Search results for: geological setting

Authors: Jennifer Sturgeon

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Stable relationships provide a predictable and trusting environment and are essential for early development, but high teacher turnover rates in childcare settings make it challenging for infants and toddlers to form stable relationships with their teachers. This can have an adverse effect on development and learning. The qualitative study discussed in this article draws from the experiences of early Head Start teachers and administrators to describe both the impact of teacher turnover and the motivational factors that contribute to teacher retention. A case study approach was used and included classroom observations, a review of exit interviews, and perceptions from focus groups of early Head Start staff in an urban early Head Start childcare center. Emerging from the case study was the discovery that teacher turnover has an impact on the social-emotional development of toddlers, particularly in self-regulation. Additional key findings that emerged include teacher turnover leading to negative effects on learning, a decrease in preschool preparation, and increased chaos in the classroom and center. Motivational factors that contributed to teacher retention included positive leadership, the mission to make a difference, and fair compensation.

Keywords: early childhood, teacher turnover, continuity of care, early head start

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Authors: Deepak Raj Bhat, Kazushige Hayashi, Yorihiro Tanaka, Shigeru Ogita, Akihiko Wakai

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Slow-moving landslides are one of the major natural disasters in mountainous regions. Therefore, study of the creep displacement behaviour of a landslide and associated geological and geotechnical issues seem important. This study has addressed and evaluated the slow-moving behaviour of landslide using the 2D-FEM based Elasto-viscoplastic constitutive model. To our based knowledge, two new control constitutive parameters were incorporated in the numerical model for the first time to better understand the slow-moving behaviour of a landslide. First, the predicted time histories of horizontal displacement of the landslide are presented and discussed, which may be useful for landslide displacement prediction in the future. Then, the simulation results of deformation pattern and shear strain pattern is presented and discussed. Moreover, the possible failure mechanism along the slip surface of such landslide is discussed based on the simulation results. It is believed that this study will be useful to understand the slow-moving behaviour of landslides, and at the same time, long-term monitoring and management of the landslide disaster will be much easier.

Keywords: numerical simulation, ground water fluctuations, elasto-viscoplastic model, slow-moving behaviour

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Authors: Ali Al-Bakri, Mohammed Sazid

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The investigated study area locates about 72 km from Jeddah city, Makkah district, Kingdom of Saudi Arabia. The study mainly aimed to define only in detail the most significant zones of possible mineralization and outline their subsurface parameters (location and strike) in the southeast part of Jabal Al-Qashah. Several geophysical methods have been conducted to carry out the goal. Among these methods are the ground magnetic method, self-potential (SP) method, and induced polarization (IP) method. Integrating these methods aims to help in delineating the possible mineralization in the study area. The magnetic survey was conducted along 17 profiles where these profiles were chosen to be perpendicular to the strike of the quartz shear zone. Self-potential was applied along with five profiles covering the study area. At the same time, induced polarization was used along with one profile located at the western side of the study area corresponding to some magnetic and SP profiles. The most interesting zones of mineralization were successfully determined by comparing the results of residual magnetic profile (3), SP profile (1), and IP profile, where geological structures control some mineralization.

Keywords: geophysical methods, magnetic method, self-potential, induced polarization, Jabal Al-Qashah

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Authors: Elena Bulmer

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The research for this study has found that the formation of alliances for the successful revitalization of the global partnership for sustainable development, as defined by UN Sustainable Development Goal 17, entails considerable difficulty. This study uses for its empirical work marine environmental conservation projects and analyses the potential involvement of nonhuman actors as primordial stakeholders in these types of projects. The idea is to extend the scope of SDG 17 for it to also consider nonhuman subjects in order for it to better achieve its goal. The results of this study may be extrapolated to the business and management fields, which depend on natural resources for the development of their products. In the same way, in these areas, natural resources as nonhuman actors are not present in the stakeholder maps of these projects. Environmental Conservation projects are thus especially interesting to study with regards to their stakeholder context and have been used as the experimental setting for the empirical work of this study. The primordial stakeholders of these projects are not social objects and therefore go beyond the present limits of present stakeholder theory. The study that has been used to analyse this concept is a marine conservation project based in Spain, and to shed light in potential extending the role of the 17th Sustainable Development Goal to include nonhuman beings to be able to better achieve the rest of the SDGs, in this case, SDG 14 whose aim is to promote the conservation and sustainability of the world´s oceans.

