Search results for: student support services

Authors: William Elnemer, Nauman Hussain, Samir Al-Ali, Henry Shu, Diane Ghanem, Babar Shafiq

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Introduction: The incidence of infection in open tibial shaft injuries varies depending on the severity of the injury, with rates ranging from 1.8% for Gustilo-Anderson type I to 42.9% for type IIIB fractures. The timely administration of antibiotics upon presentation to the emergency department (ED) is an essential component of fracture management, and evidence indicates that prompt delivery of antibiotics is associated with improved outcomes. The objective of this study is to identify factors that contribute to the expedient administration of antibiotics. Methods: This is a retrospective study of open tibial shaft fractures at an academic Level I trauma center. Current Procedural Terminology (CPT) codes identified all patients treated for open tibial shaft fractures between 2015 and 2021. Open fractures were identified by reviewing ED and provider notes, and with ballistic fractures were considered open. Chart reviews were performed to extract demographics, fracture characteristics, postoperative outcomes, time to operative room, time to antibiotic order, and delivery. Univariate statistical analysis compared patients who received early antibiotics (EA), which were delivered within one hour of ED presentation, and those who received late antibiotics (LA), which were delivered outside of one hour of ED presentation. A multivariate analysis was performed to investigate patient, fracture, and transport/ED characteristics contributing to faster delivery of antibiotics. The multivariate analysis included the dependent variables: ballistic fracture, activation of Delta Trauma, Gustilo-Andersen (Type III vs. Type I and II), AO-OTA Classification (Type C vs. Type A and B), arrival between 7 am and 11 pm, and arrival via Emergency Medical Services (EMS) or walk-in. Results: Seventy ED patients with open tibial shaft fractures were identified. Of these, 39 patients (55.7%) received EA, while 31 patients (44.3%) received LA. Univariate analysis shows that the arrival via EMS as opposed to walk-in (97.4% vs. 74.2%, respectively, p = 0.01) and activation of Delta Trauma (89.7% vs. 51.6%, respectively, p < 0.001) was significantly higher in the EA group vs. the LA group. Additionally, EA cases had significantly shorter intervals between the antibiotic order and delivery when compared to LA cases (0.02 hours vs. 0.35 hours, p = 0.007). No other significant differences were found in terms of postoperative outcomes or fracture characteristics. Multivariate analysis shows that a Delta Trauma Response, arrival via EMS, and presentation between 7 am and 11 pm were independent predictors of a shorter time to antibiotic administration (Odds Ratio = 11.9, 30.7, and 5.4, p = 0.001, 0.016, and 0.013, respectively). Discussion: Earlier antibiotic delivery is associated with arrival to the ED between 7 am and 11 pm, arrival via EMS, and a coordinated Delta Trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to employ a coordinated Delta Trauma response. Hospital personnel should be attentive to the rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.

Keywords: antibiotics, emergency department, fracture management, open tibial shaft fractures, orthopaedic surgery, time to or, trauma fractures

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Authors: Angel Pérez Sánchez

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Magnet attraction or repulsion is not a product of a strange force from afar but comes from anchored lines of force inside the magnet as if it were reinforced concrete since you can move a small block by taking the steel rods that protrude from its interior. This approach serves as a basis for studying the behavior of diamagnetic materials. The significance of this study is to unify all diamagnetic phenomena: Movement of grapes, cooper approaching a magnet, Magnet levitation, etc., with a single explanation for all these phenomena. The method followed has consisted of observation of hundreds of diamagnetism experiments (in copper, aluminum, grapes, tomatoes, and bismuth), including the creation of own and new experiments and application of logical deduction product of these observations. Approaching a magnet to a hanging grape, Diamagnetism seems to consist not only of a slight repulsion but also of a slight attraction at a small distance. Replacing the grapes with a copper sphere, it behaves like the grape, pushing and pulling a nearby magnet. Diamagnetism could be redefined in the following way: There are materials that don't magnetize their internal structure when approaching a magnet, as ferromagnetic materials do. But they do allow magnetic lines of force to run through its interior, enhancing them without creating their own lines of force. Magnet levitates on superconducting ceramics because magnet gives lines near poles a force superior to what a superconductor can enhance these lines. Little further from the magnet, enhancing of lines by the superconductor is greater than the strength provided by the magnet due to the distance from the magnet's pole. It is this point that defines the magnet's levitation band. The anchoring effect of lines is what ultimately keeps the magnet and superconductor at a certain distance. The magnet seeks to levitate the area in which magnetic lines are stronger near de magnet's poles. Pouring ferrofluid into a magnet, lines of force are observed coming out of the poles. On other occasions, diamagnetic materials simply enhance the lines they receive without moving their position since their own weight is greater than the strength of the enhanced lines. (This is the case with grapes and copper). Magnet and diamagnetic materials look for a place where the lines of force are most enhanced, and this is at a small distance. Once the ideal distance is established, they tend to keep it by pushing or pulling on each other. At a certain distance from the magnet: the power exerted by diamagnetic materials is greater than the force of lines in the vicinity of the magnet's poles. All Diamagnetism phenomena: copper, aluminum, grapes, tomatoes, bismuth levitation, and magnet levitation on superconducting ceramics can now be explained with the support of magnetic lines of force.

Keywords: diamagnetism, magnetic levitation, magnetic lines of force, enhancing magnetic lines

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Authors: Chiara Magliacane

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This project aims to analyse the relationship between the post-conflict Northern Irish environment and youth trauma in deprived areas. Using an anthropological perspective and methodology, the study investigates the possible contribution that a socio-cultural perspective can give to the current research on the field, with a special focus on the role of transgenerational trauma. The recognition of the role that socio-economic determinants have on health is usually a challenge for social researchers. In post-conflict Northern Ireland, the overall lack of research about connections between the social context and youth trauma opens the way to the present project. Anthropological studies on social implications of mental disorders have achieved impressive results in many societies; they show how conditions of sufferance and poverty are not intrinsically given, but are the products of historical processes and events. The continuum of violence and the politics of victimhood sustains a culture of silence and fear in deprived areas; this implies the need of investigating the structural and symbolic violence that lies behind the diffusion of mental suffering. The project refers to these concepts from Medical Anthropology and looks at connections between trauma and social, political and economic structures. Accordingly, the study considers factors such as poverty, unemployment, social inequality and gender and class perspectives. At the same time, the project problematises categories such as youth and trauma. 'Trauma' is currently debated within the social sciences since the 'invention' of the Post-Traumatic Stress Disorder (PTSD) in 1980. Current critics made to its clinical conception show how trauma has been mainly analysed as a memory of the past. On the contrary, medical anthropological research focuses on wider perspectives on society and its structures; this is a new and original approach to the study of youth trauma considering that, to author’s best knowledge, there is no research of this kind regarding Northern Ireland. Methods: Qualitative interviews, participant observation. Expected Impact: Local Northern Ireland organizations, i.e. specific charities that provide mental health support. Ongoing and present connections will ensure they will hear about this research.

