Search results for: phenomenological criteria

Authors: C. Greenstone, R. Hansmann, L. Mbandla, J. Houghton, G. Lincoln

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All beach areas in South Africa are constituted as public land, open to all to walk on or swim in these spaces. With the completed development of the Durban promenade in 2023 from the Umgeni estuary to the harbour entrance, Durban’s beachfront promenade is a notable example of innovative urban design that has transformed formerly segregated spaces into a paved public walkway linking over 15 beaches. Public spaces, however, are not all created equally, with ideas on how individuals and groups become the producers of space can be a useful tool for designing future public spaces. It is the role of planners, architects, and other built environment specialists to ensure inclusivity and symbiosis between how spaces are separated and then created. Lefebvre’s ideas about space and social practice provide a foundation for this research, specifically on how spaces like the Durban promenade function as democratic spaces, highlighting questions of what draws individuals and groups to certain areas on the promenade are important. Some public spaces are well designed, accessible, and inclusive, while others create more contestation amongst users. In this research article, Durban’s beachfront promenade is used as a case study to better understand the creation of public spaces, more specifically regarding who uses the beachfront promenade and for what reasons. This research adopts a phenomenological and descriptive approach to understanding place by exploring human experiences, emotions and meanings individuals attach to the beachfront promenade and how social processes and interactions shape our understanding, experience, and meaning of places. This research will collect both qualitative and quantitative data along specific nodes located on the beachfront promenade to determine the number of visitors based on demographics such as age, race and gender and the perceptions of visitors to these nodes. The aim is to coordinate and give meaning through surveys and visitor observations to better understand the type of perceptions people have of these spaces, for example, the rationale for utilising space, which already encompasses several activities ranging from cultural, social, economic, environmental, spiritual, physical as well as numerous others.

Keywords: perceptions of space, social practice, identity, urban planning, public space

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Authors: Tobias Schramm, Günther Prokop

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The average age of passenger cars is rising steadily around the world. Older vehicles are more sensitive to the degradation of chassis components. A higher age and a higher mileage of passenger cars correlate with an increased failure rate of vehicle shock absorbers. The most common degradation mechanism of vehicle shock absorbers is the loss of oil and gas. It is not yet fully understood how the loss of oil and gas in twin-tube shock absorbers affects the lateral dynamics of passenger cars. The aim of this work is to estimate the effect of degraded twin-tube shock absorbers of passenger cars on their safety-critical lateral dynamics. A characteristic curve-based five-mass full vehicle model and a semi-physical phenomenological shock absorber model were set up, parameterized and validated. The shock absorber model is able to reproduce the damping characteristics of vehicle twin-tube shock absorbers with oil and gas loss for various excitations. The full vehicle model was used to simulate stationary cornering and steering wheel angle step maneuvers on road classes A to D. The simulations were carried out in a realistic parameter space in order to demonstrate the influence of various vehicle characteristics on the effect of degraded shock absorbers. As a result, it was shown that degraded shock absorbers have a negative effect on the understeer gradient of vehicles. For stationary lateral dynamics, degraded shock absorbers for high road excitations reduce the maximum lateral accelerations. Degraded rear axle shock absorbers can change the understeer gradient of a vehicle in the direction of oversteer. Degraded shock absorbers also lead to increased rolling angles. Furthermore, degraded shock absorbers have a major impact on driving stability during steering wheel angle steps. Degraded rear axle shock absorbers, in particular, can lead to unstable handling. Especially the tire stiffness, the unsprung mass and the stabilizer stiffness influence the effect of degraded shock absorbers on the lateral dynamics of passenger cars.

Keywords: driving dynamics, numerical simulation, road safety, shock absorber degradation, stationary and nonstationary lateral dynamics.

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Authors: Rita Phillips, Mark Burgess, Maga Berlinski

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Although the positive impact of religiosity on well-being, health, and life-coping abilities is well known, up to date research has failed to provide scientific evidence for the relationship reasons. Therefore the present study took a qualitative approach by examining how religiosity interacts in coping with emotionally distressful situations, for which wedding preparations are an example. Wedding preparations, related to the experience of ambiguous emotions, can be the reason for phases of high distress. Although being per-se religious ceremonies, they are also socially-scripted and characterized by people’s striving for personally meaningful celebrations. The negotiation of these many influences can evoke conflicts. To reveal components of religiosity which contribute to stress-resolution, eight biographic-narrative interviews with recently married spouses were conducted. Participants were from different nationalities and Catholic deep-belief communities in order to determine factors independent from national-culture and social-subgroup. The audio-tape recorded, transcribed and translated interviews were analyzed by Interpretative Phenomenological Analysis. Opposing previous research on wedding-related conflicts but in-line with the quantitative account on the relation between stress-resilience and religiosity, the present study found participants reporting very low levels of distress and ambiguity. Although similar areas of potential conflicts were revealed, deep-belief Christians seemed to handle them in a different way. Participants freed themselves from own and others’ rigor mundane expectations by their spiritual preparation and the focus on a divine instance. This evoked a feeling of perceived closeness to God and of unconditional love, resulting in acceptance of oneself and others. Through relativizing mundane goods, participants perceived absolute freedom. Thus belief did not supplement coping strategies, previously defined in the literature, but substituted them. The paper implies that in explaining the connection between stress-resilience and religiosity, one’s perception and experience of unconditional love might outweigh other social or personal factors. However, further qualitative investigations are needed to fully explain the phenomenon.

