Search results for: life narrative history interviews

Authors: Nita Mitra, Pranab Chanda

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In this paper, the issue of attitude-behavior consistency has been addressed in the context of climate change. Scientists (about 98 percent) opine that human behavior has a significant role in climate change. Such climate changes are harmful for human life. Thus, it is natural to conclude that only change of human behavior can avoid harmful consequences. Government and Non-Government Organizations are taking steps to bring in the desired changes in behavior. However, it seems that although the efforts are achieving changes in the attitudes to some degree, those steps are failing to materialize the corresponding behavioral changes. This has been a great concern for environmentalists. Psychologists have noticed the problem as a particular case of the general psychological problem of making attitude and behavior consistent with each other. The present study is in continuation of a previous work of the same author based upon descriptive research on the status of attitude and behavior of the people of a foot-hill region of the Himalayas in India regarding climate change. The observations confirm the mismatch of attitude and behavior of the people of the region with respect to climate change. While doing so an attitude-behavior mismatch has been noticed with respect to the acceptance of psychological findings by the public. People have been found to be interested in Psychology as an important subject, but they are reluctant to take the observations of psychologists seriously. A comparative study in this regard has been made with similar studies done elsewhere. Finally, an attempt has been made to perceive observations in the framework of observational learning due to Bandura's and behavior change due to Lewin.

Keywords: acceptance of psychological variables, attitude-behavior consistency, behavior change, climate change, observational learning

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Authors: Manushi Srivastava

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Introduction: Doctor’s role, and relation with respect to patient care is at the core of medical ethics. The rapid pace of medical advances along with increasing consumer awareness about their rights and hike in cost of effective health care demand a robust, transparent and patient-friendly medical care system. However, doctors’ role performance is still in the frame of activity-passivity model of Doctor-Patient Relationship (DPR) where doctors act as parent and use to instruct their patients, without their consensus that is not going to help in the 21st century. Thus the current situation is a new challenge for traditional doctor-patient relationship after the introduction of Consumer Protection Act (CPA) in medical profession and the same is evidenced by increasing cases of medical litigation. To strengthen this system of medical services, the doctor plays a vital role, and the same should be reviewed in the present context. Objective: To understand the opinion of consultants regarding medical negligence and effect of Consumer Protection Act in terms of current practices of patient care. Method: This is a cross-sectional study in which both quantitative and qualitative methods are applied. Total 69 consultants were selected from multi-specialty hospitals of densely populated Varanasi city catering a population of about 1.8 million. Two-stage sampling was used for selection of respondents. At the first stage, selection of major wards (Medicine, Surgery, Ophthalmology, Gynaecology, Orthopaedics, and Paediatrics) was carried out, which are more susceptible to medical negligence. At the second stage, selection of consultants from the respective wards was carried out. In-depth Interviews were conducted with the help of semi-structured schedule. Two case studies of medical negligence were also carried out as part of the qualitative study. Analysis: Data were analyzed with the help of SPSS software (21.0 trial version). Semi-structured research tool was used to know consultant’s opinion about the pattern of medical negligence cases, litigations and claims made by patient community and inclusion of government medical services in CPA. Statistical analysis was done to describe data, and non-parametric test was used to observe the association between the variables. Analysis of Verbatim was used in case-study. Findings and Conclusion: Majority (92.8%) of consultants felt changes in the behaviour of community (patient) after implementation of CPA, as it had increased awareness about their rights. Less than half of the consultants opined that Medical Negligence is an Unintentional act of doctors and generally occurs due to communication gap and behavioural problem between doctor and patients. Experienced consultants ( > 10 years) pointed out that unethical practice by doctors and mal-intention of patient to harass doctors were additional reasons of Medical Negligence. In-depth interview revealed that now patients’ community expects more transparency and hence they demand cafeteria approach in diagnosis and management of cases. Thus as study results, we propose ‘Agreement Model’ of DPR to re-ensure ethical practice in medical profession.

Keywords: doctors, communication, consumer protection act (CPA), medical error

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Authors: Kaavya Chandrasekar

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Healthy eating is essential to maintain good health and stable mental status regardless of age. WHO describes that a healthy diet consists of incorporating more fruits and vegetables and reducing the consumption of sugary and salty foods into a regularly scheduled healthy diet. Although this attitude is rather uncommon among all age groups, it is notably uncommon among the teens being a very vulnerable state in a man’s life. Faulty dietary habits, in the long run, interfere with health, leading to obesity, cardiovascular diseases, and mental instability. This study collates a discussion on the barriers prevailing among adolescents, to inculcate healthy eating practices by means of the socioecological model. The studies consisted of teens aged 13 to 19 years from schools and colleges of both sexes. The socio-ecological model emphasizes the interplay and interconnectedness of elements at all levels of health behavior, acknowledging that the majority of public health issues are just too complicated to be solved from a single-level perspective. As a result, it necessitates that people are not considered in isolation from bigger social groups. According to the studies retrieved from ten articles studies conducted globally, more than five articles suggest that socioeconomic class, lack of adult supervision and easy access to fast food stores and schools affect their decision of healthy eating. Awareness via personalized intervention has been tried and found successful. Future research is still needed to address various dimensions of the issue.

Keywords: socio ecological model, healthy eating, adolescents, fast food consumption, interventions.

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Authors: K. Majumdar, S. Datta

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Electricity is recognized as fundamental to industrialization and improving the quality of life of the people. Harnessing the immense untapped hydropower potential in Tripura region opens avenues for growth and provides an opportunity to improve the well-being of the people of the region, while making substantial contribution to the national economy. Gumti hydro power plant generates power to mitigate the crisis of power in Tripura, India. The first unit of hydro power plant (5 MW) was commissioned in June 1976 & another two units of 5 MW was commissioned simultaneously. But out of 15 MW capacity at present only 8-9 MW power is produced from Gumti hydro power plant during rainy season. But during lean season the production reduces to 0.5 MW due to shortage of water. Now, it is essential to implement some mitigation measures so that the further atrocities can be prevented and originality will be possible to restore. The decision making ability of the Analytic Hierarchy Process (AHP) and Concordance Analysis Techniques (CAT) are utilized to identify the better decision or solution to the present problem. Some related attributes are identified by the method of surveying within the experts and the available reports and literatures. Similar criteria are removed and ultimately seven relevant ones are identified. All the attributes are compared with each other and rated accordingly to their importance over the other with the help of Pair wise Comparison Matrix. In the present investigation different mitigation measures are identified and compared to find the best suitable alternative which can solve the present uncertainties involving the existence of the Gumti Hydro Power Plant.