Keywords: health and social inequalities, Northern Ireland, structural violence, youth

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Authors: Naiara Ozamiz Etcebarria, Sonia Ruiz De Azua Garcia, Agurtzane Ortiz Jauregi, Virginia Guillen Cañas

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Introduction: The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes´ improvement and efficiency of health services. The ability of Active listening , empathy, assertiveness and social skills, are important abilities to develop in all professions in which there is a relationship with other people. In the field of health, it is even more important to have adequate qualities so that the treatment with the patient will be adequate and satisfactory. We conducted a research with students of third year in the Degree of Medicine with the objectives: - to know how the active listening, empathy, assertiveness and social skills of students are. - to know if there are differences according to different demographic variables, such as sex, language, age, number of siblings and interest in the subject. Material and Methods: The students of the Third year in the Degree of Medicine (N = 212) participated voluntarily. Sociodemographic data were collected. Descriptive and comparative analysis of the averages of the students with respect to active listening, empathy, assertiveness and social skills were performed. Once the questionnaires were collected, they were entered into the SPSS 21 database. Four communicational aspects were evaluated: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. The active listening questionnaire assesses these factors: Listening without interruption and less contradiction, Listening with 100% attention, Listening beyond words, Listening encouraging the other to go deeper. The TECA questionnaire of cognitive and affective empathy evaluates: Adoption of perspectives, Emotional Comprehension, Emphasizing stress, Empathic joy. The EHS questionnaire Social Skills Scale: Self-expression in social situations, Defending one's own rights as a consumer, Expressing anger or dissatisfaction, Refusing to do and cutting interactions off, Making requests, Initiating positive interactions with the other sex. The ACDA questionnaire Assertiveness Assessment Scale evaluates self-assertiveness and heteroaservitivity. Applicability: To train these skills is so important for clinical practice of medical students and these capabilities that can be measured in a longitudinal way time. Ethical-legal aspects: The data were anonymous. The study was approved by the Ethics Committee. Results: The students of the Third year in the Degree of Medicine (34.4% Basque speakers and 65.6% Spanish speakers) with average age 20.93, (27.8% men and 72.2% women). There are no differences in social skills between men and women. The Basque speaker students of are more heteroactive (ACDA) than Spanish students. Active listening has a high correlation with social skills, especially with self-expression in social situations. Listening without interruption has a high correlation with self-expression in social situations and initiating positive interactions with the opposite sex. Adoption of perspectives presents a high correlation with auto- assertiveness. Emotional understanding presents a high correlation with positive interactions with the opposite sex. Empathic joy correlates with self-assertiveness, self-expression in social situations, and initiating positive interactions with the opposite sex.

Keywords: active listening, assertiveness, communicational skills, empathy, students of medicine

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Authors: Arshad Ali

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The Taliban insurgency in Swat which started apparently as a social movement in 2004 transformed into an anti-Pakistan Islamist insurgency by joining hands with the Tehrik-e-Taliban Pakistan (TTP) upon its formation in 2007. It quickly spread beyond Swat by 2009 making Swat the second stronghold of TTP after FATA. It prompted the Pakistan military to launch a full-scale counterinsurgency military operation code named Rah-i-Rast to regain the control of Swat. Operation Rah-i-Rast was successful not only in restoring the writ of the State but more importantly in creating a consensus against the spread of Taliban insurgency in Pakistan at political, social and military levels. This operation became a test case for civilian government and military to seek for a sustainable solution combating the TTP insurgency in the north-west of Pakistan. This study analyzes why the counterinsurgency operation Rah-i-Rast was successful and why the previous ones came into failure. The study also explores factors which created consensus against the Taliban insurgency at political and social level as well as reasons which hindered such a consensual approach in the past. The study argues that the previous initiatives failed due to various factors including Pakistan army’s lack of comprehensive counterinsurgency model, weak political will and public support, and states negligence. Also, the initial counterinsurgency policies were ad-hoc in nature fluctuating between military operations and peace deals. After continuous failure, the military revisited its approach to counterinsurgency in the operation Rah-i-Rast. The security forces learnt from their past experiences and developed a pragmatic counterinsurgency model: ‘clear, hold, build, and transfer.’ The military also adopted the population-centric approach to provide security to the local people. This case Study of Swat evaluates the strengths and weaknesses of the Pakistan's counterinsurgency operations as well as peace agreements. It will analyze operation Rah-i-Rast in the light of David Galula’s model of counterinsurgency. Unlike existing literature, the study underscores the bottom up approach adopted by the Pakistan’s military and government by engaging the local population to sustain the post-operation stability in Swat. More specifically, the study emphasizes on the hybrid counterinsurgency model “clear, hold, and build and Transfer” in Swat.

Keywords: Insurgency, Counterinsurgency, clear, hold, build, transfer

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Authors: Sujeeva Sebastian Pereira

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Language Anxiety (LA) – a distinct psychological construct of self-perceptions and behaviors related to classroom language learning – is perceived as a significant variable highly correlated with Second Language Acquisition (SLA). However, the existing scholarship has inadequately explored the nuances of LA in relation to South Asia, especially in terms of Sri Lankan higher education contexts. Thus, the current study, situated within the broad areas of Psychology of SLA and Applied Linguistics, investigates the impact of competency-based LA and identity-based LA on learner achievement among undergraduates of Sri Lanka. Employing a case study approach to explore the impact of LA, 750 undergraduates of the University of Sri Jayewardenepura, Sri Lanka, thus covering 25% of the student population from all seven faculties of the university, were selected as participants using stratified proportionate sampling in terms of ethnicity, gender, and disciplines. The qualitative and quantitative research inquiry utilized for data collection include a questionnaire consisting a set of structured and unstructured questions, and semi-structured interviews as research instruments. Data analysis includes both descriptive and statistical measures. As per the quantitative measures of data analysis, the study employed Pearson Correlation Coefficient test, Chi-Square test, and Multiple Correspondence Analysis; it used LA as the dependent variable, and two types of independent variables were used: direct and indirect variables. Direct variables encompass the four main language skills- reading, writing, speaking and listening- and test anxiety. These variables were further explored through classroom activities on grammar, vocabulary and individual and group presentations. Indirect variables are identity, gender and cultural stereotypes, discipline, social background, income level, ethnicity, religion and parents’ education level. Learner achievement was measured through final scores the participants have obtained for Compulsory English- a common first-year course unit mandatory for all undergraduates. LA was measured using the FLCAS. In order to increase the validity and reliability of the study, data collected were triangulated through descriptive content analysis. Clearly evident through both the statistical analysis and the qualitative analysis of the results is the significant linear negative correlation between LA and learner achievement, and the significant negative correlation between LA and culturally-operated gender stereotypes which create identity disparities in learners. The study also found that both competency-based LA and identity-based LA are experienced primarily and inescapably due to the apprehensions regarding speaking in English. Most participants who reported high levels of LA were from an urban socio-economic background of lower income families. Findings exemplify the linguistic inequality prevalent in the socio-cultural milieu in Sri Lankan society. This inequality makes learning English a dire need, yet, very much an anxiety provoking process because of many sociolinguistic, cultural and ideological factors related to English as a Second Language (ESL) in Sri Lanka. The findings bring out the intricate interrelatedness of both the dependent variable (LA) and the independent variables stated above, emphasizing that the significant linear negative correlation between LA and learner achievement is connected to the affective, cognitive and sociolinguistic domains of SLA. Thus, the study highlights the promise in linguistic practices such as code-switching, crossing and accommodating hybrid identities as strategies in minimizing LA and maximizing the experience of ESL.

Keywords: language anxiety, identity-based anxiety, competence-based anxiety, TESL, Sri Lanka

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Authors: Badriah Alayidi, Emad Alyahya

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Background: Most people with Multiple Sclerosis (MS) report worsening balance as the condition progresses. Poor balance control is also well known to be a significant risk factor for both falling and fear of falling. The increased risk of falls with disease progression thus makes balance control an essential target of gait rehabilitation amongst people with MS. Intervention programs have developed various methods to improve balance control, and accumulating evidence suggests that exercise programs may help people with MS improve their balance. Among these methods, virtual reality (VR) is growing in popularity as a balance-training technique owing to its potential benefits, including better compliance and greater user happiness. However, it is not clear if a VR environment will induce different balance control mechanisms in MS as compared to healthy individuals or traditional environments. Therefore, this study aims to examine how individuals with MS control their balance in a VR setting. Methodology: The proposed study takes an empirical approach to estimate and determine the role of balance response in persons with MS using a VR environment. It will use primary data collected through patient observations, physiological and biomechanical evaluation of balance, and data analysis. Results: The preliminary systematic review and meta-analysis indicated that there was variability in terms of the outcome assessing balance response in people with MS. The preliminary results of these assessments have the potential to provide essential indicators of the progression of MS and contribute to the individualization of treatment and evaluation of the interventions’ effectiveness. The literature describes patients who have had the opportunity to experiment in VR settings and then used what they have learned in the real world, suggesting that this VR setting could be more appealing than conditional settings. The findings of the proposed study will be beneficial in estimating and determining the effect of VR on balance control in persons with MS. In previous studies, VR was shown to be an interesting approach to neurological rehabilitation, but more data are needed to support this approach in MS. Conclusions: The proposed study enables an assessment of balance and evaluations of a variety of physiological implications related to neural activity as well as biomechanical implications related to movement analysis.

