Search results for: systemic creativity

Authors: Ali Showail Ali Alasmari

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Introduction: Cataract is the loss of transparency of the lens inside the eye. It is the most common cause of visual loss and blindness worldwide. This study provides a systemic review of the recent findings on the association of vitamin D, and vitamin B12, and their possible role in preventing cataracts in senile (S) and diabetic mellitus (DM) patient groups. Objective: This study was intended to establish and investigate if there is any role between vitamin D and vitamin B12? Secondly, the connection between serum level of vitamin D and vitamin B12 in cataract incidence senile (s) vs. diabetic mellitus (DM) cataract patient groups. Furthermore, to evaluate and analyze cataract occurrence regarding vitamin D and vitamin B12 levels with other risk factors. Finally, to evaluate lens opacities pre and post treatment with vitamin D and vitaminB12 linked to age and visual acuity loss in both senile(S) and diabetic mellitus (DM) cataract patients’ groups. Methods: This study conducted at the ophthalmology clinic at Muhyail General Hospital. Select a prospective case-control to study the effect of vitamin D and Vit B12 on senile(S) cataracts that caused by age and diabetic mellitus (DM)cataract patients; then we compare these two groups. This study prospectively enrolled a total of 50 samples, 25 with senile cataract and 25 with diabetic cataract, from ophthalmology clinic at Muhyail General Hospital. Measuring 25-hydroxy vitamin D and vitamin B12 level concentrations in the assigned samples. Analyses were performed using SAS (statistical analysis software) program. Results: The most important finding in this study was that the senile(s) cataract patients’ group greatly benefited by the combination therapy of vitamin D, and Vitamin B12 reached (28.5±1.50 and 521.1±21.10) respectively; on the contrary, the diabetic cataract patient group hardly shows any significant improvement (21.5 ± 1.00 and 197.2 ± 7.20) respectively. This is because of the Metformin, the first line drug for treating diabetes, has been reported to potentially decrease vitamin B-12 status. This epigenetic modification was correlated with the diabetic mellitus (DM) cataract patients’ group not responding. Vitamin B12 deficiency also leads to an impairment of the conversion of methylmalonyl-CoA to succinyl-CoA, which has been associated with insulin resistance. There was no significant difference between the age, body mass index (BMI), the mean of Vit-D pre-treatments, and the mean values of Hemoglobin A1C of both senile (S) and diabetic mellitus (DM) cataract patient groups. On other hand, there was a highly significant difference between the mean values of glucose levels in both senile (S) and diabetic mellitus (DM) cataract patient groups. Conclusion: Here we conclude that diabetic mellitus (DM) cataract patient group hardly benefited from this combination therapy vitamin D and vitamin B12; on the other hand senile patient group (s) benefited a lot from the therapy.

Keywords: cataract patients, senile, diabetes mellitus, vitamin B12, vitamin D, Muhyail General Hospital, Saudi Arabia

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Authors: Liat Shamri-Zeevi, Neta Ram-Vlasov

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Today the world as a whole is attempting to cope with the COVID-19, which has affected all facets of personal and social life from country-wide confinement to maintaining social distance and taking protective measures to maintain hygiene. One of the populations faced with the most severe restrictions is seniors. Various studies have shown that creativity plays a crucial role in dealing with crisis events. Painting - regardless of media - allows for emotional and cognitive processing of these situations, and enables the expression of experiences in a tangible creative way that conveys and endows meaning to the artwork. The current study was conducted in Israel immediately after a 6-week lockdown. It was designed to specifically examine the impact of the COVID-19 pandemic on the quality of life of elderly women as reflected in their artworks. The sample was composed of 21 Israeli women aged 60-90, in good mental health (without diagnosed dementia or Alzheimer's), all of whom were Hebrew-speaking, and retired with an extended family, who indicated that they painted and had engaged in artwork on an ongoing basis throughout the lockdown (from March 12 to May 30, 2020). The participants' artworks were collected, and a semi-structured in-depth interview was conducted that lasted one to two hours. The participants were asked about their feelings during the pandemic and the artworks they produced during this time, and completed a questionnaire on well-being and mental health. The initial analysis of the interviews and artworks revealed themes related to the specific role of each piece of artwork. The first theme included notions that the artwork was an activity and a framework for doing, which supported positive emotions, and provided a sense of vitality during the closure. Most of the participants painted images of nature and growth which were ascribed concrete and symbolic meaning. The second theme was that the artwork enabled the processing of difficult and /or conflicting emotions related to the situation, including anxiety about death and loneliness that were symbolically expressed in the artworks, such as images of the Corona virus and the respiratory machines. The third theme suggested that the time and space prompted by the lockdown gave the participants time for a gathering together of the self, and freed up time for creative activities. Many participants stated that they painted more and more frequently during the Corona lockdown. At the conference, additional themes and findings will be presented.

Keywords: Corona virus, artwork, quality of life of elderly

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Authors: Linghua Kong, Xinxia Chen, Mika Gissler, Catharina Lavebratt

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Background: Prenatal exposure to preeclampsia has been associated with an increased risk of offspring attention-deficit/hyperactivity disorders (ADHD), autism spectrum disorder (ASD), and intellectual disability. However, little is known about the association between prenatal exposure to severe preeclampsia and neurodevelopmental and psychiatric disorders in offspring. Objective: This study aimed to assess the risk of maternal preeclampsia combined with perinatal problems, specifically low birth weight and prematurity, on offspring neuropsychiatric disorders. Methods: All singleton live births in Finland between 1996 and 2014 (n=1 012 723) were followed up in nation-wide registries until 2018. Main exposures included pre-eclampsia, small for gestational age, and delivery before 34 gestational weeks. Offspring neurodevelopmental and psychiatric disorders (ICD-10 codes) were examined as outcomes variables. Offspring birth year, sex, maternal age at delivery, parity, marital status at birth, mother's country of birth, maternal smoking, maternal gestational diabetes, maternal use of psychotropic medication during pregnancy, and maternal systemic inflammatory diseases were used as covariates. Risks for neurodevelopmental and psychiatric disorders were estimated using Cox proportional hazards modeling. Results: Of the 1 012 723 offspring, 25 901 (2.6%) were exposed to preeclampsia, and 93 281 (9.2%) were diagnosed with a neuropsychiatric disorder. Compared to births unexposed to preeclampsia, small for gestational age or delivery before 34 gestational weeks, those exposed to preeclampsia only had a 21% increase in the likelihood of any neuropsychiatric disorders after adjusting for potential confounding (adjusted HR=1.21, 95% CI: 1.15-1.26), while exposure to preeclampsia combined with small for gestational age or delivery before 34 gestational weeks had a more than twofold increased risk of having a child with neuropsychiatric disorders (adjusted HR=2.16, 95% CI: 2.02-2.32). The adjusted HR for neuropsychiatric disorders in offspring with small for gestational age or delivery before 34 gestational weeks only was 1.79 (95% CI: 1.73-1.83). In addition, the risk estimate in offspring exposed to both preeclampsia and perinatal problems was greater than those only exposed to preeclampsia for having personality disorders (adjusted HR=1.66; 95% CI: 1.07-2.57), intellectual disabilities (adjusted HR=3.47; 95% CI: 2.86-4.22), specific developmental disorders (adjusted HR=2.91; 95% CI: 2.69-3.15), ASD (adjusted HR=1.75; 95% CI: 1.42-2.17), ADHD and conduct disorders (adjusted HR=2.00; 95%CI: 1.76-2.27), and other behavioral and emotional disorders (adjusted HR=2.09; 95% CI: 1.84-2.37). Conclusion: In utero exposure to severe preeclampsia increased the risk of several neurodevelopmental and psychiatric disorders in offspring. Our findings are relevant to women with hypertensive disorders with regard to pregnancy consultation and management and may yield effective clues for the prevention of neurodevelopmental and psychiatric disorders in childhood.

