Search results for: calculation of risk factor

Authors: David Tennison

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In the wake of the Covid-19 pandemic, a new chronic illness emerged onto the global stage: Long Covid. Long Covid presents with several symptoms commonly seen in other poorly-understood illnesses, such as fibromyalgia (FM) and myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). However, while Long Covid has swiftly become a recognised illness, FM and ME/CFS are still seen as contested, which impacts patient care and healthcare experiences. This study aims to examine what the differences are between Long Covid and FM; and if the Long Covid case can provide guidance for how to address the healthcare challenge of contested illnesses. To address this question, this study performed comprehensive research into the history of FM; our current biomedical understanding of it; and available healthcare interventions (within the context of the UK NHS). Analysis was undertaken of the stigma and stereotypes around FM, and a comparison made between FM and the emerging Long Covid literature, along with the healthcare response to Long Covid. This study finds that healthcare for chronic contested illnesses in the UK is vastly insufficient - in terms of pharmaceutical and holistic interventions, and the provision of secondary care options. Interestingly, for Long Covid, many of the treatment suggestions are pulled directly from those used for contested illnesses. The key difference is in terms of funding and momentum – Long Covid has generated exponentially more interest and research in a short time than there has been in the last few decades of contested illness research. This stands to help people with FM and ME/CFS – for example, research has recently been funded into “brain fog”, a previously elusive and misunderstood symptom. FM is culturally regarded as a “women’s disease” and FM stigma stems from notions of “hysteria”. A key finding is that the idea of FM affecting women disproportionally is not reflected in modern population studies. Emerging data on Long Covid also suggests a slight leaning towards more female patients, however it is less feminised, potentially due to it emerging in the global historical moment of the pandemic. Another key difference is that FM is rated as an extremely low-prestige illness by healthcare professionals, while it was in large part due to the advocacy of affected healthcare professionals that Long Covid was so quickly recognised by science and medicine. In conclusion, Long Covid (and the risk of future pandemics and post-viral illnesses) highlight a crucial need for implementing new, and reinforcing existing, care networks for chronic illnesses. The difference in how contested illnesses like FM, and new ones like Long Covid are treated have a lot to do with the historical moment in which they emerge – but cultural stereotypes, from within and without medicine, need updating. Particularly as they contribute to disease stigma that causes genuine harm to patients. However, widespread understanding and acceptance of Long Covid could help fight contested illness stigma, and the attention, funding and research into Long Covid may actually help raise the profile of contested illnesses and uncover answers about their symptomatology.

Keywords: long COVID, fibromyalgia, myalgic encephalomyelitis, chronic fatigue syndrome, NHS, healthcare, contested illnesses, chronic illnesses, COVID-19 pandemic

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Authors: Helen Nelly Naiga, Jane Frances Zalwango, Saudah N. Kizito, Brian Agaba, Brenda N Simbwa, Maria Goretti Zalwango, Richard Migisha, Benon Kwesiga, Daniel Kadobera, Alex Ario Riolexus, Sarah Paige, Julie R. Harris

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Background: Traditional community beliefs and practices can facilitate the spread of Ebola virus during outbreaks. On September 20, 2022, Uganda declared a Sudan Virus Disease (SVD) outbreak after a case was confirmed in Mubende District. During September–November 2022, the outbreak spread to eight additional districts. We investigated the role of community beliefs and practices in the spread of SUDV in Uganda in 2022. Methods: A qualitative study was conducted in Mubende, Kassanda, and Kyegegwa districts in February 2023. We conducted nine focus group discussions (FGDs) and six key informant interviews (KIIs). FGDs included SVD survivors, household members of SVD patients, traditional healers, religious leaders, and community leaders. Key informants included community, political, and religious leaders, traditional healers, and health workers. We asked about community beliefs and practices to understand if and how they contributed to the spread of SUDV. Interviews were recorded, translated, transcribed, and analyzed thematically. Results: Frequently-reported themes included beliefs that the community deaths, later found to be due to SVD, were the result of witchcraft or poisoning. Key informants reported that SVD patients frequently first consulted traditional healers or spiritual leaders before seeking formal healthcare, and noted that traditional healers treated patients with signs and symptoms of SVD without protective measures. Additional themes included religious leaders conducting laying-on-of-hands prayers for SVD patients and symptomatic contacts, SVD patients and their symptomatic contacts hiding in friends’ homes, and exhumation of SVD patients originally buried in safe and dignified burials, to enable traditional burials. Conclusion: Multiple community beliefs and practices likely promoted SVD outbreak spread during the 2022 outbreak in Uganda. Engaging traditional and spiritual healers early during similar outbreaks through risk communication and community engagement efforts could facilitate outbreak control. Targeted community messaging, including clear biological explanations for clusters of deaths and information on the dangers of exhuming bodies of SVD patients, could similarly facilitate improved control in future outbreaks in Uganda.

Keywords: Ebola, Sudan virus, outbreak, beliefs, traditional

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Authors: Hui-Chieh Li

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Circular economy promotes greater resource productivity and avoids pollution through greater recycling and re-use which bring benefits for both the environment and the economy. The concept is contrast to a linear economy which is ‘take, make, dispose’ model of production. A well-design reverse logistics service strategy could enhance the willingness of recycling of the users and reduce the related logistics cost as well as carbon emissions. Moreover, the recycle brings the manufacturers most advantages as it targets components for closed-loop reuse, essentially converting materials and components from worn-out product into inputs for new ones at right time and right place. This study considers demand-supply interaction, time-dependent recycle demand, time-dependent surplus value of recycled product and constructs models on recycle service strategy for the recyclable waste collector. A crucial factor in optimizing a recycle service strategy is consumer demand. The study considers the relationships between consumer demand towards recycle and product characteristics, surplus value and user behavior. The study proposes a recycle service strategy which differs significantly from the conventional and typical uniform service strategy. Periods with considerable demand and large surplus product value suggest frequent and short service cycle. The study explores how to determine a recycle service strategy for recyclable waste collector in terms of service cycle frequency and duration and vehicle type for all service cycles by considering surplus value of recycled product, time-dependent demand, transportation economies and demand-supply interaction. The recyclable waste collector is responsible for the collection of waste product for the manufacturer. The study also examines the impacts of utilization rate on the cost and profit in the context of different sizes of vehicles. The model applies mathematical programming methods and attempts to maximize the total profit of the distributor during the study period. This study applies the binary logit model, analytical model and mathematical programming methods to the problem. The model specifically explores how to determine a recycle service strategy for the recycler by considering product surplus value, time-dependent recycle demand, transportation economies and demand-supply interaction. The model applies mathematical programming methods and attempts to minimize the total logistics cost of the recycler and maximize the recycle benefits of the manufacturer during the study period. The study relaxes the constant demand assumption and examines how service strategy affects consumer demand towards waste recycling. Results of the study not only help understanding how the user demand for recycle service and product surplus value affects the logistics cost and manufacturer’s benefits, but also provide guidance such as award bonus and carbon emission regulations for the government.

Keywords: circular economy, consumer demand, product surplus value, recycle service strategy

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Authors: Elizabeth Crafton, Donald Ott, Teresa Cutright

