Authors: Antoine Dumont, Weiji Hong, Zheng-Hong Lu

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Light emitting diodes (LEDs) are steadily becoming the new standard for luminescent display devices because of their energy efficiency and relatively low cost, and the purity of the light they emit. Our research focuses on the optical properties of the lead halide perovskite CsPbBr₃ and its family that is showing steadily improving performances in LEDs and solar cells. The objective of this work is to investigate CsPbBr₃ as an emitting layer made by physical vapor deposition instead of the usual solution-processed perovskites, for use in LEDs. The deposition in vacuum eliminates any risk of contaminants as well as the necessity for the use of chemical ligands in the synthesis of quantum dots. Initial results show the versatility of the dual-source evaporation method, which allowed us to create different phases in bulk form by altering the mole ratio or deposition rate of CsBr and PbBr₂. The distinct phases Cs₄PbBr₆, CsPbBr₃ and CsPb₂Br₅ – confirmed through XPS (x-ray photoelectron spectroscopy) and X-ray diffraction analysis – have different optical properties and morphologies that can be used for specific applications in optoelectronics. We are particularly focused on the blue shift expected from quantum dots (QDs) and the stability of the perovskite in this form. We already obtained proof of the formation of QDs through our dual source evaporation method with electron microscope imaging and photoluminescence testing, which we understand is a first in the community. We also incorporated the QDs in an LED structure to test the electroluminescence and the effect on performance and have already observed a significant wavelength shift. The goal is to reach 480nm after shifting from the original 528nm bulk emission. The hole transport layer (HTL) material onto which the CsPbBr₃ is evaporated is a critical part of this study as the surface energy interaction dictates the behaviour of the QD growth. A thorough study to determine the optimal HTL is in progress. A strong blue shift for a typically green emitting material like CsPbBr₃ would eliminate the necessity of using blue emitting Cl-based perovskite compounds and could prove to be more stable in a QD structure. The final aim is to make a perovskite QD LED with strong blue luminescence, fabricated through a dual-source evaporation technique that could be scalable to industry level, making this device a viable and cost-effective alternative to current commercial LEDs.

Keywords: material physics, perovskite, light emitting diode, quantum dots, high vacuum deposition, thin film processing

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Authors: Ophir Segal, Daniel Weltsch, Shay Tenenbaum, Ran Thein

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Purpose: Patients with lateral patellar dislocation (LPD) are not always referred to perform an MRI. This might be the case in first time LPD patients without surgical indications or in patients with recurrent LPD who had MRI in previous episodes. Unfortunately, in some cases, there are additional knee pathological findings, which include tearing of the collateral or cruciate ligaments and injury to the tendons or menisci. These findings might be overlooked during the physical examination or masked by nonspecific clinical findings like knee pain, effusion, or hemarthrosis. The prevalence of these findings, which can be revealed by MRI, is misreported in literature and is considered rare. In our practice, all patients with LPD are sent for MRI after LPD. Therefore, we have designed a retrospective comparative study to evaluate the prevalence of additional pathological findings in patients with acute traumatic LPD that had performed MRI, comparing different groups of patients according to age, sex, and Tibial Tuberosity-Trochlear Groove(TT-TG) distance. Methods: MRI of the knee in patients after traumatic LPD were evaluated for the presence of additional pathological findings such as injuries to ligaments: Anterior/Posterior cruciate ligament(ACL, PCL), Medial/Lateral collateral ligament(MCL, LCL), injuries to tendons(QUADICEPS, PATELLAR), menisci(Medial/Lateral meniscus(MM, LM)) and tibial plateau, by a fellowship-trained, senior musculoskeletal radiologist. A comparison between different groups of patients was performed according to age (age group < 25 years, age group > 25 years), sex (Male/Female group), and TT-TG distance (TT-TG<15 groups, TT-TG>15 groups). A descriptive and comparative statistical analysis was performed. Results: 150 patients were included in this study. All suffered from LPD between the years 2012-2017 (mean age 21.3( ± SD 8.9), 86 males). ACL, PCL, MCL, and LCL complete or partial tears were found in 17(11.3%), 3(2%), 22(14.6%), and 4(2.7%) of the patients, respectively. MM and LM tears were found in 10(6.7%) and 3(2%) of the patients, respectively. A higher prevalence of PCL injury, MM tear, and LM tear were found in the older age group compared to the younger group of patients (10.5% vs. 1.8%, 18.4% vs. 2.7%, and 7.9% vs. 0%, respectively, p<0.05). A higher prevalence of non-displaced MM tear and LCL injury was found in the male group compared to the female group (8.1% vs. 0% and 8.1% vs. 0% respectively, p<0.05). A higher prevalence of ACL injury was found in the normal TT-TG group compared to the pathologic TT-TG group (17.5% vs. 2.3%, p= 0.0184). Conclusions: Overall, 43 out of 150 (28.7%) of the patient's MRI’s were positive for additional pathological radiological findings. Interestingly, a higher prevalence of additional pathologies was found in the groups of patients with a lower risk for recurrent LPD, including males, patients older than 25, and patients with TT-TG lower than 15mm, and therefore might not be referred for an MRI scan. Thus, we recommend a strict physical examination, awareness to the high prevalence of additional pathological findings, and to consider performing an MRI in all patients after LPD.