Keywords: SDG 17, sustainability, stakeholder management, environmental conservation projects

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Authors: Vinayambika S. Bhat, S. Shanmuga Priya, I. Thirunavukkarasu, Shreeranga Bhat

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An attempt has been made to design a decoupling controller for systems with more inputs more outputs with dead time in it. The de-coupler is designed for the chemical process industry 3×3 plant transfer function with dead time. The Quantitative Feedback Theory (QFT) based controller has also been designed here for the 2×2 distillation column transfer function. The developed control techniques were simulated using the MATLAB/Simulink. Also, the stability of the process was analyzed, together with the presence of various perturbations in it. Time domain specifications like setting time along with overshoot and oscillations were analyzed to prove the efficiency of the de-coupler method. The load disturbance rejection was tested along with its performance. The QFT control technique was synthesized based on the stability and performance specifications in the presence of uncertainty in time constant of the plant transfer function through sequential loop shaping technique. Further, the energy efficiency of the distillation column was improved by proper tuning of the controller. A distillation column consumes 3% of the total energy consumption of the world. A suitable control technique is very important from an economic point of view. The real time implementation of the process is under process in our laboratory.

Keywords: distillation, energy, MIMO process, time delay, robust stability

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Authors: Simon Mwima, Kasule Solomon Kibirige, Evans Jennifer Mann, Bosco Mukuba, Edson Chipalo, Agnes Nzomene, Eusebius Small, Moses Okumu

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Introduction: Social workers must create, implement, and evaluate client-centered psychosocial interventions (CCPI) to reduce the impact of intersectional stigma on HIV service utilization among sexual minorities. We contribute to the scarcity of evidence about sexual minorities in Uganda by using social support theory to explore clients' perceptions that shape CCPI. Based on Focused Group Discussion (FGD) with 31 adolescents recruited from Kampala's HIV clinics in 2021, our findings reveal the positive influence of instrumental, informational, esteem, emotional, and social network support as intersectional stigma reduction interventions. Men who have sex with men, lesbians, and bisexual women used such strategies to navigate a heavily criminalized and stigmatizing setting during the COVID-19 pandemic in Uganda. Conclusion: This study provides evidence for the social work profession to develop and implement psychosocial interventions that reduce HIV stigma and discrimination among MSM, lesbians, and bisexual young people living with HIV in Uganda.

Keywords: pyschosocial interventions, social work, intersectional stigma, HIV/AIDS, adolescents, sexual minorities, Uganda

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Authors: Carl Eiselen, Stephen O’Hagan

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Background: Q fever, caused by the obligate intracellular bacterium Coxiella burnetii, is an infectious disease with variable systemic manifestations. Its potential to cause ocular complications has not been reported before in Australia. This case study explores the unusual presentation of asymptomatic acute multifocal retinitis (AMR) in a patient with acute Q fever endocarditis and hepatitis in rural Queensland, Australia. Case Presentation: A 48-year-old male gardener presented with flu-like symptoms, weight loss, and encephalopathy. Despite systemic malaise, he had no ocular symptoms. Laboratory investigations confirmed acute Q fever, and imaging studies identified hepatic involvement and endocarditis. The retinal screening revealed asymptomatic AMR, corroborated by fundus examination and SD-OCT. Following treatment with Doxycycline and hydroxychloroquine, both systemic and ocular manifestations improved. Discussion: This is the first documented case of asymptomatic AMR associated with Q fever. The patient’s lack of autoantibodies challenges the established understanding of Q fever endocarditis and suggests potential alternative mechanisms. Conclusion: This case report expands our understanding of the multi-systemic impact of Q fever, highlighting the need for comprehensive clinical evaluation and including retinal screening in the setting of acute infection. The disease's underlying mechanism for ocular involvement is not yet established.

Keywords: Coxiella Burnetti, Q fever, ocular manifestation, acute multifocal retintis, endocarditis

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Authors: Paula C. Latorre Arroyo, Andrea C. Latorre Arroyo

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In the present society, children are exposed to and impacted by technology from very early on in various ways. Artificial intelligence (AI), in particular, directly affects them, be it positively or negatively. The concept of artificial intelligence is commonly defined as the technological programming of computers or robotic mechanisms with humanlike capabilities and characteristics. These technologies are often designed as helpful machines or disguised as handy tools that could ultimately steal private information for illicit purposes. Children, being one of the most vulnerable groups due to their lack of experience and knowledge, do not have the ability to recognize or have the malice to distinguish if an apparatus with artificial intelligence is good or bad for them. For this reason, as a society, there must be a sense of responsibility to regulate and monitor different types of uses for artificial intelligence to protect children from potential risks that might arise. This article aims to investigate the many implications that artificial intelligence has in the lives of children, starting from a home setting, within the classroom, and, ultimately, in online spaces. Irrefutably, there are numerous beneficial aspects to the use of artificial intelligence. However, due to its limitless potential and lack of specific and substantial regulations to prevent the illicit use of this technology, safety and privacy concerns surface, specifically regarding the youth. This written work aims to provide an in-depth analysis of how artificial intelligence can both help children and jeopardize their safety. Concluding with resources and data supporting the aforementioned statement.

