Search results for: medical records management

Authors: Humphrey Atwijukiire, Gladys Nakidde, Anne Tweheyo Otwine, Jane Kabami

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Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda Introduction: Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. This study explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Methods: We conducted 12 in-depth interviews using translated interview guide, and audio recorders. Participants were purposively enrolled in the study. The study was conducted at three public health facilities in Mbarara City. Data was analyzed using thematic content analysis. Approval for this research was obtained from Mbarara University Research Ethics Committee and administrative clearance from city clerk of Mbarara City. Results: The mean age of participants was 38 years. An equal number of males (six) and females participated. Most of them had at least secondary level education, only three had primary education. Experienced benefits of HIV serostatus disclosure included: social support and care; decisions regarding health, fertility, and child bearing; sharing information on HIV prevention and protection; positive living; and, ease of HIV disclosure. The challenges included: misunderstandings in the families. Conclusion: Socially, psychologically and financially PLWHIV have benefited from their negative partners. Health wise, they have been supported, and cared for, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Keywords: discordant couples, disclosure, experiences, HIV

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Authors: Debarati Bhaumik, Diptish Dey

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Multilevel models, increasingly deployed in industries such as insurance, food production, and entertainment within functions such as marketing and supply chain management, need to be transparent and ethical. Applications usually result in binary classification within groups or hierarchies based on a set of input features. Using open-source datasets, we demonstrate that popular explainability methods, such as SHAP and LIME, consistently underperform inaccuracy when interpreting these models. They fail to predict the order of feature importance, the magnitudes, and occasionally even the nature of the feature contribution (negative versus positive contribution to the outcome). Besides accuracy, the computational intractability of SHAP for binomial classification is a cause of concern. For transparent and ethical applications of these hierarchical statistical models, sound audit frameworks need to be developed. In this paper, we propose an audit framework for technical assessment of multilevel regression models focusing on three aspects: (i) model assumptions & statistical properties, (ii) model transparency using different explainability methods, and (iii) discrimination assessment. To this end, we undertake a quantitative approach and compare intrinsic model methods with SHAP and LIME. The framework comprises a shortlist of KPIs, such as PoCE (Percentage of Correct Explanations) and MDG (Mean Discriminatory Gap) per feature, for each of these three aspects. A traffic light risk assessment method is furthermore coupled to these KPIs. The audit framework will assist regulatory bodies in performing conformity assessments of AI systems using multilevel binomial classification models at businesses. It will also benefit businesses deploying multilevel models to be future-proof and aligned with the European Commission’s proposed Regulation on Artificial Intelligence.

Keywords: audit, multilevel model, model transparency, model explainability, discrimination, ethics

Procedia PDF Downloads 87

Authors: Nyimas Annissa Mutiara Andini

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There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

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Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

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Authors: Karla Hrbackova, Anna Petr Safrankova, Jakub Hladik

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Machiavellianism as social phenomenon reveals certain methods of communication that man puts in contact with other people in both personal and working life (and work with clients). Especially at the helping-profession students is honesty, openness or low motivation for personal benefit important part of the profession. The aim of a study is to expose intercultural differences influence of Machiavellianism between Czech and Slovak university students and to determine whether these differences manifest themselves differently among students focusing on management and social profession (by helping degrees). The research involved 1120 university students from the Czech Republic and the Slovak Republic. The measurement of Machiavellianism used a test Mach IV. The test contained 20 statements divided into four central dimensions of Machiavellianism: flattery, deception and falsehood, immorality and cynicism. We found out, that Czech and Slovak's student expressed a similar attitude toward Machiavellianism as a means of manipulation in the interpersonal relationship, but this is not true in all dimensions. Czech and Slovak's students perceive differently flattery, deception and falsehood and cynicism too. In addition to specific features of cultural conditionality, we found out differences depending on the helping profession. Students focusing on managerial occupation (lower level of helping) tend towards greater acceptance of the use flattery as a means of communication than students specializing in the social profession (high-grade assisting). If they are an intercultural and interdisciplinary influences combined and effect on the perception of Machiavellianism together, then their significant importance for the perception of flattery and cynicism. The result will help us to reveal certain specific traits that students apply communication and with whom we can continue to work during their training.

Keywords: use of manipulative strategies, Machiavellianism, helping-profession students, professional training of students

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Authors: Nthabiseng Portia Mahumapelo, Andre van Niekerk, Ndabenhle Sosibo, Nirdesh Singh

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The foundry industry generates large quantities of solid waste in the form of waste foundry sand. The ever-increasing quantities of this type of industrial waste put pressure on land-filling space and its proper management has become a global concern. The South African foundry industry is not different when it comes to this solid waste generation. Utilizing the foundry waste sand in other applications has become an attractive avenue to deal with this waste stream. In the present paper, an evaluation was done on the suitability of foundry waste sand as an additive in clay masonry products. Purchased clay was added to the foundry waste sand sample in a 50/50 ratio. The mixture was named FC sample. The FC sample was mixed with water in a pan mixer until the mixture was consistent and suitable for extrusion. The FC sample was extruded and cut into briquettes. Water absorption, shrinkage and modulus of rupture tests were conducted on the resultant briquettes. Foundry waste sand and FC samples were respectively characterized mineralogically using X-Ray Diffraction, and the major and trace elements were determined using Inductively Coupled Plasma Optical Emission Spectroscopy. Adding purchased clay to the foundry waste sand positively influenced the workability of the test sample. Another positive characteristic was the low linear shrinkage, which indicated that products manufactured from the FC sample would not be susceptible to cracking. The water absorption values were acceptable and the unfired and fired strength values of the briquette’s samples were acceptable. In conclusion, tests showed that foundry waste sand can be used as an additive in masonry clay bricks, provided it is blended with good quality clay.