Keywords: low birth weight, neurodevelopmental disorders, preeclampsia, prematurity, psychiatric disorders

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Authors: Rajendra Chetty

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The paper aims to address two aspects of postgraduate studies: interdisciplinary research and creative models of supervision. Interdisciplinary research can be viewed as a key imperative to solve complex problems. While excellent research requires a context of disciplinary strength, the cutting edge is often found at the intersection between disciplines. Interdisciplinary research foregrounds a team approach and information, methodologies, designs, and theories from different disciplines are integrated to advance fundamental understanding or to solve problems whose solutions are beyond the scope of a single discipline. Our aim should also be to generate research that transcends the original disciplines i.e. transdisciplinary research. Complexity is characteristic of the knowledge economy, hence, postgraduate research and engaged scholarship should be viewed by universities as primary vehicles through which knowledge can be generated to have a meaningful impact on society. There are far too many ‘ordinary’ studies that fall into the realm of credentialism and certification as opposed to significant studies that generate new knowledge and provide a trajectory for further academic discourse. Secondly, the paper will look at models of supervision that are different to the dominant ‘apprentice’ or individual approach. A reflective practitioner approach would be used to discuss a range of supervision models that resonate well with the principles of interdisciplinarity, growth in the postgraduate sector and a commitment to engaged scholarship. The global demand for postgraduate education has resulted in increased intake and new demands to limited supervision capacity at institutions. Team supervision lodged within large-scale research projects, working with a cohort of students within a research theme, the journal article route of doctoral studies and the professional PhD are some of the models that provide an alternative to the traditional approach. International cooperation should be encouraged in the production of high-impact research and institutions should be committed to stimulating international linkages which would result in co-supervision and mobility of postgraduate students and global significance of postgraduate research. International linkages are also valuable in increasing the capacity for supervision at new and developing universities. Innovative co-supervision and joint-degree options with global partners should be explored within strategic planning for innovative postgraduate programmes. Co-supervision of PhD students is probably the strongest driver (besides funding) for collaborative research as it provides the glue of shared interest, advantage and commitment between supervisors. The students’ field serves and informs the co-supervisors own research agendas and helps to shape over-arching research themes through shared research findings.

Keywords: interdisciplinarity, internationalisation, postgraduate, supervision

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Authors: Ana Bermudez de Castro Muela, Xiomara Santos Salas, Silvia Cayon Somacarrera

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The aim of this review is to explain what is the intracranial hypotension and its main causes, and also to approach to the diagnostic management in the different clinical situations, understanding radiological findings, and physiopathological substrate. An approach to the diagnostic management is presented: what are the guidelines to follow, the different tests available, and the typical findings. We review the myelo-CT and myelo-RM studies in patients with suspected CSF fistula or hypotension of unknown cause during the last 10 years in three centers. Signs of intracranial hypotension (subdural hygromas/hematomas, pachymeningeal enhancement, venous sinus engorgement, pituitary hyperemia, and lowering of the brain) that are evident in baseline CT and MRI are also sought. The intracranial hypotension is defined as a lower opening pressure of 6 cmH₂O. It is a relatively rare disorder with an annual incidence of 5 per 100.000, with a female to male ratio 2:1. The clinical features it’s an orthostatic headache, which is defined as development or aggravation of headache when patients move from a supine to an upright position and disappear or typically relieve after lay down. The etiology is a decrease in the amount of cerebrospinal fluid (CSF), usually by loss of it, either spontaneous or secondary (post-traumatic, post-surgical, systemic disease, post-lumbar puncture etc.) and rhinorrhea and/or otorrhea may exist. The pathophysiological mechanisms of hypotension and CSF hypertension are interrelated, as a situation of hypertension may lead to hypotension secondary to spontaneous CSF leakage. The diagnostic management of intracranial hypotension in our center includes, in the case of being spontaneous and without rhinorrhea and/or otorrhea and according to necessity, a range of available tests, which will be performed from less to more complex: cerebral CT, cerebral MRI and spine without contrast and CT/MRI with intrathecal contrast. If we are in a situation of intracranial hypotension with the presence of rhinorrhea/otorrhea, a sample can be obtained for the detection of b2-transferrin, which is found in the CSF physiologically, as well as sinus CT and cerebral MRI including constructive interference steady state (CISS) sequences. If necessary, cisternography studies are performed to locate the exact point of leakage. It is important to emphasize the significance of myelo-CT / MRI to establish the diagnosis and location of CSF leak, which is indispensable for therapeutic planning (whether surgical or not) in patients with more than one lesion or doubts in the baseline tests.

Keywords: cerebrospinal fluid, neuroradiology brain, magnetic resonance imaging, fistula

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Authors: Alija Uzunovic, Sasa Pilipovic, Aida Sapcanin, Zahida Ademovic, Berina Pilipović

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Capsaicin is a naturally occurring alkaloid extracted from capsicum fruit extracts of different of Capsicum species. It has been employed topically to treat many diseases such as rheumatoid arthritis, osteoarthritis, cancer pain and nerve pain in diabetes. The high degree of pre-systemic metabolism of intragastrical capsaicin and the short half-life of capsaicin by intravenous administration made topical application of capsaicin advantageous. In this study, we have evaluated differences in the dissolution characteristics of capsaicin patch 11 mg (purchased from market) at different dissolution rotation speed. The proposed patch area is 308 cm2 (22 cm x 14 cm; it contains 36 µg of capsaicin per square centimeter of adhesive). USP Apparatus 5 (Paddle Over Disc) is used for transdermal patch testing. The dissolution study was conducted using USP apparatus 5 (n=6), ERWEKA DT800 dissolution tester (paddle-type) with addition of a disc. The fabricated patch of 308 cm2 is to be cut into 9 cm2 was placed against a disc (delivery side up) retained with the stainless-steel screen and exposed to 500 mL of phosphate buffer solution pH 7.4. All dissolution studies were carried out at 32 ± 0.5 °C and different rotation speed (50± 5; 100± 5 and 150± 5 rpm). 5 ml aliquots of samples were withdrawn at various time intervals (1, 4, 8 and 12 hours) and replaced with 5 ml of dissolution medium. Withdrawn were appropriately diluted and analyzed by reversed-phase liquid chromatography (RP-LC). A Reversed Phase Liquid Chromatography (RP-LC) method has been developed, optimized and validated for the separation and quantitation of capsaicin in a transdermal patch. The method uses a ProntoSIL 120-3-C18 AQ 125 x 4,0 mm (3 μm) column maintained at 600C. The mobile phase consisted of acetonitrile: water (50:50 v/v), the flow rate of 0.9 mL/min, the injection volume 10 μL and the detection wavelength 222 nm. The used RP-LC method is simple, sensitive and accurate and can be applied for fast (total chromatographic run time was 4.0 minutes) and simultaneous analysis of capsaicin and dihydrocapsaicin in a transdermal patch. According to the results obtained in this study, we can conclude that the relative difference of dissolution rate of capsaicin after 12 hours was elevated by increase of dissolution rotation speed (100 rpm vs 50 rpm: 84.9± 11.3% and 150 rpm vs 100 rpm: 39.8± 8.3%). Although several apparatus and procedures (USP apparatus 5, 6, 7 and a paddle over extraction cell method) have been used to study in vitro release characteristics of transdermal patches, USP Apparatus 5 (Paddle Over Disc) could be considered as a discriminatory test. would be able to point out the differences in the dissolution rate of capsaicin at different rotation speed.