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Harmful algal blooms (HABs), more notably cyanobacteria-dominated HABs, compromise water quality, jeopardize access to drinking water and are a risk to public health and safety. HABs are representative of ecosystem imbalance largely caused by environmental changes, such as eutrophication, that are associated with the globally expanding human population. Cyanobacteria-dominated HABs are anticipated to increase in frequency, magnitude, and are predicted to plague a larger geographical area as a result of climate change. The weather pattern is important as storm-driven, pulse-input of nutrients have been correlated to cyanobacteria-dominated HABs. The mobilization of aqueous and particulate nutrients and the response of the phytoplankton community is an important relationship in this complex phenomenon. This relationship is most apparent in high-impact areas of adequate sunlight, > 20ᵒC, excessive nutrients and quiescent water that corresponds to ideal growth of HABs. Typically the impact of particulate phosphorus is dismissed as an insignificant contribution; which is true for areas that are not considered high-impact. The objective of this study was to assess the impact of a simulated storm-driven, pulse-input of reactive phosphorus and the response of three different cyanobacteria assemblages (~5,000 cells/mL). The aqueous and particulate sources of phosphorus and changes in HAB were tracked weekly for 4 weeks. The first cyanobacteria composition consisted of Planktothrix sp., Microcystis sp., Aphanizomenon sp., and Anabaena sp., with 70% of the total population being non-diazotrophic and 30% being diazotrophic. The second was comprised of Anabaena sp., Planktothrix sp., and Microcystis sp., with 87% diazotrophic and 13% non-diazotrophic. The third composition has yet to be determined as these experiments are ongoing. Preliminary results suggest that both aqueous and particulate sources are contributors of total reactive phosphorus in high-impact areas. The results further highlight shifts in the cyanobacteria assemblage after the simulated pulse-input. In the controls, the reactors dosed with aqueous reactive phosphorus maintained a constant concentration for the duration of the experiment; whereas, the reactors that were dosed with aqueous reactive phosphorus and contained soil decreased from 1.73 mg/L to 0.25 mg/L of reactive phosphorus from time zero to 7 days; this was higher than the blank (0.11 mg/L). Suggesting a binding of aqueous reactive phosphorus to sediment, which is further supported by the positive correlation observed between total reactive phosphorus concentration and turbidity. The experiments are nearly completed and a full statistical analysis will be completed of the results prior to the conference.

Keywords: Anabaena, cyanobacteria, harmful algal blooms, Microcystis, phosphorous, response surface methodology

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Authors: Ritika Chaturvedi

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Introduction: Sexual objectification, characterized by the reduction of an individual to a mere object of sexual desire, remains a pervasive societal issue with profound repercussions on individual well-being. Such experiences, often rooted in systemic and cultural norms, have long-lasting implications for mental and emotional health. This study aims to explore the intricate relationship between experiences of sexual objectification and insidious trauma, further investigating the potential moderating effects of overexcitabilities as proposed by Dabrowski's theory of positive disintegration. Methodology: The research involved a comprehensive cohort of 204 women, spanning ages from 18 to 65 years. Participants were tasked with completing self-administered questionnaires designed to capture their experiences with sexual objectification. Additionally, the questionnaire assessed symptoms indicative of insidious trauma and explored overexcitabilities across five distinct domains: emotional, intellectual, psychomotor, sensory, and imaginational. Employing advanced statistical techniques, including multiple regression and moderation analysis, the study sought to decipher the intricate interplay among these variables. Findings: The study's results revealed a compelling positive correlation between experiences of sexual objectification and the onset of symptoms indicative of insidious trauma. This correlation underscores the profound and detrimental effects of sexual objectification on an individual's psychological well-being. Interestingly, the moderation analyses introduced a nuanced understanding, highlighting the differential roles of various overexcitabilities. Specifically, emotional, intellectual, and sensual overexcitabilities were found to exacerbate trauma symptomatology. In contrast, psychomotor overexcitability emerged as a protective factor, demonstrating a mitigating influence on the relationship between sexual objectification and trauma. Implications: The study's findings hold significant implications for a diverse array of stakeholders, encompassing mental health practitioners, educators, policymakers, and advocacy groups. The identified moderating effects of overexcitabilities emphasize the need for tailored interventions that consider individual differences in coping and resilience mechanisms. By recognizing the pivotal role of overexcitabilities in modulating the traumatic consequences of sexual objectification, this research advocates for the development of more nuanced and targeted support frameworks. Moreover, the study underscores the importance of continued research endeavors to unravel the intricate mechanisms and dynamics underpinning these relationships. Such endeavors are crucial for fostering the evolution of informed, evidence-based interventions and strategies aimed at mitigating the adverse effects of sexual objectification and promoting holistic well-being.

Keywords: sexual objectification, insidious trauma, emotional overexcitability, intellectual overexcitability, sensual overexcitability, psychomotor overexcitability, imaginational overexcitability

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Authors: Natalie Tyldesley-Marshall, Janette Parr, Anna Brown, Yen-Fu Chen, Amy Grove

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It is widely recognised in policy and research that the provision of services for children and young people (CYP) with Special Educational Needs and Disabilities (SEND) is enhanced when health and social care, and education services collaborate and interact effectively. In the UK, there have been significant changes to policy and provisions which support and improve collaboration. However, professionals responsible for implementing these changes face multiple challenges, including a lack of specific implementation guidance or framework to illustrate how effective multi-agency working could or should work. This systematic review will identify the key components of effective multi-agency working in services for CYP with SEND; and the most effective forms of partnership working in this setting. The review highlights interventions that lead to service improvements; and the conditions in the local area that support and encourage success. A protocol was written and registered with PROSPERO registration: CRD42022352194. Searches were conducted on several health, care, education, and applied social science databases from the year 2012 onwards. Citation chaining has been undertaken, as well as broader grey literature searching to enrich the findings. Qualitative, quantitative, mixed methods studies and systematic reviews were included, assessed independently, and critically appraised or assessed for risk of bias using appropriate tools based on study design. Data were extracted in NVivo software and checked by a more experienced researcher. A convergent segregated approach to synthesis and integration was used in which the quantitative and qualitative data were synthesised independently and then integrated using a joint display integration matrix. Findings demonstrate the key ingredients for effective partnership working for services delivering SEND. Interventions deemed effective are described, and lessons learned across interventions are summarised. Results will be of interest to educators and health and social care professionals that provide services to those with SEND. These will also be used to develop policy recommendations for how UK healthcare, social care, and education services for CYP with SEND aged 0-25 can most effectively collaborate and achieve service improvement. The review will also identify any gaps in the literature to recommend areas for future research. Funding for this review was provided by the Department for Education.

Keywords: collaboration, joint commissioning, service delivery, service improvement

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Authors: Agâh Tuğrul Korucu, Ismail Fatih Yavuzaslan, Lale Toraman

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Nowadays, thanks to development of technology, integration of technology into teaching and learning activities is spreading. Increasing technological literacy which is one of the expected competencies for individuals of 21st century is associated with the effective use of technology in education. The most important factor in effective use of technology in education institutions is ICT teachers. The concept of computer assisted instruction (CAI) refers to the utilization of information and communication technology as a tool aided teachers in order to make education more efficient and improve its quality in the process of educational. Teachers can use computers in different places and times according to owned hardware and software facilities and characteristics of the subject and student in CAI. Analyzing teachers’ use of computers in education is significant because teachers are the ones who manage the course and they are the most important element in comprehending the topic by students. To accomplish computer-assisted instruction efficiently is possible through having positive attitude of teachers. Determination the level of knowledge, attitude and behavior of teachers who get the professional knowledge from educational faculties and elimination of deficiencies if any are crucial when teachers are at the faculty. Therefore, the aim of this paper is to identify ICT teachers' attitudes toward computer-assisted instruction in terms of different variables. Research group consists of 200 prospective ICT teachers studying at Necmettin Erbakan University Ahmet Keleşoğlu Faculty of Education CEIT department. As data collection tool of the study; “personal information form” developed by the researchers and used to collect demographic data and "the attitude scale related to computer-assisted instruction" are used. The scale consists of 20 items. 10 of these items show positive feature, while 10 of them show negative feature. The Kaiser-Meyer-Olkin (KMO) coefficient of the scale is found 0.88 and Barlett test significance value is found 0.000. The Cronbach’s alpha reliability coefficient of the scale is found 0.93. In order to analyze the data collected by data collection tools computer-based statistical software package used; statistical techniques such as descriptive statistics, t-test, and analysis of variance are utilized. It is determined that the attitudes of prospective instructors towards computers do not differ according to their educational branches. On the other hand, the attitudes of prospective instructors who own computers towards computer-supported education are determined higher than those of the prospective instructors who do not own computers. It is established that the departments of students who previously received computer lessons do not affect this situation so much. The result is that; the computer experience affects the attitude point regarding the computer-supported education positively.