Keywords: concordance analysis techniques, analytic hierarchy process, hydro power

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Authors: Tebogo Emma Makaba, Barnabas Ndlovu Gatsheni

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The cities of Johannesburg and Pretoria both located in the Gauteng province are separated by a distance of 58 km. The traffic queues on the Ben Schoeman freeway which connects these two cities can stretch for almost 1.5 km. Vehicle traffic congestion impacts negatively on the business and the commuter’s quality of life. The goal of this paper is to identify variables that influence the flow of traffic and to design a vehicle traffic prediction model, which will predict the traffic flow pattern in advance. The model will unable motorist to be able to make appropriate travel decisions ahead of time. The data used was collected by Mikro’s Traffic Monitoring (MTM). Multi-Layer perceptron (MLP) was used individually to construct the model and the MLP was also combined with Bagging ensemble method to training the data. The cross—validation method was used for evaluating the models. The results obtained from the techniques were compared using predictive and prediction costs. The cost was computed using combination of the loss matrix and the confusion matrix. The predicted models designed shows that the status of the traffic flow on the freeway can be predicted using the following parameters travel time, average speed, traffic volume and day of month. The implications of this work is that commuters will be able to spend less time travelling on the route and spend time with their families. The logistics industry will save more than twice what they are currently spending.

Keywords: bagging ensemble methods, confusion matrix, multi-layer perceptron, vehicle traffic flow

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Authors: Patrick Dzimiri

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This chapter discusses the military-orchestrated leadership change in Zimbabwe that transpired in November 2017. Fundamentally, the chapter provides a critical examination of military interference in the country's politics and its implications for a political transition in the post-Mugabe dispensation. This chapter offers insight into Zimbabwe's political crises propelled by the lack of a succession plan. It emerged that the succession battle within ZANU-PF got complicated by the militarisation of factionalism. The chapter builds from an extensive review of primary and secondary data sources on political developments before and post-Mugabe era. Vilfredo Pareto's (1848-18923) theory on elite circulation is deployed herein to explain the absence of a succession mechanism within ZANU-PF and the militarisation of socio-politics life Zimbabwe. The chapter argues that what transpired in Zimbabwe’s power wrangle within the ZANU-PF political elites was triggered by a lack of a clear succession policy. Building from insights offered by Pareto's theory of elite circulation, it is averred that the removal of Mugabe by the military did not herald any form of political transition but rather a mere power play of one elite replacing another. In addition, it is argued that the lack of political reform by the Mnangagwa government affirms the position that political elites seek power for personal self-actualisation and not the public good. The chapter concludes that Mnangagwa's rise to power is nothing but a new elite displacing the old elite structure and does not herald a positive transition and transformation in the politics of Zimbabwe.

Keywords: military, politics, zimbabwe, governance, political transition

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Authors: Chuang Bing-Kai, Shih Hsiang-Ju

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Previous studies showed that emergent adults used dating applications the most since it would satisfy their needs for intimacy. It's also found that those emergent adults were mostly non-heterosexual. What’s more, in this digital era, more and more bisexuals and homosexuals choose to establish connections with others through Internet to seek a sense of belonging. However, studies rarely focused on gay men in their emergent adulthood to explore their experiences of dating applications. The purpose of this study was to explore the experience of gay men using dating applications in their emerging adulthood and to understand their self-presentations and the process of it among different relationships while interacting with others upon using dating applications. The semi-structured interview was conducted with those gay men who aged from 18 to 29, felt attracted to people with same gender physically and mentally, considered themselves homosexual from their subjective understanding and had been using dating applications for more than half a year. Research invitations were distributed with the assistance of social media platforms and LGBTQ+ friends in the community. This study adopted a qualitative research approach and applied hermeneutic phenomenology as the method to analyze the transcripts transcribed from the recorded audio, and to explore their using experiences and self-presentations while interacting with others while using dating apps. It’s expected to find out that there are four stages in the self-presentation process including establishing personal identity, self-exploration and experimentation, exploring shared interest and values, developing and maintaining connections. Plus, gay men’s motives to use dating apps play an important role in this process and thus influence how they position the apps in their life. Through this study, professional workers can better understand gay men’s considerations and strategies in their self-presentation process as well as the impact of using motives.

Keywords: dating applications, emerging adulthood, gay men, hermeneutic phenomenology

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Authors: Amy Williamson, Kerry Armstrong, Jason Edwards, Patricia Obst

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Australian national policy endorses a responsive approach to work health and safety (WHS) regulation, combining positive motivators (education and guidance), with compliance monitoring and enforcement to encourage and secure compliance with legislation. Despite theoretical support for responsive regulation, there is limited evidence regarding how to achieve best results in practice. Using positive psychology as a novel paradigm, this study aims to investigate how non-punitive regulatory interactions can be improved to further encourage regulatory compliance in the construction industry. As part of a larger project, semi-structured interviews were conducted with 35 inspectorate staff and 11 managers in the Australian (Queensland) construction industry. Using an inductive, grounded approach, an in-depth qualitative investigation was conducted to identify the positive psychological principles which underpin effective use of the non-punitive aspects of responsive regulation. Results highlighted the importance of effective engagement between inspectors and industry managers. This involved the need to interact cooperatively and encourage compliance with WHS legislation. Several strategies were identified that assisted regulatory interactions and the ability of inspectors to engage. The importance of communication and interpersonal skills was reported to be critical to any interaction, regardless of the nature of the visit and regulatory tools used. In particular, the use of clear and open communication fostered trust and rapport which facilitated more positive interactions. The importance of respect and empathy was also highlighted. The need for provision of guidance and direction on how to achieve compliance was also reported. This related to ensuring companies understand their WHS obligations, providing specific advice regarding how to rectify a breach and meet compliance requirements, and ensuring sufficient follow up to confirm that compliance is successfully achieved. In the absence of imminent risk, allowing companies the opportunity to comply before further action is taken was also highlighted. Increased proactive engagement with industry to educate and promote the vision of safety at work was also reported. Finally, provision of praise and positive feedback was reported to assist interactions and encourage the continuation of good practices. Evidence from positive psychology and organisational psychology was obtained to support the use of each strategy in practice. In particular, the area of positive leadership provided a useful framework to consider the factors and conditions that drive positive interactions within the context of work health and safety and the specific relationship between inspectors and industry managers. This study provides fresh insight into key psychological principles which support non-punitive regulatory interactions in the area of workplace health and safety. The findings of this research contribute to a better understanding of how inspectors can enhance the efficacy of their regulatory interactions to improve compliance with legislation. Encouraging and assisting compliance through effective non-punitive activity offers a sustainable pathway for promoting safety and preventing fatalities and injuries in the construction industry.

