Search results for: construction safety practices

Authors: A. Gonzalez Aguna, J. M. Santamaria Garcia, J. L. Gomez Gonzalez, R. Barchino Plata, M. Fernandez Batalla, S. Herrero Jaen

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Background: Computer Science is a field that transcends other disciplines of knowledge because it allows to support all kinds of physical and mental tasks. Health centres have a greater number and complexity of technological devices and the population consume and demand services derived from technology. Also, nursing education plans have included competencies related to and, even, courses about new technologies are offered to health professionals. However, nurses still limit their performance to the use and evaluation of products previously built. Objective: Develop a teaching-learning methodology for acquiring skills on designing applications for care. Methodology: Blended learning teaching with a group of graduate nurses through official training within a Master's Degree. The study sample was selected by intentional sampling without exclusion criteria. The study covers from 2015 to 2017. The teaching sessions included a four-hour face-to-face class and between one and three tutorials. The assessment was carried out by written test consisting of the preparation of an IEEE 830 Standard Specification document where the subject chosen by the student had to be a problem in the area of care. Results: The sample is made up of 30 students: 10 men and 20 women. Nine students had a degree in nursing, 20 diploma in nursing and one had a degree in Computer Engineering. Two students had a degree in nursing specialty through residence and two in equivalent recognition by exceptional way. Except for the engineer, no subject had previously received training in this regard. All the sample enrolled in the course received the classroom teaching session, had access to the teaching material through a virtual area and maintained at least one tutoring. The maximum of tutorials were three with an hour in total. Among the material available for consultation was an example of a document drawn up based on the IEEE Standard with an issue not related to care. The test to measure competence was completed by the whole group and evaluated by a multidisciplinary teaching team of two computer engineers and two nurses. Engineers evaluated the correctness of the characteristics of the document and the degree of comprehension in the elaboration of the problem and solution elaborated nurses assessed the relevance of the chosen problem statement, the foundation, originality and correctness of the proposed solution and the validity of the application for clinical practice in care. The results were of an average grade of 8.1 over 10 points, a range between 6 and 10. The selected topic barely coincided among the students. Examples of care areas selected are care plans, family and community health, delivery care, administration and even robotics for care. Conclusion: The applied methodology of learning-teaching for the design of technologies demonstrates the success in the training of nursing professionals. The role of expert is essential to create applications that satisfy the needs of end users. Nursing has the possibility, the competence and the duty to participate in the process of construction of technological tools that are going to impact in care of people, family and community.

Keywords: care, learning, nursing, technology

Procedia PDF Downloads 134

Authors: Amin Masoumiganjgah, Luke Salmon, Julianne Burnton, Fahimeh Bagheri, Gavin Lenton, S. L. Ezekial Tan

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Introduction: The incidence of proximal biceps tenodesis and acute distal biceps repair is increasing, and rehabilitation protocols following both are variable. Golf is a popular sport within Australia, and the Gold Coast has become a Mecca for golfers, with more courses per capita than anywhere else in the world. Currently, there are no clear guidelines regarding return to golf play following biceps procedures. The aim of this study was to determine biceps brachii activation during the golf swing through electromyographic analysis, and subsequently, aid in rehabilitation guidelines and return to golf following tenodesis and repair. Methods: Subjects were amateur golfers with no previous upper limb surgery. Surface electromyography (EMG) and high-speed video recording were used to analyse activation of the left and right biceps brachii and the anterior deltoid during the golf swing. Each participant’s maximum voluntary contraction (MVC) was recorded, and they were then required to hit a golf ball aiming for specific distances of 2, 50, 100 and 150 metres at a driving range. Noraxon myoResearch and Matlab were used for data analysis. Mean % MVC was calculated for leading and trailing arms during the full swing and its’ 4 phases: back-swing, acceleration, early follow-through and late follow-through. Results: 12 golfers (2 female and 10 male), participated in the study. Median age was 27 (25 – 38), with all being right handed. Over all distances, the mean activation of the short and long head of biceps brachii was < 10% through the full swing. When breaking down the 50, 100 and 150m swing into phases, mean MVC activation was lowest in backswing (5.1%), followed by acceleration (9.7%), early follow-through (9.2%), and late follow-through (21.4%). There was more variation and slightly higher activation in the right biceps (trailing arm) in backswing, acceleration, and early follow-through; with higher activation in the leading arm in late follow-through (25.4% leading, 17.3% trailing). 2m putts resulted in low MVC values (3.1% ) with little variation across swing phases. There was considerable individual variation in results – one tense subject averaged 11.0% biceps MVC through the 2m putting stroke and others recorded peak mean MVC biceps activations of 68.9% at 50m, 101.3% at 100m, and 111.3% at 150m. Discussion: Previous studies have investigated the role of rotator cuff, spine, and hip muscles during the golf swing however, to our knowledge, this is the first study that investigates the activation of biceps brachii. Many rehabilitation programs following a biceps tenodesis or repair allow active range against gravity and restrict strengthening exercises until 6 weeks, and this does not appear to be associated with any adverse outcome. Previous studies demonstrate a range of < 10% MVC is similar to the unloaded biceps brachii during walking(1), active elbow flexion with the hand positioned either in pronation or supination will produce MVC < 20% throughout range(2) and elbow flexion with a 4kg dumbbell can produce mean MVC’s of around 40%(3). Our study demonstrates that increasing activation is associated with the leading arm, increasing shot distance and the late follow-through phase. Although the cohort mean MVC of the biceps brachii is <10% through the full swing, variability is high and biceps activation reach peak mean MVC’s of over 100% in different swing phases for some individuals. Given these EMG values, caution is advised when advising patients post biceps procedures to return to long distance golf shots, particularly when the leading arm is involved. Even though it would appear that putting would be as safe as having an unloaded hand out of a sling following biceps procedures, the variability of activation patterns across different golfers would lead us to caution against accelerated golf rehabilitation in those who may be particularly tense golfers. The 50m short iron shot was too long to consider as a chip shot and more work can be done in this area to determine the safety of chipping.