Keywords: additional findings, lateral patellar dislocation (LPD), MRI scan, traumatic patellar dislocation, cruciate ligaments injuries, menisci injuries, collateral ligaments injuries

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Authors: Toshiki Ito, Takahiro Yamane, Yuki Adachi, Yoshiko Kato, Eiji Tsuda, Kousaku Nagasaka, Keigo Yoshida, Yoshiko Kawasaki, Naoki Aizawa, Kyouhei Nishi, Tetsuko Kato

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The epidemic of the coronavirus (COVID-19), first reported in Wuhan at the end of 2019, has drastically changed our daily lives. Under these circumstances, counseling, which provides psychological support to people, was also greatly affected. The structure of counseling, which had generally been implicitly common practice to be conducted in person, was greatly shaken. The author wondered how counseling can be conducted in situations where it is impossible to meet face-to-face. This is where telepsychological support (online counseling) came into use. The authors found that there were the following problems in telepsychological support: (1) anxiety about whether the communication is appropriate, (2) difficulty in understanding the client's situation and condition, (3) inability to perceive what was normally perceived in person, (4) difficulty in adjusting to severely ill clients, (5) difficulty in dealing with emergency situations, etc. In this study, we interviewed psychologists who had been accustomed to telepsychological support for more than two years after the Corona disaster began to clarify how they had or had not overcome the problems of telepsychological support identified in the above studies. We also aim to consider the unique possibilities of how telepsychological support, a new technique of psychological support, can be implemented to provide more effective and meaningful support in society after the end of the Corona disaster (post-Corona society). Thirteen psychologists who are currently providing telepsychological support in the Corona Disaster will be interviewed, and semi-structured interviews will be conducted for one hour per person. In order to empirically examine how the problems in telepsychological support had been overcome or not through the interview survey, the authors asked (1) how they overcame their anxiety about whether they were able to communicate appropriately, (2) how they devised ways to overcome it, (3) how they overcame the difficulty in adapting to heavy clients in terms of the level of the disease, (4) how they overcame the difficulty in dealing with emergency situations. The interviews were analyzed using Thematic Analysis, a qualitative analysis method commonly used in qualitative research overseas. The authors found that some devices and perspectives were newly discovered as a result of two years of practice of telepsychological support and that psychologists in this study considered face-to-face interviews and telepsychological support to be separate and were flexible enough to use them when available and to move to face-to-face interviews when not appropriate.