Keywords: artificial intelligence, children, privacy, rights, safety

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Authors: Saeko Takahashi, Kazuo Hiraki

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Is it more fun to watch videos together than watching alone? Previous studies showed that synchronizing with others enhances subsequent prosocial behavior and affiliation, and conversely, prosocial individuals tend to coordinate with a partner to a greater extent. However, compared to adults, less is known about interpersonal coordination of young children in real-life situations because most studies have focused on children’s particular movement using specific tools or tasks in a laboratory setting. It has also been unclear if prosociality of young children affect the extent of interpersonal coordination within dyads. The present study examined data from motion capture of five body parts of 4-year-old dyads watching the same stimuli together or alone. A questionnaire survey including participants’ prosocial trait was also conducted. The wavelet coherence of each body parts within dyads was calculated as a measure of the extent of interpersonal coordination. Results showed that the dyads became significantly more coordinated in a social situation compared to a non-social situation. Moreover, dyads with averagely higher prosociality were more coordinated. These results shed some light on the development of interpersonal coordination in terms of social ability in young children. This study also offers a useful method for a study of spontaneous coordination in young children and infants without instructions or verbal responses.

Keywords: child development, interpersonal coordination, prosociality, synchrony, wavelet transform

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Authors: Leon Pan

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The first programming course within post-secondary education has long been recognized as a challenging endeavor for both educators and students alike. Historically, these courses have exhibited high failure rates and a notable number of dropouts. Instructors often lament students' lack of effort in their coursework, and students often express frustration that the teaching methods employed are not effective. Drawing inspiration from the successful principles of Extreme Programming, this study introduces an approach—the Extremes-based teaching model — aimed at enhancing the teaching of introductory programming courses. To empirically determine the effectiveness of the model, a comparison was made between a section taught using the extreme-based model and another utilizing traditional teaching methods. Notably, the extreme-based teaching class required students to work collaboratively on projects while also demanding continuous assessment and performance enhancement within groups. This paper details the application of the extreme-based model within the post-secondary online classroom context and presents the compelling results that emphasize its effectiveness in advancing the teaching and learning experiences. The extreme-based model led to a significant increase of 13.46 points in the weighted total average and a commendable 10% reduction in the failure rate.

Keywords: extreme-based teaching model, innovative pedagogical methods, project-based learning, team-based learning

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Authors: Seyed Aliasghar Mosavi, Mostafa Naderi, Khosrow Jadidi, Amir Hashem Mohammadi

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To study the measurement of intraocular pressure (IOP) before and after implantation of intrastromal corneal ring (MyoRing) in patients with keratoconus. Setting: Baqiyatallah University of Medical Sciences, Tehran, Iran. Methods: We compared the IOP of 13 eyes which underwent MyoRing implantation prior and six months post operation using Goldman applanation (as gold standard), Icare, and Corvis ST (uncorrected, corrected and corrected with cornea biomechanics). Results: The resulting intraocular pressure measurements prior to surgery, Icare, Corvis (corrected with cornea biomechanics) overestimated the IOP, however measurements by Corvis uncorrected underestimate the IOP. The resulting intraocular pressure measurements after surgery, Icare, Corvis (corrected with cornea biomechanics) overestimated the IOP but measurements by Corvis uncorrected underestimate the IOP. Conclusion: Consistent intraocular pressure measurements on eyes with Myoring in keratoconus can be obtained with the Goldman applanation tonometer as the gold standard measurement. We were not able to obtain consistent results when we measured the IOP by Icare and Corvis prior and after surgery.