Keywords: multiple sclerosis, virtual reality, postural control, balance

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Authors: Arkadiusz Gut, Joanna Afek

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The first issue that we discuss in this paper is a battery of research demonstrating that culture influences children’s performance in tasks testing their theory of mind, also known as mindreading. We devote special attention to research done within Chinese culture; namely, studies with children speaking Cantonese and Mandarin natively and growing up in an environment dominated by the Chinese model of informal home education. Our attention focuses on the differences in development and functioning of social abilities and competences between children from China and the West. Another matter we turn to is the description of the nature of Chinese early childhood education. We suggest that the differences between the Chinese model and that of the West reveal a set of modifiers responsible for the variation observed in empirical research on children’s theory of mind (mindreading). The modifiers we identify are the following: (1) early socialization – that is, the transformation of the child into a member of the family and society that set special value by the social and physical environment; (2) the Confucian model of education – that is, the Chinese alphabet and tradition that determine a certain way of education in China; (3) the authoritarian style of upbringing – that is, reinforcing conformism, discouraging voicing of private opinions, and respect for elders; (4) the modesty of children and protectiveness of parents – that is, obedience as a desired characteristic in the child, overprotectiveness of parents, especially mothers; and (5) gender differences – that is, different educational styles for girls and boys. In our study, we conduct a thorough meta-analysis of empirical data on the development of mindreading and ToM (children’s theory of mind), as well as a cultural analysis of early childhood education in China. We support our analyses with questionnaire and narrative studies conducted in China that use the ‘Children’s Social Understanding Scale’ questionnaire, conversations based on the so-called ‘Scenarios Presented to Parents’, and questions designed to measure the ‘my child and I’ relation. With our research we aim to identify the factors in early childhood education that serve as moderators explaining the nature of the development and functioning of social cognition based on mind reading in China. Additionally, our study provides a valuable insight for comparative research of social cognition between China and the West.

Keywords: early childhood education, China, mindreading, parenting

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Authors: Nada Mohamed, Abdel Aziz Mohamed

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Climate change in coastal areas is a global issue that can be felt on local scale and will be around for decades and centuries to come to an end; it also has critical risks on the city’s economy, communities, and the natural environment. One of these changes that cause a huge risk on coastal cities is the sea level rise (SLR). SLR is a result of scarcity and reduction in global environmental system. The main cause of climate change and global warming is the countries with high development index (HDI) as Japan and Germany while the medium and low HDI countries as Egypt does not have enough awareness and advanced tactics to adapt with this changes that destroy urban areas and cause loss in land and economy. This is why Climate Resilience is one of the UN sustainable development goals 2030, which is calling for actions to strengthen climate change resilience through mitigation and adaptation. For many reasons, adaptation has received less attention than mitigation and it is only recently that adaptation has become a focal global point of attention. This adaption can be achieved through some actions such as upgrading the use and the design of the land, adjusting business and activities of people, and increasing community understanding of climate risks. To reach the adaption goals, and we have to apply a strategic pathway to Climate Resilience, which is the Urban Bioregionalism Paradigm. Resiliency has been framed as persistence, adaptation, and transformation. Climate Resilience decision support system includes a visualization platform where ecological, social, and economic information can be viewed alongside with specific geographies that's why Urban Bioregionalism is a socio-ecological system which is defined as a paradigm that has potential to help move social attitudes toward environmental understanding and deepen human-environment connections within ecological development. The research aim is to achieve an adaptive integrated urban development model throughout the analyses of tactics and strategies that can be used to adapt urban areas and coastal communities to the challenges of climate changes especially SLR and also simulation model using advanced technological software for a coastal city corridor to elaborates the suitable strategy to apply.

Keywords: climate resilience, sea level rise, SLR, coastal resilience, adaptive development simulation

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Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Razia Sultana, Md Faroque Miah

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Mental health remains a significant global public health challenge, profoundly affecting millions worldwide. In Bangladesh, the situation is dire, with the National Mental Health Survey 2018-19 indicating that 19% of adults suffer from any kind of mental disorders, including severe mental disorder of around 2%. Despite these high prevalence rates, there is a substantial treatment gap in low- and middle-income countries, including Bangladesh, where up to 92% of individuals with mental illnesses do not receive adequate care. This gap is exacerbated by social barriers such as stigma, discrimination, social exclusion, poverty, homelessness, and human rights violations. To address these challenges, the SAJIDA Foundation launched the Proshanti in November 2022. Proshanti is a community based supportive housing intervention designed to provide cost-effective, sustainable, long-term care for individuals with chronic mental illnesses. It aims to rehabilitate participants by improving their mental health, quality of life, and equipping them with skills necessary for independent living and social mobility. Currently, Proshanti operates seven houses in Manikganj and Habiganj districts of Bangladesh, accommodating up to 40 individuals. Over a two-year period, individuals have received personalized support from trained personal assistants and care coordinators, regular health checkups, and opportunities for vocational training and community engagement. In this presentation, we will present the outcome of such intervention on individual’s functionality, quality of life and psychological health generated from 24 months of journey. Additionally, a qualitative approach will be employed to understand the facilitators and barriers of program implementation. The Proshanti program represents a promising model for addressing the significant mental health treatment gap in Bangladesh at the community level. Our findings will provide crucial insights into the program's feasibility, effectiveness, and the factors influencing its implementation, potentially guiding future mental health interventions in similar contexts.

Keywords: mental health, community based supportive housing, treatment gap, bangladesh

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Authors: Nadia Allouache, Mohamed Belmedani

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—It is imperative today to further explore alternatives to fossil fuels by promoting in particular renewable sources such as solar energy to produce cold. It is also important to carefully examine its current state as well as its future prospects in order to identify the best conditions to support its optimal development. Technologies linked to this alternative source fascinate their users because they seem magical in their ability to directly transform solar energy into cooling without resorting to polluting fuels such as those derived from hydrocarbons or other toxic substances. In addition, these not only allow significant savings in electricity, but can also help reduce the costs of electrical energy production when applied on a large scale. In this context, our study aims to analyze the performance of solar adsorption cooling systems by selecting the appropriate pair Adsorbent/Adsorbat. This paper presents a model describing the heat and mass transfer in tubular finned adsorber of solar adsorption refrigerating machine. The modelisation of the solar reactor take into account the heat and mass transfers phenomena. The reactor pressure is assumed to be uniform, the reactive reactor is characterized by an equivalent thermal conductivity and assumed to be at chemical and thermodynamic equilibrium. The numerical model is controlled by heat, mass and sorption equilibrium equations. Under the action of solar radiation, the mixture of adsorbent–adsorbate has a transitory behavior. Effect of key parameters on the adsorbed quantity and on the thermal and solar performances are analyzed and discussed. The results show that, The performances of the system that depends on the incident global irradiance during a whole day depends on the weather conditions. For the used working pairs, the increase of the fins number corresponds to the decreasing of the heat losses towards environmental and the increasing of heat transfer inside the adsorber. The system performances are sensitive to the evaporator and condenser temperatures. For the considered data measured for clear type days of may and july 2023 in Algeria and Tunisia, the performances of the cooling system are very significant in Algeria compared to Tunisia.