Keywords: telepsychology, COVID-19, Corona, psychologist

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Authors: Mariana Fernandes

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Instituto Politécnico de Viana do Castelo (IPVC) has adopted a policy of inclusion and equity and the promotion of health and academic well-being, reinforcing measures already implemented in previous years, but also with the inclusion of new inclusion and equity policies that allow access, throughout all students, to Higher Education (ES). The Inclusive School project, the Plan for Equality, the IPVC's own Regulations for students with Special Educational Needs (SEN), and the support guaranteed by the Health and Wellbeing Office, Academic Services, and teaching staff are some of the examples of the varied strategies that IPVC undertakes to guarantee effective conditions so that students with disabilities can enter ES and experience a positive academic experience. This study's main objective is to reflect and disseminate the inclusion practices that IPVC practices with regard to Students with SEN. To this, a consultation and documentary analysis of internal documentation was carried out, consultation of the IPVC Quality Management System (QMS) process and, also, using the report referring to the ENEE questionnaire implemented in the year 2023, this report which presents the opinion of IPVC students with SEN, whether with support throughout the ENEE application submission process, with response deadlines, with the Individual Support Plan, as well as with physical and technological accessibility and communication. The results obtained show IPVC's effective commitment to this topic, in addition to the entire circuit created to guarantee equitable access for these students from the moment they join IPVC, a circuit that involves various human resources and( s) its sensitivity to this topic, it also promoted, through the Health and Wellbeing Office, the restructuring of the IPVC ENEE Regulation itself based on the needs and challenges felt in monitoring these students, the innovation of the services themselves of health and consequent awareness of all surrounding resources and services (from the Management, to the teaching staff and academic services). Currently, there is already an Individual Pedagogical Support Plan (PIAP), frequent meetings with the Reception Group, Psychology consultations – both clinically and educationally – and a growing concern in listening to the student community to improve the process. Based on these results, it is concluded that IPVC is an institution sensitive to promoting a positive, equitable, and, above all, inclusive higher education path.

Keywords: special educational needs, inclusion, equity, equality

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Authors: Irene Kretchy, Frances Owusu-Daaku, Samuel Danquah

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Hypertension is the leading risk factor for cardiovascular diseases, and a major cause of death and disability worldwide. This study examined whether psychosocial variables influenced patients’ perception and experience of side effects of their medicines, how they coped with these experiences and the impact on mental health and medication adherence to conventional hypertension therapies. Methods: A hospital-based mixed methods study, using quantitative and qualitative approaches was conducted on hypertensive patients. Participants were asked about side effects, medication adherence, common psychological symptoms, and coping mechanisms with the aid of standard questionnaires. Information from the quantitative phase was analyzed with the Statistical Package for Social Sciences (SPSS) version 20. The interviews from the qualitative study were audio-taped with a digital audio recorder, manually transcribed and analyzed using thematic content analysis. The themes originated from participant interviews a posteriori. Results: The experiences of side effects – such as palpitations, frequent urination, recurrent bouts of hunger, erectile dysfunction, dizziness, cough, physical exhaustion - were categorized as no/low (39.75%), moderate (53.0%) and high (7.25%). Significant relationships between depression (x 2 = 24.21, P < 0.0001), anxiety (x 2 = 42.33, P < 0.0001), stress (x 2 = 39.73, P < 0.0001) and side effects were observed. A logistic regression model using the adjusted results for this association are reported – depression [OR = 1.9 (1.03 – 3.57), p = 0.04], anxiety [OR = 1.5 (1.22 – 1.77), p = < 0.001], and stress [OR = 1.3 (1.02 – 1.71), p = 0.04]. Side effects significantly increased the probability of individuals to be non-adherent [OR = 4.84 (95% CI 1.07 – 1.85), p = 0.04] with social factors, media influences and attitudes of primary caregivers further explaining this relationship. The personal adoption of medication modifying strategies, espousing the use of complementary and alternative treatments, and interventions made by clinicians were the main forms of coping with side effects. Conclusions: Results from this study show that contrary to a biomedical approach, the experience of side effects has biological, social and psychological interrelations. The result offers more support for the need for a multi-disciplinary approach to healthcare where all forms of expertise are incorporated into health provision and patient care. Additionally, medication side effects should be considered as a possible cause of non-adherence among hypertensive patients, thus addressing this problem from a Biopsychosocial perspective in any intervention may improve adherence and invariably control blood pressure.