Keywords: capsaicin, in vitro, patch, RP-LC, transdermal

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Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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Authors: Maria L. G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal sepsis is a systemic response of acute infection by bacteria that may lead to high mortality in a litter. This study aims to report a case of sepsis by alpha-hemolytic Streptococcus and Mannheimia haemolytica in neonate dogs. A pregnant, mixed-breed bitch at approximately the 60th day of pregnancy was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, and subjected to a c-section due to uterine atony and fetuses no heartbeats on the ultrasound examination. The mother presented leukopenia of 1.6 thousand leukocytes, and there was no other information regarding previous clinical history. Among the offspring, four were stillborn, and five were born alive. On clinical examination, neonates weighed between 312 and 384 grams. Reflexes were present, and the newborn's body temperature was between 89.9 ºF and 96.4 ºF. Neonates also presented clinical signs of neonatal infection: omphalitis, abdomen, and extremities with cyanotic color, hematuria, and diarrhea (meconium). Complementary tests revealed leukopenia. The presence of alpha hemolytic streptococcus and Mannheimia haemolytica was revealed in the bacterial culture. The bacteria were sensitive to cephalosporins and penicillin on the antibiogram. Treatment for sepsis was instituted with the drug ceftriaxone, at a dose of 50 mg per kilogram, administered intravenous (jugular vein). Subsequently administered subcutaneous, every 12 hours, for seven days. Heated fluid therapy was performed, with Ringer lactate, at a dose of 4 ml per 100 grams of weight, intravenous. Heating measures were instituted. Blood plasma was also administered, at a dose of 2 mL per 100 grams of weight, administered subcutaneous, as a source of passive immunity. A maternal milk substitute was instituted, and lactation was discontinued since the mother was unable to nurse due to the infection. The mother was neutered during the c-section and treated with ceftriaxone (50 mg/kg). After seven days, the newborns presented normal clinical signs and no alterations in the hemogram. Early diagnosis and intervention were essential for the survival of these patients.

Keywords: neonatal infection, puppies, bacteria, newborn

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Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

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Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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Authors: Gulden Aykinbaeva, Assem Umirzakova, Assel Makhadiyeva

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The problem of studying of young married couples in connection with a change of social institute of a family and marriage is represented very actual for family consultation, considering a family role in the development of modern society. Results of numerous researchs say that one of difficult in formation and stabilization of a matrimony is the period of a young family. This period is characterized by various processes of integration, adaptation and emotional compatibility of spouses. The young family in it the period endures the first standard crisis which postpones a print for the further development of the family scenario. Emergence new, earlier not existing, systems of values render a huge value on the process of formation of a young family and each of spouses separately. Possibly to solve the set family tasks at the development of the uniform system of the family relations in which socially mature persons capable to consider a family as the creativity of each other act as subjects. Due to the research objective in work the following techniques were used: a questionnaire of satisfaction with V. V. Stolin's marriage and A. N. Volkova's technique directed on detection of coherence of family values and role installations in a married couple, and also content – the analysis. Development of an internal basis of a family on mutual clearing of values is important during the work with married couples. 'The mature view' of the partner in the marriage union provides coherence between the expected and real behavior of the partner that is important for the realization of the purposes of adaptation in a family. For research of communication of the data obtained by means of A. N. Volkova's techniques, V. V. Stolina and content – the analysis, the correlation analysis, with the application of the criterion of Spirmen was used. The analysis of results of the conducted research allowed us to determine the number of consistent patterns: 1. Nature of change of satisfaction with marriage at spouses testifies that the matrimonial relations undergo high-quality changes at different stages of formation of a young family. 2. The matrimonial relations in the course of their development, formation and functioning in young marriage undergo considerable changes on psychological, social and psychological and insignificant — at the psychophysiological and sociocultural levels. The material received by us allows to plan ways of further detailed researches of the development of the matrimonial relations not only in the young marriage but also at further stages of development of a matrimony. We believe that the results received in this research can be almost applied at creation of algorithms of selection of marriage partners, at diagnostics of character and the maintenance of matrimonial disharmonies, at the forecast of stability of marriage and a family.

Keywords: married couples, formation of the young family, psychological consultation, matrimony

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Authors: Joanna Wozniak-Holecka, Sylwia Jaruga-Sekowska

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There are 45 statutory spa and treatment areas in Poland, and the demand for spa and treatment services increases year by year. Within each type of spa treatment facilities, nutritional education services are provided. During spa treatment, the patient learns the principles of rational nutrition and applied diet therapy. It should help him develop proper eating habits, which will also follow at home. However, the nutrition education system of spa resort patients should be considered as very imperfect and requiring a definite systemic correction. It has, at the same time, a wide human and infrastructure base, which guarantees to obtain positive reinforcement in the scope of undertaken activities and management. Unfortunately, this advantage is not fully used. The aim of the project was to assess the quality of implemented nutritional education and to assess the diet of patients in spa treatment entities from a nationwide perspective. The material for the study was data obtained as part of an in-depth interview conducted among nutrition department managers (25 interviews) and a survey addressed to patients (600 questionnaires) of a selected group of spa resorts from across the country about the implementation of nutritional education in institutions. Also, decade menus for the basic diet, easily digestible diet and diet with limitation of easily digestible carbohydrates (a total of 1,120 menus) were obtained for the study. Almost 2/3 of respondents (73.2%) were overweight or obese, but only 32.8% decided on an easily digestible or low-energy diet during the treatment. Most of the surveyed patients rated the nutrition in spa resorts as satisfactory. Classes on nutrition education were carried out mainly by a dietitian (65% of meetings), the other educators were doctors and nurses. The meetings (95%) were of a group nature and lasted only 30 minutes on average. The subjects of the classes concerned the principles of proper nutrition and composition of meals, a nutrition pyramid and a diet adapted to a given disease. The assessed menus did not meet the nutrition standards and, therefore, did not provide patients with the correct quality of nutrition. The norm of protein, fat, vitamin A, B12, phosphorus, iron and sodium was exceeded, while vitamin D, folic acid, magnesium and zinc were not enough than recommended. The study allowed to conclude that there is a large discrepancy between the recommendations presented during the nutrition education classes and the quality of diet implemented in the examined institutions. The project may contribute to the development of effective educational tools in nutrition, especially about a specific group of chronically ill patients.

Keywords: diet, management, nutritional education, spa resort

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Authors: Jason Michael Crozier

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The wrestling territories of the mid-twentieth century in the United States are widely considered the birthplace of modern professional wrestling, and by many professional wrestlers, to be a beacon of hope for the easing of racial tensions during the civil rights era and beyond. The performers writing on this period speak of racial equality but fail to acknowledge the exploitation of black athletes as a racialized capital commodity who suffered the challenges of systemic racism, codified by a false narrative of aspirational exceptionalism and equality measured by audience diversity. The promoters’ ability to equate racial and capital exploitation with equality leads to a broader discussion of the history of Muscular Christianity in the United States and the exploitation of black bodies. Narratives of racial erasure that dominate the historical discourse when examining athleticism and exceptionalism redefined how blackness existed and how physicality and race are conceived of in sport and entertainment spaces. When discussing the implications of race and professional wrestling, it is important to examine the role of promotions as ‘imagined communities’ where the social agency of wrestlers is defined and quantified based on their ‘desired elements’ as a performer. The intentionally vague nature of this language masks a deep history of racialization that has been perpetuated by promoters and never fully examined by scholars. Sympathetic racism and the omission of cultural identity are also key factors in the limitations and racial barriers placed upon black athletes in the squared circle. The use of sympathetic racism within professional wrestling during the twentieth century defined black athletes into two distinct categorizations, the ‘black savage’ or the ‘black minstrel’. Black wrestlers of the twentieth century were defined by their strength as a capital commodity and their physicality rather than their knowledge of the business and in-ring skill. These performers had little agency in their ability to shape their own character development inside and outside the ring. Promoters would often create personas that heavily racialized the performer by tying them to a regional past or memory, such as that of slavery in the deep south using dog collar matches and adoring black characters in chains. Promoters softened cultural memory by satirizing the historic legacy of slavery and the black identity.