Keywords: adsorption, adsorbent-adsorbate pair, finned reactor, numerical modeling, solar energy

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Authors: John Acord, Ankita Batla, Kiran Khepar, Maude Schmidt, Charlotte Allen, Russ Bradford

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Objectives: Despite the availability oftreatment options, Parkinson’s disease (PD) continues to impact heavily on a patient’s quality of life (QoL), as many symptoms that bother the patient remain unexplored and untreated in clinical settings. The aims of this research were to understand the burden of PDsymptoms from a patient perspective, particularly those which are the most persistent and debilitating, and to determine if current treatments and treatment algorithms adequately focus on their resolution. Methods: A13-question, online, patient-reported survey was created based on the MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)and symptoms listed on Parkinson’s Disease Patient Advocacy Groups websites, and then validated by 10 Parkinson’s patients. In the survey, patients were asked to choose both their most common and their most bothersome symptoms, whether they had received treatment for those and, if so, had it been effective in resolving those symptoms. Results: The most bothersome symptoms reported by the 111 participants who completed the survey were sleep problems (61%), feeling tired (56%), slowness of movements (54%), and pain in some parts of the body (49%). However, while 86% of patients reported receiving dopamine or dopamine like drugs to treat their PD, far fewer reported receiving targeted therapies for additional symptoms. For example, of the patients who reported having sleep problems, only 33% received some form of treatment for this symptom. This was also true for feeling tired (30% received treatment for this symptom), slowness of movements (62% received treatment for this symptom), and pain in some parts of the body (61% received treatment for this symptom). Additionally, 65% of patients reported that the symptoms they experienced were not adequately controlled by the treatments they received, and 9% reported that their current treatments had no effect on their symptoms whatsoever. Conclusion: The survey outcomes highlight that the majority of patients involved in the study received treatment focused on their disease, however, symptom-based treatments were less well represented. Consequently, patient-reported symptoms such as sleep problems and feeling tired tended to receive more fragmented intervention than ‘classical’ PD symptoms, such as slowness of movement, even though they were reported as being amongst the most bothersome symptoms for patients. This research highlights the need to explore symptom burden from the patient’s perspective and offer Customised treatment/support for both motor and non-motor symptoms maximize patients’ quality of life.

Keywords: survey, patient reported symptom burden, unmet needs, parkinson's disease

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Authors: K. C. Sharda

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Introduction: In the world, almost half of the population are lacking proper access to improved sanitation services. In Nepal, large number of people are living without access to any sanitation facility. Ecological sanitation toilet which is defined as water conserving and nutrient recycling system for use of human urine and excreta in agriculture would count a lot to utilize locally available resources, to regenerate soil fertility, to save national currency and to achieve the goal of elimination open defecation in country like Nepal. The objectives of the research were to test the efficacy of human urine for improving crop performance and to evaluate the feasibility of ecological sanitation in rural area of Central Nepal. Materials and Methods: The field investigation was carried out at Palung Village Development Committee (VDC) of Makawanpur District, Nepal from March – August, 2016. Five eco-san toilets in two villages (Angare and Bhot Khoriya) were constructed and questionnaire survey was carried out. During the questionnaire survey, respondents were asked about socio-economic parameters, farming practices, awareness of ecological sanitation and fertilizer value of human urine and excreta in agriculture. In prior to a field experiment, soil was sampled for analysis of basic characteristics. In the field experiment, cauliflower was cultivated for a month in the two sites to compare the fertilizer value of urine with chemical fertilizer and no fertilizer with three replications. The harvested plant samples were analyzed to understand the nutrient content in plant with different treatments. Results and Discussion: Eighty three percent respondents were engaged in agriculture growing mainly vegetables, which may raise the feasibility of ecological sanitation. In the study area, water deficiencies in dry season, high demand of chemical fertilizer, lack of sanitation awareness were found to be solved. The soil at Angare has sandier texture and lower nitrogen content compared to that in Bhot Khoriya. While the field experiment in Angare showed that the aboveground biomass of cauliflower in the urine fertilized plot were similar with that in the chemically fertilized plot and higher than those in the non-fertilized plots, no significant difference among the treatments were found in Bhot Khoriya. The more distinctive response of crop growth to the three treatments in the former might be attributed to the poorer soil productivity, which in turn could be caused by the poorer inherent soil fertility and the poorer past management by the farmer in Angare. Thus, use of urine as fertilizer could help poor farmers with low quality soil. The significantly different content of nitrogen and potassium in the plant samples among three treatments in Bhot Khoriya would require further investigation. When urine is utilized as a fertilizer, the productivity could be increased and the money to buy chemical fertilizer would be utilized in other livelihood activities. Ecological sanitation is feasible in the area with similar socio-economic parameter.

Keywords: cauliflower, chemical fertilizer, ecological sanitation, Nepal, urine

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Authors: Jatin Gupta, Bishakh Bhattacharya

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With the aging process, many people start suffering from the problem of weak limbs resulting in mobility disorders and loss of sensory and motor function of limbs. Wearable robotic devices are viable solutions to help people suffering from these issues by augmenting their strength. These robotic devices, popularly known as exoskeletons aides user by providing external power and controlling the dynamics so as to achieve desired motion. Present work studies a simplified dynamic model of the human gait. A four link open chain kinematic model is developed to describe the dynamics of Single Support Phase (SSP) of the human gait cycle. The dynamic model is developed integrating mathematical models of the motion of inverted and triple pendulums. Stance leg is modeled as inverted pendulum having single degree of freedom and swing leg as triple pendulum having three degrees of freedom viz. thigh, knee, and ankle joints. The kinematic model is formulated using forward kinematics approach. Lagrangian approach is used to formulate governing dynamic equation of the model. For a system of nonlinear differential equations, numerical method is employed to obtain system response. Reference trajectory is generated using human body simulator, LifeMOD. For optimal mechanical design and controller design of exoskeleton system, it is imperative to study parameter sensitivity of the system. Six different parameters viz. thigh, shank, and foot masses and lengths are varied from 85% to 115% of the original value for the present work. It is observed that hip joint of swing leg is the most sensitive and ankle joint of swing leg is the least sensitive one. Changing link lengths causes more deviation in system response than link masses. Also, shank length and thigh mass are most sensitive parameters. Finally, the present study gives an insight on different factors that should be considered while designing a lower extremity exoskeleton.

Keywords: lower limb exoskeleton, multibody dynamics, energy based formulation, optimal design

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Authors: Victor Counted

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Staying true to self is complicated. In most cases, we might not fully come to terms with this realities. Just like any journey, a self-discovery experience with the ‘self’, is like a rollercoaster ride. The researcher attempts to engage the reader in an empirical study on authenticity tendencies of African Christian Millennials. Hence, attempting the all-important question: What does it actually mean to be true to self for the African youth? A comprehensive, yet an unfinished business that applies the authenticity theory in its exploratory navigations to uncover the “lived world” of the participants who were part of this study. Using a mixed methods approach, the researcher will exhaustively give account to the authenticity tendencies and experiences of the respondents in the study by providing the reader with a unique narrative for understanding what it means to be true to oneself in Africa. At the quantitative study, the participants recorded higher scores on the Authenticity Scale (AS) authentic living, while showing a significant correlation within the subscales. Hypotheses were tested at the quantitative phase, which statistically supported gender and church affiliation as possible predictors for the authenticity orientations of the participants, while being a Christian native and race/ethnicity were not impact factors statistically. The results helped the researcher to develop the objectives behind the qualitative study, where only fifteen AS-authentic living participants were interviewed to understand why they scored high on authentic living, in order to understand what it means to be authentic. The hallmark of the qualitative case study exploration was the common coping mechanism of splitting adopted by the respondents to deal with their self-crisis as they tried to remain authentic to self, whilst self-regulating and self-investing the self to discover ‘self’. Specifically, the researcher observed the concurrent utilization of some kind of the religious-self by the respondents to regulate their self crisis, as they relate with self fragmenting through different splitting stages in hope for some kind of redemption. It was an explanation that led to the conclusion that being authentic is the new pieces. Authenticity is in fragments. This proposition led the researcher to introduce a hermeneutical support-system that will enable future researchers engage more critically and responsibly with their “living human documents” in order to inspire timely solutions that resolve the concerns of authenticity and wellbeing among Millennials in Africa.