Keywords: deep-belief, religiosity, resilience, wedding

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Authors: Muhammad Yasir Tarar

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Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.

Keywords: arthrocentesis, warfarin, bleeding, injection

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Authors: Mjellma Rexhepi, Blerta Rexhepi Kelmendi, Blana Krasniqi, Shaip Krasniqi

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Rheumatoid arthritis is a chronic disease that causes inflammation of the joints which can be so severe that can cause not only deformities but also impairment of function that limits movement. This also contributes to the pain that accompanies this disease. This remains a problematic and challenging disease of modern medicine because treatment is still symptomatic. The main purpose of drug treatment is to reduce the activity of the disease, achieve remission, avoid disability and death. The etiology of the disease is idiopathic, but can also be linked to genetic, nongenetic factors such as hormonal, environmental or infectious. Current scientific evidence shows that vitamin D plays an important role in immune regulation mechanisms. Lack of this vitamin has been linked to loss of immune tolerance and the appearance of autoimmune processes, including rheumatoid arthritis. The purpose of the work was to define Vitamin D in patients hospitalized with rheumatoid arthritis in University Clinical Center of Kosova, as a basis of their connection with lifestyle and physical inactivity. The sample for the work was selected from patients with criteria met for rheumatoid arthritis who were hospitalized at the tertiary level of health care in Kosova. During the work have been investigated 100 consecutive patients fulfilling diagnostic criteria for rheumatoid arthritis, whereas in addition to the general characteristics are also determined the values of vitamin D at the beginning of hospitalization. The average age of the sample analyzed was 50.9±5.7 years old, with an average duration of rheumatoid arthritis disease 7.8±3.4 years. At the beginning of hospitalization, before treatment was initiated, the average value of vitamin D was 15.86±3.43, which according to current reference values is classified into the category of insufficient values. Correlating the duration of the disease, from the time of diagnosis to the day of hospitalization, on one side and the level of vitamin D on the other side, the negative correlation of a lower degree derived (r =-0.1). Physical activity affects the concentration of vitamin D in the blood through increased metabolism of fat and the release of vitamin D and its metabolites from adipose tissue. To now it is evident that physical activity is also accompanied by higher levels of vitamin D. In patients with rheumatoid arthritis, vitamin D levels were low compared to normal. Future works should be oriented toward investigating in detail the bone structure, quality of life and pain in patients with rheumatoid arthritis. More detailed scientific projects, with larger numbers of participants, should be designed for the future to clarify more possible mechanisms as factors related to this phenomenon such as inactivity, lifestyle and the duration of the disease, as well as the importance of keeping vitamin D values at normal limits.

Keywords: hospitalization, lifestyle, rheumatoid arthritis, vitamin D

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Authors: Xiao Wang, Qinge Zhang

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Background: This randomized, open-label study examined the therapeutic effects of computerized cognitive training (CCT) combined with selective serotonin reuptake inhibitors (SSRIs) on cognitive impairment among patients with late-life depression (LLD). Method: Study data were collected from May 5, 2021, to April 21, 2023. Outpatients who met diagnostic criteria for major depressive disorder according to the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria (i.e., a total score on the 17-item Hamilton Depression Rating Scale (HAMD-17) ≥ 18 and a total score on the Montreal Cognitive Assessment scale (MOCA) <26) were randomly assigned to receive up to 12 weeks of CCT and SSRIs treatment (n=57) or SSRIs and Control treatment (n=61). The primary outcome was the change in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores from baseline to week 12 between the two groups. The secondary outcomes included changes in the HAMD-17 score, Hamilton Anxiety Scale (HAMA) score and Neuropsychiatric Inventory (NPI) score. Mixed model repeated measures (MMRM) analysis was performed on modified intention-to-treat (mITT) and completer populations. Results: The full analysis set (FAS) included 118 patients (CCT and SSRIs group, n=57; SSRIs and Control group, n =61). Over the 12-week study period, the reduction in the ADAS-cog total score was significant (P < 0.001) in both groups, while MMRM analysis revealed a significantly greater reduction in cognitive function (ADAS-cog total scores) from baseline to posttreatment in the CCT and SSRIs group than in the SSRI and Control group [(F (1,115) =13.65, least-squares mean difference [95% CI]: −2.77 [−3.73, −1.81], p<0.001)]. There were significantly greater improvements in depression symptoms (measured by the HAMD-17) in the CCT and SSRIs group than in the control group [MMRM, estimated mean difference (SE) between groups −3.59 [−5.02, −2.15], p < 0.001]. The least-squares mean changes in the HAMA scores and NPI scores between baseline and week 8 were greater in the CCT and SSRIs group than in the control group (all P < 0.05). There was no significant difference between groups on response rates and remission rates by using the last-observation-carried-forward (LOCF) method (all P > 0.05). The most frequent adverse events (AEs) in both groups were dry mouth, somnolence, and constipation. There was no significant difference in the incidence of adverse events between the two groups. Conclusions: CCT combined with SSRIs was efficacious and well tolerated in LLD patients with cognitive impairment.