Keywords: sympathetic racism, social agency, racial commodification, stereotyping

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Authors: Pauline Cuenin, Marcelo Leles Romarco Oliveira

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Based on their localities and following their ecological rationality, family-based farmers have experimented, adapted and innovated to improve their production systems continuously for millennia. With the technological package transfer processes of the so-called Green Revolution for agricultural holdings, farmers have become increasingly dependent on ready-made "recipes" built from so-called "universal" and global knowledge to face the problems that emerge in the management of local agroecosystems, thus reducing their creative and experiential capacities. However, the production of novelties within farms is fundamental to the transition to more sustainable agro food systems. In fact, as the fruits of local knowledge and / or the contextualization of exogenous knowledge, novelties are seen as seeds of transition. By presenting new techniques, new organizational forms and epistemological approaches, agroecology was pointed out as a way to encourage and promote the creative capacity of farmers. From this perspective, this theoretical work aims to analyze how agroecology encourages the innovative capacity of farmers, and in general, the production of novelties. For this, an analysis was made of the theoretical and methodological bases of agroecology through a literature review, specifically looking for the way in which it articulates the local with the global, complemented by an analysis of agro ecological Brazilian experiences. It was emphasized that, based on the peasant way of doing agriculture, that is, on ecological / social co-evolution or still called co-production (interaction between human beings and living nature), agroecology recognizes and revalues peasant involves the deep interactions of the farmer with his site (bio-physical and social). As a "place science," practice and movement, it specifically takes into consideration the local and empirical knowledge of farmers, which allows questioning and modifying the paradigms that underpin the current agriculture that have disintegrated farmers' creative processes. In addition to upgrade the local, agroecology allows the dialogue of local knowledge with global knowledge, essential in the process of changes to get out of the dominant logic of thought and give shape to new experiences. In order to reach this articulation, agroecology involves new methodological focuses seeking participatory methods of study and intervention that express themselves in the form of horizontal spaces of socialization and collective learning that involve several actors with different knowledge. These processes promoted by agroecology favor the production of novelties at local levels for expansion at other levels, such as the global, through trans local agro ecological networks.

Keywords: agroecology, creativity, global, local, novelty

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Authors: Leslie Nobler

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African fabrics based specifically on the Dutch Wax Print, or Ankara, popularized during Africa's colonial era, have had an enormous impact on western fashion (especially in the US and UK), in the last half-decade. The trend has had an effect on the world of visual arts as well, which circuitously, also heavily impacts fashion design. In fashion, and notably in celebrity apparel choices, this is in part due to ‘identity’ and taking pride in one's African roots; in the visual arts, artists such as Yinka Shonibare and Njideka Akunyili Crosby are making statements about identity politics, colonialism up through post-colonialism, and racism. The ‘global village’ brought on by the internet has driven this proliferation, as have improvements in the printing technology with which the Ankara print is made, combining wax-resist with roller printing. The newest patterns can now be designed authentically in western African and easily sent electronically to Europe for printing. Examples of Ankara's new reach across the Atlantic abound. They have taken several paths, which the paper will detail. Briefly, the first is its greater utilization in the fashion world, from authentic textile shops in African American neighborhoods to copied (knocked-off) low-end reproductions in discount chains. Secondly, we are seeing far more uses of these textiles/patterns in important works of fine arts from major museums, in Philadelphia to Palm Beach to the Mass MOCA (in the US), all the way to the Israel Museum in Jerusalem, and everywhere in between. And lastly, but quite significantly, we see this trend throughout social media thanks to Instagram, Pinterest and celebrity photos –even at the recent royal wedding. What shall sustain this major new design direction is that Ankara changes with and adapts to the times. Some of it is now printed in West Africa, often in the Nigeria area. And some may be designed in Europe or even at knock-off apparel studios in NY or Asia. But it stays utterly relevant because the motifs are based on objects and scenes in everyday life. In my design studio and university design classes, this idea is first and foremost, from our big spiritual eye motifs to drawings of our art supplies to the ‘politically-loaded’ chain patterns. This first-hand creativity experience becomes part of the research of this paper, along with historic and contemporary sources of inquiry, both through a literature/image search and anecdotal experience into what is behind this exciting and surprising trend.

Keywords: African wax print, Ankara, identity (politics), textile design, surface design

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Authors: Jiang Niu, Yue Jiang

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With the ultimate goal to automatically generate translated texts with high quality, machine translation has made tremendous improvements. However, its translations of literary works are still plagued with problems in coherence, esp. the translation between distant language pairs. One of the causes of the problems is probably the lack of linguistic knowledge to be incorporated into the training of machine translation systems. In order to enable readers to better understand the problems of machine translation in coherence, to seek out the potential knowledge to be incorporated, and thus to improve the quality of machine translation products, this study applies Theme-Rheme structure to examine how a machine-translated literary text is organized and developed in terms of coherence. Theme-Rheme structure in Systemic Functional Linguistics is a useful tool for analysis of textual coherence. Theme is the departure point of a clause and Rheme is the rest of the clause. In a text, as Themes and Rhemes may be connected with each other in meaning, they form thematic and rhematic progressions throughout the text. Based on this structure, we can look into how a text is organized and developed in terms of coherence. Methodologically, we chose Chinese and English as the language pair to be studied. Specifically, we built a comparable corpus with two modes of English translations, viz. machine translation (MT) and human translation (HT) of one Chinese literary source text. The translated texts were annotated with Themes, Rhemes and their progressions throughout the texts. The annotated texts were analyzed from two respects, the different types of Themes functioning differently in achieving coherence, and the different types of thematic and rhematic progressions functioning differently in constructing texts. By analyzing and contrasting the two modes of translations, it is found that compared with the HT, 1) the MT features “pseudo-coherence”, with lots of ill-connected fragments of information using “and”; 2) the MT system produces a static and less interconnected text that reads like a list; these two points, in turn, lead to the less coherent organization and development of the MT than that of the HT; 3) novel to traditional and previous studies, Rhemes do contribute to textual connection and coherence though less than Themes do and thus are worthy of notice in further studies. Hence, the findings suggest that Theme-Rheme structure be applied to measuring and assessing the coherence of machine translation, to being incorporated into the training of the machine translation system, and Rheme be taken into account when studying the textual coherence of both MT and HT.