Keywords: foundry waste sand, masonry clay bricks, modulus of rupture, shrinkage

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Authors: Pamela E. Mukaire

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Anemia and chronic energy deficiency are significant manifestations of poor nutritional health. Anaemia and nutritional status screening are practical ways for assessing the prevalence of iron deficiency anemia in the food insecure populations with large groups of childbearing women and children. The objective of the study was to assess anemia prevalence and other clinical manifestations of malnutrition among pairs of mothers and young children in rural Uganda. This community cross-sectional study used consecutive sampling to select 214 mothers and 214 children for the study. Data was generated using structured questionnaire, anthropometric measurements and on site analysis for anemia. Bivariable and multivariable analyses were used to assess the effect of different factors on anaemia. Of the 214 mothers, 54.2% were 25-34 years of age, 76.7% unmarried, 63% low income, and 55% had more than four children. Of the 214 children, 57% were female, 50% between 1 to 3 years of age and 35% under one year, and. Overall, 38% of the households had more 4 children under the age of 12. The prevalence of anemia was 48% for mothers and 72% for children; 20.6% of mothers had moderate to severe chronic energy deficiency, 39% had moderately-severe anaemia (10 to 7.1 g/dL). Among children, 53% had moderately-severe anaemia, and 18.2% had severe anaemia. Parity X2 =20, p < .037, number of children under 12 years living in a household X2 =10, p < .015, and child’s gender X2 =6.5, p < .038, had a significant relationship with maternal anaemia. There was a significant relationship between household income X2 =10, p < .005, marital status X2 =9, p < .011, owing a piece of land X2 =18, p < .000, owing home X2 =7, p < .036, and anaemia in children. The prevalence of anemia was high in both mothers and children. Income, marital status, owing a piece of land, owing home, number of children under age 12 in a household were associated with anaemia. Hence, efforts should be made for early diagnosis and management of anaemia deficiencies with special emphasis on those households with large number of children under age 12.

Keywords: anemia, maternal-child, nutrition, rural population

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Authors: Malathi Balakrishnan, Cheng Lee Ooi, Chander Vengadasalam

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The purpose of this study is to explore a case study of trainee teachers’ learning experience on innovating traditional games during the traditional game carnival. It explores issues arising from multiple case studies of trainee teachers learning experiences in innovating traditional games. A qualitative methodology was adopted through observations, semi-structured interviews and reflective journals’ content analysis of trainee teachers’ learning experiences creating and implementing innovative traditional games. Twelve groups of 36 trainee teachers who registered for Sports and Physical Education Management Course were the participants for this research during the traditional game carnival. Semi structured interviews were administrated after the trainee teachers learning experiences in creating innovative traditional games. Reflective journals were collected after carnival day and the content analyzed. Inductive data analysis was used to evaluate various data sources. All the collected data were then evaluated through the Nvivo data analysis process. Inductive reasoning was interpreted based on the Self Determination Theory (SDT). The findings showed that the trainee teachers had positive game participation experiences, game knowledge about traditional games and positive motivation to innovate the game. The data also revealed the influence of themes like cultural significance and creativity. It can be concluded from the findings that the organized game carnival, as a requirement of course work by the Institute of Teacher Training Malaysia, was able to enhance teacher trainers’ innovative thinking skills. The SDT, as a multidimensional approach to motivation, was utilized. Therefore, teacher trainers may have more learning experiences using the SDT.

Keywords: learning experiences, innovation, traditional games, trainee teachers

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Authors: Alok Shiomurti Tripathi, Ajay Kumar Timiri, Papiya Mitra Mazumder, Anil Chandewar

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The present study evaluates the possible drug interaction between glimepiride (GLIM) and sildenafil citrate (SIL) in streptozotocin (STZ) induced in diabetic nephropathic (DN) animals and also postulates the possible mechanism of interaction by molecular modeling studies. Diabetic nephropathy was induced by single dose of STZ (60 mg/kg, ip) and confirms it by assessing the blood and urine biochemical parameters on 28th day of its induction. Selected DN animals were used for the drug interaction between GLIM (0.5mg/kg, p.o.) and SIL (2.5 mg/kg, p.o.) after 29th and 70th day of protocol. Drug interaction were assessed by evaluating the plasma drug concentration using HPLC-UV and also determine the change in the biochemical parameter in blood and urine. Mechanism of the interaction was postulated by molecular modeling study using Maestro module of Schrodinger software. DN was confirmed as there was significant alteration in the blood and urine biochemical parameter in STZ treated groups. The concentration of SIL increased significantly (p<0.001) in rat plasma when co administered with GLIM after 70th day of protocol. Molecular modelling study revealed few important interactions with rat serum albumin and CYP2C9.GLIM has strong hydrophobic interaction with binding site residues of rat serum albumin compared to SIL. Whereas, for CYP2C9, GLIM has strong hydrogen bond with polar contacts and hydrophobic interactions than SIL. Present study concludes that bioavailability of SIL increases when co-administered chronically with GLIM in the management of DN animals and mechanism has been supported by molecular modeling studies.