Keywords: late-life depression, cognitive function, computerized cognitive training, SSRIs

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Authors: Sven Tackenberg, Sönke Duckwitz, Andreas Petz, Christopher M. Schlick

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This paper introduces an extension to the well-established Resource-Constrained Project Scheduling Problem (RCPSP) to apply it to complex maintenance problems. The problem is to assign technicians to a team which has to process several tasks with multi-level skill requirements during a work shift. Here, several alternative activities for a task allow both, the temporal shift of activities or the reallocation of technicians and tools. As a result, switches from one valid work process variant to another can be considered and may be selected by the developed evolutionary algorithm based on the present skill level of technicians or the available tools. An additional complication of the observed scheduling problem is that the locations of the construction sites are only temporarily accessible during a day. Due to intensive rail traffic, the available time slots for maintenance and repair works are extremely short and are often distributed throughout the day. To identify efficient working periods, a first concept of a Bayesian network is introduced and is integrated into the extended RCPSP with pre-emptive and non-pre-emptive tasks. Thereby, the Bayesian network is used to calculate the probability of a maintenance task to be processed during a specific period of the shift. Focusing on the domain of maintenance of the railway infrastructure in metropolitan areas as the most unproductive implementation process at construction site, the paper illustrates how the extended RCPSP can be applied for maintenance planning support. A multi-criteria evolutionary algorithm with a problem representation is introduced which is capable of revising technician-task allocations, whereas the duration of the task may be stochastic. The approach uses a novel activity list representation to ensure easily describable and modifiable elements which can be converted into detailed shift schedules. Thereby, the main objective is to develop a shift plan which maximizes the utilization of each technician due to a minimization of the waiting times caused by rail traffic. The results of the already implemented core algorithm illustrate a fast convergence towards an optimal team composition for a shift, an efficient sequence of tasks and a high probability of the subsequent implementation due to the stochastic durations of the tasks. In the paper, the algorithm for the extended RCPSP is analyzed in experimental evaluation using real-world example problems with various size, resource complexity, tightness and so forth.

Keywords: maintenance management, scheduling, resource constrained project scheduling problem, genetic algorithms

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Authors: Xue Li, Hui Xu

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Mild cognitive impairment (MCI) is a clinical stage that occurs between normal aging and dementia. Although MCI increases the risk of developing dementia, individuals with MCI may maintain stable cognitive function and even recover to a typical cognitive state. An intervention to prevent or delay the progression to dementia in individuals with MCI may involve promoting social engagement. Social participation is the engagement in socially relevant social exchanges and meaningful activities. Older adults with MCI may encounter restricted cognitive abilities, mood changes, and behavioral difficulties during social participation, influencing their willingness to engage. Therefore, this study aims to employ qualitative research methods to gain an in-depth comprehension of the authentic social participation experiences of older adults with mild cognitive impairment, which will establish a foundation for designing appropriate intervention programs. A phenomenological research was conducted. The study participants were selected using the purposive sampling method in combination with the maximum differentiation sampling strategy. Face-to-face semistructured interviews were conducted among 12 elderly individuals suffering from mild cognitive impairment in a community in Zhengzhou City from May to July 2023. Colaizzi 7-step method was used to analyze the data and extract the theme. The real experience of social participation in older adults with mild cognitive impairment can be summarized into 3 themes: (1) a single social relationship but a strong desire to participate, (2) a dual experience of social participation with both positive and negative aspects, (3) multiple barriers to social participation, including impaired memory capacity, heavy family responsibilities and lack of infrastructure. The study found that elderly individuals with mild cognitive impairment and one social interaction display an increased desire to engage in society. To improve social participation levels and reduce cognitive function decline, healthcare providers should work with relevant government agencies and the community to create a comprehensive social participation system. It is important for healthcare providers to note the social participation status of the elderly with mild cognitive impairment.

Keywords: mild cognitive impairment, the elderly, social participation, qualitative research

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Authors: Seyed Esmail Seyedi Bariran, Laysheng Ewe, Amy Ling

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Since supplier selection appears as a vital decision, selecting supplier based on the best and most accurate ways has a lot of importance for enterprises. In this study, a new Artificial Intelligence approach is exerted to remove weaknesses of supplier selection. The paper has three parts. First part is choosing the appropriate criteria for assessing the suppliers’ performance. Next one is collecting the data set based on experts. Afterwards, the data set is divided into two parts, the training data set and the testing data set. By the training data set the best structure of GEP and ANN are selected and to evaluate the power of the mentioned methods the testing data set is used. The result obtained shows that the accuracy of GEP is more than ANN. Moreover, unlike ANN, a mathematical equation is presented by GEP for the supplier selection.