Keywords: engagement, non-punitive approaches to compliance, positive interactions in the workplace, work health and safety compliance

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Authors: Georges F. Hatoum, Thomas H. Temple, Silvio Garcia, Xiaodong Wu

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Soft Tissue Sarcomas (STS) represent a diverse group of malignancies with heterogeneous clinical and pathological features. The treatment of extremity STS aims to achieve optimal local tumor control, improved survival, and preservation of limb function. The National Comprehensive Cancer Network guidelines, based on the cumulated clinical data, recommend radiation therapy (RT) in conjunction with limb-sparing surgery for large, high-grade STS measuring greater than 5 cm in size. Such treatment strategy can offer a cure for patients. However, when recurrence occurs (in nearly half of patients), the prognosis is poor, with a median survival of 12 to 15 months and with only palliative treatment options available. The spatially-fractionated-radiotherapy (SFRT), with a long history of treating bulky tumors as a non-mainstream technique, has gained new attention in recent years due to its unconventional therapeutic effects, such as bystander/abscopal effects. Combining single fraction of GRID, the original form of SFRT, with conventional RT was shown to have marginally increased the rate of pathological necrosis, which has been recognized to have a positive correlation to overall survival. In an effort to consistently increase the pathological necrosis rate over 90%, multiple fractions of Lattice RT (LRT), a newer form of 3D SFRT, interdigitated with the standard RT as neoadjuvant therapy was conducted in a preliminary clinical setting. With favorable results of over 95% of necrosis rate in a small cohort of patients, a Phase I/II clinical study was proposed to exam the safety and feasibility of this new strategy. Herein the design of the clinical study is presented. In this single-arm, two-stage phase I/II clinical trial, the primary objectives are >80% of the patients achieving >90% tumor necrosis and to evaluation the toxicity; the secondary objectives are to evaluate the local control, disease free survival and overall survival (OS), as well as the correlation between clinical response and the relevant biomarkers. The study plans to accrue patients over a span of two years. All patient will be treated with the new neoadjuvant RT regimen, in which one of every five fractions of conventional RT is replaced by a LRT fraction with vertices receiving dose ≥10Gy while keeping the tumor periphery at or close to 2 Gy per fraction. Surgical removal of the tumor is planned to occur 6 to 8 weeks following the completion of radiation therapy. The study will employ a Pocock-style early stopping boundary to ensure patient safety. The patients will be followed and monitored for a period of five years. Despite much effort, the rarity of the disease has resulted in limited novel therapeutic breakthroughs. Although a higher rate of treatment-induced tumor necrosis has been associated with improved OS, with the current techniques, only 20% of patients with large, high-grade tumors achieve a tumor necrosis rate exceeding 50%. If this new neoadjuvant strategy is proven effective, an appreciable improvement in clinical outcome without added toxicity can be anticipated. Due to the rarity of the disease, it is hoped that such study could be orchestrated in a multi-institutional setting.

Keywords: lattice RT, necrosis, SFRT, soft tissue sarcoma

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Authors: Karen Hong

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Smart tactile textiles are a series of textile-based products that incorporates smart embedded technology to be utilized as tactile therapeutic applications for 2 main groups of target users. The first group of users will be children with sensory processing disorder who are suffering from tactile sensory dysfunction. Children with tactile sensory issues may have difficulty tolerating the sensations generated from the touch of certain textures on the fabrics. A series of smart tactile textiles, collectively known as ‘Tactile Toys’ are developed as tactile therapy play objects, exposing children to different types of touch sensations within textiles, enabling them to enjoy tactile experiences together with interactive play which will help them to overcome fear of certain touch sensations. The second group of users will be the elderly or geriatric patients who are suffering from deteriorating sense of touch. One of the common consequences of aging is suffering from deteriorating sense of touch and a decline in motoric function. With the focus in stimulating the sense of touch for this particular group of end users, another series of smart tactile textiles, collectively known as ‘Tactile Aids’ are developed also as tactile therapy. This range of products can help to maintain touch sensitivity and at the same time allowing the elderly to enjoy interactive play to practice their hand-eye coordination and enhancing their motor skills. These smart tactile textile products are being designed and tested out by the end users and have proofed their efficacy as tactile therapy enabling the users to lead a better quality of life.

Keywords: smart textiles, embedded technology, tactile therapy, tactile aids, tactile toys

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Authors: Tien-Hui Chiang

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The code theory, proposed by Basil Bernstein, indicates that framing can be viewed as the core element in constituting the phenomenon of cultural reproduction because it is able to regulate the transmission of pedagogical information. Strong framing increases the social relation boundary between a teacher and pupils, which obstructs information transmission, so that in order to improve underachieving students’ academic performances, teachers need to reduce to strength of framing. Weak framing enables them to transform academic knowledge into commonsense knowledge in daily life language. This study posits that most teachers would deliver strong framing due to their belief mainly confined within the aspect of instrumental rationality that deprives their critical minds. This situation could make them view the normal distribution bell curve of students’ academic performances as a natural outcome. In order to examine the interplay between framing, instrumental rationality and pedagogical action, questionnaires were completed by over 5,000 primary school teachers in Henan province, China, who were stratified sample. The statistical results show that most teachers employed psychological concepts to measure students’ academic performances and, in turn, educational inequity was legitimatized as a natural outcome in the efficiency-led approach. Such efficiency-led minds made them perform as the agent practicing the mechanism of social control and in turn sustaining the phenomenon of cultural reproduction.