Keywords: diabetic nephropathy, glimepiride, sildenafil citrate, pharmacokinetics, homology modeling, schrodinger

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Authors: Tom Ryan

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This paper investigates the rural mobility and accessibility challenges of a specific target group - Seniors. The target group is those over 66 years of age who are entitled to use the Public Transport (PT) Free Travel Scheme in rural Ireland. The paper explores at a high level some of the projected rural PT challenges and requirements over the next 10-15 years, noting that statistical predictions show that there will be a significant population demographic shift within the Senior's age profile. Using the PESTEL framework, the literature review explored existing research concerning mobility, accessibility challenges, and the opportunities Seniors face. Twenty-seven qualitative in-depth interviews with stakeholders within the ecosystem were undertaken. The stakeholders included: rural PT customers, Local-Link managers, NTA senior management, a Minister of State, and a European parliament policymaker. Tier 1 interviewee feedback spotlights that the PT network system does not exist for rural patients to access hospital facilities. There was no evidence from the Tier 2 research findings to show that health policymakers and transport planners are working to deliver a national solution to support patients getting access to hospital appointments. Several research interviewees discussed the theme of isolation and the perceived stigma of senior males utilising PT. The findings indicated that MaaS is potentially revolutionary in the PT arena. Finally, this paper suggests several short-, medium- and long-term recommendations based on the research findings. These recommendations are a potential springboard to ensure that rural PT is suitable for future Irish generations.

Keywords: accessibility, active ageing, car dependence, isolation, seniors health issues, behavioural changes, environmental challenges, internet of things, demand responsive, mobility as a service

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Authors: Adane Kassa Shikur

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Today’s supply chains (SC) have become vulnerable to unexpected and ever-intensifying disruptions from myriad sources. Consequently, the concept of supply chain resilience (SCRes) has become crucial to complement the conventional risk management paradigm, which has failed to cope with unexpected SC disruptions, resulting in severe consequences affecting SC performances and making business continuity questionable. Advancements in cutting-edge technologies like artificial intelligence (AI) and their potential to enhance SCRes by improving critical antecedents in the different phases have attracted the attention of scholars and practitioners. The research from academia and the practical interest of the industry have yielded significant publications at the nexus of AI and SCRes during the last two decades. However, the applications and examinations have been primarily conducted independently, and the extant literature is dispersed into research streams despite the complex nature of SCRes. To close this research gap, this study conducts a systematic literature review of 106 peer-reviewed articles by curating, synthesizing, and consolidating up-to-date literature and presents the state-of-the-art development from 2010 to 2022. Bayesian networks are the most topical ones among the 13 AI techniques evaluated. Concerning the critical antecedents, visibility is the first ranking to be realized by the techniques. The study revealed that AI techniques support only the first 3 phases of SCRes (readiness, response, and recovery), and readiness is the most popular one, while no evidence has been found for the growth phase. The study proposed an AI-SCRes framework to inform research and practice to approach SCRes holistically. It also provided implications for practice, policy, and theory as well as gaps for impactful future research.

Keywords: ANNs, risk, Bauesian networks, vulnerability, resilience

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Authors: Hicham Amar, Mustapha El Ghorfi, Yassine Taha, Abdellatif Elghali, Rachid Hakkou, Mostafa Benzaazoua

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Phosphate mine waste rock (PMWR) generated during ore extraction is continuously increasing, resulting in a significant environmental footprint. The main objectives of this study consist of i) elaboration of the sampling strategy of PMWR piles, ii) a mineralogical and chemical characterization of PMWR piles, and iii) 3D block model creation to evaluate the potential valorization of the existing PMWR. Destructive drilling using reverse circulation from 13 drills was used to collect samples for chemical (X-ray fluorescence analysis) and mineralogical assays. The 3D block model was created based on the data set, including chemical data of the realized drills using Datamine RM software. The optical microscopy observations showed that the sandy phosphate from drills in the PMWR piles is characterized by the abundance of carbonate fluorapatite with the presence of calcite, dolomite, and quartz. The mean grade of composite samples was around 19.5±2.7% for P₂O₅. The mean grade of P₂O₅ exhibited an increasing tendency by depth profile from bottom to top of PMWR piles. 3D block model generated with chemical data confirmed the tendency of the mean grades’ variation and may allow a potential selective extraction according to %P₂O₅. The 3D block model of P₂O₅ grade is an efficient sampling approach that confirmed the variation of P₂O₅ grade. This integrated approach for PMWR management will be a helpful tool for decision-making to recover the residual phosphate, adopting the circular economy and sustainability in the phosphate mining industry.

Keywords: 3D modelling, reverse circulation drilling, circular economy, phosphate mine waste rock, sampling

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Authors: Caspar S. Carson, Gabriel W. Prather, Nicholas E. Wong, Jeffery R. Anton, William H. McCoy

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Cutibacterium acnes is a commensal bacterium found on human skin that has been linked to acne. C. acnes can also be an opportunistic pathogen when it infiltrates the body during surgery. This pathogen can cause dangerous infections of medical implants, such as shoulder replacements, leading to life-threatening blood infections. Compounding this issue, C. acnes resistance to many antibiotics has become an increasing problem worldwide, creating a need for special forms of treatment. C. acnes expresses the protein RoxP, and it requires this protein to colonize human skin. Though this protein is required for C. acnes skin colonization, its function is not yet understood. Inhibition of RoxP function might be an effective treatment for C. acnes infections. To develop such reagents, the McCoy Laboratory generated four unique anti-RoxP antibodies. Preliminary studies in the McCoy Lab have established that each antibody binds a distinct site on RoxP. To assess the potential of these antibodies as therapeutics, it is necessary to specifically characterize these antibody epitopes and evaluate them in assays that assess their ability to inhibit RoxP-dependent C. acnes growth. To provide material for these studies, an antibody expression construct, Fv-clasp(v2), was adapted to encode anti-RoxP antibody sequences. The author hypothesizes that this expression strategy can produce sufficient amounts of >95% pure antibody fragments for further characterization of these antibodies. Four anti-RoxP Fv-clasp(v2) expression constructs (pET vector-based) were transformed into E. coli BL21-Gold(DE3) cells and a small-scale expression and purification trial was performed for each construct to evaluate anti-RoxP Fv-clasp(v2) yield and purity. Successful expression and purification of these antibody constructs will allow for their use in structural studies, such as protein crystallography and cryogenic electron microscopy. Such studies would help to define the antibody binding sites on RoxP, which could then be leveraged in the development of certain methods to treat C. acnes infection through RoxP inhibition.