Keywords: intraocular pressure, MyoRing, Keratoconus, Goldmann applanation, Icare, Corvis ST

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Authors: Fauziahtion A. G. Samad, Imelda Albert Gisip

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Community-Based Ecotourism (CBET) is one of the most significant parts of the sustainability in tourism. To achieve the goal of sustainability, the Framework for Sustainable Community Based Ecotourism (FSCBE) was developed from the experience in setting and implementing Community-Based Ecotourism (CBE) under IMPAK (Community-Based Tourism Development Initiative, Kota Kinabalu City Hall) program. Desa Cinta Kobuni located in Inanam, a sub-district of Kota Kinabalu city was the first project under this program. The goal was to transform the village into a sustainable tourism destination. After five years of the program, there are three tourism destination were established included Homestay Id Kalangadan and Homestay Darau Wetland. They currently are still in the growth stage and now becoming a model for other inspiring villages to emulate. There are three major impacts to the villages, which are 1) the increment of secondary income; 2) the advancement of women’s empowerment; and 3) the enhanced sustainability initiatives of the villagers. The experience in developing the CBET has resulted the Kota Kinabalu City Hall to produce the Framework for Sustainable Community Based Ecotourism (FSCBE) that integrates Sustainable Development Goals and Global Sustainable Tourism Criteria (GSTC) for future CBET development in other villages in the city.

Keywords: community-based ecoturism, sustainability, Sabah, Malaysia

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Authors: Desmond Adair, Kairat Ismailov, Martin Jaeger

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Modelling of Timoshenko beams on elastic foundations has been widely used in the analysis of buildings, geotechnical problems, and, railway and aerospace structures. For the elastic foundation, the most widely used models are one-parameter mechanical models or two-parameter models to include continuity and cohesion of typical foundations, with the two-parameter usually considered the better of the two. Knowledge of free vibration characteristics of beams on an elastic foundation is considered necessary for optimal design solutions in many engineering applications, and in this work, the efficient and accurate variational iteration method is developed and used to calculate natural frequencies of a Timoshenko beam on a two-parameter foundation. The variational iteration method is a technique capable of dealing with some linear and non-linear problems in an easy and efficient way. The calculations are compared with those using a finite-element method and other analytical solutions, and it is shown that the results are accurate and are obtained efficiently. It is found that the effect of the presence of the two-parameter foundation is to increase the beam’s natural frequencies and this is thought to be because of the shear-layer stiffness, which has an effect on the elastic stiffness. By setting the two-parameter model’s stiffness parameter to zero, it is possible to obtain a one-parameter foundation model, and so, comparison between the two foundation models is also made.

Keywords: Timoshenko beam, variational iteration method, two-parameter elastic foundation model

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Authors: Kimuli Ismail, Michael Lubwama, John Baptist Kirabira, Adam Sebbit

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This study develops 4 energy scenarios for Greater Kampala Metropolitan Area (GKMA). GKMA is Uganda’s capital with a population of 4.1million and a GDP growth rate of 5.8 with a nonsustainable energy management system. The study uses TIMES-VEDA to examine the energy impacts of business as usual (BAU), Kabejja, Carbon-Tax, and Lutta scenarios in commercial, industrial, transportation, residential, agricultural, and electricity generation activities. BAU is the baseline scenario with limited CO2 emissions restrictions against which Kabejja with 20% CO2 emissions restriction, a carbon tax of $100/ton imposed in 2050 for Carbon-Tax scenario, and Lutta with 95% CO2 emissions restriction is made. The analysis suggests that if the current policy trends continue as BAU, consumption would increase from 139.6PJ to 497.42PJ and CO2 emissions will increase from 4.6mtns to 7mtns. However, consumption would decrease by 2.3% in Kabejja, 3.4% in Carbon-Tax, and 3.3 % in Lutta compared to BAU. The CO2 emissions would decrease by 8.57% in Kabejja, 55.14% in Carbon-Tax, and 60% in Lutta compared to BAU. Sustainability is achievable when low-carbon electricity is increased by 53.68% in the EMS, and setting up an electrified Kampala metro. The study recommends Lutta as the sustainable pathway to a lowcarbon 2050.

Keywords: Sustainability, Scenario Plannnig, Times-Veda Modelling, Energy Policy Development

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Authors: Ali Reza Tahavvor, Saeed Hosseini, Nazli Jowkar, Afshin Karimzadeh Fard

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Experimental & numeral study of temperature distribution during milling process, is important in milling quality and tools life aspects. In the present study the milling cross-section temperature is determined by using Artificial Neural Networks (ANN) according to the temperature of certain points of the work piece and the points specifications and the milling rotational speed of the blade. In the present work, at first three-dimensional model of the work piece is provided and then by using the Computational Heat Transfer (CHT) simulations, temperature in different nods of the work piece are specified in steady-state conditions. Results obtained from CHT are used for training and testing the ANN approach. Using reverse engineering and setting the desired x, y, z and the milling rotational speed of the blade as input data to the network, the milling surface temperature determined by neural network is presented as output data. The desired points temperature for different milling blade rotational speed are obtained experimentally and by extrapolation method for the milling surface temperature is obtained and a comparison is performed among the soft programming ANN, CHT results and experimental data and it is observed that ANN soft programming code can be used more efficiently to determine the temperature in a milling process.