Keywords: electromyographic analysis, biceps brachii rupture, golf swing, tendon surgery

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Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

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Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

Procedia PDF Downloads 92

Authors: Leah Li Echiverri, Haoyu Shang, Yue Li

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Wenzhou-Kean University (WKU) is a Sino-US Cooperative University in China. It practices the English Immersion Program (EIP), where all the courses are taught in English. Class discussions and presentations are pervasively interwoven in designing students’ learning experiences. This WKU model has brought positive influences on students and is in some way ahead of traditional college English majors. However, literature to support the perceptions on the positive outcomes of this teaching and learning model remain scarce. The distinctive profile of Chinese-ESL students in an English Medium of Instruction (EMI) environment contributes further to the scarcity of literature compared to existing studies conducted among ESL learners in Western educational settings. Hence, the study investigated the students’ perceptions towards the English Immersion Program and determine how it influences Chinese-ESL students’ academic performance (AP). This research can provide empirical data that would be helpful to educators, teaching practitioners, university administrators, and other researchers in making informed decisions when developing curricular reforms, instructional and pedagogical methods, and university-wide support programs using this educational model. The purpose of the study was to establish the relationship between the English Immersion Program and Academic Performance among Chinese-ESL students enrolled at WKU for the academic year 2020-2021. Course length, immersion location, course type, and instructional design were the constructs of the English immersion program. English language learning, learning efficiency, and class participation were used to measure academic performance. Descriptive-correlational design was used in this cross-sectional research project. A quantitative approach for data analysis was applied to determine the relationship between the English immersion program and Chinese-ESL students’ academic performance. The research was conducted at WKU; a Chinese-American jointly established higher educational institution located in Wenzhou, Zhejiang province. Convenience, random, and snowball sampling of 283 students, a response rate of 10.5%, were applied to represent the WKU student population. The questionnaire was posted through the survey website named Wenjuanxing and shared to QQ or WeChat. Cronbach’s alpha was used to test the reliability of the research instrument. Findings revealed that when professors integrate technology (PowerPoint, videos, and audios) in teaching, students pay more attention. This contributes to the acquisition of more professional knowledge in their major courses. As to course immersion, students perceive WKU as a good place to study, providing them a high degree of confidence to talk with their professors in English. This also contributes to their English fluency and better pronunciation in their communication. In the construct of designing instruction, the use of pictures, video clips, and professors’ non-verbal communication, and demonstration of concern for students encouraged students to be more active in-class participation. Findings on course length and academic performance indicated that students’ perception regarding taking courses during fall and spring terms can moderately contribute to their academic performance. In conclusion, the findings revealed a significantly strong positive relationship between course type, immersion location, instructional design, and academic performance.