Keywords: authenticity, self, identity, self-fragmentation, weak self integration, postmodern self, splitting

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Authors: Minh Chien Vu, Tomoaki Satomi, Hiroshi Takahashi

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As being lack of sufficient strength to support the loading of construction as well as service life cause the clay content and clay mineralogy, soft and highly compressible soils (sludge) constitute a major problem in geotechnical engineering projects. Geopolymer, a kind of inorganic polymer, is a promising material with a wide range of applications and offers a lower level of CO₂ emissions than conventional Portland cement. However, the feasibility of geopolymer in term of modified the soft and highly compressible soil has not been received much attention due to the requirement of heat treatment for activating the fly ash component and the existence of high content of clay-size particles in the composition of sludge that affected on the efficiency of the reaction. On the other hand, the geopolymer modified sludge could be affected by other important factors such as initial curing time, initial water content and apparent water content. Therefore, this paper describes a different potential application of geopolymer: soil stabilization in landslide areas to adapt to the technical properties of sludge so that heavy machines can move on. Sludge condition process is utilized to demonstrate the possibility for stabilizing sludge using fly ash-based geopolymer at ambient curing condition ( ± 20 °C) in term of failure strength, strain and bulk density. Sludge conditioning is a process whereby sludge is treated with chemicals or various other means to improve the dewatering characteristics of sludge before applying in the construction area. The effect of initial curing time, water content and apparent water content on the modification of sludge are the main focus of this study. Test results indicate that the initial curing time has potential for improving failure strain and strength of modified sludge with the specific condition of soft soil. The result further shows that the initial water content over than 50% total mass of sludge could significantly lead to a decrease of strength performance of geopolymer-based modified sludge. The optimum apparent water content of geopolymer modified sludge is strongly influenced by the amount of geopolymer content and initial water content of sludge. The solution to minimize the effect of high initial water content will be considered deeper in the future.

Keywords: landslide, sludge, fly ash, geopolymer, sludge conditioning

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Authors: Ekaterina Reznikova

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The paper provides an overview of the comparative analysis of legal novelties on telework in Portugal and Spain from a gender perspective. Telework, defined as the practice of working remotely using information and communication technologies, has gained increased attention in recent years, particularly in the context of the COVID-19 pandemic. As countries implement legal frameworks to regulate telework, it is essential to assess their gender implications and their impact on promoting gender equality in the workplace. In Portugal, legal novelties on telework have been introduced through various legislative measures, including the Telework Regulation Act (Lei do Teletrabalho) enacted in 2018. This legislation aims to provide a framework for telework arrangements, outlining rights and obligations for both employers and employees. However, the gender perspective in Portugal's telework regulations remains somewhat limited, with few explicit provisions addressing gender disparities in telework participation or the unequal distribution of caregiving responsibilities. In contrast, Spain has taken a more proactive approach to addressing gender equality in telework through its legal novelties. The Spanish government passed the Royal Decree-Law 28/2020, which introduced significant reforms to telework regulations in response to the COVID-19 pandemic. This legislation includes provisions aimed at promoting gender equality in telework, such as measures to ensure work-life balance and prevent discrimination based on gender in telework arrangements. Additionally, Spain has implemented initiatives to encourage "joint responsibility" at home, emphasizing the importance of shared caregiving duties between men and women. By comparing the legal novelties on telework in Portugal and Spain from a gender perspective, this study aims to identify best practices and areas for improvement in promoting gender equality in telework arrangements. Through a comprehensive analysis of the legal frameworks, this study will assess the extent to which Portugal and Spain's telework regulations address gender disparities and support the advancement of women in the workforce. The findings of this comparative analysis will have significant implications for policymakers, employers, and other stakeholders involved in shaping telework policies. By identifying effective strategies for promoting gender equality in telework, this study seeks to contribute to the development of inclusive and sustainable work environments that benefit all employees, regardless of gender.

Keywords: telework, labour law, digitalization, gender

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Authors: Laura Mclean

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A recurring point of interest in computational phylogenetic analysis of Indo-European family trees is the inference of a Germano-Italo-Celtic clade in some versions of the trees produced. The presence of this clade in the models is intriguing as there is little evidence for innovations shared among Germanic, Italic, and Celtic, the evidence generally used in the traditional method to construct a subgroup. One source of this unexpected outcome could be the input to the models. The datasets in the various models used so far, for the most part, take as their basis the Swadesh list, a list compiled by Morris Swadesh and then revised several times, containing up to 207 words that he believed were resistant to change among languages. The judgments made by Swadesh for this list, however, were subjective and based on his intuition rather than rigorous analysis. Some scholars used the Swadesh 200 list as the basis for their Indo-European dataset and made cognacy judgements for each of the words on the list. Another dataset is largely based on the Swadesh 207 list as well although the authors include additional lexical and non-lexical data, and they implement ‘split coding’ to deal with cases of polymorphic characters. A different team of scholars uses a different dataset, IECoR, which combines several different lists, one of which is the Swadesh 200 list. In fact, the Swadesh list is used in some form in every study surveyed and each dataset has three words that, when they are coded as cognates, seemingly contribute to the inference of a Germano-Italo-Celtic clade which could happen due to these clades sharing three words among only themselves. These three words are ‘fish’, ‘flower’, and ‘man’ (in the case of ‘man’, one dataset includes Lithuanian in the cognacy coding and removes the word ‘man’ from the screened data). This collection of cognates shared among Germanic, Italic, and Celtic that were deemed important enough to be included on the Swadesh list, without the ability to account for possible reasons for shared cognates that are not shared innovations, gives an impression of affinity between the Germanic, Celtic, and Italic branches without adequate methodological support. However, by changing how cognacy is defined (ie. root cognates, borrowings vs inherited cognates etc.), we will be able to identify whether these three cognates are significant enough to infer a clade for Germanic, Celtic, and Italic. This paper examines the question of what definition of cognacy should be used for phylogenetic datasets by examining the Germano-Italo-Celtic clade as a case study and offers insights into the reconstruction of a Germano-Italo-Celtic clade.