Keywords: artificial neural networks, milling process, rotational speed, temperature

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Authors: Gabriel K. Nzulu, Hans Högberg, Per Eklund, Lars Hultman, Martin Magnuson

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X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDX) are applied to investigate the properties of rock samples from a drill hole from the Kubi Gold Project of the Asante Gold Corporation near Dunwka-on-Offin in the Central Region of Ghana. The distribution of these minerals in the rocks were observed in the drill hole sections. X-ray diffraction indicates that the samples contain garnet, pyrite, periclase, and quartz as the main indicator minerals. SEM revealed morphologies of these minerals. From EDX and XPS, Fe, Mg, Al, S, O, Hg, Ti, Mn, Na, Ag, Au, Cu, Si, and K are identified as the pathfinder elements in the area that either form alloys with gold or inherent elements in the sediments. This finding can be ascribed to primary geochemical distribution, which developed from crystallization of magma and hydrothermal liquids as well as the movement of metasomatic elements and the precipitous rate of chemical weathering of lateralization in secondary processes. The results indicate that Au mineralization in the Kubi Mine area is controlled by garnet, pyrite, goethite, and kaolinite that grades up to the surface (oxides) with hematite and limonite alterations.

Keywords: gold, minerals, pathfinder element, spectroscopy, X-ray

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Authors: Lukman Omobola Adisa

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Spelling is rule bound in a written discourse. It, however, calls into question, when such convention is grossly contravened in a formal setting revered as citadel of learning, despite availability of computer spell-checker, human knowledge, and lexicon. The foregoing reveals the extent of decadence pervading education sector in Nigeria. It is on this premise that this study reviews the effect of spelling on communicative competence of the University of Ibadan Registry Staff. The theoretical framework basically evaluates diverse scholars’ views on communicative competence and how spelling influences the intended meaning of a word/ sentence as a result of undue infringement on grammatical (spelling) rule. Newsletter, bulletin, memo, and letter are four print materials purposively selected while the methodology adopted is content analysis. Similarly, five categories, though not limited to, through which spelling blunders are committed are considered: effect of spelling (omission, addition, and substitution); sound ( homophone); transposition (heading/body: content) and ambiguity (capitalisation, space, and acronym). Subsequently, the analyses, findings, and recommendations are equally looked into. Summarily, the study x-rays effective role(s) plays by spelling in enhancing communicative competence through appropriate usage of linguistic registers.

Keywords: communicative competence, content analysis, effect of spelling, linguistics registers

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Authors: Dong Wook Lee, Seung Hyun Kim

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Geological structure formed by volcanic activities shows polymorphic characteristics due to repeated cooling and hardening of lava. The Jeju region is showing polymorphic characteristics in which clinker layers are irregularly distributed along with vesicular basalt due to volcanic activities. Accordingly, resident damages and environmental disputes occur frequently in the Jeju region due to blasting. The purpose of this study is to develop a blast vibration equation considering the polymorphic characteristics of basaltic ground in Jeju. The blast vibration equation consists of a functional formula of the blasting vibration constant K that changes according to ground characteristics, and attenuation index n. The case study results in Jeju showed that if there are clinker layers, attenuation index n showed a distribution of -1.11~-1.87, whereas if there are no clinker layers, n was -2.79. Moreover, if there are no clinker layers, the frequency of blast vibration showed a high frequency band from 30Hz to 100Hz, while in rocks with clinker layers it showed a low frequency band from 10Hz to 20Hz.

Keywords: blast vibration equation, basaltic ground, clinker layer, blasting vibration constant, attenuation index

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Authors: Lukasz Grzegorz Broda, Taiwo Oseni, Andrew Stranieri, Rodrigo Marino, Ronelle Welton, Mark Yates

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The oral health of residents in aged care centres in Australia is poor, contributing to infections, hospital admissions, and increased suffering. Although the use of electric toothbrushes has been deployed in many centres, smartbrushes that record and transmit information about brushing patterns and duration are not routinely deployed. Yet, the use of smartbrushes for aged care residents promises better oral care. Thus, a study aimed at investigating the appropriateness and suitability of a smartbrush for aged care residents is currently underway. Due to the peculiarity of the aged care setting, the incorporation of smartbrushes into residents’ care does require careful planning and design considerations. This paper describes an initial design process undertaken through the use of an actor to understand the important elements to be incorporated whilst installing a smartbrush for use in aged care settings. The design covers the configuration settings of the brush and app, including ergonomic factors related to brush and smartphone placement. A design science approach led to an installation re-design and a revised protocol for the planned study, the ultimate aim being to design installations to enhance perceived usefulness, ease of use, and attitudes towards the incorporation of smartbrushes for improving oral health care for aged care residents.