Keywords: supplier selection, automotive supply chains, ANN, GEP

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Authors: Augustar Omoze Ehighalua, Itotenaan Henry Ogiri

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As a mono-product economy, Nigeria relies largely on oil revenues for its foreign exchange earnings and the exploration activities of firms operating in the Niger Delta region have left in its wake tales of environmental degradation, poverty and misery. This, no doubt, have created corporate social responsibility issues in the region. The focus of this research is the critical evaluation of the ethical response to Corporate Social Responsibility (CSR) practice by firms operating in Nigeria Delta Swamplands. While CSR is becoming more popular in developed society with effective practice guidelines and reporting benchmark, there is a relatively low level of awareness and selective applicability of existing international guidelines to effectively support CSR practice in Nigeria. This study, haven identified the lack of CSR institutional framework attempts to develop an ethically-driven CSR transparency benchmark laced within a regulatory framework based on international best practices. The research adopts a qualitative methodology and makes use of primary data collected through semi-structured interviews conducted across the six core states of the Niger Delta Region. More importantly, the study adopts an inductive, interpretivist philosophical paradigm that reveal deep phenomenological insights into what local communities, civil society and government officials consider as good ethical benchmark for responsible CSR practice by organizations. The institutional theory provides for the main theoretical foundation, complemented by the stakeholder and legitimacy theories. The Nvivo software was used to analyze the data collected. This study shows that ethical responsibility is lacking in CSR practice by firms in the Niger Delta Region of Nigeria. Furthermore, findings of the study indicate key issues of environmental, health and safety, human rights, and labour as fundamental in developing an effective CSR practice guideline for Nigeria. The study has implications for public policy formulation as well as managerial perspective.

Keywords: corporate social responsibility, CSR, ethics, firms, Niger-Delta Swampland, Nigeria

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Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

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Authors: Dimitra Alexiou, Stefanos Katsavounis, Ria Kalfakakou

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In an urban area the determination of transportation routes should be planned so as to minimize the provoked pollution taking into account the cost of such routes. In the sequel these routes are cited as pollution routes. The transportation network is expressed by a weighted graph G= (V, E, D, P) where every vertex represents a location to be served and E contains unordered pairs (edges) of elements in V that indicate a simple road. The distances/cost and a weight that depict the provoked air pollution by a vehicle transition at every road are assigned to each road as well. These are the items of set D and P respectively. Furthermore the investigated pollution routes must not exceed predefined corresponding values concerning the route cost and the route pollution level during the vehicle transition. In this paper we present an algorithm that generates such routes in order that the decision maker selects the most appropriate one.

Keywords: bi-criteria, pollution, shortest paths, computation

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Authors: P. Dhesi, R. Burns

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Background: The UK has one of the largest immigration detention estates in Europe and is under increasing scrutiny, particularly regarding the lack of transparency over the use of detention and the conditions. Therefore, this research seeks to explore the professional perceptions of the ability of immigration detention in the UK to promote health and dignity. Methods: A phenomenological approach to qualitative methods were used, with social constructivist theorisations of health and dignity. Seven semi-structured interviews were conducted using Microsoft Teams. Participants included a range of immigration detention stakeholders who have visited closed immigration detention centres in the UK in a professional capacity. Recorded interviews were transcribed verbatim, and analysis was data-driven through inductive reflexive thematic analysis of the entire data set to account for the small sample size. This study received ethical approval from University College London Research Ethics Committee. Results: Two global themes were created through analysis: apathetic place and hostile space. Apathetic place discusses the lack of concern for detainees' daily living and healthcare needs within immigration detention in the UK. This is explored through participants' perceptions of the lack of ability of monitoring and evaluation processes to ensure detainees are able to live with dignity and understand the unfulfilled duty of care that exists in detention. Hostile space discusses immigration detention in the UK as a wider system of hostility. This is explored through the disempowering impact on detainees, the perception of a failing system as a result of inadequate safeguarding procedures, and a belief that the intention of immigration detention is misaligned with its described purpose. Conclusion: This research explains why the current immigration detention system in the UK is unable to promote health and dignity, offering a social justice and action-orientated approach to research in this sphere. The findings strengthen the discourse against the use of detention as an immigration control tool in the UK. Implications for further research include a stronger emphasis on investigating alternatives to detention and culturally considerate opportunities for patient-centred healthcare.

Keywords: access to healthcare, dignity, health, immigration detention, migrant, refugee, UK

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Authors: Benedicta N. Nkeh-Chungag, Constance R. Sewani-Rusike, Isaac M. Malema, Daniel T. Goon, Oladele V. Adeniyi, Idowu A. Ajayi

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Background: Childhood and adolescent obesity is an important predictor of adult cardiometabolic diseases. Current data on age- and gender-specific cardiometabolic risk factors are lacking in the peri-urban Eastern Cape Province, South Africa. However, such information is important in designing innovative strategies to promote healthy living among children and adolescents. The purpose of this pilot study was to compare and determine the extent of cardiometabolic risk factors between samples of lean and overweight/obese adolescent population in a peri-urban township of South Africa. Methods: In this case-control study, age-matched, non-pregnant and non-lactating female adolescents consisting of equal number of cases (50 overweight/obese) and control (50 lean) participated in the study. Fasting venous blood samples were obtained for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (Trig), highly sensitive C-reactive protein (hsCRP) and blood sugar. Anthropometric measurements included weight, height, waist and hip circumferences. Body mass index was calculated. Blood pressure was measured; and metabolic syndrome was assessed using appropriate diagnostic criteria for children and adolescents. Results: Of the 76 participants with complete data, 12/38 of the overweight/obese and 1/38 of the lean group met the criteria for adolescent metabolic syndrome. All cardiometabolic risk factors were elevated in the overweight/obese group compared with the lean group: low HDL-C (RR = 2.21), elevated TC (RR = 1.23), elevated LDL-C (RR = 1.42), elevated Trig (RR = 1.73), and elevated hsCRP (RR = 1.9). There were significant atherosclerotic indices among the overweight/obese group compared with the lean group: TC/HDL and LDL/HDL (2.99±0.91 vs 2.63±0.48; p=0.016 and 1.73±0.61 vs 1.41±0.46; p= 0.014, respectively). Conclusion: There are multiple cardiometabolic risk factors among the overweight/obese female adolescent group compared with lean adolescent group in the study. Female adolescent who are overweight and obese have higher relative risks of developing cardiometabolic diseases compared with their lean counterparts in the peri-urban Mthatha, South Africa. School health programme focusing on promoting physical exercise, healthy eating and keeping appropriate weight are needed in the country.