Keywords: coherence, corpus-based, literary translation, machine translation, Theme-Rheme structure

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Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

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Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

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Authors: Vicente Espinola, Luis Torres, Christhian Gonzalez

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Entrepreneurship is a topic of current interest in Mexico and the World, which has been fostered through public policies with great impact on its generation. The strategies used in Mexico have not been successful, being motivational strategies aimed at the masses with the intention that someone in the process generates a venture. The strategies used for its development have been "picking of winners" favoring those who have already overcome the initial stages of undertaking without effective support. This situation shows a disarticulation that appears even more in social entrepreneurship; due to this, it is relevant to research on those elements that could develop them and thus integrate a model of entrepreneurship and social innovation for Mexico. Social entrepreneurship should be generating social innovation, which is translated into business models in order to make the benefits reach the population. These models are proposed putting the social impact before the economic impact, without forgetting its sustainability in the medium and long term. In this work, we present a simple model of innovation and social entrepreneurship for Guanajuato, Mexico. This algorithm was based on how social innovation could be generated in a systemic way for Mexico through different institutions that promote innovation. In this case, the technological parks of the state of Guanajuato were studied because these are considered one of the areas of Mexico where its main objectives are to make technology transfer to companies but overlooking the social sector and entrepreneurs. An experimental design of n = 60 was carried out with potential entrepreneurs to identify their perception of the social approach that the enterprises should have, the skills they consider required to create a venture, as well as their interest in generating ventures that solve social problems. This experiment had a 2K design, the value of k = 3 and the computational simulation was performed in R statistical language. A simple model of interconnected variables is proposed, which allows us to identify where it is necessary to increase efforts for the generation of social enterprises. The 96.67% of potential entrepreneurs expressed interest in ventures that solve social problems. In the analysis of the variables interaction, it was identified that the isolated development of entrepreneurial skills would only replicate the generation of traditional ventures. The variable of social approach presented positive interactions, which may influence the generation of social entrepreneurship if this variable was strengthened and permeated in the processes of training and development of entrepreneurs. In the future, it will be necessary to analyze the institutional actors that are present in the social entrepreneurship ecosystem, in order to analyze the interaction necessary to strengt the innovation and social entrepreneurship ecosystem.

Keywords: social innovation, model, entrepreneurship, technological parks

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Authors: Chua Si Wen Alicia, Marcus Goh Tian Xi, Eunice Gan Ghee Wu, Helen Bound, Lee Liang Ying, Albert Lee

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In a world full of rapid changes, people often need a set of skills to help them navigate an ever-changing workscape. These skills, often known as “future-oriented skills,” include learning to learn, critical thinking, understanding multiple perspectives, and knowledge creation. Future-oriented skills are typically assumed to be domain-general, applicable to multiple domains, and can be cultivated through a learning approach called Dialogical Inquiry. Dialogical Inquiry is known for its benefits of making sense of multiple perspectives, encouraging critical thinking, and developing learner’s capability to learn. However, it currently exists as a quantitative tool, which makes it hard to track and compare learning processes over time. With these concerns, the present research aimed to develop and validate a quantitative tool for the Map of Dialogical Inquiry, focusing Imagining aspect of learning. The Imagining aspect four dimensions: 1) speculative/ look for alternatives, 2) risk taking/ break rules, 3) create/ design, and 4) vision/ imagine. To do so, an exploratory literature review was conducted to better understand the dimensions of Imagining. This included deep-diving into the history of the creation of the Map of Dialogical Inquiry and a review on how “Imagining” has been conceptually defined in the field of social psychology, education, and beyond. Then, we synthesised and validated scales. These scales measured the dimension of Imagination and related concepts like creativity, divergent thinking regulatory focus, and instrumental risk. Thereafter, items were adapted from the aforementioned procured scales to form items that would contribute to the preliminary version of the Imagining Scale. For scale validation, 250 participants were recruited. A Confirmatory Factor Analysis (CFA) sought to establish dimensionality of the Imagining Scale with an iterative procedure in item removal. Reliability and validity of the scale’s dimensions were sought through measurements of Cronbach’s alpha, convergent validity, and discriminant validity. While CFA found that the distinction of Imagining’s four dimensions could not be validated, the scale was able to establish high reliability with a Cronbach alpha of .96. In addition, the convergent validity of the Imagining scale was established. A lack of strong discriminant validity may point to overlaps with other components of the Dialogical Map as a measure of learning. Thus, a holistic approach to forming the tool – encompassing all eight different components may be preferable.

Keywords: learning, education, imagining, pedagogy, dialogical teaching

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Authors: Gracia Lwanzo Kasongo

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In the realm of cultural heritage, few issues loom larger than the ongoing battle for restitution faced by European and African museums. In Belgium, this contentious process was set in motion by two pivotal events. Firstly, the resounding revelations of the French report on restitution, which boldly declared that 'over 90% of African cultural heritage resides outside of Africa Secondly, the seismic impact of the Black Lives Matter movement following the tragic death of George Floyd. These two events unleashed a wave of outrage among Afro-descendants, who viewed the possession of colonial collections as an enduring symbol of colonial dominance and a stark validation of the systemic racism deeply ingrained within Belgian society. The instrumentalization of cultural property as a means of wielding political power is by no means a novel concept. Its roots can be traced back to the constructed justifications that emerged in the 1950s, during which the Royal Museum for Central Africa in Tervuren played a pivotal role as the self-proclaimed 'guardian of Congolese cultural heritage'. This legacy of legitimizing colonial presence permeates the fabric of Belgium's museum reform policies and the structural management of museums in the Democratic Republic of Congo (DRC). Employing a dialectical approach, I embark on an exploration of the intricate historical interplay between the Royal Museum for Central Africa and the Institute of National Museums of Congo. From this vantage point, I delve into the arduous struggles faced by museums in both the DRC and Belgium as they grapple with the complex and contentious issue of cultural heritage restitution. Central to these struggles is the profound quest for meaning and (re)definition of museums, particularly for Congolese and Afro-descendant communities whose identities and narratives have long been marginalized and suppressed. As the narrative unfolds, I shed light on the prospects for cooperation that have emerged from my extensive fieldwork. Within the interplay of historical entanglements, struggles for restitution, and the search for a more inclusive and equitable museum landscape, glimmers of hope emerge. Collaborative efforts and potential avenues for mutual understanding between Belgium and the DRC begin to take shape, offering a beacon of possibility amidst the often tumultuous discourse surrounding cultural heritage.

Keywords: restitution, museum stuggles, belgium, DRCongo

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Authors: María de los Ángeles Cerda González, Itzel Arriaga Hurtado, Pascacio José Martínez Pichardo

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In México, the recognition of refugee condition is a fundamental right which, as host State, has the obligation of respect, protect, and fulfill to the foreigners – where we can find the figure of immigrants in irregular situation-, that cannot return to their country of origin for humanitarian reasons. The recognition of the refugee condition as a fundamental right in the Mexican law system proceeds under these situations: 1. The immigrant applies for the refugee condition, even without the necessary proving elements to accredit the humanitarian character of his departure from his country of origin. 2. The immigrant does not apply for the recognition of refugee because he does not know he has the right to, even if he has the profile to apply for. 3. The immigrant who applies fulfills the requirements of the administrative procedure and has access to the refugee recognition. Of the three situations above, only the last one is contemplated for the national indexes of the status refugee; and the first two prove the inefficiency of the governmental system viewed from its lack of sensibility consequence of the no education in human rights matter and which results in the legal vulnerability of the immigrants in irregular situation because they do not have access to the procuration and administration of justice. In the aim of determining the causes and consequences of the no recognition of the refugee status, this investigation was structured from a systemic analysis which objective is to show the advances in Central American humanitarian emergency investigation, the Mexican States actions to protect, respect and fulfil the fundamental right of refugee of immigrants in irregular situation and the social and legal vulnerabilities suffered by Central Americans in Mexico. Therefore, to achieve the deduction of the legal nature of the humanitarian emergency from the Human Rights as a branch of the International Public Law, a conceptual framework is structured using the inductive deductive method. The problem statement is made from a legal framework to approach a theoretical scheme under the theory of social systems, from the analysis of the lack of communication of the governmental and normative subsystems of the Mexican legal system relative to the process undertaken by the Central American immigrants to achieve the recognition of the refugee status as a human right. Accordingly, is determined that fulfilling the obligations of the State referent to grant the right of the recognition of the refugee condition, would mean a guideline for a new stage in Mexican Law, because it would enlarge the constitutional benefits to everyone whose right to the recognition of refugee has been denied an as consequence, a great advance in human rights matter would be achieved.