Keywords: computer based instruction, teacher candidate, attitude, technology based instruction, information and communication technologies

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Authors: Palash Bandyopadhyay

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Background and significance of the study: Crude oil and natural gas is of crucial importance due to its increasing demand in India. The demand has been increased because of change of lifestyle overtime. Since India has poor utilization of oil production capacity, constantly the import of it has been increased progressively day by day. This ultimately hit the foreign exchange reserves of India, however it negatively affect the Indian economy as well. The financial performance of crude oil and natural gas companies in India has been trimmed down year after year because of underutilization of production capacity, enhancement of demand, change in life style, and change in import bill and outflows of foreign currencies. In this background, the current study seeks to measure the financial performance of crude oil and natural gas companies of India in the post liberalization period. Keeping in view of this, this study assesses the financial performance in terms of liquidity management, solvency, efficiency, financial stability, and profitability of the companies under study. Methodology: This research work is encircled on yearly ratio data collected from Centre for Monitoring Indian Economy (CMIE) Prowess database for the periods between 1993-94 and 2012-13 with 20 observations using liquidity, solvency and efficiency indicators, profitability indicators and financial stability indicators of all the major crude oil and natural gas companies in India. In the course of analysis, descriptive statistics, correlation statistics, and linear regression test have been utilized. Major findings: Descriptive statistics indicate that liquidity position is satisfactory in case of three crude oil and natural gas companies (Oil and Natural Gas Companies Videsh Limited, Oil India Limited and Selan exploration and transportation Limited) out of selected companies under study but solvency position is satisfactory only for one company (Oil and Natural Gas Companies Videsh Limited). However, efficiency analysis points out that Oil and Natural Gas Companies Videsh Limited performs effectively the management of inventory, receivables, and payables, but the overall liquidity management is not well. Profitability position is very much satisfactory in case of all the companies except Tata Petrodyne Limited, but profitability management is not satisfactory for all the companies under study. Financial stability analysis shows that all the companies are more dependent on debt capital, which bears a financial risk. Correlation and regression test results illustrates that profitability is positively and negatively associated with liquidity, solvency, efficiency, and financial stability indicators. Concluding statement: Management of liquidity and profitability of crude oil and natural gas companies in India should have been improved through controlling unnecessary imports in spite of the heavy demand of crude oil and natural gas in India and proper utilization of domestic oil reserves. At the same time, Indian government has to concern about rupee depreciation and interest rates.

Keywords: financial performance, crude oil and natural gas companies, India, linear regression

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Authors: M. Qamarul Islam, Ergun Dogan, Mehmet Yazici

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There is a growing body of evidence that non-normal data is more prevalent in nature than the normal one. Examples can be quoted from, but not restricted to, the areas of Economics, Finance and Actuarial Science. The non-normality considered here is expressed in terms of fat-tailedness and asymmetry of the relevant distribution. In this study a skew t distribution that can be used to model a data that exhibit inherent non-normal behavior is considered. This distribution has tails fatter than a normal distribution and it also exhibits skewness. Although maximum likelihood estimates can be obtained by solving iteratively the likelihood equations that are non-linear in form, this can be problematic in terms of convergence and in many other respects as well. Therefore, it is preferred to use the method of modified maximum likelihood in which the likelihood estimates are derived by expressing the intractable non-linear likelihood equations in terms of standardized ordered variates and replacing the intractable terms by their linear approximations obtained from the first two terms of a Taylor series expansion about the quantiles of the distribution. These estimates, called modified maximum likelihood estimates, are obtained in closed form. Hence, they are easy to compute and to manipulate analytically. In fact the modified maximum likelihood estimates are equivalent to maximum likelihood estimates, asymptotically. Even in small samples the modified maximum likelihood estimates are found to be approximately the same as maximum likelihood estimates that are obtained iteratively. It is shown in this study that the modified maximum likelihood estimates are not only unbiased but substantially more efficient than the commonly used moment estimates or the least square estimates that are known to be biased and inefficient in such cases. Furthermore, in conventional regression analysis, it is assumed that the error terms are distributed normally and, hence, the well-known least square method is considered to be a suitable and preferred method for making the relevant statistical inferences. However, a number of empirical researches have shown that non-normal errors are more prevalent. Even transforming and/or filtering techniques may not produce normally distributed residuals. Here, a study is done for multiple linear regression models with random error having non-normal pattern. Through an extensive simulation it is shown that the modified maximum likelihood estimates of regression parameters are plausibly robust to the distributional assumptions and to various data anomalies as compared to the widely used least square estimates. Relevant tests of hypothesis are developed and are explored for desirable properties in terms of their size and power. The tests based upon modified maximum likelihood estimates are found to be substantially more powerful than the tests based upon least square estimates. Several examples are provided from the areas of Economics and Finance where such distributions are interpretable in terms of efficient market hypothesis with respect to asset pricing, portfolio selection, risk measurement and capital allocation, etc.

Keywords: least square estimates, linear regression, maximum likelihood estimates, modified maximum likelihood method, non-normality, robustness

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Authors: Fong-Zuo Lee, Jihn-Sung Lai, Yung-Bin Lin, Xiaoqin Liu, Kuo-Chun Chang, Zhi-Xian Yang, Wen-Dar Guo, Jian-Hao Hong

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In recent years, climate change is a major factor to increase rainfall intensity and extreme rainfall frequency. The increased rainfall intensity and extreme rainfall frequency will increase the probability of flash flood with abundant sediment transport in a river basin. The floods caused by heavy rainfall may cause damages to the bridge, embankment, hydraulic works, and the other disasters. Therefore, the foundation scouring of bridge pier, embankment and spur dike caused by floods has been a severe problem in the worldwide. This severe problem has happened in many East Asian countries such as Taiwan and Japan because of these areas are suffered in typhoons, earthquakes, and flood events every year. Results from the complex interaction between fluid flow patterns caused by hydraulic works and the sediment transportation leading to the formation of river morphology, it is extremely difficult to develop a reliable and durable sensor to measure river bed degradation and bridge pier scouring. Therefore, an innovative scour monitoring sensor using vibration-based Micro-Electro Mechanical Systems (MEMS) was developed. This vibration-based MEMS sensor was packaged inside a stainless sphere with the proper protection of the full-filled resin, which can measure free vibration signals to detect scouring/deposition processes at the bridge pier. In addition, a friendly operational system includes rainfall runoff model, one-dimensional and two-dimensional numerical model, and the applicability of sediment transport equation and local scour formulas of bridge pier are included in this research. The friendly operational system carries out the simulation results of flood events that includes the elevation changes of river bed erosion near the specified bridge pier and the erosion depth around bridge piers. In addition, the system is developed with easy operation and integrated interface, the system can supplies users to calibrate and verify numerical model and display simulation results through the interface comparing to the scour monitoring sensors. To achieve the forecast of the erosion depth of river bed and main bridge pier in the study area, the system also connects the rainfall forecast data from Taiwan Typhoon and Flood Research Institute. The results can be provided available information for the management unit of river and bridge engineering in advance.

Keywords: flash flood, river bed degradation, bridge pier scouring, a friendly operational system

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Authors: Mohammad R. Bhuyan, Mohammad J. Khattak

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Deterioration of flexible pavements due to crack reflection from its soil-cement base layer is a major concern around the globe. The service life of flexible pavement diminishes significantly because of the reflective cracks. Highway agencies are struggling for decades to prevent or mitigate these cracks in order to increase pavement service lives. The root cause of reflective cracks is the shrinkage crack which occurs in the soil-cement bases during the cement hydration process. The primary factor that causes the shrinkage is the cement content of the soil-cement mixture. With the increase of cement content, the soil-cement base gains strength and durability, which is necessary to withstand the traffic loads. But at the same time, higher cement content creates more shrinkage resulting in more reflective cracks in pavements. Historically, various states of USA have used the soil-cement bases for constructing flexile pavements. State of Louisiana (USA) had been using 8 to 10 percent of cement content to manufacture the soil-cement bases. Such traditional soil-cement bases yield 2.0 MPa (300 psi) 7-day compressive strength and are termed as cement stabilized design (CSD). As these CSD bases generate significant reflective cracks, another design of soil-cement base has been utilized by adding 4 to 6 percent of cement content called cement treated design (CTD), which yields 1.0 MPa (150 psi) 7-day compressive strength. The reduction of cement content in the CTD base is expected to minimize shrinkage cracks thus increasing pavement service lives. Hence, this research study evaluates the long-term field performance of CTD bases with respect to CSD bases used in flexible pavements. Pavement Management System of the state of Louisiana was utilized to select flexible pavement projects with CSD and CTD bases that had good historical record and time-series distress performance data. It should be noted that the state collects roughness and distress data for 1/10th mile section every 2-year period. In total, 120 CSD and CTD projects were analyzed in this research, where more than 145 miles (CTD) and 175 miles (CSD) of roadways data were accepted for performance evaluation and benefit-cost analyses. Here, the service life extension and area based on distress performance were considered as benefits. It was found that CTD bases increased 1 to 5 years of pavement service lives based on transverse cracking as compared to CSD bases. On the other hand, the service lives based on longitudinal and alligator cracking, rutting and roughness index remain the same. Hence, CTD bases provide some service life extension (2.6 years, on average) to the controlling distress; transverse cracking, but it was inexpensive due to its lesser cement content. Consequently, CTD bases become 20% more cost-effective than the traditional CSD bases, when both bases were compared by net benefit-cost ratio obtained from all distress types.