Keywords: code, cultural reproduction, framing, instrumental rationality, social relation and interaction

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Authors: Abdul Latheef O. Mavukkandy

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Islamization of knowledge (IOK) is an intellectual movement emerged in the middle of 1970s to address the threats by modern western civilizational onslaughts. This paper analyzes the discourse of Islamization of knowledge with special reference to the views of Kamal Hassan who prefers an alternative term called 'Islamicization'. First of all the theoretical and practical outlines of IOK movement were presented by Ismail Raji al-Faruqi in his book 'Islamization of Knowledge; General Principles and Work Plan' in 1982. He identified that the educational system in the Muslim world accounted for the decline of Muslim Ummah through de-Islamization and demoralization. So, the need for IOK was an academic challenge to reconstruct the Ummah. Kamal Hassan kept just different view from Ismail Raji al-Faruqi and Muhammed Naquib al-Attas that he coined the terms 'Relevantization and Contextualization'. So, he wanted the 'Islamization of Islamic Revealed Knowledge'. So, he used Islamization of Human Knowledge (IOHK) instead of IOK. As part of this movement, the IOK identified that the textbooks used in Muslim educational institutions systematically keep the students estranged from Islam and its heritage. Furthermore, the modern secular knowledge develops secular attitude devoid of Islamic moral philosophy and the sense of mission in life. Based upon the content analysis of some of the sources, this study found that Islamization of Knowledge is an important movement in Islamic world, but the IOK project is not practicable completely because of the lack of trained teachers and resources. Although, the project resulted in the foundation of some universities and publishing more works, journals and doctoral thesis on different dimensions of Islamization of Knowledge.

Keywords: Islamization, Islamicization, releventization, human knowledge

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Authors: Rose-Michelle Smith, Musandji Fuamba, Salomon Salumu

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Water is vital for life. Access to drinking water and sanitation for humans is one of the Sustainable Development Goals (specifically the sixth) approved by United Nations Member States in September 2015. There are various problems identified relating to water: insufficient fresh water, inequitable distribution of water resources, poor water management in certain places on the planet, detection of water-borne diseases due to poor water quality, and the negative impacts of climate change on water. One of the major challenges in the world is finding ways to ensure that people and the environment have enough water resources to sustain and support their existence. Thus, this research project aims to develop a tool to assess the availability, quality and needs of water in current and future situations with regard to climate change. This tool was tested using threshold values for three regions in three countries: the Metropolitan Community of Montreal (Canada), Normandie Region (France) and North Department (Haiti). The WEAP software was used to evaluate the available quantity of water resources. For water quality, two models were performed: the Canadian Council of Ministers of the Environment (CCME) and the Malaysian Water Quality Index (WQI). Preliminary results showed that the ratio of the needs could be estimated at 155, 308 and 644 m3/capita in 2023 for Normandie, Cap-Haitian and CMM, respectively. Then, the Water Quality Index (WQI) varied from one country to another. Other simulations regarding the water availability and quality are still in progress. This tool will be very useful in decision-making on projects relating to water use in the future; it will make it possible to estimate whether the available resources will be able to satisfy the needs.

Keywords: climate change, water needs, balance sheet, water quality

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Authors: M. Kaya, M. Eris

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Internet use, intelligent communication tools, and social media have all become an integral part of our daily life as a result of rapid developments in information technology. However, this widespread use increases crimes committed in the digital environment. Therefore, digital forensics, dealing with various crimes committed in digital environment, has become an important research topic. It is in the research scope of digital forensics to investigate digital evidences such as computer, cell phone, hard disk, DVD, etc. and to report whether it contains any crime related elements. There are many software and hardware tools developed for use in the digital evidence acquisition process. Today, the most widely used digital evidence investigation tools are based on the principle of finding all the data taken place in digital evidence that is matched with specified criteria and presenting it to the investigator (e.g. text files, files starting with letter A, etc.). Then, digital forensics experts carry out data analysis to figure out whether these data are related to a potential crime. Examination of a 1 TB hard disk may take hours or even days, depending on the expertise and experience of the examiner. In addition, it depends on examiner’s experience, and may change overall result involving in different cases overlooked. In this study, a hash-based matching and digital evidence evaluation method is proposed, and it is aimed to automatically classify the evidence containing criminal elements, thereby shortening the time of the digital evidence examination process and preventing human errors.

Keywords: block matching, digital evidence, hash list, evaluation of digital evidence

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Authors: Laura Irimies, Cosmin Irimies

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The public space all over the world is currently confronted with the aggressive assault of fake news that have lately impacted public agenda setting, collective decisions and social attitudes. Top leaders constantly call out most mainstream news as “fake news” and the public opinion get more confused. "Fake news" are generally defined as false, often sensational, information disseminated under the guise of news reporting and has been declared the word of the year 2017 by Collins Dictionary and it also has been one of the most debated socio-political topics of recent years. Websites which, deliberately or not, publish misleading information are often shared on social media where they essentially increase their reach and influence. According to international reports, the exposure to fake news is an undeniable reality all over the world as the exposure to completely invented information goes up to the 31 percent in the US, and it is even bigger in Eastern Europe countries, such as Hungary (42%) and Romania (38%) or in Mediterranean countries, such as Greece (44%) or Turkey (49%), and lower in Northern and Western Europe countries – Germany (9%), Denmark (9%) or Holland (10%). While the study of fake news (mechanism and effects) is still in its infancy, it has become truly relevant as the phenomenon seems to have a growing impact on democratic systems. Studies conducted by the European Commission show that 83% of respondents out of a total of 26,576 interviewees consider the existence of news that misrepresent reality as a threat for democracy. Studies recently conducted at Arizona State University show that people with higher education can more easily spot fake headlines, but over 30 percent of them can still be trapped by fake information. If we were to refer only to some of the most recent situations in Romania, fake news issues and hidden agenda suspicions related to the massive and extremely violent public demonstrations held on August 10th, 2018 with a strong participation of the Romanian diaspora have been massively reflected by the international media and generated serious debates within the European Commission. Considering the above framework, the study raises four main research questions: 1. Is fake news a problem or just a natural consequence of mainstream media decline and the abundance of sources of information? 2. What are the implications for democracy? 3. Can fake news be controlled without restricting fundamental human rights? 4. How could the public be properly educated to detect fake news? The research uses mostly qualitative but also quantitative methods, content analysis of studies, websites and media content, official reports and interviews. The study will prove the real threat fake news represent and also the need for proper media literacy education and will draw basic guidelines for developing a new and essential skill: that of detecting fake in news in a society overwhelmed by sources of information that constantly roll massive amounts of information increasing the risk of misinformation and leading to inadequate public decisions that could affect democratic stability.