Keywords: structural biology, protein expression, infectious disease, antibody, therapeutics, E. coli

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Authors: Torsten Schwan, Rene Unger

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Simulation of thermal and electrical building performance more and more becomes part of an integrative planning process. Increasing requirements on energy efficiency, the integration of volatile renewable energy, smart control and storage management often cause tremendous challenges for building engineers and architects. This mainly affects commercial or non-residential buildings. Their energy consumption characteristics significantly distinguish from residential ones. This work focuses on the many-objective optimization problem indoor air quality and comfort, especially in non-residential buildings. Based on a brief description of intermediate dependencies between different requirements on indoor air treatment it extends existing Modelica-based building physics models with additional system states to adequately represent indoor air conditions. Interfaces to corresponding HVAC (heating, ventilation, and air conditioning) system and control models enable closed-loop analyzes of occupants' requirements and energy efficiency as well as profitableness aspects. A complex application scenario of a nearly-zero-energy school building shows advantages of presented evaluation process for engineers and architects. This way, clear identification of air quality requirements in individual rooms together with realistic model-based description of occupants' behavior helps to optimize HVAC system already in early design stages. Building planning processes can be highly improved and accelerated by increasing integration of advanced simulation methods. Those methods mainly provide suitable answers on engineers' and architects' questions regarding more exuberant and complex variety of suitable energy supply solutions.

Keywords: indoor air quality, dynamic simulation, energy efficient control, non-residential buildings

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Authors: Ernest Nweke

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The work of Professional Accountants and Corporate governance are synonymous and cannot be divorced from each other. Organizations, profit and non-profit alike cannot implement sound corporate practices without inputs from Professional Accountants. In today’s dynamic corporate world, good corporate governance practice is a sine qua non. More so, following the corporate failures of the past decades like Enron and WorldCom, governments around the world, including Mongolia are becoming more proactive in ensuring sound corporate governance mechanisms. In the past fifteen years, the Mongolian government has taken several measures to establish and strengthen internal corporate governance structures in firms. This paper highlights the role of professional accountants and auditors play in ensuring that good corporate governance mechanisms are entrenched in listed companies in Mongolia. Both primary and secondary data are utilized in this research. In collection of primary data, Delphi method was used, securing responses from only knowledgeable senior employees, top managers, and some CEOs. Using this method, a total of 107 top-level company employees and executives randomly selected from 22 companies were surveyed; maximum of 5 and minimum of 4 from each company. These companies cut across several sectors. It was concluded that Professional Accountants play key roles in setting and maintaining firm governance. They do this by ensuring full compliance with all the requirements of good and sound corporate governance, establishing reporting, monitoring and evaluating standards, assisting in the setting up of proper controls, efficient and effective audit systems, sound fraud risk management and putting in place an overall vision for the enterprise. Companies with effective corporate governance mechanisms are usually strong and fraud-resilient. It was also discovered that companies with big 4 audit firms tend to have better governance structures in Mongolia.

Keywords: accountants, corporate disclosure, corporate failure, corporate governance

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Authors: David Cobham

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In higher education, a great degree of importance is placed on the internationalization of the student experience. This is seen as a valuable contributor to elements such as building confidence, broadening knowledge, creating networks and connections, and enhancing employability for current students who will become the next generation of managers in technology and business. The COVID-19 pandemic has affected all areas of people’s lives. The limitations of travel coupled with the fears and concerns generated by the health risks have dramatically reduced the opportunity for students to engage with this agenda. Institutions of higher education have been required to rethink fundamental aspects of their business model from recruitment and enrolment through learning approaches, assessment methods, and the pathway to employment. This paper presents a case study which focuses on student mobility and how the physical experience of being in another country, either to study, to work, to volunteer or to gain cultural and social enhancement, has of necessity been replaced by alternative approaches. It considers trans-national education as an alternative to physical study overseas, virtual mobility and internships as an alternative to international work experience, and adopting collaborative online projects as an alternative to in-person encounters. The paper concludes that although these elements have been adopted to address the current situation, the lessons learned and the feedback gained suggests that they have contributed successfully in new and sometimes unexpected ways and that they will persist beyond the present to become part of the 'new normal' for the future. That being the case, senior leaders of institutions of higher education will be required to revisit their international plans and to rewrite their international strategies to take account of and build upon these changes.