Keywords: cement treated base, cement stabilized base, reflective cracking , service life, flexible pavement

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Authors: Thomas J. Bell III

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This paper explores the value of assimilating certification training within a traditional course curriculum. This innovative approach is believed to increase stakeholder value within the Computer Information System program at Texas Wesleyan University. Stakeholder value is obtained from increased job marketability and critical thinking skills that create employment-ready graduates. This paper views value as first developing the capability to earn an industry-recognized certification, which provides the student with more job placement compatibility while allowing the use of critical thinking skills in a liberal arts business program. Graduates with industry-based credentials are often given preference in the hiring process, particularly in the information technology sector. And without a pioneering curriculum that better prepares students for an ever-changing employment market, its educational value is dubiously questioned. Since certifications are trending in the hiring process, academic programs should explore the viability of incorporating certification training into teaching pedagogy and courses curriculum. This study will examine the use of the balanced scorecard across four performance dimensions (financial, customer, internal process, and innovation) to measure the stakeholder value of certification training within a traditional course curriculum. The balanced scorecard as a strategic management tool may provide insight for leveraging resource prioritization and decisions needed to achieve various curriculum objectives and long-term value while meeting multiple stakeholders' needs, such as students, universities, faculty, and administrators. The research methodology will consist of quantitative analysis that includes (1) surveying over one-hundred students in the CIS program to learn what factor(s) contributed to their certification exam success or failure, (2) interviewing representatives from the Texas Workforce Commission to identify the employment needs and trends in the North Texas (Dallas/Fort Worth) area, (3) reviewing notable Workforce Innovation and Opportunity Act publications on training trends across several local business sectors, and (4) analyzing control variables to identify specific correlations between industry alignment and job placement to determine if a correlation exists. These findings may provide helpful insight into impactful pedagogical teaching techniques and curriculum that positively contribute to certification credentialing success. And should these industry-certified students land industry-related jobs that correlate with their certification credential value, arguably, stakeholder value has been realized.

Keywords: certification exam teaching pedagogy, exam preparation, testing techniques, exam study tips, passing certification exams, embedding industry certification and curriculum alignment, balanced scorecard performance evaluation

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Authors: Tin Yee Ling, Kavita Maravar, Ruzica Ardalic

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Background: Uterine torsion (UT) in pregnancy of more than 45-degree along the longitudinal axis is a rare occurrence, and the aetiology remains unclear. Case: A 34-year-old G2P1 woman with a history of one previous caesarean section presented at 36+2 weeks with sudden onset lower abdominal pain, syncopal episode, and tender abdomen on examination. She was otherwise haemodynamically stable. Cardiotocography showed a pathological trace with initial prolonged bradycardia followed by a subsequent tachycardia with reduced variability. An initial diagnosis of uterine dehiscence was made, given the history and clinical presentation. She underwent an emergency caesarean section which revealed a 180-degree UT along the longitudinal axis, with oedematous left round ligament lying transverse anterior to the uterus and a segment of large bowel inferior to the round ligament. Detorsion of uterus was performed prior to delivery of the foetus, and anterior uterine wall was intact with no signs of rupture. There were no anatomical uterine abnormalities found other than stretched left ovarian and round ligaments, which were repaired. Delivery was otherwise uneventful, and she was discharged on day 2 postpartum. Discussion: UT is rare as the number of reported cases is within the few hundreds worldwide. Generally, the uterus is supported in place by uterine ligaments, which limit the mobility of the structure. The causes of UT are unknown, but risk factors such as uterine abnormalities, increased uterine ligaments’ flexibility in pregnancy, and foetal malposition has been identified. UT causes occlusion of uterine vessels, which can lead to ischaemic injury of the placenta causing premature separation of the placenta, preterm labour, and foetal morbidity and mortality if delivery is delayed. Diagnosing UT clinically is difficult as most women present with symptoms similar to placenta abruption or uterine rupture (abdominal pain, vaginal bleeding, shock), and one-third are asymptomatic. The management of UT involves surgical detorsion of the uterus and delivery of foetus via caesarean section. Extra vigilance should be taken to identify the anatomy of the uterus experiencing torsion prior to hysterotomy. There have been a few cases reported with hysterotomy on posterior uterine wall for delivery of foetus as it may be difficult to identify and reverse a gravid UT when foetal well-being is at stake. Conclusion: UT should be considered a differential diagnosis of acute abdominal pain in pregnancy. It is crucial that the torsion is addressed immediately as it is associated with maternal and foetal morbidity and mortality.

Keywords: uterine torsion, pregnancy complication, abdominal pain, torted uterus

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Authors: Vivek Bhat, Rohini Kelkar, Sanjay Biswas

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Introduction: Cancer patients are at increased risk of bacterial infections. This may due to the disease process itself, the effect of chemotherapeutic drugs or invasive procedures such as catheterization. A wide variety of bacteria including some emerging pathogens are increasingly being reported from these patients. The incidence of multidrug-resistant organisms particularly in the Gram negative group is also increasing, with higher resistance rates seen to cephalosporins, β-lactam/β-lactam inhibitor combinations, and the carbapenems. This study documents the bacteriological spectrum of infections and their resistance patterns in cancer patients. Methods: This study includes all bacterial isolates recovered from infections cancer patients over a period of 18 months. Samples included Blood cultures, Pus/wound swabs, urine, tissue biopsies, body fluids, catheter tips and respiratory specimens such as sputum and bronchoalveolar lavage (BAL). All samples were processed in the microbiology laboratory as per standard laboratory protocols. Organisms were identified to species level and antimicrobial susceptibility testing was performed manually by the disc diffusion technique or in the Vitek-2 (Biomereux, France) instrument. Interpretations were as per Clinical laboratory Standards Institute (CLSI) guidelines. Results: A total of 1150 bacterial isolates were cultured from 884 test samples during the study period. Of these 227 were Gram-positive and 923 were Gram-negative organisms. Staphylococcus aureus (99 isolates) was the commonest Gram-positive isolate followed by Enterococcus (79) and Gr A Streptococcus (30). Among the Gram negatives, E. coli (304), Pseudomonas aeruginosa (201) and Klebsiella pneumoniae (190) were the most common. Of the Staphylococcus aureus isolates 27.2% were methicillin resistant. Only 5.06% enterococci were vancomycin resistant. High rates of resistance to cefotaxime and ciprofloxacin were seen amongst E. coli (84.8% & 83.55%) and Klebsiella pneumoniae (71 & 62.1%) respectively. Resistance to carbapenems (meropenem) was high at 70% in Acinetobacter spp.; however all isolates were sensitive to colistin. Among the aminoglycosides, amikacin retained good efficacy against Escherichia coli (82.9%) and Pseudomonas aeruginosa (78.1%). Occasional isolates of emerging pathogens such as Chryseobacterium indologens, Roseomonas, and Achromobacter xyloxidans were also recovered. Conclusion: The common infections in cancer patients include respiratory, wound, tract infections and sepsis. The commonest isolates include Staphylococcus aureus, Enterococci, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. There is a high level of resistance to the commonly used antibiotics among Gram-negative organisms.