Keywords: historical, computational, Italo-Celtic, Germanic

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Authors: Nnodi Chinweikpe Akelachi, Adebayo Oladini Kachollom Ifeoma

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Insecurity and the possession of nuclear weapons for non-peaceful purposes constitute a major threat to global peace and security, and this undermines the capacity for sustainable development. In Nigeria, the threat of terrorism is a challenge to national stability. For over a decade, Nigeria has been faced with insecurity ranging from Boko-Haram terrorist groups, kidnapping and banditry. The threat exhibited by this non-state actor poses a huge challenge to nuclear and radiological high risks facilities in Nigeria. This challenge has resulted in the regulatory authority and International stakeholders formulating policies for a good mitigation strategy. This strategy is enshrined in formulated laws, regulations and guides like the repealed Nuclear Safety and Radiation Protection Act 19 of 1995 (Nuclear safety, Physical Security and Safeguards Bill), the Nigerian Physical Protection of Nuclear Material and Nuclear Facilities, and Nigerian Nuclear Safeguards Regulations of 2021. All this will help Nigeria’s effort to meet its national nuclear security and safeguards obligations. To further enhance the implementation of nuclear security and safeguards system, Nigeria has signed the Non-Proliferation Treaty (NPT) in 1970, the Comprehensive Safeguards Agreement (INFCIRC/358) in 1988, Additional Protocol in 2007 as well as the Convention on Physical Protection of Nuclear Material and its amendment in 2005. In view of the evolving threats by non-state actors in Nigeria, physical protection security upgrades are being implemented in nuclear and all high-risk radiological facilities through the support of the United States Department of Energy (US-DOE). Also, the IAEA has helped strengthen nuclear security and safeguard systems through the provision of technical assistance and capacity development. Efforts are being made to address some of the challenges identified in the cause of implementing the measures for effective nuclear security and safeguards systems in Nigeria. However, there are eminent challenges in the implementation of the measures within the security and systems in Nigeria. These challenges need to be addressed for an effective security and safeguard regime in Nigeria. This paper seeks to address the challenges encountered in implementing the regulatory and stakeholder measures for effective security and safeguards regime in Nigeria, amongst others.

Keywords: nuclear regulatory body, nuclear facilities and activities, international stakeholders, security and safeguards measures

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Authors: David Obafemi Adebayo

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An occupational challenge has been identified as one of the factors that could cripple set goals and life ambitions of an Internally Displaced Person (IDP). The main thrust of this study is therefore, explore the use of life support/adjustment strategy with a view to repositioning these internally displaced persons in Nigeria in revamping their goals and achieving their life-long ambitions. The study intends to investigate whether there exist, on the basis of gender, religion, years of working experience and educational qualification any significant difference in the occupational challenges and adjustment strategies of IDPs. The study being descriptive of survey type adopted a multi-stage sampling technique to select the minimum of 400 internally displaced persons from IDP camps in Yimitu Village, Waru District in the Federal Capital Territory (FCT), Abuja. The research instrument used for the study was a researcher-designed questionnaire entitled “Questionnaire on Occupational Challenges and Adjustment Strategy of Internally Displaced Persons (QOCASIDPs)”. Eight null hypotheses were tested at 0.05 alpha levels of significance. Frequency counts and percentages, means and rank order, t-test, Analysis of Variance (ANOVA) and Duncan Multiple Range Test (DMRT) (where applicable) were employed to analyze the data. The Study determined whether occupational challenges of internally displaced persons included loss of employment, vocational discrimination, marginalization by employers of labour, isolation due to joblessness, lack of occupational freedom, which were found to be true. The results were discussed in line with the findings. The study established the place of notable adjustment strategies adopted by internally displaced person like engaging in petty trading, sourcing soft loans from NGOs, setting up small-scale businesses in groups, acquiring new skills, engaging in further education, among others. The study established that there was no significant difference in the occupational challenges of IDPs on the basis of years of working experience and highest educational qualifications, though there was significant difference on the basis of gender as well as religion. Based on the findings of the study, recommendations were made.

Keywords: internally displaced persons, occupational challenges, adjustment strategies, Abuja-Nigeria

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Authors: Weikang Peng

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The innovation corridor is an important spatial carrier to promote regional collaborative innovation, and its development process is the spatial re-organization process of regional innovation resources. This paper takes the Nanjing-Zhenjiang G312 Industrial Innovation Corridor, which involves seven municipal districts in Jiangsu Province, as empirical evidence. Based on multi-source spatial big data in 2010, 2016, and 2022, this paper applies triangulated irregular network (TIN), head/tail breaks, regional innovation ecosystem (RIE) niche fitness evaluation model, and social network analysis to carry out empirical research on the spatial organization and functional structural evolution characteristics of innovation corridors and their correlation with the structural evolution of collaborative innovation network. The results show, first, the development of innovation patches in the corridor has fractal characteristics in time and space and tends to be multi-center and cluster layout along the Nanjing Bypass Highway and National Highway G312. Second, there are large differences in the spatial distribution pattern of niche fitness in the corridor in various dimensions, and the niche fitness of innovation patches along the highway has increased significantly. Third, the scale of the collaborative innovation network in the corridor is expanding fast. The core of the network is shifting from the main urban area to the periphery of the city along the highway, with small-world and hierarchical levels, and the core-edge network structure is highlighted. With the development of the Innovation Corridor, the main collaborative mode in the corridor is changing from collaboration within innovation patches to collaboration between innovation patches, and innovation patches with high ecological suitability tend to be the active areas of collaborative innovation. Overall, polycentric spatial layout, graded functional structure, diversified innovation clusters, and differentiated environmental support play an important role in effectively constructing collaborative innovation linkages and the stable expansion of the scale of collaborative innovation within the innovation corridor.

Keywords: innovation corridor development, spatial structure, niche fitness evaluation model, head/tail breaks, innovation network

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Authors: Muhammad Umer Mehmood, Muhammad Luqman, Muhammad Yaseen, Imtiaz Hussain

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Climate change is an arduous fact, which could not be unheeded easily. It is a phenomenon which has brought a collection of challenges for the mankind. Scientists have found many of its negative impacts on the life of human being and the resources on which the life of humanity is dependent. There are many issues which are associated with the factor of prime importance in this study, 'climate change'. Whenever changes happen in nature, they strike the whole globe. Effects of these changes vary from region to region. Climate of every region of this globe is different from the other. Even within a state, country or the province has different climatic conditions. So it is mandatory that the response in that specific region and the coping strategy of this specific region should be according to the prevailing risk. In the present study, the objective was to assess the coping strategies and vulnerability of small landholders. So that a professional suggestion could be made to cope with the vulnerability factor of small farmers. The cross-sectional research design was used with the intervention of quantitative approach. The study was conducted in the Khanewal district, of Punjab, Pakistan. 120 small farmers were interviewed after randomized sampling from the population of respective area. All respondents were above the age of 15 years. A questionnaire was developed after keen observation of facts in the respective area. Content and face validity of the instrument was assessed with SPSS and experts in the field. Data were analyzed through SPSS using descriptive statistics. From the sample of 120, 81.67% of the respondents claimed that the environment is getting warmer and not fit for their present agricultural practices. 84.17% of the sample expressed serious concern that they are disturbed due to change in rainfall pattern and vulnerability towards the climatic effects. On the other hand, they expressed that they are not good at tackling the effects of climate change. Adaptation of coping strategies like change in cropping pattern, use of resistant varieties, varieties with minimum water requirement, intercropping and tree planting was low by more than half of the sample. From the sample 63.33% small farmers said that the coping strategies they adopt are not effective enough. The present study showed that subsistence farming, lack of marketing and overall infrastructure, lack of access to social security networks, limited access to agriculture extension services, inappropriate access to agrometeorological system, unawareness and access to scientific development and low crop yield are the prominent factors which are responsible for the vulnerability of small farmers. A comprehensive study should be conducted at national level so that a national policy could be formulated to cope with the dilemma in future with relevance to climate change. Mainstreaming and collaboration among the researchers and academicians could prove beneficiary in this regard the interest of national leaders’ does matter. Proper policies to avoid the vulnerability factors should be the top priority. The world is taking up this issue with full responsibility as should we, keeping in view the local situation.