Keywords: agenda setting democracy, fake news, journalism, media literacy

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Authors: Ali Kuzu

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There are about 800 thousand chemicals in our environment and the number is increasing more than a thousand every year. While most of these chemicals are used as components in various consumer products, some are faced as industrial waste in the environment. Unfortunately, many of these chemicals are hazardous and affect humans. According to the “International Program on Chemical Safety” of World Health Organization; Among the chronic health effects of chemicals, cancer is of major concern. Many substances have found in recent years to be carcinogenic in one or more species of laboratory animals. Especially with respect to long-term effects, the response to a chemical may vary, quantitatively or qualitatively, in different groups of individuals depending on predisposing conditions, such as nutritional status, disease status, current infection, climatic extremes, and genetic features, sex and age of the individuals. Understanding the response of such specific risk groups is an important area of toxicology research. People with age 65+ is defined as “aged (or elderly)”. The elderly population in the world is about 600 million, which corresponds to ~8 percent of the world population. While every 1 of each 4 people is aged in Japan, the elderly population is quite close to 20 percent in many developed countries. And elderly population in these countries is growing more rapidly than the total population. The negative effects of chemicals on elderly take an important place in health-care related issues in last decades. The aged population is more susceptible to the harmful effects of environmental chemicals. According to the poor health of the organ systems in elderly, the ability of their body to eliminate the harmful effects and chemical substances from their body is also poor. With the increasing life expectancy, more and more people will face problems associated with chemical residues.

Keywords: elderly, chemicals’ effects, aged care, care need

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Authors: Karim Hajjar, Luis Lillo, Diego Martinez, Manuel Hermosilla, Nicholas Risko

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Objectives: This study examines the relationship between universal health coverage (UCH) and the burden of emergency diseases at a global level. Methods: Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables, 1) coverage of essential health services and 2) proportion of population spending more than 10% of household income on out-of-pocket health care expenditure, was extracted from the World Bank Database for years preceding our outcome of interest. Linear regression was performed, analyzing the effect of the UHC variables on the DALYs of emergency diseases, controlling for other variables. Results: A total of 133 countries were included. 44.4% of the analyzed countries had coverage of essential health services index of at least 70/100, and 35.3% had at least 10% of their population spend greater than 10% of their household income on healthcare. For every point increase in the coverage of essential health services index, there was a 13-point reduction in DALYs of emergency medical diseases (95% CI -16, -11). Conversely, for every percent decrease in the population with large household expenditure on healthcare, there was a 0.48 increase in DALYs of emergency medical diseases (95% CI -5.6, 4.7). Conclusions: After adjusting for multiple variables, an increase in coverage of essential health services was significantly associated with improvement in DALYs for emergency conditions. There was, however, no association between catastrophic health expenditure and DALYs.

Keywords: emergency medicine, universal healthcare, global health, health economics

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Authors: Nor Anisa

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This paper aims to describe the use of conservation and rehabilitation of Mangrove forests as an alternative area in protecting the natural environment and ecosystems and ecology, community education and innovation of sustainable industrial development such as oil companies, gas and coal. The existence of globalization encourages energy needs such as gas, diesel and coal as an unaffected resource which is a basic need for human life while environmental degradation and natural phenomena continue to occur in Indonesia, especially global warming, sea water pollution, extinction of animal steps. The phenomenon or damage to nature in Indonesia is caused by a population explosion in Indonesia that causes unemployment, the land where the residence will disappear so that this will encourage the exploitation of nature and the environment. Therefore, Pertamina as a state-owned oil and gas company carries out its social responsibility efforts, namely to carry out conservation and rehabilitation and management of Mangrove fruit seeds which will provide an educational effect on the benefits of Mangrove seed maintenance. The method used in this study is a qualitative method and secondary data retrieval techniques where data is taken based on Pertamina activity journals and websites that can be accounted for. So the conclusion of this paper is: the benefits and function of conservation of mangrove forests in Indonesia physically, chemically, biologically and socially and economically and can provide innovation to the CSR (Corporate Social Responsibility) of the company in continuing social responsibility in the scope of environmental conservation and social education.

Keywords: mangrove, environmental damage, conservation and rehabilitation, innovation of corporate social responsibility

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Authors: Michaela Dušková, Kateřina Šimůnková, Martin Hill, Hana Hruškovičová, Hana Pospíšilová, Eva Králíková, Luboslav Stárka

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Smoking represents the most widespread substance dependence in the world. Several studies show the nicotine's ability to alter women hormonal homeostasis. Women smokers have higher testosterone and lower estradiol levels throughout life compared to non-smoker women. We monitored the effect of smoking discontinuation on steroid spectrum with 40 premenopausal and 60 postmenopausal women smokers. These women had been examined before they discontinued smoking and also after 6, 12, 24, and 48 weeks of abstinence. At each examination, blood was collected to determine steroid spectrum (measured by GC-MS), LH, FSH, and SHBG (measured by IRMA). Repeated measures ANOVA model was used for evaluation of the data. The study has been approved by the local Ethics Committee. Given the small number of premenopausal women who endured not to smoke, only the first 6 week period data could be analyzed. A slight increase in androgens after the smoking discontinuation occurred. In postmenopausal women, an increase in testosterone, dihydrotestosterone, dehydroepiandrosterone, and other androgens occurred, too. Nicotine replacement therapy, weight changes, and age does not play any role in the androgen level increase. The higher androgens levels correlated with failure in smoking cessation. Women smokers have higher androgen levels, which might play a role in smoking dependence development. Women successful in smoking cessation, compared to the non-successful ones, have lower androgen levels initially and also after smoking discontinuation. The question is what androgen levels women have before they start smoking.