Keywords: adolescents, cardiometabolic risk factors, obesity, peri-urban South Africa

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Authors: Habib Alshuwaikhat, Nahid Hossain

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Residential sector consumes more than half of the produced electricity in Saudi Arabia, and fossil fuel is the main source of energy to meet growing household electricity demand in the Kingdom. Several studies forecasted and expressed concern that unless the domestic energy demand growth is controlled, it will reduce Saudi Arabia’s crude oil export capacity within a decade and the Kingdom is likely to be incapable of exporting crude oil within next three decades. Though the Saudi government has initiated to address the domestic energy demand growth issue, the demand side energy management policies and programs are focused on industrial and commercial sectors. It is apparent that there is an urgent need to develop a comprehensive energy efficiency strategy for addressing efficient energy use in residential sector in the Kingdom. Then again as Saudi Arabia is at its primary stage in addressing energy efficiency issues in its residential sector, there is a scope for the Kingdom to learn from global energy efficiency practices and design its own energy efficiency policies and programs. However, in order to do that sustainable, it is essential to address local contexts of energy efficiency. It is also necessary to find out the policies and programs that will fit to the local contexts. Thus the objective of this study was set to identify globally best practice energy efficiency policies and programs in residential sector that have replication potential in Saudi Arabia. In this regard two sets of multi-criteria decision analysis matrices were developed to evaluate the energy efficiency policies and programs. The first matrix was used to evaluate the global energy efficiency policies and programs, and the second matrix was used to evaluate the replication potential of global best practice energy efficiency policies and programs for Saudi Arabia. Wuppertal Institute’s guidelines for energy efficiency policy evaluation were used to develop the matrices, and the different attributes of the matrices were set through available literature review. The study reveals that the best practice energy efficiency policies and programs with good replication potential for Saudi Arabia are those which have multiple components to address energy efficiency and are diversified in their characteristics. The study also indicates the more diversified components are included in a policy and program, the more replication potential it has for the Kingdom. This finding is consistent with other studies, where it is observed that in order to be successful in energy efficiency practices, it is required to introduce multiple policy components in a cluster rather than concentrate on a single policy measure. The developed multi-criteria decision analysis matrices for energy efficiency policy and program evaluation could be utilized to assess the replication potential of other globally best practice energy efficiency policies and programs for the residential sector of the Kingdom. In addition it has potential to guide Saudi policy makers to adopt and formulate its own energy efficiency policies and programs for Saudi Arabia.

Keywords: Saudi Arabia, residential sector, energy efficiency, policy evaluation

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Authors: Malay Niraj, Praveen Kumar

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The present study is a new approach for improving equipment life and Overall Equipment Efficiency (O.E.E.) through suitable maintenance practice with the help of value engineering. Value engineering is a one of the most powerful decision-making techniques which depend on many factors. The improvements are the result of recommendations made by multidisciplinary teams representing all parties involved. VE is a rigorous, systematic effort to improve the OEE and optimize the life cycle cost of a facility. The study describes problems in maintenance arising due to the absence of having clear criteria and strong decision constrain how to maintain failing equipment. Using factor comparisons, the study has been made between different maintenance practices and finally best maintenance practice based on value engineering technique has been selected.

Keywords: maintenance strategy, overall equipment efficiency, value engineering, decision-making

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Authors: Ariyan S. Araghi, Guy C. Jackson, Stephen J. Bonsor