Keywords: adaptation, coping strategies, climate change, Pakistan, small farmers, vulnerability

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Authors: George Hikah Benson

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The promotion of lesbian, gay, bisexual, transgender, queer and Intersex (LGBTQIs) rights within the continent of Africa in general and Ghana, in particular, has for some time now, met the fiercest of resistance; premised mainly on socio-cultural-religious factors. This phenomenon contrasts with notions of countries of the Global North where persons within the context of their fundamental freedoms and rights have the right to sexual choices and preferences. A Private Member’s Bill was introduced to the Ghanaian Parliament in 2021, seeking to criminalize the promotion and advocacy of LGBTQIs related activities. This paper in assessing public views on the matter also seeks to ascertain the security implications regarding the passage of the law at the community level. The study also evaluates LGBTQIs rights vis-a-vis the provisions of Chapter 5 of the 1992 Ghana Constitution and global legal jurisprudence on fundamental human rights. To that end, the study adopted a mixed design approach (quantitative and qualitative) to gather data from 1,550 respondents from all ‘walks of life, across all sixteen regions of Ghana. The main findings are that first, over 85% of Ghanaians abhor the practices of LGBTQIs in keeping with the societal, cultural and religious beliefs of Ghanaians, and will go any length to prevent its survival in the country. Further, the time is not ripe for the acceptance of LGBTQ rights in Ghana as the activities will disrupt family values and poison the existing peace that Ghanaians are currently enjoying. However, it is generally believed that when the bill is passed into law, Ghana’s international image will be dented, and 60% of participants and respondents will be unmoved. Against this hostile, intolerant backdrop regarding LGBTQIs rights in the country and in many other African countries, the study foremost recommends that such a law, when passed, should come with a ‘human face’ that will not just seek to be punitive of LGBTQIs persons but corrective. Additionally, the law should be one that offers them support in line with their rights as Ghanaian and African citizens. Moreover, religious and traditional bodies should endeavor to engage LGBTQIs persons in a friendlier, corrective and loving manner rather than in the current hostile environment that society exposes them to.

Keywords: Ghanaian parliament, LGBTQIs rights, perceptions, socio-culture-religious

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Authors: Jovina Concepcion Bachynski, Lenora Duhn, Idevania G. Costa, Pilar Camargo-Plazas

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Kidney failure is a life-limiting condition for which treatment, such as dialysis (hemodialysis and peritoneal dialysis), can exact a tremendously high physical and psychosocial symptom burden. Kidney failure can be severe enough to require a palliative approach to care. The term supportive care can be used in lieu of palliative care to avoid the misunderstanding that palliative care is synonymous with end-of-life or hospice care. Kidney supportive care, encompassing advance care planning, is an approach to care that improves the quality of life for people receiving dialysis through early identification and treatment of symptoms throughout the disease trajectory. Advanced care planning involves ongoing conversations about the values, goals, and preferences for future care between individuals and their healthcare teams. Kidney supportive care is underutilized and often initiated late in this population. There is evidence to indicate nurses are not providing the necessary elements of supportive kidney care. Dialysis nurses’ delay or lack of engagement in supportive care until close to the end of life may result in people dying without receiving optimal palliative care services. Using Charmaz’s constructivist grounded theory, the purpose of this doctoral study is to develop a substantive theory that explains the process of engagement in supportive care by nurses working in dialysis settings in Canada. Through initial purposeful and subsequent theoretical sampling, 23 nurses with current or recent work experience in outpatient hemodialysis, home hemodialysis, and peritoneal dialysis settings drawn from across Canada were recruited to participate in two intensive interviews using the Zoom© teleconferencing platform. Concurrent data collection and data analysis, constant comparative analysis of initial and focused codes until the attainment of theoretical saturation, and memo-writing, as well as researcher reflexivity, have been undertaken to aid the emergence of concepts, categories, and, ultimately, the constructed theory. At the time of abstract submission, data analysis is currently at the second level of coding (i.e., focused coding stage) of the research study. Preliminary categories include: (a) focusing on biomedical care; (b) multi-dimensional challenges to having the conversation; (c) connecting and setting boundaries with patients; (d) difficulty articulating kidney-supportive care; and (e) unwittingly practising kidney-supportive care. For the conference, the resulting theory will be presented. Nurses working in dialysis are well-positioned to ensure the delivery of quality kidney-supportive care. This study will help to determine the process and the factors enabling and impeding nurse engagement in supportive care in dialysis to effect change for normalizing advance care planning conversations in the clinical setting. This improved practice will have substantive beneficial implications for the many individuals living with kidney failure and their supporting loved ones.

Keywords: dialysis, kidney failure, nursing, supportive care

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Authors: Laura Struik, Sarah Dow-Fleisner, Robert Janke

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Introduction: The use of e-cigarettes, also known as vaping, has risen exponentially among North American youth and young adults (YYA) in recent years and has become a critical public health concern. The marketing strategies used by e-cigarette companies have been associated with the uptick in use among YYA, with video advertisements on TV and other electronic platforms being the most pervasive strategy. It is unknown if or how these advertisements capitalize on the recently documented multi-faceted influences that contribute to the initiation of vaping among this demographic (e.g., stress, anxiety, gender, peers, etc.), which is examined in this study. Methods: This content analysis is phase one of a two-phased research project that aims to inform meaningful approaches to anti-vaping messaging and campaigns. As part of this first phase, a scoping review has been conducted to identify various influences (environmental, cognitive, contextual, social, and emotional) on e-cigarette uptake among YYA. The results of this scoping review will inform the development of a coding framework to analyze the multiple influences present in vaping advertisements, as seen on two popular television channels (Discovery and AMC). In addition, advertisement characteristics will be incorporated into the coding framework (e.g., the number of people present, demographic details, context, and setting, etc.), and analyzed. Findings: Findings will reveal the types of influences being leveraged in vaping advertisements, and identify the underlying messages that may be particularly attractive to YYA. This will contribute to a more nuanced understanding of how e-cigarette companies market their products and to whom. The results will also inform the next phase of this research project, which will encompass an analysis of anti-vaping advertisements and how the underpinning strategies align with those of the pro-vaping advertisements. Conclusions: Findings of this will study bring forward important implications for developing effective anti-vaping messages, and assist public health professionals in providing more comprehensive prevention and cessation support as it relates to e-cigarette use. Understanding which marketing strategies e-cigarette companies use is vital to our understanding of how to combat them. Findings will inform recommendations for public health efforts aimed at curbing e-cigarette use among YYA, and ultimately contribute to the health and well-being of YYA.

Keywords: e-cigarettes, youth and young adults, advertisements, public health

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Authors: Galuh Asri Bestari, Hajar Shofiyya

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Double burden of malnutrition (DBM) has been a global problem in these last decades occurs in both developed and developing countries. Overweight in adults and stunting among preschool children have dramatically increased and become the main problems of malnutrition that should be solved immediately since they are directly related with the health status and productivity. Reformulation of food product by using the local sea resources called terasi shrimp (Acetes indicus) has a potential possibility in facing the DBM. A study was carried out in Indonesia to determine the acceptability of terasi shrimp powder through sensory evaluation. Terasi shrimps were processed into powder form through sun drying and pounding methods. The powder form was directly added in food as alternative seasonings and tested among stunted and normal preschool children. Meanwhile, a further processing method is given to the shrimp powder tested in overweight and normal-weighed adults. The shrimp powder was mixed with sago flour and formed into balls, then steamed for 15-20 minutes, and finally served as alternative snacks. Based on the sensory evaluation, the shrimp powder has a good acceptance in taste (54%), shape (60%), and color properties (63%), while the shrimp balls has a good acceptance in size (65%), shape (50%), color (48%), taste (40%), and texture (36%). Terasi shrimp powder can be stored for a month in room temperature. In addition, carried out chemical analysis revealed that terasi shrimp (Acetes indicus) has higher percentage of protein, calcium, and iron than other animal sources, but conversely contains zero sodium and very low percentage of fat. Terasi shrimp’s shell also contains a substance called chitosan which acts by forming gels in the intestinal tract to entrap lipids, thus interfering with their absorption. After going through some processing methods, the shrimp powder and balls did not show any significant changes in their nutrient contents. So that, terasi shrimp powder is good to be consumed not only by overweight adults, but also by children to support their optimum growth. Intervention of terasi shrimp powder should be implemented step by step from national up to global governance program to face the DBM.