Keywords: addiction, smoking, cessation, androgens

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Authors: B. G. Abiona, A. A. Onaseso, T. D. Odetayo, J. Yila, O. E. Fapojuwo, K. G. Adeosun

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This study determines the perceived effects of work-family balance on employees’ job satisfaction among Extension Agents in the Agricultural Development Programme (ADP) in southwest Nigeria. A multistage sampling technique was used to select 256 respondents for the study. Data on personal characteristics, work-family balance domain, and job satisfaction were collected. The collected data were analysed using descriptive statistics, Chi-square, Pearson Product Moment Correlation (PPMC), multiple linear regression, and Student T-test. Results revealed that the mean age of the respondents was 40 years; the majority (59.3%) of the respondents were male, and slightly above half (51.6%) of the respondents had MSc as their highest academic qualification. Findings revealed that turnover intention (x ̅ = 3.20) and work-role conflict (x ̅ = 3.06) were the major perceived work-family balance domain in the studied areas. Further, the result showed that the respondents have a high (79%) level of job satisfaction. Multiple linear regression revealed that job involvement (ß=0.167, p<0.01) and work-role conflict (ß= -0.221, p<0.05) contributed significantly to employees’ level of job satisfaction. The results of the Student T-test revealed a significant difference in the perceived work-family balance domain (t = 0.43, p<0.05) between the two studied areas. The study concluded that work-role conflict among employees causes work-family imbalance and, therefore, negatively affects employees’ job satisfaction. The definition of job design among the respondents that will create a balance between work and family is highly recommended.

Keywords: work-life, conflict, job satisfaction, extension agent

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Authors: Jenee Gooden, Kevin Vasquez-monterroso, Lady Paula Dejesus, Sandra Wainwright, Daniel Kim, Mackenzie Walker

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Introduction: Pyoderma gangrenosum (PG) is a rare, rapidly progressive, neutrophilic ulcerative colitis condition with an incidence of 3 to 10 cases per year ¹ ². Due to the similar appearance, PG is often misdiagnosed as a diabetic ulcer in diabetic patients. Though they may clinically appear similar in appearance, the treatment protocol and diagnostic criteria differ. Also, end-stage renal disease (ESRD) is often a condition seen in diabetic patients, which can have a significant impact on wound healing due to the wide range of uremic toxins³. This case study demonstrates a multidisciplinary team and multimodal treatment approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine for an uncontrolled diabetic with pyoderma gangrenosum of a significant circumferential wound, covering almost the entire right lower extremity. Methods:56 y.o male presents with multiple PG ulcerations, including the chest, right posterior lower extremity and sacrum. All ulcerations were previously managed by the same wound care specialist. His chief complaint was worsening PG ulcerations accompanied by a fever of 103 °F . This case study focuses on the wound to his RLE. Past medical history significant for diabetes mellitus type 2 with hemoglobin A1c of 10% and end stage renal disease (ESRD) on hemodialysis. A multidisciplinary team approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine was successfully used to perform right lower extremity limb salvage. The patient was managed by rheumatology for the continuation of prior medication, as well as the mutual agreement with wound care for the addition of dapsone. A coronary CT angiogram was performed by interventional cardiology, but no significant disease was noted, and no further vascular workup was necessary. Multiple surgical sharp wide excisional debridements with application of allografts and split thickness skin grafts for the circumferential ulceration that encompassed almost the entire right lower extremity were performed by both podiatric surgery and general surgery. Wound cultures and soft tissue biopsies were performed, and infectious disease managed antibiotic therapy. Hyperbaric oxygen therapy and wound vac therapy by wound care were also completed as adjunct management. Results: Prevention of leg amputation by limb salvage of the RLE was accomplished by a multidisciplinary team approach, with the wound size decreasing over a total of 29 weeks from 600 cm² to 12.0 x 3.5 x 0.2 cm. Our multidisciplinary team included podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine. Discussion: Wound healing, in general, can have its challenges, and those challenges are only magnified when accompanied by multiple systemic illnesses. Though the negative impact of diabetes on wound healing is well known, the compound impact of being a diabetic with ESRD and having pyoderma gangrenosum is not. This case demonstrates the necessity for a multidisciplinary team approach with a wide array of treatment modalities to optimize wound healing and perform limb salvage with prevention of lower extremity amputation.

Keywords: diabetes, podiatry, pyoderma gangrenosum, end stage renal disease

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Authors: Alamrew Eyayu

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Riverine ecosystems are highly exposed to different forms of human activities, and different water features can affect fish distribution in such habitats. Tributaries of the Abbay and Tekeze Basins are supporting all life-requesting activities in Ethiopia. Fisheries of these habitats are also the mainstay of livelihoods. However, brutal human activities are affecting these ecosystems and the fish therein. This study was thus undertaken to examine fish distribution and community structure in relation to water parameters in Ayima, Gelegu and Shinfa Rivers. 2719 fish specimens identified into 43 species were sampled using gillnets, cast nets and electro-fishing on a seasonal campaign. Based on frequency of occurrence (%FO), 5 species fell in the ‘euconstant occurrence’ category or their FO was ≥75%, while many species were in the ‘constant occurrence’ category. Among others, site depth, total phosphorus, dissolved oxygen, and river channel diameter were key environmental factors determining fish community structure. Similarity percentage produced an overall average Bray-Curtis dissimilarity of 60.8% between the fish communities of the three rivers. The final model accounted for 77.2% of the total variance in fish composition, and all canonical axes were significant (Monte Carlo test 499, p =0.002). Generally, this study was conducted in areas where no ecological studies are undertaken, and the results obtained from this study could be important for the sustainable utilization of Ethiopian fisheries.