Keywords: higher education management, internationalization, transnational education, virtual mobility

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Authors: Rachel Talbot, Nasuh Malas

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Stigma in child and adolescent psychiatry continues to be a significant barrier for youth to receive much needed psychiatric care. Parents misperceptions regarding mental health may interfere with their child’s care and negatively influence their child’s view of mental health. For some children, their first experience with psychiatry may occur during medical hospitalization when they are seen by the Psychiatry Consultation-Liaison (C/L) Service. Despite this unique role, there is limited data on how to address mental health stigma with patients and families within the context of Child and Adolescent C/L Psychiatry. This study explores the use of a brief introductory video with messages from the psychiatry C/L team, families who have accessed mental health consultation in the hospital, as well as clips of family and C/L team interactions to address parental stigma of psychiatry. Common stigmatized concerns shared by parents include concerns about confidentiality, later ramifications of mental healthcare, outsider status, and parental self-blame. There are also stigmatized concerns about psychiatric medication use including overmedication, sedation, long-term effects, medicating ‘real problems’ and personality blunting. Each of these are addressed during the video parents will see with the intent of reducing negative parental perceptions relating to mental healthcare. For this study, families are given a survey highlighting these concerns, prior to and after watching the video. Pre-and post-video responses are compared with the hypothesis that watching the video will effectively reduce parental stigma about psychiatric care. Data collection is currently underway and will be completed by the end of November 2017 with data analysis completed by January 2018. This study will also give vital information about the demographic differences in perceptions of stigma so future interventions can be targeted towards those with higher perceived stigma. This study posits that use of an introductory video is an effective strategy to combat stigma and help educate and empower families. In this way, we will be reducing further barriers for patients and families to seek out mental health resources and supports that are often desperately needed for these youths.

Keywords: child and adolescent psychiatry, consult-liaison psychiatry, media, stigma

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Authors: D. F. Zeynalov, T. V. Kartseva, O. V. Sorokin

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Currently, approaches to assess cardiointervalography are based on the calculation of data variance intervals RR. However, they do not allow the evaluation of features related to a period of the cardiac cycle, so how electromechanical phenomena during cardiac subphase are characterized by differently directed changes. Therefore, we have proposed a method of subphase analysis of the cardiac cycle, developed in the department of hominal physiology Novosibirsk State Medical University to identify the features of the dispersion subphase of the cardiac cycle. In the present paper we have examined the 5-minute intervals cardiointervalography (CIG) to isolate RR-, QT-, ST-ranges in healthy children and children with acute respiratory diseases (ARD) in comparison. It is known that primary school-aged children suffer at ARD 5-7 times per year. Consequently, it is one of the most relevant problems in pediatrics. It is known that the spectral indices and indices of temporal analysis of heart rate variability are highly sensitive to the degree of intoxication during immunological process. We believe that the use of subphase analysis of heart rate will allow more thoroughly evaluate responsiveness of the child organism during the course of ARD. The study involved 60 primary school-aged children (30 boys and 30 girls). In order to assess heart rhythm regulation, the record CIG was used on the "VNS-Micro" device of Neurosoft Company (Ivanovo) for 5 minutes in the supine position and 5 minutes during active orthostatic test. Subphase analysis of variance QT-interval and ST-segment was performed on the "KardioBOS" software Biokvant Company (Novosibirsk). In assessing the CIG in the supine position and in during orthostasis of children with acute respiratory diseases only RR-intervals are observed typical trend of general biological reactions through pressosensitive compensation mechanisms to lower blood pressure, but compared with healthy children the severity of the changes is different, of sick children are more pronounced indicators of heart rate regulation. But analysis CIG RR-intervals and analysis subphase ST-segment have yielded conflicting trends, which may be explained by the different nature of the intra- and extracardiac influences on regulatory mechanisms that implement the various phases of the cardiac cycle.

Keywords: acute respiratory diseases, cardiointervalography, subphase analysis, cardiac cycle

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Authors: Atiq U. Zaman, Juliet Arnott

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This paper analyses the various benefits and barriers of residential deconstruction in the context of environmental performance and circular economy based on a case study project in Christchurch, New Zealand. The case study project “Whole House Deconstruction” which aimed, firstly, to harvest materials from a residential house, secondly, to produce new products using the recovered materials, and thirdly, to organize an exhibition for the local public to promote awareness on resource conservation and sustainable deconstruction practices. Through a systematic deconstruction process, the project recovered around 12 tonnes of various construction materials, most of which would otherwise be disposed of to landfill in the traditional demolition approach. It is estimated that the deconstruction of a similar residential house could potentially prevent around 27,029 kg of carbon emission to the atmosphere by recovering and reusing the building materials. In addition, the project involved local designers to produce 400 artefacts using the recovered materials and to exhibit them to accelerate public awareness. The findings from this study suggest that the deconstruction project has significant environmental benefits, as well as social benefits by involving the local community and unemployed youth as a part of their professional skills development opportunities. However, the project faced a number of economic and institutional challenges. The study concludes that with proper economic models and appropriate institutional support a significant amount of construction and demolition waste can be reduced through a systematic deconstruction process. Traditionally, the greatest benefits from such projects are often ignored and remain unreported to wider audiences as most of the external and environmental costs have not been considered in the traditional linear economy.

Keywords: circular economy, construction and demolition waste, resource recovery, systematic deconstruction, sustainable waste management

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Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Background and aims: While in Western countries, unilateral spinal anesthesia has been widely practiced for a long time, it remains little known in the local anesthesia community, and has not been the object of many studies. However, it is a simple, practical and effective technique. Our objective was to evaluate this practice in emergency anesthesia management in frail patients and to compare it with conventional spinal anesthesia. Methods: This is a prospective, observational, comparative study between hypobaric unilateral and conventional spinal anaesthesia for hip fracture surgery carried out in the operating room of the university military hospital of Staoueli. The work was spread over of 12-month period from 2019 to 2020. The parameters analyzed were hemodynamic variations, vasopressor use, block efficiency, postoperative adverse events, and postoperative morphine consumption. Results: -75 cases (mean age 72±14 years) -Group1= 41 patients (54.6%) divided into (ASA1=14.6% ASA2=60.98% ASA3=24.39%) single shoot spinal anaesthesia -Group2= 34 patients (45.3%) divided into (ASA1=2.9%, ASA2=26.4% ASA3=61.7%, ASA4=8.8%) unilateral hypobaric spinal anesthesia. -Hemodynamic variations were more severe in group 1 (51% hypotension) compared to 30% in group 2 RR=1.69 and odds ratio=2.4 -these variations were more marked in the ASA3 subgroup (group 1=70% hypotension versus group 2=30%) with an RR=2.33 and an odds ratio=5.44 -39% of group 1 required vasoactive drugs (15mg +/- 11) versus 32% of group 2 (8mg+/- 6.49) - no difference in the use of morphine in post-op. Conclusions: Within the limits of the population studied, this work demonstrates the clinical value of unilateral spinal anesthesia in ortho-trauma surgery in the frail patient.