Keywords: smartbrush, applied computing, life and medical sciences, health informatics

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Authors: Mehdi Modabberifar, Sanaz Jabary, Mojtaba Ghodsi

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Stiffness sensing is an important issue in medical diagnostic, robotics surgery, safe handling, and safe grasping of objects in production lines. Detecting and obtaining the characteristics in dwelling lumps embedded in a soft tissue and safe removing and handling of detected lumps is needed in surgery. Also in industry, grasping and handling an object without damaging in a place where it is not possible to access a human operator is very important. In this paper, a method for object handling is presented. It is based on the use of an intelligent gripper to detect the object stiffness and then setting a programmable force for grasping the object to move it. The main components of this system includes sensors (sensors for measuring force and displacement), electrical (electrical and electronic circuits, tactile data processing and force control system), mechanical (gripper mechanism and driving system for the gripper) and the display unit. The system uses a rotary potentiometer for measuring gripper displacement. A microcontroller using the feedback received by the load cell, mounted on the finger of the gripper, calculates the amount of stiffness, and then commands the gripper motor to apply a certain force on the object. Results of Experiments on some samples with different stiffness show that the gripper works successfully. The gripper can be used in haptic interfaces or robotic systems used for object handling.

Keywords: gripper, haptic, stiffness, robotic

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Authors: Tiffany Gallagher, Sheila Bennett

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Based on data from a larger study, this research is based in a small school district in Ontario, Canada, that has made a transition from self-contained classes for students with exceptionalities to inclusive classroom placements for all students with their age-appropriate peers. The school board aided this transition by hiring Inclusion Coaches with a background in special education to work alongside teachers as partners and inform their inclusive practice. Based on qualitative data from four focus groups conducted with Inclusion Coaches, as well as four blog-style reflections collected at various points over two years, six principles of inclusive practice were identified for coaches. The six principles form a model during transition: pre-requisite, process, precipice, promotion, proof, and promise. These principles are encapsulated in a visual model of a spiraling staircase displaying the conditions that exist prior to coaching, during coaching interactions and considerations for the sustainability of coaching. These six principles are re-iterative and should be re-visited each time a coaching interaction is initiated. Exploring inclusion coaching as a model emulates coaching in other contexts and allows us to examine an established process through a new lens. This research becomes increasingly important as more school boards transition toward inclusive classrooms, The Six ‘P’ Model: Principles of Inclusive Practice for Inclusion Coaches allows for a unique look into a scaffolding model of building educator capacity in an inclusive setting.

Keywords: capacity building, coaching, inclusion, special education

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Authors: Mohammad Javad Behzadnia, Hamidreza Javadzadeh

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Background: Pain management is essential to surmounting multi-injured people in an overcrowded emergency setting. Its role would be more apparent when the physician encounters a mass casualty in a war zone or even a military prehospital. Having sedative and analgesic properties, rapid onset and offset effects, and maintaining the cardiovascular and respiratory contain are the main reason for selecting Ketamine as a good choice in the war zone. Methods: In a prospective interventional study in a war zone, we have selected and followed two groups of casualties for pain management. All were men with an average age of 26.6±8 y/o and 27.5 ±7 y/o in A and B groups, respectively. Group A received only Ketamine and Group B received Ketamine and diazepam. Results: This study showed that all of the injured patients who received Ketamine had experienced some agitation, and they may finally need benzodiazepines for sedation, but in group B that received benzodiazepine before or simultaneous with Ketamine, the agitation was significantly reduced. (P Value ≤0.05) Conclusion: Various factors may affect pain score and perception; patients' culture, mental health, previous drug usage, and addiction could alter the pain score in similar situations. It seems that the significant agitation is due to catecholamine release in stressful Moments of the battlefield. Accordingly, this situation could be exacerbated due to ketamine properties. Nonetheless, as a good choice in the war zone, Ketamine is now recommended to combine with benzodiazepines for procedural sedation and analgesia (PSA).