Keywords: bacteria, resistance, infection, cancer

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Authors: Mustafa İlhan Akbaş, Özlem Garibay, Ivan Garibay

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The economic entities in innovation ecosystems form various industry clusters, in which they compete and cooperate to survive and grow. Within a successful and stable industry cluster, the entities acquire different roles that complement each other in the system. The universities and research centers have been accepted to have a critical role in these systems for the creation and development of innovations. However, the real effect of research institutions on regional economic growth is difficult to assess. In this paper, we present our approach for the identification of the impact of research activities on the regional entrepreneurship for a specific high-tech industry: optics and photonics. The optics and photonics has been defined as an enabling industry, which combines the high-tech photonics technology with the developing optics industry. The recent literature suggests that the growth of optics and photonics firms depends on three important factors: the embedded regional specializations in the labor market, the research and development infrastructure, and a dynamic small firm network capable of absorbing new technologies, products and processes. Therefore, the role of each factor and the dynamics among them must be understood to identify the requirements of the entrepreneurship activities in optics and photonics industry. There are three main contributions of our approach. The recent studies show that the innovation in optics and photonics industry is mostly located around metropolitan areas. There are also studies mentioning the importance of research center locations and universities in the regional development of optics and photonics industry. These studies are mostly limited with the number of patents received within a short period of time or some limited survey results. Therefore the first contribution of our approach is conducting a comprehensive analysis for the state and recent history of the photonics and optics research in the US. For this purpose, both the research centers specialized in optics and photonics and the related research groups in various departments of institutions (e.g. Electrical Engineering, Materials Science) are identified and a geographical study of their locations is presented. The second contribution of the paper is the analysis of regional entrepreneurship activities in optics and photonics in recent years. We use the membership data of the International Society for Optics and Photonics (SPIE) and the regional photonics clusters to identify the optics and photonics companies in the US. Then the profiles and activities of these companies are gathered by extracting and integrating the related data from the National Establishment Time Series (NETS) database, ES-202 database and the data sets from the regional photonics clusters. The number of start-ups, their employee numbers and sales are some examples of the extracted data for the industry. Our third contribution is the utilization of collected data to investigate the impact of research institutions on the regional optics and photonics industry growth and entrepreneurship. In this analysis, the regional and periodical conditions of the overall market are taken into consideration while discovering and quantifying the statistical correlations.

Keywords: entrepreneurship, industrial clusters, optics, photonics, emerging industries, research centers

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Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: TPO antibody, subclinical hypothyroidism, anti nuclear antibody, thyroxin

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Authors: Sonia Boulos

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The prohibition on ‘inhuman treatment’ constitutes one of the central tenets of modern international human rights law. It is incorporated in principal international human rights instruments including Article 5 of the Universal Declaration of Human Rights, and Article 7 of the International Covenant on Civil and Political Rights. However, in the absence of any legislative definition of the term ‘inhuman’, its interpretation becomes challenging. The aim of this article is to critically analyze the interpretation of the term ‘inhuman’ in international human rights law and to suggest a new approach to construct its meaning. The article is composed of two central parts. The first part is a critical appraisal of the interpretation of the term ‘inhuman’ by supra-national human rights law institutions. It highlights the failure of supra-national institutions to provide an independent definition for the term ‘inhuman’. In fact, those institutions consistently fail to distinguish the term ‘inhuman’ from its other kin terms, i.e. ‘cruel’ and ‘degrading.’ Very often, they refer to these three prohibitions as ‘CIDT’, as if they were one collective. They were primarily preoccupied with distinguishing ‘CIDT’ from ‘torture.’ By blurring the conceptual differences between these three terms, supra-national institutions supplemented them with a long list of specific and purely descriptive subsidiary rules. In most cases, those subsidiary rules were announced in the absence of sufficient legal reasoning explaining how they were derived from abstract and evaluative standards embodied in the prohibitions collectively referred to as ‘CIDT.’ By opting for this option, supra-national institutions have created the risk for the development of an incoherent body of jurisprudence on those terms at the international level. They also have failed to provide guidance for domestic courts on how to enforce these prohibitions. While blurring the differences between the terms ‘cruel,’ ‘inhuman,’ and ‘degrading’ has consequences for the three, the term ‘inhuman’ remains the most impoverished one. It is easy to link the term ‘cruel’ to the clause on ‘cruel and unusual punishment’ originating from the English Bill of Rights of 1689. It is also easy to see that the term ‘degrading’ reflects a dignatarian ideal. However, when we turn to the term ‘inhuman’, we are left without any interpretative clue. The second part of the article suggests that the ordinary meaning of the word ‘inhuman’ should be our first clue. However, regaining the conceptual independence of the term ‘inhuman’ requires more than a mere reflection on the word-meaning of the term. Thus, the second part introduces philosophical concepts related to the understanding of what it means to be human. It focuses on ‘the capabilities approach’ and the notion of ‘human functioning’, introduced by Amartya Sen and further explored by Martha Nussbaum. Nussbaum’s work on the basic human capabilities is particularly helpful or even vital for understanding the moral and legal substance of the prohibition on ‘inhuman’ treatment.

Keywords: inhuman treatment, capabilities approach, human functioning, supra-national institutions

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Authors: Neha Pranav Kolhe, Harithapriya Vijaye, Arushi Kamle

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The economic growth engines are urban regions. As the economy expands, so does the need for peace and quiet, and noise pollution is one of the important social and environmental issue. Health and wellbeing are at risk from environmental noise pollution. Because of urbanisation, population growth, and the consequent rise in the usage of increasingly potent, diverse, and highly mobile sources of noise, it is now more severe and pervasive than ever before, and it will only become worse. Additionally, it will expand as long as there is an increase in air, train, and highway traffic, which continue to be the main contributors of noise pollution. The current study will be conducted in two zones of class I city of central India (population range: 1 million–4 million). Total 56 measuring points were chosen to assess noise pollution. The first objective evaluates the noise pollution in various urban habitats determined as formal and informal settlement. It identifies the comparison of noise pollution within the settlements using T- Test analysis. The second objective assess the noise pollution in silent zones (as stated in Central Pollution Control Board) in a hierarchical way. It also assesses the noise pollution in the settlements and compares with prescribed permissible limits using class I sound level equipment. As appropriate indices, equivalent noise level on the (A) frequency weighting network, minimum sound pressure level and maximum sound pressure level were computed. The survey is conducted for a period of 1 week. Arc GIS is used to plot and map the temporal and spatial variability in urban settings. It is discovered that noise levels at most stations, particularly at heavily trafficked crossroads and subway stations, were significantly different and higher than acceptable limits and squares. The study highlights the vulnerable areas that should be considered while city planning. The study demands area level planning while preparing a development plan. It also demands attention to noise pollution from the perspective of residential and silent zones. The city planning in urban areas neglects the noise pollution assessment at city level. This contributes to that, irrespective of noise pollution guidelines, the ground reality is far away from its applicability. The result produces incompatible land use on a neighbourhood scale with respect to noise pollution. The study's final results will be useful to policymakers, architects and administrators in developing countries. This will be useful for noise pollution in urban habitat governance by efficient decision making and policy formulation to increase the profitability of these systems.

Keywords: noise pollution, formal settlements, informal settlements, built environment, silent zone, residential area

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Authors: Huimin Liu, Li Xiang, Yue Liu, Jing Wang

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Background: As one of typical case for the developing countries who are stepping into the aging times globally, more and more older people in China might face the problem of which they could not maintain normal life due to the functional disability. While the government take efforts to build long-term care system and further carry out related policies for the core concept, there is still lack of strong evidence to evaluating the profile of disability states in the elderly population and its transition rate. It has been proved that disability is a dynamic condition of the person rather than irreversible so it means possible to intervene timely on them who might be in a risk of severe disability. Objective: The aim of this study was to depict the picture of the disability transferring status of the older people in China, and then find out individual characteristics that change the state of disability to provide theory basis for disability prevention and early intervention among elderly people. Methods: Data for this study came from the 2011 baseline survey and the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Normal ADL function, 1~2 ADLs disability,3 or above ADLs disability and death were defined from state 1 to state 4. Multi-state Markov model was applied and the four-state homogeneous model with discrete states and discrete times from two visits follow-up data was constructed to explore factors for various progressive stages. We modeled the effect of explanatory variables on the rates of transition by using a proportional intensities model with covariate, such as gender. Result: In the total sample, state 2 constituent ratio is nearly about 17.0%, while state 3 proportion is blow the former, accounting for 8.5%. Moreover, ADL disability statistics difference is not obvious between two years. About half of the state 2 in 2011 improved to become normal in 2013 even though they get elder. However, state 3 transferred into the proportion of death increased obviously, closed to the proportion back to state 2 or normal functions. From the estimated intensities, we see the older people are eleven times as likely to develop at 1~2 ADLs disability than dying. After disability onset (state 2), progression to state 3 is 30% more likely than recovery. Once in state 3, a mean of 0.76 years is spent before death or recovery. In this model, a typical person in state 2 has a probability of 0.5 of disability-free one year from now while the moderate disabled or above has a probability of 0.14 being dead. Conclusion: On the long-term care cost considerations, preventive programs for delay the disability progression of the elderly could be adopted based on the current disabled state and main factors of each stage. And in general terms, those focusing elderly individuals who are moderate or above disabled should go first.