Keywords: spinal anaesthesia, vasopressor, morphine, hypobaric unilateral spinal anesthesia, ropivacaine, hip surgery, eldery, hemodynamic

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Authors: Yazidu Saidi Mbalamula

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Free Basic Education (FBE) policy implementation in Secondary Schools has been one of thrilled undertaking both to the government and household in Tanzania. On the one hand, the government has achieved citizenry acceptance to responsibility and accountability, and on the other hand, the household has been relieved from social costs that were unbearable and deprived many Tanzanians access to basic education and secondary education in particular. Specifically, this study presents a descriptive survey conducted in two districts of Kagera region located at the northern part of Tanzania. Three objectives were pursued to identify achievements realized and challenges in the FBE implementation, and also stakeholders’ proposals were explored on how to improve FBE implementation. A sample of 91 respondents, including school managers, teachers, students, and parents, were involved in the study. Both questionnaires and interviews were used whereby the quantitative data were analyzed using Statistical Package for Social Sciences (SPSS), and content analysis was used to analyze the qualitative data. The results show that implementation of free education policy in secondary schools had far positive impact on the improvement of school management, school attendance, reduced school drop-out, reduced parents-school managers conflicts, and increased enrollment rates. Notwithstanding that, the political machinery remains instrumental to instigate policy reforms in education sector. Nevertheless, the alienating interests of politibureau, often top-down and blanketed by superficial government redness, can hardly be feasible to wield such huge programme given staggering stakeholders’ awareness of the actual requirements and unlatching resources to back up policy implementation. The study recommends that further studies on stakeholders’ conceptions on the FBE and equity of financing of basic education in Tanzania.

Keywords: capitation grant, CCM, free basic education, kagera, education policy

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Authors: S. Brain, P. J. Storer, H. Strydom, Z. M. Solaiman

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Increasing farmer awareness of soil health, the impact of agricultural management practices, and the requirement for high-quality agricultural produce are major factors driving the rapid adoption of biological seed treatments - currently valued globally at USD 1.5 billion. Biological seed coatings with multistrain plant beneficial microbial technology have the capability to affect plant establishment, growth, and development positively. These beneficial plant microbes can potentially increase soil health, plant yield, and nutrition – acting as bio fertilisers, rhizoremediators, phytostimulators, and stress modulators, and can ultimately reduce the overall use of agrichemicals. A field trial was conducted on MACE wheat in the central wheat belt of Western Australia to evaluate a proprietary seed coating technology (Langleys Bio-EnergeticTM Microbe blend (BMB)) on a conventional program (+/- BMB microbes) and a Regenerative Biomineral fertiliser program (+/- BMB microbes). The Conventional (+BMB) and Biomineral (+BMB) treated plants had no fungicide treatments and had no disease issues. Control (No fertiliser, No microbes), Conventional (No Microbes), and Biomineral (No Microbes) were treated with fungicides (seed dressing and foliar). From the research findings, compared to control and no microbe treatments, both the Conventional (+ BMB) and Biomineral (+ BMB) showed significant increases in Soil Carbon (SOC), Seed germination, nutrient use efficiency (NUE) of nitrogen, phosphate and mineral nutrients, grain mineral nutrient uptake, protein %, hectolitre weight, and fewer screenings, yield, and gross margins.

Keywords: biological seed coating, biomineral fertiliser, plant nutrition, regenerative and conventional agriculture

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Authors: Lizinis Cassendra Frederick Dony, Dewi Binti Tajuddin, Jirom Jeremy Frederick Dony, Andrew Nicholas

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Unemployed graduates have become among the world major concerns lately. 70% of Malaysian graduates are jobless. Due to this concerns, this paper aims to identify major factors influencing Sabah minority ethnic favorable in the entrepreneurialism business interest. Hence, extensive introductory entrepreneurship syllabus clusters development beginning from the early childhood, primary, secondary and university students. This may induce interest appeal and to develop focus group of self-employment. The study focus on 7 indicators consist of demographic profiles variable (DP), social norms (SN), attitude (A), self-efficacy (SE) and business management skills (BMS) with reference to university students’ entrepreneurial intention. This study also partially mediates the relationship between product attractiveness (PA) and the minority ethnic entrepreneurialism business interest (MEEBI), by testifying their direct and indirect relationships. Hence, this study provides new perception towards improving the graduates’ characteristic, capabilities to exploit the business opportunities in the market. Furthermore, this paper will assess the relationship with the product attractiveness(PA) as a mediator. The study encompasses on the type of Sabah minority ethnic (ME) and nature of family own business (FOB) background with the 280 samples students in UiTM Sabah and UMS. The descriptive and random sampling method of research which revealed that majority of the respondents agreed that FOB and entrepreneurship education had positively influenced the ethnic students’ involvement in the entrepreneurial process and career development either full-time or part-time basis.