Keywords: central American immigrants in irregular situation, humanitarian emergency, human rights, refugee

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Authors: Yonit Nissim, Eyal Weissblueth

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This research is the continuation of a process that began in 2010 with the goal of redesigning the training program for future early childhood teachers at the Ohalo College, to integrate technology and provide 21st-century skills. The article focuses on a study of the processes involved in developing a special educational unit which challenged students with the task of designing, planning and building an internet site for kindergartens. This project was part of their second-year studies in the early childhood track of an interdisciplinary course entitled 'Educating for the Future.' The goal: enabling students to gain experience in developing an internet site specifically for kindergartens, and gain familiarity with Google platforms, the acquisition and use of innovative skills and the integration of technology in pedagogy. Research questions examined how students handled the task of building an internet site. The study explored whether the guided process of building a site helped them develop proficiency in creativity, teamwork, evaluation and learning appropriate to the 21st century. The research tool was a questionnaire constructed by the researchers and distributed online to the students. Answers were collected from 50-course participants. Analysis of the participants’ responses showed that, along with the significant experience and benefits that students gained from building a website for kindergarten, ambivalence was shown toward the use of new, unfamiliar and complex technology. This attitude was characterized by unease and initial emotional distress triggered by the departure from routine training to an island of uncertainty. A gradual change took place toward the adoption of innovation with the help of empathy, training, and guidance from the instructors, leading to the students’ success in carrying out the task. Initial success led to further successes, resulting in a quality product and a feeling of personal competency among the students. A clear and extreme emotional shift was observed on the spectrum from a sense of difficulty and dissatisfaction to feelings of satisfaction, joy, competency and cognitive understanding of the importance of facing a challenge and succeeding. The findings of this study can contribute to increased understanding of the complex training process of future kindergarten teachers, coping with a changing world, and pedagogy that is supported by technology.

Keywords: early childhood teachers, educating for the future, emotions, kindergarten website

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Authors: Morgan Dombroski, Alexis Hartman

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Purpose: The present study aimed to explore factors related to overtraining within a female collegiate sample by analyzing the aftereffects of overtraining on athletes' physical and emotional well-being. Methods: 51 female collegiate athletes participated in a de-identified survey to assess factors related to overtraining. All survey questions were derived from the Recovery-Stress Questionnaire. Descriptive and bivariate correlations were conducted to test for significant factors related to the athletes' physical and emotional well-being relating to sports engagement. Results: Descriptive statistics indicated: 80.4% of athletes reported feeling tired from sport-related work, 72.5% reported parts of their body were aching, 47.1% reported feeling emotionally drained, and 37.3% reported feeling burnt out by sport. These findings were consistent with bivariate correlations, which yielded statistically significant findings between physical fatigue and emotional distress. Discussion: In a general sense, athletes increase their training to maximize their performance. The current study aimed to analyze how this training process can result in overtraining of female collegiate athletes, which in turn may negatively impact their physical and emotional functioning. Overtraining syndrome can occur as a maladaptive response to excessive exercise and inappropriate rest caused by systemic inflammation, which negatively affects the central nervous system. The physical manifestations of overtraining can then lead to depressed mood, fatigue, and neurohormonal changes in athletes. To remain competitive and high performing in sports, athletes partaking in excessive training can result in overtraining syndrome, athlete burnout, and compulsive exercise. Additionally, overtrained athletes were defined by displaying high levels of perfectionism, maladaptive coping, and training distress. The current study supported these findings, which yielded a strong correlation between physical and emotional functioning in the context of overtraining in sports. All in all, the environment revolving around sports and the intensity of training can be extremely stressful for athletes. There is a need to monitor athletes’ subjective responses to training, which will allow for early identification of at-risk athletes giving clinicians various opportunities to reduce the negative consequences of overtraining. By better understanding symptoms of emotional and physical fatigue, collegiate sports can become more aware of overtraining symptoms to prevent further detriment to female athletes' overall well-being.

Keywords: burnout, emotionally drained, overtraining, performance, well-being

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Authors: Swati Arun

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The present paper argues that Balance of Power (BOP) needs to conjugate with certain contingencies like geography. It is evident that sea powers (‘insular’ for better clarity) are not balanced (if at all) in the same way as land powers. Its apparent that artificial insularity that the US has achieved reduces the chances of balancing (constant) and helps it maintain preponderance (variable). But how precise is this approach in assessing the dynamics between China’s rise and reaction of other powers and US. The ‘evolved’ theory can be validated by putting China and US in the equation. Systemic Relation between the nations was explained through the Balance of Power theory much before the systems theory was propounded. The BOP is the crux of functionality of ‘power relation’ dynamics which has played its role in the most astounding ways leading to situations of war and peace. Whimsical; but true that, the BOP has remained a complicated and indefinable concepts since Hans. Morganthau to Kenneth Waltz. A challenge of the BOP, however remains; “ that it has too many meanings”. In the recent times it has become evident that the myriad of expectations generated by BOP has not met the practicality of the current world politics. It is for this reason; the BoP has been replaced by Preponderance Theory (PT) to explain prevailing power situation. PT does provide an empirical reasoning for the success of this theory but fails in a abstract logical reasoning required for making a theory universal. Unipolarity clarifies the current system as one where balance of power has become redundant. It seems to reach beyond the contours of BoP, where a superpower does what it must to remain one. The centrality of this arguments pivots around - an exception, every time BOP fails to operate, preponderance of power emerges. PT does not sit well with the primary logic of a theory because it works on an exception. The evolution of such a pattern and system where BOP fails and preponderance emerges is absent. The puzzle here is- if BOP really has become redundant or it needs polishing. The international power structure changed from multipolar to bipolar to unipolar. BOP was looked at to provide inevitable logic behind such changes and answer the dilemma we see today- why US is unchecked, unbalanced? But why was Britain unchecked in 19th century and why China was unbalanced in 13th century? It is the insularity of the state that makes BOP reproduce “imbalance of power”, going a level up from off-shore balancer. This luxury of a state to maintain imbalance in the region of competition or threat is the causal relation between BOP’s and geography. America has applied imbalancing- meaning disequilibrium (in its favor) to maintain the regional balance so that over time the weaker does not get stronger and pose a competition. It could do that due to the significant parity present between the US and the rest.