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Materials & Methods: A systematic literature search was undertaken using pre-determined inclusion and exclusion criteria. This review followed the Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) statement. Several databases were used to search for randomised control trials and longitudinal cohort studies, which were published less than thirty years ago. A total of 54 studies met the predefined inclusion criteria. Four studies reviewed the success, survival, and failure characteristics of zirconia framework resin retained bridges, whilst two reviewed non-precious metal resin retained bridges. Results: The analysis of the studies revealed an overall survival rate of 95.9% for zirconia-based restorations compared to 90.7% for non-precious metal frameworks. Non-precious metal resin retained bridges displayed a higher overall failure rate of 11.9% compared to 4.6% for zirconia-based restorations in the analysed papers. The most frequent complications were wing debonding for the non-precious metal wing group, whereas substructure fracture and veneering ceramic fracture were more prevalent for the zirconia arm of the study. Conclusion: Both types of resin retained bridges provide effective medium to long-term survival. Zirconia-based frameworks will provide marginally increased success and survival and greatly improved aesthetics. However, catastrophic failure is more likely with zirconia-based restorations. Non-precious metal is time tested but performs worse than its zirconia counterpart with regards to longevity; it does not exhibit the same framework fractures as zirconia. Cement choice and attention to the adhesive bonding systems used appear to be paramount to restoration longevity with both restoration subtypes. Furthermore, improved longevity can be seen when air particle abrasion is incorporated into the adhesive protocol. Within the limitations of this study, it has been determined that zirconia-based resin retained bridges can be effectively used in anterior cantilever bridges. Clinical Significance: Zirconia-based resin retained bridges have been demonstrating promising results in terms of improved success and survival characteristics, together with improved aesthetics when compared to non-precious metal winged resin retained bridges. Their popularity is increasing in the age of digital dentistry as many restorations are manufactured using such technology. It is essential that clinicians understand the limitations of each material type and principles of adhesion to ensure restoration longevity.

Keywords: resin retained bridge, fixed partial denture, zirconia bridge, adhesive bridge

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Authors: Roger-Claude Liwanga

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Over the last seven decades, there has been a proliferation of international tribunals. Yet, they have not received unanimous approval, raising a question about their legitimacy. A legitimate international tribunal is one whose authority to adjudicate international disputes is perceived as justified. Using the case study of the International Court of Justice (ICJ), this article highlights the three criteria that should be considered in assessing the legitimacy of an international tribunal, which include legal, sociological, and moral elements. It also contends that the ICJ cannot claim 'full' legitimacy if any of these components of legitimacy is missing in its decisions. The article further suggests that the legitimacy of the ICJ has a dynamic nature, as litigating parties may constantly change their perception of the court’s authority at any time before, during, or after the judicial process. The article equally describes other factors that can contribute to maintaining the international court’s legitimacy, including fairness and unbiasedness, sound interpretation of international legal norms, and transparency.

Keywords: international tribunals, legitimacy, human rights, international law

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Authors: Roberto Cabezas H

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The current work shows the methodology developed to create narrative lighting spaces for the multimedia performance piece 'cluster: the vanished paradise.' This empirical research is focused on exploring unconventional roles for machines in subjective creative processes, by delving into the semantics of data and machine intelligence algorithms in hybrid technological, creative contexts to expand epistemic domains trough human-machine cooperation. The creative process in scenic and performing arts is guided mostly by intuition; from that idea, we developed an approach to embed collective intuition in computational creative systems, by joining the properties of Generative Adversarial Networks (GAN’s) and Fuzzy Clustering based on a semi-supervised data creation and analysis pipeline. The model makes use of GAN’s to learn from phenomenological data (data generated from experience with lighting scenography) and algorithmic design data (augmented data by procedural design methods), fuzzy logic clustering is then applied to artificially created data from GAN’s to define narrative transitions built on membership index; this process allowed for the creation of simple and complex spaces with expressive capabilities based on position and light intensity as the parameters to guide the narrative. Hybridization comes not only from the human-machine symbiosis but also on the integration of different techniques for the implementation of the aided design system. Machine intelligence tools as proposed in this work are well suited to redefine collaborative creation by learning to express and expand a conglomerate of ideas and a wide range of opinions for the creation of sensory experiences. We found in GAN’s and Fuzzy Logic an ideal tool to develop new computational models based on interaction, learning, emotion and imagination to expand the traditional algorithmic model of computation.

Keywords: fuzzy clustering, generative adversarial networks, human-machine cooperation, hybrid collective data, multimedia performance

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Authors: Alireza Shayegan, Morteza Amirabadi

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The y tool was developed to quantitatively compare dose distributions, either measured or calculated. Before computing ɣ, the dose and distance scales of the two distributions, referred to as evaluated and reference, are re-normalized by dose and distance criteria, respectively. The re-normalization allows the dose distribution comparison to be conducted simultaneously along dose and distance axes. Several two-dimensional images were acquired using a Scanning Liquid Ionization Chamber EPID and Extended Dose Range (EDR2) films for regular and irregular radiation fields. The raw images were then converted into two-dimensional dose maps. Transitional and rotational manipulations were performed for images using Matlab software. As evaluated dose distribution maps, they were then compared with the corresponding original dose maps as the reference dose maps.

Keywords: energetic electron, gamma function, penumbra, Matlab software

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Authors: Mohammad Safaeipour, Yousef Amer

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This study directs its focus on developing a conceptual model to offer a systematic and integrated method to weigh the related measures and evaluate a competence of hospitals and rank of the selected hospitals that involve and consider the stakeholders’ key performance indicators (KPI’s). The Analytical Hierarchy Process (AHP) approach will use to weigh the dimensions and related sub- components. The weights and performance scores will combine by using the Technique for Order Performance by Similarity to Ideal Solution (TOPSIS) and rank the selected hospitals. The results of this study provide interesting insight into the necessity of process improvement implementation in which hospital that received the lowest ranking score.