Keywords: battlefield, ketamine, benzodiazepine, pain control

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Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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Authors: Zakieh Rostamzadeh , Nariman Sepehrvand-Zahra Shirmohamadi

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Background: Cytomegalovirus (CMV) infection is one of the most common infectious problems following kidney transplantation. In this study, we are aimed to investigate the CMV infection in the setting of renal transplant recipients in Urmia-Iran, using both ELISA and polymerase chain reaction (PCR) methods. Methods: Ninety-six renal transplant recipients were selected randomly and enrolled in a cross-sectional study. Blood sampling was done via venipuncture, and all sera were investigated for anti-CMV IgM, and the seropositive cases in association with 14 randomly selected seronegative cases were investigated with PCR assay. Results: Thirty-three patients (34.3%) were seropositive for anti-CMV IgM, 3 patients (3.1%) were in borderline range, and 60 patients (62.5%) were seronegative. By considering the patients with borderline anti-CMV IgM levels as seropositive, 37.5% were seropositive for anti-CMV IgM. Among 36 seropositive cases, the CMV infection was confirmed in 19 (52.7%) of them using PCR. Age (P = 0.40), educational status (P = 0.77), history of pre-transplantation dialysis (0.52), history of blood transfusion (P = 0.52), and immunosuppressive regimen were not statistically different among recipients with positive versus negative CMV PCR study results. Conclusion: The seroprevalence of CMV infection was demonstrated to be high in renal transplant recipients of Urmia-Iran. The rate was higher compared to several previous reports in the literature. ELISA method has an appropriate sensitivity to screen the recipients for CMV infection but considering its relatively low specificity, the seropositive cases are better to be confirmed by further PCR study.

Keywords: cytomegalovirus, renal transplantation, ELISA, IgM, PCR

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Authors: Nazia Shehzad

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An icebreaker is a facilitation exercise intended to help a group to begin the process of forming themselves into a team. Icebreakers are commonly presented as a game to ‘warm up’ the group by helping the members to get to know each other. They often focus on sharing personal information such as names, hobbies, etc. Challenging icebreakers also have the ability to allow a group to be better prepared to complete its assigned tasks. For example, if the team's objective is to redesign a business process such as Accounts Payable, the icebreaker activity might take the team through a process analysis. The analysis could include the identification of failure points, challenging assumptions, and development of new solutions — all in a simpler and ‘safer’ setting where the team can practice the group dynamics which they will use to solve the assigned problem. Icebreakers help establish a positive environment and provide an opportunity for students to get to know one another and the instructor. Both are critical to the retention and success of students. There are a number of benefits of using ice-breakers activities in the classroom. It reduces both student and instructor anxiety prior to introducing the course, fosters in a powerful way both student-student and faculty-student interactions. It creates an environment where the learner is expected to participate and the instructor is willing to listen, actively engage students from the onset. It conveys the message that the instructor cares about getting to know the students and makes it easier for students to form relationships early in the semester so they can work together both in and out of class.

Keywords: actively engages students, facilitation exercise, faculty- student interactions, group dynamics, warm up

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Authors: Philippa Sambevski

Abstract:

Breast cancer is the most common cancer diagnosed in Australian women. The incidence of breast cancer for Aboriginal and Torres Strait Islander (ATSI) women is lower than for non-indigenous women. However, the mortality rate for ATSI women is higher. The participation rate of ATSI women in BreastScreen Australia is below the general population. In this thematic literature review, the author collates viable strategies to increase breast screening rates among culturally and linguistically diverse individuals and provide culturally competent care. Barriers to accessing BreastScreen for ATSI women include language or communication limits, isolation, and a lack of culturally sensitive information. Culturally competent strategies require healthcare workers with an appropriate cultural and social background, clear messages, and the embedding of cultural respect within healthcare organisations. Cultural safety is determined by partnering with local indigenous groups, recognising the consumer experience, and allowing people to raise their concerns. The corresponding academic poster identifies strategies for healthcare workers to provide culturally competent care in a BreastScreen setting.

Keywords: breast screen, closing the gap, Australia, cultural safety, Aboriginal and Torres Strait Islander

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Authors: Ali H. Muhammad

Abstract:

This paper investigates both instrumental and emotional family support on employee job satisfaction and perception of work-family conflict. Instrumental family support is manifested in family behavior that contributes to the reduction of employee’s family responsibilities and keeping the physical home environment in a proper shape. Emotional family support includes the encouragement and praise that the employee receives from his family and families for the employee’s work problem and their role in assisting the employees in dealing with these problems. The paper suggests that instrumental and emotional family support increases employee’s job satisfaction. Furthermore, the study proposes that family support decreases employee’s perception of work-family conflict. In addition, this study examines the reliability and validity of the family support index developed by Lynda King and her colleagues in 1995. Confirmatory factor analysis is used to test the validity of the instrument in an Arab business setting. A paper-pencil questionnaire was used to collect data from a random sample of 70 Kuwaiti employees working in the oil sector. Data were analyzed using factor analysis, reliability tests, and regression analysis. Results confirmed the research hypothesis. Family support had a positive effect on job satisfaction. Furthermore, family support significantly contributed to the reduction of employee perception of work-family conflict.