Keywords: balance of power, china, preponderance of power, US

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Authors: Ariadna Gassiot, Raquel Camprubi, Lluis Coromina

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Creative tourism involves the participation of tourists in the co-creation of their own experiences in a tourism destination. Consequently, creative tourists move from a passive behavior to an active behavior, and tourism destinations address this type of tourism by changing the scenario and making tourists learn and participate while they travel instead of merely offering tourism products and services to them. In creative tourism experiences, tourists are in close contact with locals and their culture. In destinations where culture (i.e. food, heritage, etc.) is the basis of their offer, such as Girona, Spain, tourism stakeholders must especially consider, analyze, and further foster the co-creation of authentic tourism experiences. They should focus on discovering more about these experiences, their main attributes, visitors’ opinions, etc. Creative tourists do not only participate while they travel around the world, but they also have and active post-travel behavior. They feel free to write about tourism experiences in different channels. User-generated content becomes crucial for any tourism destination when analyzing the market, making decisions, planning strategies, and when addressing issues, such as their reputation and performance. Sentiment analysis is a methodology used to automatically analyze semantic relationships and meanings in texts, so it is a way to extract tourists’ emotions and feelings. Tourists normally express their views and opinions regarding tourism products and services. They may express positive, neutral or negative feelings towards these products or services. For example, they may express anger, love, hate, sadness or joy towards tourism services and products. They may also express feelings through verbs, nouns, adverbs, adjectives, among others. Sentiment analysis may help tourism professionals in a range of areas, from marketing to customer service. For example, sentiment analysis allows tourism stakeholders to forecast tourism expenditure and tourist arrivals, or to analyze tourists’ profile. While there is an increasing presence of creativity in tourists’ experiences, there is also an increasing need to explore tourists’ expressions about these experiences. There is a need to know how they feel about participating in specific tourism activities. Thus, the main objective of this study is to analyze the meanings, emotions and feelings that tourists express about their creative experiences in Girona, Spain. To do so, sentiment analysis methodology is used. Results show the diversity of tourists who actively participate in tourism in Girona. Their opinions refer both to tangible aspects (e.g. food, museums, etc.) and to intangible aspects (e.g. friendliness, nightlife, etc.) of tourism experiences. Tourists express love, likeliness and other sentiments towards tourism products and services in Girona. This study can help tourism stakeholders in understanding tourists’ experiences and feelings. Consequently, they can offer more customized products and services and they can efficiently make them participate in the co-creation of their own tourism experiences.

Keywords: creative tourism, sentiment analysis, text mining, user-generated content

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Authors: Efleda Preclaro Tolentino

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Research indicates that an educator’s belief system is reflected in the way they structure the learning environment. Their values and belief system have the potential to positively impact school readiness through an understanding of children’s development and the creation of a stable, motivating environment. Based on the premise that the social environment influences the development of social skills, knowledge construct, and shared values of young children, this study examined verbal and nonverbal exchanges between early childhood teachers and their preschool students within the context of remote learning. Using the qualitative method of data collection, the study determined the nature of interactions between preschoolers and their teachers within a remote learning environment at a preschool in Southeast Asia that utilized the Mother Tongue-based Multilingual Education (MTBMLE) Approach. From the lens of sociocultural theory, the study investigated preschoolers’ use of literacies to convey meaning and to interact within a remote learning environment. Using a Strengths Perspective, the study revealed the creativity and resourcefulness of preschoolers in expressing themselves through trans-literacies that were made possible by the use of online mode of learning within cultural and subcultural norms. The study likewise examined how social skills acquired by young children were transmitted (verbally or nonverbally) in their interactions with peers during Zoom meetings. By examining the dynamics of social exchanges between teachers and children, the findings of the study underscore the importance of providing support for preschool students as they apply acquired values and shared practices within a remote learning environment. The potential of distance learning in the early years will be explored, specifically in supporting young children’s language and literacy development. At the same time, the study examines the role of teachers as cultivators of trans-literacies. The teachers’ skillful use of technology in facilitating young children’s learning, as well as in supporting interactions with families, will be examined. The findings of this study will explore the potential of distance learning in early childhood education to establish continuity in learning, supporting young children’s social and emotional transitions, and nurturing trans-literacies that transcend prevailing definitions of learning contexts. The implications of teachers and parents working collaboratively to support student learning will be examined. The importance of preparing teachers to be resourceful, adaptable, and innovative to ensure that learning takes place across a variety of modes and settings will be discussed.

Keywords: transliteracy, preschoolers, remote learning, strengths perspective

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Authors: A. G. Back

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In the context of global climate change, extreme weather events are increasingly intense and frequent, challenging the adaptability of urban space. In this sense, urban planning is a relevant instrument for addressing, in a systemic manner, various sectoral policies capable of linking the urban agenda to the reduction of social and environmental risks. The Master Plan of the Municipality of Sao Paulo, 2014, presents innovations capable of promoting the transition to sustainability in the urban space. Among such innovations, the following stand out: i) promotion of density in the axes of mass transport involving mixture of commercial, residential, services, and leisure uses (principles related to the compact city); ii) vulnerabilities reduction based on housing policies, including regular sources of funds for social housing and land reservation in urbanized areas; iii) reserve of green areas in the city to create parks and environmental regulations for new buildings focused on reducing the effects of heat island and improving urban drainage. However, long-term implementation involves distributive conflicts and may change in different political, economic, and social contexts over time. Thus, the central objective of this paper is to identify which factors limit or support the implementation of these policies. That is, to map the challenges and interests of converging and/or divergent urban actors in the sustainable urban development agenda and what resources they mobilize to support or limit these actions in the city of Sao Paulo. Recent proposals to amend the urban zoning law undermine the implementation of the Master Plan guidelines. In this context, three interest groups with different views of the city come into dispute: the real estate market, upper middle class neighborhood associations ('not in my backyard' movements), and social housing rights movements. This paper surveys the different interests and visions of these groups taking into account their convergences, or not, with the principles of sustainable urban development. This approach seeks to fill a gap in the international literature on the causes that underpin or hinder the continued implementation of policies aimed at the transition to urban sustainability in the medium and long term.

Keywords: adaptation, ecosystem-based adaptation, interest groups, urban planning, urban transition to sustainability

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Authors: Aiydh Aljeddani, Fran Martin

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The study mainly aims at exploring and understanding the current practice of social studies and citizenship education curriculum contribution to sustainability literacy and competency of the ninth and tenth grade students in the Saudi general education context. This study stems from a need for conducting research in general education contexts in order to prepare future graduate students who possess fundamental elements of education for sustainable development. To the best of our knowledge, the literature on education for sustainable development reveals that little research has been conducted so far on general education contexts and this study will add new knowledge in the literature. The study is interpretive in nature and employs a qualitative case study approach, and ethnography methodologies to understand deeply this complex educational phenomenon. 167 participants took part in this study, they were from six general education schools and made up of 25 teachers, and 142 students. Document analysis, semi-structured interviews, nominal group technique, and passive participant observation were used in order to gather the data for this study. The outcomes of the study showed the keenness of the Saudi government on promoting and raising awareness education for sustainable development among its younger generation via a sustainable development promoting curriculum. However, applying this vision in a real school setting, particularly via the social studies and citizenship education curriculum in grades nine and ten, has been challenging for different reasons as revealed by this study. First, incorporating sustainability in the social studies and citizenship education curriculum in the Saudi grade ninth and tenth grade, is based on the vision of the Saudi government but the ministry of education’s rules and regulations do not support it. Moreover, the circulars issued by the ministry are also not supportive of teachers and students efforts to implement a sustainable development education curriculum. Second, teachers, as members of this community who play a significant role in achieving the objectives of incorporating sustainability, are often seen as technicians and not as professional human beings. They are confined to the curriculum, the classroom and stripped of their will power by the school management and the educational administration. The subjects, who are students here, are also not prepared nor guided to achieve the objects. In addition, the tools mediated between subjects and objects are not convenient. There were some major challenges regarding the contradictions in incorporating sustainability processes such as demanding creativity from a teacher who is overloaded with tasks irrelevant to teaching and teachers’ training programs not meeting the teachers’ training needs.