Keywords: performance measurement system, PMS, hospitals, AHP, TOPSIS

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Authors: Agnes Utari Widyaningdyah

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This study investigates the relationship between strategy, intellectual capital (IC) disclosure, and the firm’s performance by considering business competition as a moderating variable. The secondary sectors manufacturing firms in the Jakarta Stock Industrial Classification as sample because this group represents a knowledge-intensive firm according to the OECD (Organization for Economic Cooperation and Development) criteria. Using path analysis, this study reveals that there is a significant influence of strategy toward IC disclosure. Firms with differentiation strategy tend to withhold its strategic information included IC because of afraid in losing their competitive advantage. The results also indicate that firms are more likely to withhold information about IC if they perceive that current or potential competition is strong. However, firms should consider that IC disclosure is a positive signal to the investor.

Keywords: strategy, IC disclosure, market performance, business competition

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Authors: Hilary Modir, Kyle Dutton, Michelle Swab, Shabnam Asghari

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Since its emergence, the cutaneous manifestations of COVID-19 have been documented in the literature. However, the majority are case reports with significant limitations in appraisal quality, thus leaving the role of dermatological manifestations of COVID-19 erroneously underexplored. The primary aim of this review was to systematically examine clinical patterns of dermatological manifestations as reported in the literature. This study was designed as a systematic review of case reports. The inclusion criteria consisted of all published reports and articles regarding COVID-19 in English, from September 1st, 2019, until June 22nd, 2020. The population consisted of confirmed cases of COVID-19 with associated cutaneous signs and symptoms. Exclusion criteria included research in planning stages, protocols, book reviews, news articles, review studies, and policy analyses. With the collaboration of a librarian, a search strategy was created consisting of a mixture of keyword terms and controlled vocabulary. Electronic databases searched were MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, LILACS, PsycINFO, WHO Global Literature on Coronavirus Disease, Cochrane Library, Campbell Collaboration, Prospero, WHO International Clinical Trials Registry Platform, Australian and New Zealand Clinical Trials Registry, U.S. Institutes of Health Ongoing Trials Register, AAD Registry, OSF preprints, SSRN, MedRxiV and BioRxiV. The study selection featured an initial pre-screening of titles and abstracts by one independent reviewer. Results were verified by re-examining a random sample of 1% of excluded articles. Eligible studies progressed for full-text review by two calibrated independent reviewers. Covidence was used to store and extract data, such as citation information and findings pertaining to COVID-19 and cutaneous signs and symptoms. Data analysis and summarization methodology reflect the framework proposed by PRISMA and recommendations set out by Cochrane and Joanna Brigg’s Institute for conducting systematic reviews. The Oxford Centre for Evidence-Based Medicine’s level of evidence was used to appraise the quality of individual studies. The literature search revealed a total of 1221 articles. After the abstract and full-text screening, only 95 studies met the eligibility criteria, proceeding to data extraction. Studies were divided into 58% case reports and 42% series. A total of 833 manifestations were reported in 723 confirmed COVID-19 cases. The most frequent lesions were 23% maculopapular, 15% urticarial and 13% pseudo-chilblains, with 46% of lesions reporting pruritus, 16% erythema, 14% pain, 12% burning sensation, and 4% edema. The most common lesion locations were 20% trunk, 19.5% lower limbs, and 17.7% upper limbs. The time to resolution of lesions was between one and twenty-one days. In conclusion, over half of the reported cutaneous presentations in COVID-19 positive patients were maculopapular, urticarial and pseudo-chilblains, with the majority of lesions distributed to the extremities and trunk. As this review’s sample size only contained COVID-19 confirmed cases with skin presentations, it becomes difficult to deduce the direct relationship between skin findings and COVID-19. However, it can be correlated that acute onset of skin lesions, such as chilblains-like, may be associated with or may warrant consideration of COVID-19 as part of the differential diagnosis.

Keywords: COVID-19, cutaneous manifestations, cutaneous signs, general dermatology, medical dermatology, Sars-Cov-2, skin and infectious disease, skin findings, skin manifestations

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Authors: Odd Jarl Borch, Marina Z. Solesvik

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The paper analyses partner selection approaches related to large scale R&D-based innovation projects at the different stages of development. We emphasize innovation projects in the maritime value chain and how partners are selected to improve quality according to high spec customer demands, and to reduce investment costs on new production technology such as advanced offshore service vessels. We elaborate on the differences in innovation approach and especially the role that purposive inflows and outflows of knowledge from external partners may be used to accelerate internal innovation. We present three cases related to different projects in terms of specificity and scope. We explore how the partner selection criteria change over time when the goals move from wide scope to a very specific R&D tasks.

Keywords: partner selection, innovation, offshore industry, concept design

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Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

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Authors: S. Ivanova, K. Ivanov

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Bemitil (2-ethylthiobenzimidazole hydrobromide) is a synthetic adaptogen and actoprotector, with wide-ranging pharmacological activities such as nootropic, antihypoxic, antioxidant, immunostimulant. The intake of Bemitil increases mental and physical performance and could be applied under either normal or extreme conditions. Until 2017 Bemitil was not considered as doping and was used by professional athletes more than 30 years because of its high efficiency and safety. The drug was included in WADA monitoring programme for 2018, and most likely it would be included in WADA Prohibited List for 2019. Usually, a substance/method is included in WADA Prohibited List if it meets any two of the following three criteria: the potential to enhance or enhances sports performance/ potential health risk to the athlete/ violates the spirit of sport. Bemitil has high performance-enhancing potential, but it is also safe- it is controversial whether it should be considered as doping.