Keywords: Demographic profile (DP), soci, unemployed graduates, Malaysian minority

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Authors: Girts Bumanis, Diana Bajare

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With demand for primary energy continuously growing, search for renewable and efficient energy sources has been high on agenda of our society. One of the most promising energy sources is biogas technology. Residues coming from dairy industry and milk processing could be used in biogas production; however, low efficiency and high cost impede wide application of such technology. One of the main problems is management and conversion of organic residues through the anaerobic digestion process which is characterized by acidic environment due to the low whey pH (<6) whereas additional pH control system is required. Low buffering capacity of whey is responsible for the rapid acidification in biological treatments; therefore alkali activated material is a promising solution of this problem. Alkali activated material is formed using SiO2 and Al2O3 rich materials under highly alkaline solution. After material structure forming process is completed, free alkalis remain in the structure of materials which are available for leaching and could provide buffer capacity potential. In this research porous alkali activated material was investigated. Highly porous material structure ensures gradual leaching of alkalis during time which is important in biogas digestion process. Research of mixture composition and SiO2/Na2O and SiO2/Al2O ratio was studied to test the buffer capacity potential of alkali activated material. This research has proved that by changing molar ratio of components it is possible to obtain a material with different buffer capacity, and this novel material was seen to have considerable potential for using it in processes where buffer capacity and pH control is vitally important.

Keywords: alkaline material, buffer capacity, biogas production, bioreactors

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Authors: Kalpana Sharma, Jyoti Mann

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The study was designed towards institutional analysis for a clear understanding of the process involved in functioning and layout of determinants influencing physical education teacher’s education program in India. This further can be recommended for selection of parameters for creating sector benchmarking for physical education teachers training institutions across India. 165 stakeholders involving students, teachers, parents, administrators were surveyed from the identified seven institutions and universities from different states of India. They were surveyed on the basis of seven broad parameters which were associated with the post graduate physical education program in India. A physical education program assessment tool of 52 items was designed to administer it among the stakeholders selected for the survey. An item analysis of the contents was concluded through the review process from selected experts working in higher education with experience in teacher training program in physical education. The data was collected from the stakeholders of the selected institutions through Physical Education Program Assessment Tool (PEPAT). The hypothesis that PE teacher education program is independent of physical education institutions was significant. The study directed a need towards robust admission process emphasizing on identification, selection of potential candidates and quality control of intake with the scientific process developed according to the Indian education policies and academic structure. The results revealed that the universities do not have similar functional and delivery process related to the physical education teacher training program. The study reflects towards the need for physical education universities and institutions to identify the best practices to be followed regarding the functioning of delivery of physical education programs at various institutions through strategic management studies on the identified parameters before establishing strict standards and norms for achieving excellence in physical education in India.

Keywords: assessment, benchmarking, curriculum, physical education, teacher education

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Authors: Daniel Llanes, Alfredo Reyes, Sonia E. Ruiz, Federico Valenzuela Beltran

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Steel frames have been used in building construction for more than one hundred years. Beam-column may be connected to columns using either stiffened or unstiffened angles at the top and bottom beam flanges. Designers often assume that these assemblies acted as “pinned” connections for gravity loads and that the stiffened connections would act as “fixed” connections for lateral loads. Observation of damages sustained by buildings during the 1994 Northridge earthquake indicated that, contrary to the intended behavior, in many cases, brittle fractures initiated within the connections at very low levels of plastic demand, and in some cases, while the structures remained essentially elastic. Due to the damage presented in these buildings other type of alternative connections have been proposed. According to a research funded by the Federal Emergency Management Agency (FEMA), the screwed connections have better performance when they are subjected to cyclic loads, but at the same time, these connections have some degree of flexibility. Due to this situation, some researchers ventured into the study of semi-rigid connections. In the present study three steel buildings, constituted by regular frames are analyzed. Two types of connections are considered: pinned and semi-rigid connections. With the aim to estimate their structural capacity, a number of incremental dynamic analyzes are performed. 3D structural models are used for the analyses. The seismic ground motions were recorded on sites near Los Angeles, California, where the structures are supposed to be located. The vulnerability curves of the building are obtained in terms of maximum inter-story drifts. The vulnerability curves (which correspond to the models with two different types of connections) are compared, and its implications on its structural design and performance is discussed.

Keywords: steel frame Buildings, vulnerability curves, semi-rigid connections, pinned connections

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Authors: Thabiso Michael Mokotjomela, Jasper Knight

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Intensification of agricultural food production in sub-Saharan Africa is of paramount importance as a means of increasing the food security of communities that are already experiencing a range of environmental and socio-economic stresses. However, achieving this aim faces several challenges including ongoing climate change, increased resistance of diseases and pests, extreme environmental degradation partly due to biological invasions, land tenure and management practices, socio-economic developments of rural populations, and national population growth. In particular, non-native plant species tend to display greater adaptation capacity to environmental stress than native species that form important food resource base for human beings, thus suggesting a potential for usage to shift accordingly. Based on review of the historical benefits of non-native plant species in food production in sub-Saharan Africa, we propose that use of non-invasive, non-native plant species and/or the genetic modification of native species might be viable options for future agricultural sustainability in this region. Coupled with strategic foresight planning (e.g. use of biological control agents that suppress plant species’ invasions), the consumptive use of already-introduced non-native species might help in containment and control of possible negative environmental impacts of non-native species on native species, ecosystems and biodiversity, and soil fertility and hydrology. Use of non-native species in food production should be accompanied by low cost agroecology practices (e.g. conservation agriculture and agrobiodiversity) that may promote the gradual recovery of natural capital, ecosystem services, and promote conservation of the natural environment as well as enhance food security.