Keywords: practice, integrating sustainability, curriculum, educational context

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Authors: Aron Witkowski, Andrzej Wodecki

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Purpose: This study aims to explore the feasibility and effectiveness of utilizing Generative Artificial Intelligence (GenAI) agents as product managers within the manufacturing sector. It seeks to evaluate whether current GenAI capabilities can fulfill the complex requirements of product management and deliver comparable outcomes to human counterparts. Study Design/Methodology/Approach: This research involved the creation of a support application for product managers, utilizing high-quality sources on product management and generative AI technologies. The application was designed to assist in various aspects of product management tasks. To evaluate its effectiveness, a study was conducted involving 10 experienced product managers from the manufacturing sector. These professionals were tasked with using the application and providing feedback on the tool's responses to common questions and challenges they encounter in their daily work. The study employed a mixed-methods approach, combining quantitative assessments of the tool's performance with qualitative interviews to gather detailed insights into the user experience and perceived value of the application. Findings: The findings reveal that GenAI-based product management agents exhibit significant potential in handling routine tasks, data analysis, and predictive modeling. However, there are notable limitations in areas requiring nuanced decision-making, creativity, and complex stakeholder interactions. The case study demonstrates that while GenAI can augment human capabilities, it is not yet fully equipped to independently manage the holistic responsibilities of a product manager in the manufacturing sector. Originality/Value: This research provides an analysis of GenAI's role in product management within the manufacturing industry, contributing to the limited body of literature on the application of GenAI agents in this domain. It offers practical insights into the current capabilities and limitations of GenAI, helping organizations make informed decisions about integrating AI into their product management strategies. Implications for Academic and Practical Fields: For academia, the study suggests new avenues for research in AI-human collaboration and the development of advanced AI systems capable of higher-level managerial functions. Practically, it provides industry professionals with a nuanced understanding of how GenAI can be leveraged to enhance product management, guiding investments in AI technologies and training programs to bridge identified gaps.

Keywords: generative artificial intelligence, GenAI, NPD, new product development, product management, manufacturing

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Authors: Ana L. Gonzalez-Celis, Edgardo Ruiz-Carrillo, Karina Reyes-Jarquin, Margarita Chavez-Becerra

Abstract:

Since recent decades, the aging has been viewed from a more positive perspective, where is not only about losses and damage, but also about being on a stage where you can enjoy life and live with well-being and quality of life. The challenge to feel better is to find those resources that seniors have. For that reason, psychological well-being has shown interest in the study of the affect and life satisfaction (hedonic well-being), while from a more recent tradition, focus on the development of capabilities and the personal growth, considering both as the main indicators of the quality of life. A resource that can be used in the later age is generativity, which refers to the ability of older people to develop and grow through activities that contribute with the improvement of the context in which they live and participate. In this way the generative interest is understood as a favourable attitude that contribute to the common benefit while strengthening and enriching the social institutions, to ensure continuity between generations and social development. On the other hand, generative behavior, differentiating from generative interest, is the expression of that attitude reflected in activities that make a social contribution and a benefit for generations to come. Hence the purpose of the research was to test if there is an association between the generative behaviour type and the psychological well-being with their dimensions. For this reason 188 Mexican adults from 60 to 94 years old (M = 69.78), 67% women, 33% men, completed two instruments: The Ryff’s Well-Being Scales to measure psychological well-being with 39 items with two dimensions (Hedonic and Eudaimonic well-being), and the Loyola’s Generative Behaviors Scale, grouped in five categories: Knowledge transmitted to the next generation, things to be remember, creativity, be productive, contribution to the community, and responsibility of other people. In addition, the socio-demographic data sheet was tested, and self-reported health status. The results indicated that the psychological well-being and its dimensions were significantly associated with the presence of generative behavior, where the level of well-being was higher when the frequency of some generative behaviour excelled; finding that the behavior with greater psychological well-being (M = 81.04, SD = 8.18) was "things to be remembered"; while with greater hedonic well-being (M = 73.39, SD = 12.19) was the behavior "responsibility of other people"; and with greater Eudaimonic well-being (M = 84.61, SD = 6.63), was the behavior "things to be remembered”. The most important findings highlight the importance of generative behaviors in adulthood, finding empirical evidence that the generativity in the last stage of life is associated with well-being. However, by finding differences in the types of generative behaviors at the level of well-being, is proposed the idea that generativity is not situated as an isolated construct, but needs other contextualized and related constructs that can simultaneously operate at different levels, taking into account the relationship between the environment and the individual, encompassing both the social and psychological dimension.

Keywords: eudaimonic well-being, generativity, hedonic well-being, Mexican elders, psychological well-being

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Authors: Vasudha Govil, Prashant Kumar, Ishwar Singh, Kiranpreet Kaur

Abstract:

Traumatic brain injury leads to elevated intracranial pressure. Intraocular pressure (IOP) may also be affected by intracranial pressure. Increased venous pressure in the cavernous sinus is transmitted to the episcleral veins, resulting in an increase in IOP. All drugs used in anesthesia induction can change IOP. Irritation of the gag reflex after usage of the endotracheal tube can also increase IOP; therefore, the administration of anesthetic drugs, which make the lowest change in IOP, is important, while cardiovascular depression must also be avoided. Thiopentone decreases IOP by 40%, whereas etomidate decreases IOP by 30-60% for up to 5 minutes. Hundred patients (age 18-55 years) who underwent emergency craniotomy for TBI are selected for the study. Patients are randomly assigned to two groups of 50 patients each accord¬ing to the drugs used for induction: group T was given thiopentone sodium (5mg kg-1) and group E was given etomi¬date (0.3mg kg-1). Preanaesthesia intraocular pressure (IOP) was measured using Schiotz tonometer. Induction of anesthesia was achieved with etomidate (0.3mg kg-1) or thiopentone (5mg kg-1) along with fentanyl (2 mcg kg-1). Intravenous rocuronium (0.9mg kg-1) was given to facilitate intubation. Intraocular pressure was measured after 1 minute of induction agent administration and 5 minutes after intubation. Maintainance of anesthesia was done with isoflurane in 50% nitrous oxide with fresh gas flow of 5 litres. At the end of the surgery, the residual neuromuscular block was reversed and the patient was shifted to ward/ICU. Patients in both groups were comparable in terms of demographic profile. There was no significant difference between the groups for the hemody¬namic and respiratory variables prior to thiopentone or etomidate administration. Intraocular pressure in thiopentone group in left eye and right eye before induction was 14.97±3.94 mmHg and 14.72±3.75 mmHg respectively and for etomidate group was 15.28±3.69 mmHg and 15.54±4.46 mmHg respectively. After induction IOP decreased significantly in both the eyes (p<0.001) in both the groups. After 5 min of intubation IOP was significantly less than the baseline in both the eyes but it was more than the IOP after induction with the drug. It was found that there was no statistically significant difference in IOP between the two groups at any point of time. Both the drugs caused a significant decrease in IOP after induction and after 5 minutes of endotracheal intubation. The mechanism of decrease in IOP by intravenous induction agents is debatable. Systemic hypotension after the induction of anaesthesia has been shown to cause a decrease in intra-ocular pressure. A decrease in the tone of the extra-ocular muscles can also result in a decrease in intra-ocular pressure. We observed that it is appropriate to use etomidate as an induction agent when elevation of intra-ocular pressure is undesirable owing to the cardiovascular stability it confers in the patients.

Keywords: etomidate, intraocular pressure, thiopentone, traumatic

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