Keywords: fish biology, fisheries socioeconomics, aquatic biodiversity, fisheries management

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Authors: L. José, S. Vieira, E. Melo, A. R. Pinheiro

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Objectives: This study aims to characterize the stroke profile and the health care provided for people with a stroke in Luanda, Angola. Methods: A prospective longitudinal study was conducted at two Health centers, from March to November 2023, enrolling stroke patients. Data was gathered using a survey created by the researchers and validated by a health panel of experts from Angola. The analysis focused on demographic and stroke characteristics, as well as the care provided. Ethical approval and informed consent were obtained. Results: Preliminary results of a total of 186 patients are described, 122 from a Central Acute Care Hospital, with a mean age of 51.3±14.35 years old, a BMI of 26.7±4.15 kg/m2, 41% male, and 64 patients from a Rehabilitation Center, with 55.6±11.55 years old, a BMI of 27.0±3.8 kg/m2, 53% male. Ischemic stroke was reported as the most representative type in both centers (71.3% and 70.3%, respectively), though 100% of patients had no imaging diagnosis confirmation, neither data about the subtype was given. For patients admitted to the Hospital, discharge occurred before rehabilitation, and no follow-up was possible. No rehabilitation care was delivered in the first 7 days after the stroke. In the Rehabilitation Center, patient’s rehabilitation started in the late subacute phase, after a mean of 171.8±11.5 days. Conclusions: Stroke diagnosis lacks imaging confirmation, which is decisive for proper treatment, and rehabilitation starts during the late subacute phase, which is too late considering the international guidelines and the best window of opportunity for neuroplasticity and recovery. These results highlight the urgent need for the definition of Stroke-directed Health Care Policies in Angola.

Keywords: stroke, personalized health care, functional recovery, quality of life, health policies

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Authors: Maryam Ziaee

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This research proposes a new approach and provides an opportunity for manufacturing companies to produce large amounts of products that meet their prospective customers’ tastes, needs, and expectations and simultaneously enable manufacturers to increase their profit. Mass customization is the production of products or services to meet each individual customer’s desires to the greatest possible extent in high quantities and at reasonable prices. This process takes place at different levels such as the customization of goods’ design, assembly, sale, and delivery status, and classifies in several categories. The main focus of this study is on one class of mass customization, called optional customization, in which companies try to provide their customers with as many options as possible to customize their products. These options could range from the design phase to the manufacturing phase, or even methods of delivery. Mass customization values customers’ tastes, but it is only one side of clients’ satisfaction; on the other side is companies’ fast responsiveness delivery. It brings the concept of agility, which is the ability of a company to respond rapidly to changes in volatile markets in terms of volume and variety. Indeed, mass customization is not effectively feasible without integrating the concept of agility. To gain the customers’ satisfaction, the companies need to be quick in responding to their customers’ demands, thus highlighting the significance of agility. This research offers a different method that successfully integrates mass customization and fast production in manufacturing industries. This research is built upon the hypothesis that the success key to being agile in mass customization is to forecast demand, cooperate with suppliers, and control inventory. Therefore, the significance of the supply chain (SC) is more pertinent when it comes to this stage. Since SC behavior is dynamic and its behavior changes constantly, companies have to apply one of the predicting techniques to identify the changes associated with SC behavior to be able to respond properly to any unwelcome events. System dynamics utilized in this research is a simulation approach to provide a mathematical model among different variables to understand, control, and forecast SC behavior. The final stage is delayed differentiation, the production strategy considered in this research. In this approach, the main platform of products is produced and stocked and when the company receives an order from a customer, a specific customized feature is assigned to this platform and the customized products will be created. The main research question is to what extent applying system dynamics for the prediction of SC behavior improves the agility of mass customization. This research is built upon a qualitative approach to bring about richer, deeper, and more revealing results. The data is collected through interviews and is analyzed through NVivo software. This proposed model offers numerous benefits such as reduction in the number of product inventories and their storage costs, improvement in the resilience of companies’ responses to their clients’ needs and tastes, the increase of profits, and the optimization of productivity with the minimum level of lost sales.

Keywords: agility, manufacturing, resilience, supply chain

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Authors: Hannah M. Russell

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‘The Attach Project’ (TAP), is an educational intervention aimed at improving educational and socio-emotional outcomes for children who are looked after. TAP is underpinned by Attachment Theory and is adapted from Dyadic Developmental Psychotherapy (DDP), which is a treatment for children and young people impacted by complex trauma and disorders of attachment. TAP has been implemented in primary schools in Northern Ireland throughout the 2018/19 academic year. During this time, a design and implementation study has been conducted to assess the promise of effectiveness for the future dissemination and ‘scaling-up’ of the programme for a larger, randomised control trial. TAP has been designed specifically for implementation in a school setting and is comprised of a whole school element and a more individualised Key Adult-Key Child pairing. This design and implementation study utilises a mixed-methods research design consisting of quantitative, qualitative, and observational measures with stakeholder input and involvement being considered an integral component. The use of quantitative measures, such as self-report questionnaires prior to and eight months following the implementation of TAP, enabled the analysis of the strengths and direction of relations between the various components of the programme, as well as the influence of implementation factors. The use of qualitative measures, incorporating semi-structured interviews and focus groups, enabled the assessment of implementation factors, identification of implementation barriers, and potential methods of addressing these issues. Observational measures facilitated the continual development and improvement of ‘TAP training’ for school staff. Preliminary findings have provided evidence of promise for the effectiveness of TAP and indicate the potential benefits of introducing this type of attachment-based intervention across other educational settings. This type of intervention could benefit not only children who are looked after but all children who may be impacted by complex trauma or disorders of attachment. Furthermore, findings from this study demonstrate that it is possible for children to form a secondary attachment relationship with a significant adult in school. However, various implementation factors which should be addressed were identified throughout the study, such as the necessity of protected time being introduced to facilitate the development of a positive Key Adult- Key Child relationship. Furthermore, additional ‘re-cap’ training is required in future dissemination of the programme, to maximise ‘attachment friendly practice’ in the whole staff team. Qualitative findings have also indicated that there is a general opinion across school staff that this type of Key Adult- Key Child pairing could be more effective if it was introduced as soon as children begin primary school. This research has provided ample evidence for the need to introduce relationally based interventions in schools, to help to ensure that children who are looked after, or who are impacted by complex trauma or disorders of attachment, can thrive in the school environment. In addition, this research has facilitated the identification of important implementation factors and barriers to implementation, which can be addressed prior to the ‘scaling-up’ of TAP for a robust, randomised controlled trial.