Keywords: class participation, English immersion program, English language learning, learning efficiency

Procedia PDF Downloads 173

Authors: Gabriela Borilova, Monika Petrakova, Petr Kralik

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Nowadays, European producers are increasingly interested in the production of halal meat products. Halal meat has been increasingly appearing in the EU's market network and meat products from European producers are being exported to Islamic countries. Halal criteria are mainly related to the origin of muscle used in production, and also to the way products are obtained and processed. Although the EU has legislatively addressed the question of food authenticity, the circumstances of previous years when products with undeclared horse or poultry meat content appeared on EU markets raised the question of the effectiveness of control mechanisms. Replacement of expensive or not-available types of meat for low-priced meat has been on a global scale for a long time. Likewise, halal products may be contaminated (falsified) by pork or food components obtained from pigs. These components include collagen, offal, pork fat, mechanically separated pork, emulsifier, blood, dried blood, dried blood plasma, gelatin, and others. These substances can influence sensory properties of the meat products - color, aroma, flavor, consistency and texture or they are added for preservation and stabilization. Food manufacturers sometimes access these substances mainly due to their dense availability and low prices. However, the use of these substances is not always declared on the product packaging. Verification of the presence of declared ingredients, including the detection of undeclared ingredients, are among the basic control procedures for determining the authenticity of food. Molecular biology methods, based on DNA analysis, offer rapid and sensitive testing. The PCR method and its modification can be successfully used to identify animal species in single- and multi-ingredient raw and processed foods and qPCR is the first choice for food analysis. Like all PCR-based methods, it is simple to implement and its greatest advantage is the absence of post-PCR visualization by electrophoresis. qPCR allows detection of trace amounts of nucleic acids, and by comparing an unknown sample with a calibration curve, it can also provide information on the absolute quantity of individual components in the sample. Our study addresses a problem that is related to the fact that the molecular biological approach of most of the work associated with the identification and quantification of animal species is based on the construction of specific primers amplifying the selected section of the mitochondrial genome. In addition, the sections amplified in conventional PCR are relatively long (hundreds of bp) and unsuitable for use in qPCR, because in DNA fragmentation, amplification of long target sequences is quite limited. Our study focuses on finding a suitable genomic DNA target and optimizing qPCR to reduce variability and distortion of results, which is necessary for the correct interpretation of quantification results. In halal products, the impact of falsification of meat products by the addition of components derived from pigs is all the greater that it is not just about the economic aspect but above all about the religious and social aspect. This work was supported by the Ministry of Agriculture of the Czech Republic (QJ1530107).

Keywords: food fraud, halal food, pork, qPCR

Procedia PDF Downloads 246

Authors: Alireza Shams, Ali Zamanian, Atefehe Shamosi, Farnaz Ghorbani

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Introduction: Although the application of a new strategy remains a remarkable challenge for treatment of disabilities due to neuronal defects, progress in Nanomedicine and tissue engineering, suggesting the new medical methods. One of the promising strategies for reconstruction and regeneration of nervous tissue is replacing of lost or damaged cells by specific scaffolds after Compressive, ischemic and traumatic injuries of central nervous system. Furthermore, ultrastructure, composition, and arrangement of tissue scaffolds are effective on cell grafts. We followed implantation and differentiation of mesenchyme stem cells to neural cells on Gelatin Polylactic-co-glycolic acid (PLGA) scaffolds coated with iron nanoparticles. The aim of this study was to evaluate the capability of stem cells to differentiate into motor neuron-like cells under topographical cues and morphogenic factors. Methods and Materials: Bone marrow mesenchymal stem cells (BMMSCs) was obtained by primary cell culturing of adult rat bone marrow got from femur bone by flushing method. BMMSCs were incubated with DMEM/F12 (Gibco), 15% FBS and 100 U/ml pen/strep as media. Then, BMMSCs seeded on Gel/PLGA scaffolds and tissue culture (TCP) polystyrene embedded and incorporated by Fe Nano particles (FeNPs) (Fe3o4 oxide (M w= 270.30 gr/mol.). For neuronal differentiation, 2×10 5 BMMSCs were seeded on Gel/PLGA/FeNPs scaffolds was cultured for 7 days and 0.5 µ mol. Retinoic acid, 100 µ mol. Ascorbic acid,10 ng/ml. Basic fibroblast growth factor (Sigma, USA), 250 μM Iso butyl methyl xanthine, 100 μM 2-mercaptoethanol, and 0.2 % B27 (Invitrogen, USA) added to media. Proliferation of BMMSCs was assessed by using MTT assay for cell survival. The morphology of BMMSCs and scaffolds was investigated by scanning electron microscopy analysis. Expression of neuron-specific markers was studied by immunohistochemistry method. Data were analyzed by analysis of variance, and statistical significance was determined by Turkey’s test. Results: Our results revealed that differentiation and survival of BMMSCs into motor neuron-like cells on Gel/PLGA/FeNPs as a biocompatible and biodegradable scaffolds were better than those cultured in Gel/PLGA in absence of FeNPs and TCP scaffolds. FeNPs had raised physical power but decreased capacity absorption of scaffolds. Well defined oriented pores in scaffolds due to FeNPs may activate differentiation and synchronized cells as a mechanoreceptor. Induction effects of magnetic FeNPs by One way flow of channels in scaffolds help to lead the cells and can facilitate direction of their growth processes. Discussion: Progression of biological properties of BMMSCs and the effects of FeNPs spreading under magnetic field was evaluated in this investigation. In vitro study showed that the Gel/PLGA/FeNPs scaffold provided a suitable structure for motor neuron-like cells differentiation. This could be a promising candidate for enhancing repair and regeneration in neural defects. Dynamic and static magnetic field for inducing and construction of cells can provide better results for further experimental studies.