Keywords: food security, invasive species, agroecology, agrobiodiversity, socio-economic stresses

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Authors: Sandeep Mehmi, Harsh Verma, A. L. Sangal

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Ever since the idea of using computing services as commodity that can be delivered like other utilities e.g. electric and telephone has been floated, the scientific fraternity has diverted their research towards a new area called utility computing. New paradigms like cluster computing and grid computing came into existence while edging closer to utility computing. With the advent of internet the demand of anytime, anywhere access of the resources that could be provisioned dynamically as a service, gave rise to the next generation computing paradigm known as cloud computing. Today, cloud computing has become one of the most aggressively growing computer paradigm, resulting in growing rate of applications in area of IT outsourcing. Besides catering the computational and storage demands, cloud computing has economically benefitted almost all the fields, education, research, entertainment, medical, banking, military operations, weather forecasting, business and finance to name a few. Smart grid is another discipline that direly needs to be benefitted from the cloud computing advantages. Smart grid system is a new technology that has revolutionized the power sector by automating the transmission and distribution system and integration of smart devices. Cloud based smart grid can fulfill the storage requirement of unstructured and uncorrelated data generated by smart sensors as well as computational needs for self-healing, load balancing and demand response features. But, security issues such as confidentiality, integrity, availability, accountability and privacy need to be resolved for the development of smart grid cloud. In recent years, a number of intrusion prevention techniques have been proposed in the cloud, but hackers/intruders still manage to bypass the security of the cloud. Therefore, precise intrusion detection systems need to be developed in order to secure the critical information infrastructure like smart grid cloud. Considering the success of artificial neural networks in building robust intrusion detection, this research proposes an artificial neural network based model for detecting attacks in smart grid cloud.

Keywords: artificial neural networks, cloud computing, intrusion detection systems, security issues, smart grid

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Authors: Jane E. Souyave, Judith Bower

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This study is an ongoing collaborative project between the University of Central Lancashire and the Alzheimer’s Society to design and test the idea of using interactive tools for a person living with dementia and their carers. It is hoped that the tools will fulfill the possible needs of engagement and interaction as dementia progresses, therefore enhancing wellbeing and improving quality of life for the person with dementia and their carers. The project was informed by Kitwood’s five psychological needs for producing wellbeing and explored evidence that fidgeting is often seen as a form of agitation and a negative symptom of dementia. Although therapy for agitation may be well established, there is a lack of appropriate items aimed at people in the later stage of dementia, that are not childlike or medical in their aesthetic. Individuals may fidget in a particular way and the tools in the Fidget Widget Toolkit have been designed to encourage repetitive movements of the hand, specifically to address the abilities of people with relatively advanced dementia. As an intervention, these tools provided a new approach that had not been tested in dementia care. Prototypes were created through an iterative design process and tested with a number of people with dementia and their carers, using quantitative and qualitative methods. Dementia Care Mapping was used to evaluate the impact of the intervention in group settings. Cohen Mansfield’s Agitation Inventory was used to record the daily use and interest of the intervention for people in their usual place of residence. The results informed the design of a new set of devices to promote safe, stigma free fidgeting as a positive experience, meaningful activity and enhance wellbeing for people in the later stage of dementia. The outcomes addressed the needs of individuals by reducing agitation and restlessness through helping them to connect, engage and act independently, providing the means of doing something for themselves that they were able to do. The next stage will be to explore the commercial feasibility of the Fidget Widget Toolkit so that it can be introduced as good practice and innovation in dementia care. It could be used by care homes, with carers and their families to support wellbeing and lead the way in providing some positive experiences and person-centred approaches that are lacking in the later stage of dementia.

Keywords: dementia, design, fidgeting, healthcare, positive moments, quality of life, wellbeing

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Authors: Sarpong Boateng, Rohit Balasundaram, Akua Afrah Amoah

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Introduction: Racial and Gender disparities have been found to be independently associated with Salivary Gland Cancers (SGCs) survival; however, to our best knowledge, there are no previous studies on the interplay of these social determinants on the prognosis of SGCs. The objective of this study was to examine the joint effect of race and gender on the survival of SGCs. Methods: We analyzed survival outcomes of 13,547 histologically confirmed cases of SGCs using the Surveillance Epidemiology and End Results (SEER) database (2004 to 2015). Multivariable Cox regression analysis and Kaplan-Meier curves were used to estimate hazard ratios (HR) after controlling for age, tumor characteristics, treatment type and year of diagnosis. Results: 73.5% of the participants were whites, 8.5% were blacks, 10.1% were Hispanics and 58.5% were males. Overall, males had poorer survival than females (HR = 1.16, p=0.003). In the adjusted multivariable model, there were no significant differences in survival by race. However, the interaction of gender and race was statistically significant (p=0.01) in Hispanic males. Thus, compared to White females (reference), Hispanic females had significantly better survival (HR=0.53), whiles Hispanic males had worse survival outcomes (HR=1.82) for SGCs. Conclusions: Our results show significant interactions between race and gender, with racial disparities varying across the different genders for SGCs survival. This study indicates that racial and gender differences are crucial factors to be considered in the prognostic counseling and management of patients with SGCs. Biologic factors, tumor genetic characteristics, chemotherapy, lifestyle, environmental exposures, and socioeconomic and dietary factors are potential yet proven reasons that could account for racial and gender differences in the survival of SGCs.

Keywords: salivary, cancer, survival, disparity, race, gender, SEER

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