Keywords: biopsychosocial, hypertension, medication adherence, psychological disorders

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Authors: Ashima Sharma, Tapan K. Chaudhuri

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Human Serum Albumin (HSA) is one of the most demanded therapeutic protein with immense biotechnological applications. The current source of HSA is human blood plasma. Blood is a limited and an unsafe source as it possesses the risk of contamination by various blood derived pathogens. This issue led to exploitation of various hosts with the aim to obtain an alternative source for the production of the rHSA. But, till now no host has been proven to be effective commercially for rHSA production because of their respective limitations. Thus, there exists an indispensable need to promote non-animal derived rHSA production. Of all the host systems, Escherichia coli is one of the most convenient hosts which has contributed in the production of more than 30% of the FDA approved recombinant pharmaceuticals. E. coli grows rapidly and its culture reaches high cell density using inexpensive and simple substrates. The fermentation batch turnaround number for E. coli culture is 300 per year, which is far greater than any of the host systems available. Therefore, E. coli derived recombinant products have more economical potential as fermentation processes are cheaper compared to the other expression hosts available. Despite of all the mentioned advantages, E. coli had not been successfully adopted as a host for rHSA production. The major bottleneck in exploiting E. coli as a host for rHSA production was aggregation i.e. majority of the expressed recombinant protein was forming inclusion bodies (more than 90% of the total expressed rHSA) in the E. coli cytosol. Recovery of functional rHSA form inclusion body is not preferred because it is tedious, time consuming, laborious and expensive. Because of this limitation, E. coli host system was neglected for rHSA production for last few decades. Considering the advantages of E. coli as a host, the present work has targeted E. coli as an alternate host for rHSA production through resolving the major issue of inclusion body formation associated with it. In the present study, we have developed a novel and innovative method for enhanced soluble and functional production of rHSA in E.coli (~60% of the total expressed rHSA in the soluble fraction) through modulation of the cellular growth, folding and environmental parameters, thereby leading to significantly improved and enhanced -expression levels as well as the functional and soluble proportion of the total expressed rHSA in the cytosolic fraction of the host. Therefore, in the present case we have filled in the gap in the literature, by exploiting the most well studied host system Escherichia coli which is of low cost, fast growing, scalable and ‘yet neglected’, for the enhancement of functional production of HSA- one of the most crucial biomolecule for clinical and biotechnological applications.

Keywords: enhanced functional production of rHSA in E. coli, recombinant human serum albumin, recombinant protein expression, recombinant protein processing

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Authors: Jun Ren, Zhen-Hua Ming, He-Feng Huang, Jian-Zhong Sheng

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Adverse intrauterine stimulus during critical or sensitive periods in early life, may lead to health risk not only in later life span, but also further generations. Intrauterine hyperglycaemia, as a major feature of gestational diabetes mellitus (GDM), is a typical adverse environment for both F1 fetus and F1 gamete cells development. However, there is scare information of phenotypic difference of metabolic memory between somatic cells and germ cells exposed by intrauterine hyperglycaemia. The direct transmission effect of intrauterine hyperglycaemia per se has not been assessed either. In this study, we built a GDM mice model and selected male GDM offspring without pre-diabetic phenotype as our founders, to exclude postnatal diabetic influence on gametes, thereby investigate the direct transmission effect of intrauterine hyperglycaemia exposure on F2 offspring, and we further compared the metabolic difference of affected F1-GDM male offspring and F2 offspring. A GDM mouse model of intrauterine hyperglycemia was established by intraperitoneal injection of streptozotocin after pregnancy. Pups of GDM mother were fostered by normal control mothers. All the mice were fed with standard food. Male GDM offspring without metabolic dysfunction phenotype were crossed with normal female mice to obtain F2 offspring. Body weight, glucose tolerance test, insulin tolerance test and homeostasis model of insulin resistance (HOMA-IR) index were measured in both generations at 8 week of age. Some of F1-GDM male mice showed impaired glucose tolerance (p < 0.001), none of F1-GDM male mice showed impaired insulin sensitivity. Body weight of F1-GDM mice showed no significance with control mice. Some of F2-GDM offspring exhibited impaired glucose tolerance (p < 0.001), all the F2-GDM offspring exhibited higher HOMA-IR index (p < 0.01 of normal glucose tolerance individuals vs. control, p < 0.05 of glucose intolerance individuals vs. control). All the F2-GDM offspring exhibited higher ITT curve than control (p < 0.001 of normal glucose tolerance individuals, p < 0.05 of glucose intolerance individuals, vs. control). F2-GDM offspring had higher body weight than control mice (p < 0.001 of normal glucose tolerance individuals, p < 0.001 of glucose intolerance individuals, vs. control). While glucose intolerance is the only phenotype that F1-GDM male mice may exhibit, F2 male generation of healthy F1-GDM father showed insulin resistance, increased body weight and/or impaired glucose tolerance. These findings imply that intrauterine hyperglycaemia exposure affects germ cells and somatic cells differently, thus F1 and F2 offspring demonstrated distinct metabolic dysfunction phenotypes. And intrauterine hyperglycaemia exposure per se has a strong influence on F2 generation, independent of postnatal metabolic dysfunction exposure.