Keywords: Markov model, elderly people, disability, transition intensity

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Authors: LaShawnda N. Fields, Valandra

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As part of a larger study, this particular line of inquiry focuses on experiences of tokenism and invisible labor expected of Black women within social work education. Black women faculty members and doctoral students participated in semi-formal, in-depth interviews. All participants were identified as members of schools of social work within Carnegie-designated R-1 institutions. Several participants believed that their race independently and the intersection of their race and gender was often misrepresented by their institution as an indication of a diverse and equitable environment. These women believed they were often solicited to participate in visual materials and make public appearances to benefit the school while feeling invisible. Most of the Black women interviewed, whether faculty members or doctoral students, were the sole Black person or one of very few Black women at these schools of social work. Similarly, the Black doctoral students spoke of being “paraded around” as a prized show horse while enduring a toxic culture that lacks inclusion. These women expressed frustration and disappointment as their images and scholarship were featured on websites and within marketing materials, not the pride and joy such exposure should elicit. These experiences of tokenism were taking place while the women constantly received messages of not being good enough or not a good fit at their institution. Invisible labor refers to work that is not compensated nor formally recognized. This labor is primarily committee work and student support. Representation of Black women faculty members is limited at these research-intensive schools of social work resulting in these women being sought out by students across disciplines. Similarly, the Black women doctoral students are informally recruited as peer mentors to support those students rising in the ranks behind them. Though this work is rooted in retention efforts, it is never identified as such. All participants identified committee work related to their identities as another way they find themselves engaged in work that often goes unrecognized and underappreciated. Committee work is usually tied to identity work, such as diversity, equity, and inclusion though it rarely translates to action and improvements. This qualitative study provides insight into the lived experiences of an at-risk and under-represented demographic. Institutions can better understand how they can support this demographic. These Black women scholars have been invited into these institutions but have not historically been granted full access. These women have survived unsavory conditions through sheer determination and support found mostly outside their schools of social work. Utilizing this data as a springboard for informed and action-oriented strategic planning would allow institutions to create inclusive and equity cultures that result in Black women thriving versus simply surviving.

Keywords: education, equity, invisible labor, tokenism, intersectionality

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Authors: Drago Bratkovic, Curtis Gravance, David Ketteridge, Ravi Krishnan, Michael Imperiale

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The mucopolysaccharidoses (MPSs) are a group of lysosomal storage diseases that have a common defect in the catabolism of glycosaminoglycans (GAGs). MPS I is the most common of the MPS diseases. Manifestations of MPS I include coarsening of facial features, corneal clouding, developmental delay, short stature, skeletal manifestations, hearing loss, cardiac valve disease, hepatosplenomegaly, and umbilical and inguinal hernias. Treatments for MPS I restore or activate the missing or deficient enzyme in the case of enzyme replacement therapy (ERT) and haematopoietic stem cell transplantation (HSCT). Pentosan polysulfate sodium (PPS) is a potential treatment to improve bone and joint manifestations of MPS I. The mechanisms of action of PPS that are relevant to the treatment of MPS I are the ability to: (i) Reduce systemic and accumulated GAG, (ii) Reduce inflammatory effects via the inhibition of NF-kB, resulting in the reduction in pro-inflammatory mediators. (iii) Reduce the expression of the pain mediator nerve growth factor in osteocytes from degenerating joints. (iv) Inhibit the cartilage degrading enzymes related to joint dysfunction in MPS I. PPS is being evaluated as an adjunctive therapy to ERT and/or HSCT in an open-label, single-centre, phase 2 study. Patients are ≥ 5 years of age with a diagnosis of MPS I and previously received HSCT and/or ERT. Three white, female, patients with MPS I-Hurler, ages 14, 15, and 19 years, and one, white male patient aged 15 years are enrolled. All were diagnosed at ≤2 years of age. All patients received HSCT ≤ 6 months after diagnosis. Two of the patients were treated with ERT prior to HSCT, and 1 patient received ERT commencing 3 months prior to HSCT. Two patients received 0.75mg/kg and 2 patients received 1.5mg/kg of PPS. PPS was well tolerated at doses of 0.75 and 1.5 mg/kg to 47 weeks of continuous dosing. Of the 19 adverse events (AEs), 2 were related to PPS. One AE was moderate (pre-syncope) and 1 was mild (injection site bruising), experienced in the same patient. All AEs were reported as mild or moderate. There have been no SAEs. One subject experienced a COVID-19 infection and PPS was interrupted. The MPS I signature GAG fragments, sulfated disaccharide and UA-HNAc S, tended to decrease in 3 patients from baseline through Week 25. Week 25 GAG data are pending for the 4th patient. Overall, most biomarkers (inflammatory, cartilage degeneration, and bone turnover) evaluated in the 3 patients with 25-week assessments have indicated either no change or a reduction in levels compared to baseline. In 3 patients, there was a trend toward improvement in the 2MWT from baseline to Week 48 with > 100% increase in 1 patient (01-201). In the 3 patients that had Week 48 assessments, patients and proxies reported improvement in PGIC, including “worthwhile difference” (n=1), or “made all the difference” (n=2).

Keywords: MPS I, pentosan polysulfate sodium, clinical study, 2MWT, QoL

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Authors: Arosha Rashmi De Silva, Ananda Chandrasekara

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This study seeks to comprehensively examine the influence of fast-food consumption and physical activity levels on the body weight of young employees within the private sector of Sri Lanka. The escalating popularity of fast food has raised concerns about its nutritional content and associated health ramifications. To investigate this phenomenon, a cohort of 100 individuals aged between 25 and 45, employed in Sri Lanka's private sector, participated in this research. These participants provided socio-demographic data through a standardized questionnaire, enabling the characterization of their backgrounds. Additionally, participants disclosed their frequency of fast-food consumption and engagement in physical activities, utilizing validated assessment tools. The collected data was meticulously compiled into an Excel spreadsheet and subjected to rigorous statistical analysis. Descriptive statistics, such as percentages and proportions, were employed to delineate the body weight status of the participants. Employing chi-square tests, our study identified significant associations between fast-food consumption, levels of physical activity, and body weight categories. Furthermore, through binary logistic regression analysis, potential risk factors contributing to overweight and obesity within the young employee cohort were elucidated. Our findings revealed a disconcerting trend, with 6% of participants classified as underweight, 32% within the normal weight range, and a substantial 62% categorized as overweight or obese. These outcomes underscore the alarming prevalence of overweight and obesity among young private-sector employees, particularly within the bustling urban landscape of Colombo, Sri Lanka. The data strongly imply a robust correlation between fast-food consumption, sedentary behaviors, and higher body weight categories, reflective of the evolving lifestyle patterns associated with the nation's economic growth. This study emphasizes the urgent need for effective interventions to counter the detrimental effects of fast-food consumption. The implementation of awareness campaigns elucidating the adverse health consequences of fast food, coupled with comprehensive nutritional education, can empower individuals to make informed dietary choices. Workplace interventions, including the provision of healthier meal alternatives and the facilitation of physical activity opportunities, are essential in fostering a healthier workforce and mitigating the escalating burden of overweight and obesity in Sri Lanka

Keywords: fast food consumption, obese, overweight, physical activity level

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Authors: Peter Modregger, Özgül Öztürk