Keywords: attachment, complex trauma, educational interventions, implementation

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: A. Ascenso, C. Silveira, B. Augusto, S. Rafael, S. Coelho, J. Ferreira, A. Monteiro, P. Roebeling, A. I. Miranda

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Innovative nature-based solutions (NBSs) can provide answers to the challenges that urban areas are currently facing due to urban densification and extreme weather conditions. The effects of NBSs are recognized and include improved quality of life, mental and physical health and improvement of air quality, among others. Part of the work developed in the scope of the UNaLab project, which aims to guide cities in developing and implementing their own co-creative NBSs, intends to assess the impacts of NBSs on air quality, using Eindhoven city as a case study. The state-of-the-art online air quality modelling system WRF-CHEM was applied to simulate meteorological and concentration fields over the study area with a spatial resolution of 1 km2 for the year 2015. The baseline simulation (without NBSs) was validated by comparing the model results with monitored data retrieved from the Eindhoven air quality database, showing an adequate model performance. In addition, land use changes were applied in a set of simulations to assess the effects of different types of NBSs. Finally, these simulations were compared with the baseline scenario and the impacts of the NBSs were assessed. Reductions on pollutant concentrations, namely for NOx and PM, were found after the application of the NBSs in the Eindhoven study area. The present work is particularly important to support public planners and decision makers in understanding the effects of their actions and planning more sustainable cities for the future.

Keywords: air quality, modelling approach, nature based solutions, urban area

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Authors: J. Constanzo, B. Paquette, G. Charest, L. Masson-Côté, M. Guillot

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Targeted and whole-brain irradiation in humans can result in significant side effects causing decreased patient quality of life. To adequately investigate structural and functional alterations after stereotactic radiosurgery, preclinical studies are needed. The first step is to establish a robust standardized method of targeted irradiation on small regions of the rat brain. Eleven euthanized male Fischer rats were imaged in a stereotactic bed, by computed tomographic (CT), to estimate positioning variations regarding to the bregma skull reference point. Using a rat brain atlas and the stereotactic bregma coordinates assessed from CT images, various regions of the brain were delimited and a treatment plan was generated. A dose of 37 Gy at 30% isodose which corresponds to 100 Gy in 100% of the target volume (X = 98.1; Y = 109.1; Z = 100.0) was set by Leksell Gamma Plan using sectors number 4, 5, 7, and 8 of the Gamma Knife unit with the 4-mm diameter collimators. Effects of positioning accuracy of the rat brain on the dose deposition were simulated by Gamma Plan and validated with dosimetric measurements. Our results showed that 90% of the target volume received 110 ± 4.7 Gy and the maximum of deposited dose was 124 ± 0.6 Gy, which corresponds to an excellent relative standard deviation of 0.5%. This dose deposition calculated with the Gamma Plan was validated with the dosimetric films resulting in a dose-profile agreement within 2%, both in X- and Z-axis,. Our results demonstrate the feasibility to standardize the irradiation procedure of a small volume in the rat brain using a Gamma Knife.

Keywords: brain irradiation, dosimetry, gamma knife, small-animal irradiation, stereotactic radiosurgery (SRS)

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Authors: Junhang Luo

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With the transformation of spatial structure and the deepening of urban development, the demand for a better life and the concerns for social resources equities of residents are increasing. As an important social resource, park plays an essential role in building environmentally sustainable cities. Thus, it is important to examine park accessibility for low-income and how it works in relative deprivation, so as to provide all residents with equitable services. Using the network and buffer methods of GIS, this paper analyzes urban park accessibility for low-income residents in Chongqing, China. And then conduct a satisfaction evaluation of park resource accessibility with low-incomes through questionnaire surveys from deprivation dimensions. Results show that the level of park accessibility in Chongqing varies significantly and the degree of relative deprivation is relatively high. Public transportation convenience improves and the number of community park increases contribute positively to improving park accessibility and alleviating the relative deprivation of public resources. Combined with the innovation pattern of social governance in China, it suggests that urban park accessibility needs to be jointly governed and optimized by multiple social resources from the government to the public, and the service efficiency needs the index system and planning standards according to local conditions to improve quality and promote equity. At the same time, building a perfect park system and complete legislation assurance system will also play a positive role in ensuring that all residents can enjoy the urban public space more fairly, especially low-income groups.

Keywords: urban park, accessibility, relative deprivation, GIS network analysis, chongqing

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Authors: Abobaker Mohammed Qasem Farhan, Shangming Yang, Mohammed Al-Nehari

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Pneumonia is a kind of lung disease that creates congestion in the chest. Such pneumonic conditions lead to loss of life of the severity of high congestion. Pneumonic lung disease is caused by viral pneumonia, bacterial pneumonia, or Covidi-19 induced pneumonia. The early prediction and classification of such lung diseases help to reduce the mortality rate. We propose the automatic Computer-Aided Diagnosis (CAD) system in this paper using the deep learning approach. The proposed CAD system takes input from raw computerized tomography (CT) scans of the patient's chest and automatically predicts disease classification. We designed the Hybrid Deep Learning Algorithm (HDLA) to improve accuracy and reduce processing requirements. The raw CT scans have pre-processed first to enhance their quality for further analysis. We then applied a hybrid model that consists of automatic feature extraction and classification. We propose the robust 2D Convolutional Neural Network (CNN) model to extract the automatic features from the pre-processed CT image. This CNN model assures feature learning with extremely effective 1D feature extraction for each input CT image. The outcome of the 2D CNN model is then normalized using the Min-Max technique. The second step of the proposed hybrid model is related to training and classification using different classifiers. The simulation outcomes using the publically available dataset prove the robustness and efficiency of the proposed model compared to state-of-art algorithms.

Keywords: CT scan, Covid-19, deep learning, image processing, lung disease classification

Procedia PDF Downloads 147