Keywords: inheritance, insulin resistance, intrauterine hyperglycaemia, offspring

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Authors: Lucie Bielská, Lucia Škulcová, Martina Hvězdová, Jakub Hofman, Zdeněk Šimek

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The currently used pesticides represent a broad group of chemicals with various physicochemical and environmental properties which input has reached 2×106 tons/year and is expected to even increases. From that amount, only 1% directly interacts with the target organism while the rest represents a potential risk to the environment and human health. Despite being authorized and approved for field applications, the effects of pesticides in the environment can differ from the model scenarios due to the various pesticide-soil interactions and resulting modified fate and behavior. As such, a direct monitoring of pesticide residues and evaluation of their impact on soil biota, aquatic environment, food contamination, and human health should be performed to prevent environmental and economic damages. The present project focuses on fluvisols as they are intensively used in the agriculture but face to several environmental stressors. Fluvisols develop in the vicinity of rivers by the periodic settling of alluvial sediments and periodic interruptions to pedogenesis by flooding. As a result, fluvisols exhibit very high yields per area unit, are intensively used and loaded by pesticides. Regarding the floods, their regular contacts with surface water arise from serious concerns about the surface water contamination. In order to monitor pesticide residues and assess their environmental and biological impact within this project, 70 fluvisols were sampled over the Czech Republic and analyzed for the total and bioaccessible amounts of 40 various pesticides. For that purpose, methodologies for the pesticide extraction and analysis with liquid chromatography-mass spectrometry technique were developed and optimized. To assess the biological risks, both the earthworm bioaccumulation tests and various types of passive sampling techniques (XAD resin, Chemcatcher, and silicon rubber) were optimized and applied. These data on chemical analysis and bioavailability were combined with the results of soil analysis, including the measurement of basic physicochemical soil properties as well detailed characterization of soil organic matter with the advanced method of diffuse reflectance infrared spectrometry. The results provide unique data on the residual levels of pesticides in the Czech Republic and on the factors responsible for increased pesticide residue levels that should be included in the modeling of pesticide fate and effects.

Keywords: currently used pesticides, fluvisoils, bioavailability, Quechers, liquid-chromatography-mass spectrometry, soil properties, DRIFT analysis, pesticides