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Glass fabric reinforced thermoplastic (GFRT) are composite materials, which combine low weight and resilient mechanical properties rendering them especially suitable for automobile construction. However, defects in the glass fabric as well as in the polymer matrix can occur during manufacturing, which may compromise component lifetime or even safety. One type of these defects is local fiber shifts, which can be difficult to detect. Recently, we have experimentally demonstrated the reliable detection of local fiber shifts by X-ray scattering based on the edge-illumination (EI) principle. EI constitutes a novel X-ray imaging technique that utilizes two slit masks, one in front of the sample and one in front of the detector, in order to simultaneously provide absorption, phase, and scattering contrast. The principle of contrast formation is as follows. The incident X-ray beam is split into smaller beamlets by the sample mask, resulting in small beamlets. These are distorted by the interaction with the sample, and the distortions are scaled up by the detector masks, rendering them visible to a pixelated detector. In the experiment, the sample mask is laterally scanned, resulting in Gaussian-like intensity distributions in each pixel. The area under the curves represents absorption, the peak offset refraction, and the width of the curve represents the scattering occurring in the sample. Here, scattering is caused by the numerous glass fiber/polymer matrix interfaces. In our recent publication, we have shown that the standard deviation of the absorption and scattering values over a selected field of view can be used to distinguish between intact samples and samples with local fiber shift defects. The quantification of defect detection performance was done by using p-values (p=0.002 for absorption and p=0.009 for scattering) and contrast-to-noise ratios (CNR=3.0 for absorption and CNR=2.1 for scattering) between the two groups of samples. This was further improved for the scattering contrast to p=0.0004 and CNR=4.2 by utilizing a harmonic decomposition analysis of the images. Thus, we concluded that local fiber shifts can be reliably detected by the X-ray scattering contrasts provided by EI. However, a potential application in, for example, production monitoring requires fast data acquisition times. For the results above, the scanning of the sample masks was performed over 50 individual steps, which resulted in long total scan times. In this paper, we will demonstrate that reliable detection of local fiber shift defects is also possible by using single images, which implies a speed up of total scan time by a factor of 50. Additional performance improvements will also be discussed, which opens the possibility for real-time acquisition. This contributes a vital step for the translation of EI to industrial applications for a wide variety of materials consisting of numerous interfaces on the micrometer scale.

Keywords: defects in composites, X-ray scattering, local fiber shifts, X-ray edge Illumination

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Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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Authors: Jui Chen Wu, Ming Yi Hsu

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Background and Purpose: Shift work of nursing staff is inevitable in hospital to provide continuing medical care. However, shift work is considered as a health hazard that may cause physical and psychological problems. Serious workplace fatigue of nursing shift work might impact on family, social and work life, moreover, causes serious reduction of quality of medical care, or even malpractice. This study aims to explore relationships among nursing staff’s shift, workplace fatigue and quality of working life. Method: Structured questionnaires were used in this study to explore relationships among shift work, workplace fatigue and quality of working life in nursing staffs. We recruited 590 nursing staffs in different Community Teaching hospitals in Taiwan. Data analysed by descriptive statistics, single sample t-test, single factor analysis, Pearson correlation coefficient and hierarchical regression, etc. Results: The overall workplace fatigue score is 50.59 points. In further analysis, the score of personal burnout, work-related burnout, over-commitment and client-related burnout are 57.86, 53.83, 45.95 and 44.71. The basic attributes of nursing staff are significantly different from those of workplace fatigue with different ages, licenses, sleeping quality, self-conscious health status, number of care patients of chronic diseases and number of care people in the obstetric ward. The shift variables revealed no significant influence on workplace fatigue during the hierarchical regression analysis. About the analysis on nursing staff’s basic attributes and shift on the quality of working life, descriptive results show that the overall quality of working life of nursing staff is 3.23 points. Comparing the average score of the six aspects, the ranked average score are 3.47 (SD= .43) in interrelationship, 3.40 (SD= .46) in self-actualisation, 3.30 (SD= .40) in self-efficacy, 3.15 (SD= .38) in vocational concept, 3.07 (SD= .37) in work aspects, and 3.02 (SD= .56) in organization aspects. The basic attributes of nursing staff are significantly different from quality of working life in different marriage situations, education level, years of nursing work, occupation area, sleep quality, self-conscious health status and number of care in medical ward. There are significant differences between shift mode and shift rate with the quality of working life. The results of the hierarchical regression analysis reveal that one of the shifts variables 'shift mode' which does affect staff’s quality of working life. The workplace fatigue is negatively correlated with the quality of working life, and the over-commitment in the workplace fatigue is positively related to the vocational concept of the quality of working life. According to the regression analysis of nursing staff’s basic attributes, shift mode, workplace fatigue and quality of working life related shift, the results show that the workplace fatigue has a significant impact on nursing staff’s quality of working life. Conclusion: According to our study, shift work is correlated with workplace fatigue in nursing staffs. This results work as important reference for human resources management in hospitals to establishing a more positive and healthy work arrangement policy.

Keywords: nursing staff, shift, workplace fatigue, quality of working life

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Authors: Wandera Stephen Ojumbo

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People living with hearing impairment in Uganda are one of the most excluded minority groups in the country. The Uganda National Association of the Deaf estimates that deaf people make up 3.4% of Uganda’s 43 million people. Deaf Children and youth often appear withdrawn because they face social stigma. In 2009, photojournalist Stephen Wandera Ojumbo conducted an exhibition in Kampala titled “Silent Voices with colourful Hearts” showcasing the life of deaf children at Uganda School for the Deaf, Ntinda, in order to create awareness of their plight, raising funds for the construction of a vocational centre for the deaf that didn’t continue their education due to: lack of funds, non-inclusive educational institutions, and for those who cannot read and write. These children, whose lives were exhibited in 2009, are currently youths. In Uganda, there are just five primary schools for the deaf (three of these are located in Kampala, the capital city), and barely five secondary schools for the deaf. At the moment, some deaf children only receive special needs training equivalent to primary seven levels and the majority don’t make it to secondary school education level due to the fact that English is a second language to them. There is a communication gap between speaking parents and deaf children, which leads to the breakage of family bonds. The deaf youth run away from their homes to form a community where they can communicate freely. Likewise, employment opportunities for the deaf are equally very limited. It’s for this reason that a follow-up photo exhibition was conducted to expose more about what the youthful deaf people and their guardians go through in Uganda to get jobs, live and fit in the community, how they communicate and get understood, bonding with families instead of running away to bond with fellow deaf persons. The photo exhibition under the theme “Loud Silence” was significant in showcasing the ability of deaf youths in Uganda and eliciting solutions to make a more inclusive society for the deaf. It is hoped that partners in development will join in for intervention. The methodology used included individual interviews with the deaf youth and their parents and caretakers; photography at household and community levels; document review at organizations working with the deaf; observations; and key informant interviews with relevant personnel working with the deaf. Some of the major findings include: i) Effective sign language communication is key in deaf education, family bonding, and developing a sense of belonging; ii) Love and intimacy can keep the deaf bound together; iii) Education is important; everybody should struggle even if alone; iv) Games and sports are a unifying factor and most loved among the deaf; and v) better communication skills build confidence in deaf youth. In conclusion, concerted efforts are still needed to make Uganda schools more inclusive for deaf persons. This will enable a secure future for deaf youths.