Keywords: differentiation, mesenchymal stem cells, nano particles, neuronal defects, Scaffolds

Procedia PDF Downloads 165

Authors: Yan Zhang

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Predictive maintenance is a technique to predict when an in-service machine will fail so that maintenance can be planned in advance. Analytics-driven predictive maintenance is gaining increasing attention in many industries such as manufacturing, utilities, aerospace, etc., along with the emerging demand of Internet of Things (IoT) applications and the maturity of technologies that support Big Data storage and processing. This study aims to build an end-to-end analytics solution that includes both real-time machine condition monitoring and machine learning based predictive analytics capabilities. The goal is to showcase a general predictive maintenance solution architecture, which suggests how the data generated from field machines can be collected, transmitted, stored, and analyzed. We use a publicly available aircraft engine run-to-failure dataset to illustrate the streaming analytics component and the batch failure prediction component. We outline the contributions of this study from four aspects. First, we compare the predictive maintenance problems from the view of the traditional reliability centered maintenance field, and from the view of the IoT applications. When evolving to the IoT era, predictive maintenance has shifted its focus from ensuring reliable machine operations to improve production/maintenance efficiency via any maintenance related tasks. It covers a variety of topics, including but not limited to: failure prediction, fault forecasting, failure detection and diagnosis, and recommendation of maintenance actions after failure. Second, we review the state-of-art technologies that enable a machine/device to transmit data all the way through the Cloud for storage and advanced analytics. These technologies vary drastically mainly based on the power source and functionality of the devices. For example, a consumer machine such as an elevator uses completely different data transmission protocols comparing to the sensor units in an environmental sensor network. The former may transfer data into the Cloud via WiFi directly. The latter usually uses radio communication inherent the network, and the data is stored in a staging data node before it can be transmitted into the Cloud when necessary. Third, we illustrate show to formulate a machine learning problem to predict machine fault/failures. By showing a step-by-step process of data labeling, feature engineering, model construction and evaluation, we share following experiences: (1) what are the specific data quality issues that have crucial impact on predictive maintenance use cases; (2) how to train and evaluate a model when training data contains inter-dependent records. Four, we review the tools available to build such a data pipeline that digests the data and produce insights. We show the tools we use including data injection, streaming data processing, machine learning model training, and the tool that coordinates/schedules different jobs. In addition, we show the visualization tool that creates rich data visualizations for both real-time insights and prediction results. To conclude, there are two key takeaways from this study. (1) It summarizes the landscape and challenges of predictive maintenance applications. (2) It takes an example in aerospace with publicly available data to illustrate each component in the proposed data pipeline and showcases how the solution can be deployed as a live demo.