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Authors: Carla Lopes

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It is clear nowadays that the proper performance of different speech acts is one of the most difficult obstacles that a foreign language learner has to overcome to be considered communicatively competent. This communication presents the results of an investigation on the pragmatic performance of Portuguese Language students at the University of Macau. The research discussed herein is based on a survey consisting of fourteen speaking situations to which the participants must respond in writing, and that includes different types of speech acts: apology, response to a compliment, refusal, complaint, disagreement and the understanding of the illocutionary force of indirect speech acts. The responses were classified in a five levels Likert scale (quantified from 1 to 5) according to their suitability for the particular situation. In general terms, we can summarize that about 45% of the respondents' answers were pragmatically competent, 10 % were acceptable and 45 % showed weaknesses at socio-pragmatic competence level. Given that the linguistic deviations were not taken into account, we can conclude that the faults are of cultural origin. It is natural that in the presence of orthogonal cultures, such as Chinese and Portuguese, there are failures of this type, barely solved in the four years of the undergraduate program. The target population, native speakers of Cantonese or Mandarin, make their first contact with the English language before joining the Bachelor of Portuguese Language. An analysis of the socio - pragmatic failures in the respondents’ answers suggests the conclusion that many of them are due to the lack of cultural knowledge. They try to compensate for this either using their native culture or resorting to a Western culture that they consider close to the Portuguese, that is the English or US culture, previously studied, and also widely present in the media and on the internet. This phenomenon, known as 'pragmatic transfer', can result in a linguistic behavior that may be considered inauthentic or pragmatically awkward. The resulting speech act is grammatically correct but is not pragmatically feasible, since it is not suitable to the culture of the target language, either because it does not exist or because the conditions of its use are in fact different. Analysis of the responses also supports the conclusion that these students present large deviations from the expected and stereotyped behavior of Chinese students. We can speculate while this linguistic behavior is the consequence of the Macao globalization that culturally casts the students, makes them more open, and distinguishes them from the typical Chinese students.

Keywords: Portuguese foreign language, pragmatic failures, pragmatic transfer, pragmatic competence

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Authors: Ibrahim M. Alwehaibi

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Recently the windows of globalization weirdly open, which increase the trade between the Western countries and Muslim nations. Sales of goods contracts are one of the most common business transaction in the world. This commercial exchange has faced many obstacles. One of the most concerned obstacles is the conflicts between laws. Thus, United Nation created a Convention on Contracts for the International Sale of Goods (CISG). Some of Islamic countries have ratified the CISG, while other Islamic countries have concerns about the feasibility of ratification of the CISG, and many businessmen have a concern of application of the convention. The concerns related to the conflict between CISG and Sharia, and the long debate about the success, ambiguity, and stability of the CISG. Therefore, this research will examine the feasibility of Muslim countries and Muslim businessmen to adopt the CISG by following steps: First, this research will introduce sharia Law (Islamic contracts law) and CISG and provide backgrounds of both laws. Second, this research will compare the provisions of CISG and Sharia and figuring out the conflicts and provide possible solutions for the conflicts. Third, this study will examine the advantages and disadvantages of adopting the CISG and examining the success of the CISG. Fourth, this study will explore the current situation in Islamic countries by taking Saudi Arabia as a case and explore how the application of Sharia law works and the possibility to enforce the CISG and explore the current practice of foreign Sales in Saudi Arabia. The research finds that there are some conflicts between CISG and Sharia Law. The most notable conflicts are interest and uncertainty in considerations. Also, this research finds that it seems that ratification of CISG is not beneficial for Muslim countries because the convention has not reached its goal which is uniformity of laws. Moreover, the CISG has been excluded and ignored by businessmen and some courts. Additionally, this research finds that it could be possible to enforce CISG in Saudi Arabia, provided that no conflict between the enforced provision and Sharia Law. This study is following the competitive and analysis methodologies to reach its findings. The researcher analyzes the provision of CISG and compares them with Sharia rules and finds the conflicts and compatibilities. In fact, CISG has 101 articles, so a comprehensive comparison of all articles in CISG with Sharia is difficult. Thus, in order to deeply analyze all aspects of this issue, this study will exclude some areas of contract which have been discussed by other researchers such as deliver of goods, conformity, and mirror image rules. The comparative section of this study will focus on the most concerned articles that conflict or doubtful of conflict with Sharia, which are interest, uncertainty, statute of limitation, specific performance, and pass of risk.

Keywords: Sharia, CISG, Contracts for International Sale of Goods, contracts, sale of goods, Saudi Arabia

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Authors: M. Warburton

Abstract:

Background: Case study examining hydrotherapy for a person with DSI. A 46 year-old lady completely deaf and blind post congenital rubella syndrome. Touch becomes the primary information gathering sense to optimise function in life. Communication is achieved via tactile finger spelling and signals onto her hand and skin. Hydrotherapy may provide a suitable mobility environment and somato-sensory input to people, and especially DSI persons. Buoyancy, warmth, hydrostatic pressure, viscosity and turbulence are elements of hydrotherapy that may offer a DSI person somato-sensory input to stimulate the mechanoreceptors, thermoreceptors and proprioceptors and offer a unique hydro-therapeutic environment. Purpose: The purpose of this case study was to establish what measurable benefits could be achieved from hydrotherapy with a DSI person. Methods: Hydrotherapy was provided for 8-weeks, 2 x week, 35-minute session duration. Pool temperature 32.5 degrees centigrade. Pool length 25-metres. Each session consisted of mobility encouragement and supervision, and activities to stimulate the somato-sensory system utilising aquatic properties of buoyancy, turbulence, viscosity, warmth and hydrostatic pressure. Somato-sensory activities focused on stimulating touch and tactile exploration including objects of various shape, size, weight, contour, texture, elasticity, pliability, softness and hardness. Outcomes were measured by the Goal Attainment Scale (GAS) and included mobility distance, attendance, and timed tactile responsiveness to varying objects. Results: Mobility distance and attendance exceeded baseline expectations. Timed tactile responsiveness to varying objects also changed positively from baseline. Average scale scores were 1.00 with an overall GAS t-score of 63.69. Conclusions: Hydrotherapy can be a quantifiable physio-therapeutic option for persons with DSI. It provides a relatively safe environment for mobility and allows the somato-sensory system to be fully engaged - important for the DSI population. Implications: Hydrotherapy can be a measurable therapeutic option for a DSI person. Physiotherapists should consider hydrotherapy for DSI people. Hydrotherapy can offer unique physical properties for the DSI population not available on land.

Keywords: chronic, disability, disease, rehabilitation

Procedia PDF Downloads 356

Authors: Hussein M. H. Mohamed, Hamdy M. B. Zaki

Abstract:

Fresh sausage is one of the cheapest and delicious meat products that are gaining popularity all over the world. It is considered as a practice of adding value to low-value meat cuts of high fat and connective tissue contents. One of the most important characteristics of fresh sausage is the distinctive marbling appearance between lean and fatty portions, which can be achieved by using animal fat. For achieving the marbling appearance of fresh sausage, a lager amount of fat needs to be used. The use of animal fat may represent a health concern due to its content of saturated fatty acids and trans-fats, which increase the risk of heart diseases. There is a need for reducing the fat content of fresh sausage to obtain a healthy product. However, fat is responsible for the texture, flavor, and juiciness of the product. Therefore, developing reduced-fat products is a challenging process. The main objectives of the current study were to incorporate chicken skin based products (chicken skin emulsion, gelatinized chicken skin, and gelatinized chicken skin emulsion) during the formulation of fresh sausage as fat replacers and to study the effect of these products on the nutritional quality, physicochemical properties, and sensory attributes of the processed product. Three fresh sausage formulae were prepared using chicken skin based fat replacers (chicken skin emulsion, gelatinized chicken skin, and gelatinized chicken skin emulsion) beside one formula prepared using mesenteric beef fat as a control. The proximate composition, fatty acid profiles, Physico-chemical characteristics, and sensory attributes of all formulas were assessed. The results revealed that the use of chicken skin based fat replacers resulted in significant (P < 0.05) reduction of fat contents from 17.67 % in beef mesenteric fat formulated sausage to 5.77, 8.05 and 8.46 in chicken skin emulsion, gelatinized chicken skin, and gelatinized chicken skin emulsion formulated sausages, respectively. Significant reduction in the saturated fatty acid contents and a significant increase in mono-unsaturated, poly-unsaturated, and omega-3 fatty acids have been observed in all formulae processed with chicken skin based fat replacers. Moreover, significant improvements in the physico-chemical characteristics and non-significant changes in the sensory attributes have been obtained. From the obtained results, it can be concluded that the chicken skin based products can be used safely to improve the nutritional quality and physico chemical properties of beef fresh sausages without changing the sensory attributes of the product. This study may encourage meat processors to utilize chicken skin based fat replacers for the production of high quality and healthy beef fresh sausages.

Keywords: chicken skin emulsion, fresh sausage, gelatinized chicken skin, gelatinized chicken skin emulsion

Procedia PDF Downloads 130