Keywords: family support, job satisfaction, work-family conflict, Kuwait oil sector

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Authors: Kejal Joshi Reddy, Sirimavo Nair

Abstract:

Micronutrient malnutrition affects pregnant women and children extremely with reference to growth manifestations in gestation as well as after birth. Early fetal development affected by iodine and iron deficiency leads to poor life quality. Various researchers have found interesting interrelations between iron and iodine. A few studies on impact assessment of DFS supplementation during pregnancy have been reported in India. Aim To provide meaningful contribution by assessing the efficacy of DFS supplementation on iodine and iron status of pregnant women. Design An interventional study. Setting A semi government hospital of urban Vadodara. Subjects Pregnant women (n=150) enrolled during first trimester (< 12 weeks) and followed up till the end of gestation, n=75 were divided in experimental (DFS supplemented) and control (Non supplemented) group. Results Impact on iron and iodine status was assessed by Hb concentration and UIE respectively. Mean Hb improved significantly (p < 0.001) (+0.42 g/dl) in experimental group and reduced non significantly (-0.20 g/dl) in control group at the end, since DFS provided additional 93 mg of iron within 6 months. Median UIE improved non significantly (278.6 to 299.01µg/L) in experimental group and decreased significantly (p < 0.05) (376.59 to 288.66 µg/L) in control group. Conclusion DFS could improve iron and iodine status of experimental group compared to control group. It is an effective measure to control two essential micronutrient deficiencies together.

Keywords: DFS supplementation, anemia, pregnancy, iodine deficiency, iron

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Authors: Walter Beck

Abstract:

Jharkhand is newly constituted 28th State in the eastern part of India which is known for the oldest settlement of the indigenous people. In the State of Jharkhand in which broadly three language family are found namely, Austric, Dravidian, and Indo-European. Ex-Mundari, kharia, Ho Santali come from the Austric Language family. Kurukh, Malto under Dravidian language family and Nagpuri Khorta etc. under Indo-European language family. There are 32 Indigenous Communities identified as Scheduled Tribe in the State of Jharkhand. Santhal, Munda, Kahria, Ho and Oraons are some of the major Tribe of the Jharkhand state. Jharkhand has a Rich Cultural heritage which includes Folk art, folklore, Folk Dance, Folk Music, Folk Songs for which diversity can been seen from place to place, season to season and all traditional Culture and practices. The languages as well as the songs are vulnerable to dominant culture and hence needed to be protected. The collection and documentation of these songs in their natural setting adds significant contribution to the conservation and propagation of the cultural elements. This paper reflects to bring out the Originality of the Collected Songs from remote areas of the plateau of Sothern Jharkhand as a rich intangible Cultural heritage of the Country. The research was done through participatory observation. In this research project more than 100 songs which were never documented before.

Keywords: cultural heritage, India, indigenous people, songs, languages

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Authors: Badeji Adebayo John

Abstract:

Technology has immense contribution in every aspect of human endeavor; it has not only made work easier but also provided exhilarating impression in the mind of the people. Theatre is not exempted from the multifaceted influence of technology on phenomenon. Therefore, theatre performances have experienced the excellence of technology in the contemporary era such that audiences have unforgettable experiences after seeing theatre performances. Some of these technological advancements that have amplified the aesthetics of performances in the theatre are techno-scenery (3D mapping) and lighting. In view of this, the objective of this study is to explore how techno-scenery and lighting technologies were used to communicate messages in the performance of Queen Moremi the Musical. In so doing, Participant-Observation Method and Content Analysis are adopted. Berlo’s model of communication is also employed to explain the communicative aesthetics of these theatre technologies in the performance. Techno-scenery and lighting are communication media modifier that facilitates audiences’ comprehension of the messages in the performance of Queen Moremi the Musical. They also create clear motion pictures of the setting which the performers cannot communicate in their acting, dances and singing, to ease the audiences’ decoding of messages that the performers are sending to the audience. Therefore, consistent incorporation of these technologies to theatre performances will facilitate easy flow of communication in-between the performers who are the sender, the message which is the performance and the audience who are the receiver.

Keywords: communication, aesthetics, techno-scenery, lighting, musical

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