Keywords: Acetes indicus, alternative food, double burden of malnutrition, sensory evaluation

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Authors: Christodoulakis Georgios, Kiourti Elisavet

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The Covid-19 pandemic has affected millions of people on a global scale, while lockdowns and quarantine measures were adopted periodically by a vast number of countries. These peculiar socio-historical conditions have led to the growth of participation in online environments. At the same time, the official educational bodies of many countries have been forced, for the first time at least for Greece and Cyprus, to switch to distance learning methods throughout the educational levels. However, this has not been done without issues, both in the technological and functional level, concerning the tools and the processes. Video games are the finest example of simulations of distance learning problem-solving environments. They incorporate different semiotic modes (e.g., a combination of image, sound, texts, gesture) while all this takes place in social and cultural constructed contexts. Players interact in the game environment in terms of spaces, objects, and actions in order to accomplish their goals, solve its problems, and win the game. In addition, players are engaging in layering literacies, which include combinations of independent and collaborative, digital and nondigital practices and spaces acting jointly to support meaning making, including interaction among and across texts and modalities (Abrams, 2017). From this point of view, players are engaged in collaborative, self-directed, and interest-based experiences by going back and forth and around gameplay. Within this context, this paper investigates the way Einstown, a greek serious video game, functions as an effective distance learning environment for teaching Greek as a second|foreign language to adults. The research methodology adopted is the case study approach using mixed methods. The participants were two adult women who are immigrants in Greece and who had zero gaming experience. The results of this research reveal that the videogame Einstown is, in fact, a digital environment of literacy through which the participants achieve active learning, cooperation, and engage in digital and non-digital literacy practices that result in improving the learning of specialized vocabulary presented throughout the gameplay.

Keywords: second/foreign language, vocabulary acquisition, literacy, serious video games

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Authors: Alica Höpken, Hergen Pargmann

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The resource-efficient planning of the complex production planning processes in the meat industry and the reduction of food waste is a permanent challenge. The complexity of the production planning process occurs in every part of the supply chain, from agriculture to the end consumer. It arises from long and uncertain planning phases. Uncertainties such as stochastic yields, fluctuations in demand, and resource variability are part of this process. In the meat industry, waste mainly relates to incorrect storage, technical causes in production, or overproduction. The high amount of food waste along the complex supply chain in the meat industry could not be reduced by simple solutions until now. Therefore, resource-efficient production planning by conventional methods is currently only partially feasible. The realization of intelligent, automated production planning is basically possible through the application of machine learning algorithms, such as those of reinforcement learning. By applying the adapted design thinking method, machine learning methods (especially reinforcement learning algorithms) are used for the complex production planning process in the meat industry. This method represents a concretization to the application area. A resource-efficient production planning process is made available by adapting the design thinking method. In addition, the complex processes can be planned efficiently by using this method, since this standardized approach offers new possibilities in order to challenge the complexity and the high time consumption. It represents a tool to support the efficient production planning in the meat industry. This paper shows an elegant adaption of the design thinking method to apply the reinforcement learning method for a resource-efficient production planning process in the meat industry. Following, the steps that are necessary to introduce machine learning algorithms into the production planning of the food industry are determined. This is achieved based on a case study which is part of the research project ”REIF - Resource Efficient, Economic and Intelligent Food Chain” supported by the German Federal Ministry for Economic Affairs and Climate Action of Germany and the German Aerospace Center. Through this structured approach, significantly better planning results are achieved, which would be too complex or very time consuming using conventional methods.

Keywords: change management, design thinking method, machine learning, meat industry, reinforcement learning, resource-efficient production planning

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Authors: Saeed Musaid H. Alzahrani

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The role of middle leaders, especially in primary schools, is a multi-faced role that has been subject to changes in nature over recent decades, with claims for more distributed leadership practices. This research examines the way 18 middle leaders in Saudi and English primary schools conceptualise their roles and responsibilities, and different factors influencing those roles and responsibilities. It begins from the premise that both the power of the role and the values of middle leaders are grounded in cultural and political bases, a belief held by the researcher as an 'insider' within the Saudi educational leadership context. The study consisted of a comparative analysis of the role and the responsibilities of middle leaders in Saudi primary schools and their equivalents in English primary schools. A purely qualitative methodological stance was adopted, using in-depth face-to-face semi-structured interviews, observations and document analysis. Middle leaders were asked to reflect deeply on their perceptions and understanding of their roles and explain what they thought influenced their daily practices and responsibilities. The findings suggest that the concept of middle leadership has been influenced by power imposed from above by political authority, via internal and external hierarchical structures, which shapes the nature of the role of the middle leaders and forces them to comply. Middle leaders seem to believe they have the power to make decisions and promote change, but these findings suggest that this is illusory. The power that keeps middle leaders performing is the power of their cultural and religious values. Those values are the resource to which they turn in their search for more energy when they lack support and are short of time taken. Middle leaders in Saudi, just like their equivalents in English schools must comply with the requirements of their role. However, Saudi middle leaders are given no leeway to make decisions or implement change, neither do they have the culture of collegiality that seems to give middle leaders in England more power over their resources and decisions. However, in neither educational setting have middle leaders been given the power to lead, so they remain managers rather than leaders. The findings of this research suggest that there are more similarities between the educational settings of Saudi and England than differences; and in the light of different factors identified in the study, suggest the establishment of a framework for middle leadership, in the hope of enhancing the way the role is practiced.

Keywords: middle leader, primary school, power, educational leadership, value, culture, model, Saudi Arabia, England

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Authors: Benjamin Beltzung, Marie Pelé, Julien P. Renoult, Cédric Sueur

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To this day, it is not known if drawing is specifically human behavior or if this behavior finds its origins in ancestor species. An interesting window to enlighten this question is to analyze the drawing behavior in genetically close to human species, such as non-human primate species. A good candidate for this approach is the orangutan, who shares 97% of our genes and exhibits multiple human-like behaviors. Focusing on figurative aspects may not be suitable for orangutans’ drawings, which may appear as scribbles but may have meaning. A manual feature selection would lead to an anthropocentric bias, as the features selected by humans may not match with those relevant for orangutans. In the present study, we used deep learning to analyze the drawings of a female orangutan named Molly († in 2011), who has produced 1,299 drawings in her last five years as part of a behavioral enrichment program at the Tama Zoo in Japan. We investigate multiple ways to decipher Molly’s drawings. First, we demonstrate the existence of differences between seasons by training a deep learning model to classify Molly’s drawings according to the seasons. Then, to understand and interpret these seasonal differences, we analyze how the information spreads within the network, from shallow to deep layers, where early layers encode simple local features and deep layers encode more complex and global information. More precisely, we investigate the impact of feature complexity on classification accuracy through features extraction fed to a Support Vector Machine. Last, we leverage style transfer to dissociate features associated with drawing style from those describing the representational content and analyze the relative importance of these two types of features in explaining seasonal variation. Content features were relevant for the classification, showing the presence of meaning in these non-figurative drawings and the ability of deep learning to decipher these differences. The style of the drawings was also relevant, as style features encoded enough information to have a classification better than random. The accuracy of style features was higher for deeper layers, demonstrating and highlighting the variation of style between seasons in Molly’s drawings. Through this study, we demonstrate how deep learning can help at finding meanings in non-figurative drawings and interpret these differences.

Keywords: cognition, deep learning, drawing behavior, interpretability

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