Keywords: doping, bemitil, sport, actoprotector

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Authors: Saeid Doaei

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The various studies have examined the relationship between FTO gene expression and macronutrients levels. In order to obtain better viewpoint from this interactions, all of the existing studies were reviewed systematically. All published papers have been obtained and reviewed using standard and sensitive keywords from databases such as CINAHL, Embase, PubMed, PsycInfo, and the Cochrane, from 1990 to 2016. The results indicated that all of 6 studies that met the inclusion criteria (from a total of 428 published article) found FTO gene expression changes at short-term follow-ups. Four of six studies found an increased FTO gene expression after calorie restriction, while two of them indicated decreased FTO gene expression. The effect of protein, carbohydrate and fat were separately assessed and suggested by all of six studies. In conclusion, the level of FTO gene expression in hypothalamus is related to macronutrients levels. Future research should evaluate the long-term impact of dietary interventions.

Keywords: obesity, gene expression, FTO, macronutrients

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Authors: Assem El-Ansary

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This paper illustrates the event-oriented Behavioral Pattern Analysis (BPA) modeling approach using the Healthcare Multi-Agent System. The Event defined in BPA is a real-life conceptual entity that is unrelated to any implementation. The major contributions of this research are: The Behavioral Pattern Analysis (BPA) modeling methodology. The development of an interactive software tool (DECISION), which is based on a combination of the Analytic Hierarchy Process (AHP) and the ELECTRE Multi-Criteria Decision Making (MCDM) methods.

Keywords: analysis, modeling methodology, software modeling, event-oriented, behavioral pattern, use cases, Healthcare Multi-Agent System

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Authors: Medina Adulyarat

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Like many other countries, Thailand is experiencing an increase in its proportion of older adults. However, the political, social, and religious climates of the various regions of Thailand are very diverse and the life experiences of older Thai citizens can vary greatly by region. For more than a decade, the southernmost provinces, namely Yala, Pattani and Narathiwat, have experienced social and political unrest, often characterized by violence in the form of bombings and shootings, which has impacted the older adults residing in these regions. While, Muslims are considered a minority in Thailand, the majority of individuals in southernmost regions are Muslims, causing these regions to be different in terms of culture and beliefs. Using a phenomenological approach, this study examines older adults’ perceptions of successful aging within the context of violent social and political unrest. This research aims to 1) understand how older adults living in these areas perceive successful aging in relation to Rowe and Kahn’s successful ageing model, and 2) describe the experiences of older adults living in areas of violent social and political unrest. Data were collected using in-depth interviews with eight older adults living in the unrest area, composing of four males and four females aged between 55-75. Content analysis was used to investigate older adults’ perception of successful aging. Older adults living their life amidst the violence did not view the situation as a threat to their life for they viewed that they are not the targets of the unrest situation. Additionally, participants identified their religious beliefs and a strong sense of community belonging as coping strategies employed to deal with social and political unrest. Thus, according to them, the violence did not affect their perception of successful aging. While the participants’ perceptions of successful aging were generally consistent with aspects identified in the successful aging model proposed by Rowe and Kahn, a theme of “financial stability” emerged. The results can be divided into four interrelated themes, which are; 1) engaging with others; 2) religiosity; 3) financial stability; and 4) health. Understanding the older persons’ view of successful aging in vulnerable situations should add more depth and enhance the conceptualization of the successful aging concept.

Keywords: cultural gerontology, minority population, successful aging, unrest situation

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Authors: Najia Zulfiqar

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Imparting moral education is the need of time, considering the obvious moral decline in society. Recent research shows the downfall of moral competence among university students. The main objective of the present study was to develop moral development intervention strategies for undergraduate students of Sports and Physical Education. Using an interpretative phenomenological approach, insight into field-specific moral issues was gained through interviews with 7 subject experts and a focus-group discussion session with 8 students. Two research assistants who were trained in qualitative interviewing collected, transcribed and analyzed data into the MAXQDA software using content and discourse analyses. The identified moral issues in Sports and Physical Education were sports gambling and betting, pay-for-play, doping, coach misconduct, tampering, cultural bias, gender equity/nepotism, bullying/discrimination, and harassment. Next, intervention modules were developed for each moral issue based on hypothetical situations, and followed by guided reflection and dilemma discussion questions. The third moral development strategy was community services that included posture screening, diet plan for different age groups, open fitness ground training, exercise camps for physical fitness, balanced diet awareness camp, gymnastic camp, shoe assessment as per health standards, and volunteering for public awareness at the playground, gymnasium, stadium, park, etc. The intervention modules were given to four subject specialists for expert validation who were from different backgrounds within Sport Sciences. Upon refinement and finalization, four students were presented with these intervention modules and questioned about accuracy, relevance, comprehension, and content organization. Iterative changes were made in the content of the intervention modules to tailor them to the moral development needs of undergraduate students. This intervention will strengthen positive moral values and foster mature decision-making about right and wrong acts. As this intervention is easy to apply as a remedial tool, academicians and policymakers can use this to promote students’ moral development.

Keywords: community service, dilemma discussion, morality, physical education, university students.

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