Keywords: deaf, education, excluded, photo exhibition

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Authors: Teng Teng, Christos Tsinopoulos

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The purpose of this research is to explore the link between IS capabilities, customer connection, and quality performance in the service context, with investigation of the impact of firm’s stable and dynamic environments. The application of Information Systems (IS) has become a significant effect on contemporary service operations. Firms invest in IS with the presumption that they will facilitate operations processes so that their performance will improve. Yet, IS resources by themselves are not sufficiently 'unique' and thus, it would be more useful and theoretically relevant to focus on the processes they affect. One such organisational process, which has attracted a lot of research attention by supply chain management scholars, is the integration of customer connection, where IS-enabled customer connection enhances communication and contact processes, and with such customer resources integration comes greater success for the firm in its abilities to develop a good understanding of customer needs and set accurate customer. Nevertheless, prior studies on IS capabilities have focused on either one specific type of technology or operationalised it as a highly aggregated concept. Moreover, although conceptual frameworks have been identified to show customer integration is valuable in service provision, there is much to learn about the practices of integrating customer resources. In this research, IS capabilities have been broken down into three dimensions based on the framework of Wade and Hulland: IT for supply chain activities (ITSCA), flexible IT infrastructure (ITINF), and IT operations shared knowledge (ITOSK); and focus on their impact on operational performance of firms in services. With this background, this paper addresses the following questions: -How do IS capabilities affect the integration of customer connection and service quality? -What is the relationship between environmental dynamism and the relationship of customer connection and service quality? A survey of 156 service establishments was conducted, and the data analysed to determine the role of customer connection in mediating the effects of IS capabilities on firms’ service quality. Confirmatory factor analysis was used to check convergent validity. There is a good model fit for the structural model. Moderating effect of environmental dynamism on the relationship of customer connection and service quality is analysed. Results show that ITSCA, ITINF, and ITOSK have a positive influence on the degree of the integration of customer connection. In addition, customer connection positively related to service quality; this relationship is further emphasised when firms work in a dynamic environment. This research takes a step towards quelling concerns about the business value of IS, contributing to the development and validation of the measurement of IS capabilities in the service operations context. Additionally, it adds to the emerging body of literature linking customer connection to the operational performance of service firms. Managers of service firms should consider the strength of the mediating role of customer connection when investing in IT-related technologies and policies. Particularly, service firms developing IS capabilities should simultaneously implement processes that encourage supply chain integration.

Keywords: customer connection, environmental dynamism, information systems capabilities, service quality, service supply chain

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Authors: Amar Ghelani

Abstract:

People with auditory verbal hallucinations (AVH) who seek support from mental health services commonly report feeling unheard and invalidated in their interactions with social workers and psychiatric professionals. Current mental health training and clinical approaches have proven to be inadequate in addressing the complex nature of voice hearing. Childhood trauma is a key factor in the development of AVH and can render people more vulnerable to hearing both supportive and/or disturbing voices. Lived experiences of racism, poverty, and immigration are also associated with development of what is broadly classified as psychosis. Despite evidence affirming the influence of environmental factors on voice hearing, the Western biomedical system typically conceptualizes this experience as a symptom of genetically-based mental illnesses which requires diagnosis and treatment. Overemphasis on psychiatric medications, referrals, and directive approaches to people’s problems has shifted clinical interventions away from assessing and addressing problems directly related to AVH. The Maastricht approach offers voice hearers and mental health workers an alternative and respectful starting point for understanding and coping with voices. The approach was developed by voice hearers in partnership with mental health professionals and entails an innovative method to assess and create meaning from voice hearing and related life stressors. The objectives of the approach are to help people who hear voices: (1) understand the problems and/or people the voices may represent in their history, and (2) cope with distress and find solutions to related problems. The Maastricht approach has also been found to help voice hearers integrate emotional conflicts, reduce avoidance or fear associated with AVH, improve therapeutic relationships, and increase a sense of control over internal experiences. The proposed oral presentation will be guided by a recovery-oriented theoretical framework which suggests healing from psychological wounds occurs through social connections and community support systems. The presentation will start with a brainstorming exercise to identify participants pre-existing knowledge of the subject matter. This will lead into a literature review on the relations between trauma, intersectionality, and AVH. An overview of the Maastricht approach and review of research related to its therapeutic risks and benefits will follow. Participants will learn trauma-informed coping skills and questions which can help voice hearers make meaning from their experiences. The presentation will conclude with a review of resources and learning opportunities where participants can expand their knowledge of the Hearing Voices Movement and Maastricht approach.

Keywords: Maastricht interview, recovery, therapeutic assessment, voice hearing

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Authors: Moses Jenkins

Abstract:

Much of the focus when improving energy efficiency in buildings fall on the raising of standards within new build dwellings. However, as a significant proportion of the building stock across Europe is of historic or traditional construction, there is also a pressing need to improve the thermal performance of structures of this sort. On average, around twenty percent of buildings across Europe are built of historic masonry construction. In order to meet carbon reduction targets, these buildings will require to be retrofitted with insulation to improve their thermal performance. At the same time, there is also a need to balance this with maintaining the ability of historic masonry construction to allow moisture movement through building fabric to take place. This moisture transfer, often referred to as 'breathable construction', is critical to the success, or otherwise, of retrofit projects. The significance of this paper is to demonstrate that substantial thermal improvements can be made to historic buildings whilst avoiding damage to building fabric through surface or interstitial condensation. The paper will analyze the results of a wide range of retrofit measures installed to twenty buildings as part of Historic Environment Scotland's technical research program. This program has been active for fourteen years and has seen interventions across a wide range of building types, using over thirty different methods and materials to improve the thermal performance of historic buildings. The first part of the paper will present the range of interventions which have been made. This includes insulating mass masonry walls both internally and externally, warm and cold roof insulation and improvements to floors. The second part of the paper will present the results of monitoring work which has taken place to these buildings after being retrofitted. This will be in terms of both thermal improvement, expressed as a U-value as defined in BS EN ISO 7345:1987, and also, crucially, will present the results of moisture monitoring both on the surface of masonry walls the following retrofit and also within the masonry itself. The aim of this moisture monitoring is to establish if there are any problems with interstitial condensation. This monitoring utilizes Interstitial Hygrothermal Gradient Monitoring (IHGM) and similar methods to establish relative humidity on the surface of and within the masonry. The results of the testing are clear and significant for retrofit projects across Europe. Where a building is of historic construction the use of materials for wall, roof and floor insulation which are permeable to moisture vapor provides both significant thermal improvements (achieving a u-value as low as 0.2 Wm²K) whilst avoiding problems of both surface and intestinal condensation. As the evidence which will be presented in the paper comes from monitoring work in buildings rather than theoretical modeling, there are many important lessons which can be learned and which can inform retrofit projects to historic buildings throughout Europe.

Keywords: insulation, condensation, masonry, historic

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Authors: Jose R. Garcia, Lexi Frankel, Amalia Ardeljan, Sergio Medina, Ali Yasback, Omar Rashid

Abstract:

Background: Helicobacter pylori (H. pylori) is a gram-negative, spiral-shaped bacterium that affects nearly half of the population worldwide and humans serve as the principal reservoir. Infection rates usually follow an inverse relationship with hygiene practices and are higher in developing countries than developed countries. Incidence varies significantly by geographic area, race, ethnicity, age, and socioeconomic status. H. pylori is primarily associated with conditions of the gastrointestinal tract such as atrophic gastritis and duodenal peptic ulcers. Infection is also associated with an increased risk of carcinogenesis as there is evidence to show that H. pylori infection may lead to gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. It is suggested that H. pylori infection may be considered as a systemic condition, leading to various novel associations with several different neoplasms such as colorectal cancer, pancreatic cancer, and lung cancer, although further research is needed. Emerging evidence suggests that H. pylori infection may offer protective effects against Mycobacterium tuberculosis as a result of non-specific induction of interferon- γ (IFN- γ). Similar methods of enhanced immunity may affect the development of bronchogenic carcinoma due to the antiproliferative, pro-apoptotic and cytostatic functions of IFN- γ. The purpose of this study was to evaluate the correlation between Helicobacter pylori infection and the incidence of bronchogenic carcinoma. Methods: The data was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to evaluate the patients infected versus patients not infected with H. pylori using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale for the purpose of academic research. Standard statistical methods were used. Results:-Between January 2010 and December 2019, the query was analyzed and resulted in 163,224 in both the infected and control group, respectively. The two groups were matched by age range and CCI score. The incidence of bronchogenic carcinoma was 1.853% with 3,024 patients in the H. pylori group compared to 4.785% with 7,810 patients in the control group. The difference was statistically significant (p < 2.22x10-16) with an odds ratio of 0.367 (0.353 - 0.383) with a confidence interval of 95%. The two groups were matched by treatment and incidence of cancer, which resulted in a total of 101,739 patients analyzed after this match. The incidence of bronchogenic carcinoma was 1.929% with 1,962 patients in the H. pylori and treatment group compared to 4.618% with 4,698 patients in the control group with treatment. The difference was statistically significant (p < 2.22x10-16) with an odds ratio of 0.403 (0.383 - 0.425) with a confidence interval of 95%.

Keywords: bronchogenic carcinoma, helicobacter pylori, lung cancer, pathogen-associated molecular patterns

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