Keywords: Internet of Things, machine learning, predictive maintenance, streaming data

Procedia PDF Downloads 383

Authors: Juergen Junk, Franz Ronellenfitsch, Michael Eickermann

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An appropriate weed management in autumn is a prerequisite for an economically successful harvest in the following year. In Luxembourg oilseed rape, wheat and barley is sown from August until October, accompanied by a chemical weed control with soil active herbicides, depending on the state of the weeds and the meteorological conditions. Based on regular ground and surface water-analysis, high levels of contamination by transformation products of respective herbicide compounds have been found in Luxembourg. The most ideal conditions for incorporating soil active herbicides are single rain events. Weed control may be reduced if application is made when weeds are under drought stress or if repeated light rain events followed by dry spells, because the herbicides tend to bind tightly to the soil particles. These effects have been frequently reported for Luxembourg throughout the last years. In the framework of a multisite long-term field experiment (EFFO) weed monitoring, plants observations and corresponding meteorological measurements were conducted. Long-term time series (1947-2016) from the SYNOP station Findel-Airport (WMO ID = 06590) showed a decrease in the number of days with precipitation. As the total precipitation amount has not significantly changed, this indicates a trend towards rain events with higher intensity. All analyses are based on decades (10-day periods) for September and October of each individual year. To assess the future meteorological conditions for Luxembourg, two different approaches were applied. First, multi-model ensembles from the CORDEX experiments (spatial resolution ~12.5 km; transient projections until 2100) were analysed for two different Representative Concentration Pathways (RCP8.5 and RCP4.5), covering the time span from 2005 until 2100. The multi-model ensemble approach allows for the quantification of the uncertainties and also to assess the differences between the two emission scenarios. Second, to assess smaller scale differences within the country a high resolution model projection using the COSMO-LM model was used (spatial resolution 1.3 km). To account for the higher computational demands, caused by the increased spatial resolution, only 10-year time slices have been simulated (reference period 1991-2000; near future 2041-2050 and far future 2091-2100). Statistically significant trends towards higher air temperatures, +1.6 K for September (+5.3 K far future) and +1.3 K for October (+4.3 K), were predicted for the near future compared to the reference period. Precipitation simultaneously decreased by 9.4 mm (September) and 5.0 mm (October) for the near future and -49 mm (September) and -10 mm (October) in the far future. Beside the monthly values also decades were analyzed for the two future time periods of the CLM model. For all decades of September and October the number of days with precipitation decreased for the projected near and far future. Changes in meteorological variables such as air temperature and precipitation did already induce transformations in weed societies (composition, late-emerging etc.) of arable ecosystems in Europe. Therefore, adaptations of agronomic practices as well as effective weed control strategies must be developed to maintain crop yield.

Keywords: CORDEX projections, dry spells, ensembles, weed management

Procedia PDF Downloads 234

Authors: Anzal Abbas Jaffari, Wajiha Javed, Naseem Salahuddin

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Rationale: Rabies, a vaccine preventable disease, continues to be a critical public health issue as it kills around 2000-5000 people annually in Pakistan. Along with the disease spread among animals, the dog population remains a victim of brutal culling practices by the local authorities, which adversely affects ecosystem (sinking of poison in the soil – affecting vegetation & contaminating water) and the disease spread. The dog population has been exponentially rising primarily because a lack of a consolidated nationwide Animal Birth Control program and awareness among the local communities in general and children in particular. This is reflected in Pakistan’s low SARE score - 1.5, which makes the country trails behind other developing countries like Bangladesh (2.5) and Philippines (3.5).According to an estimate, the province of Sindh alone is home to almost 2.5 million dogs. The clustering of dogs in Peri-Urban areas and inner cities localities leads to an increase of reported dog bite cases in these areas specifically. Objective: Rabies Free Pakistan (RFP), which is a joint venture of Getz Pharma Private Limited and Indus Hospital & Health Network (IHHN); it was established in 2018 to eliminate Rabies from Pakistan by 2030 using the One Health Approach. Methodology: The RFP team is actively working on advocacy and policy front with both the Federal & Provincial government to ensure that all stakeholders currently involved in dog culling in Pakistan have a paradigm shift towards humane methods of vaccination and ABC. Along with the federal government, RFP aims to declare Rabies as a notifiable disease. Whereas RFP closely works with the provincial government of Sindh to initiate a province wide Rabies Control Program.RFP program follows international standards and WHO approved protocols for this program in Pakistan.RFP team has achieved various milestones in the fight against Rabies after successfully scaling up project operations and has vaccinated more than 30,000 dogs and neutered around 7,000 dogs since 2018. Recommendations: Effective implementation of Rabies program (MDV and ABC) requires a concentrated effort to address a variety of structural and policy challenges. This essentially demands a massive shift in the attitude of individuals towards rabies. The two most significant challenges in implementing a standard policy at the structural level are lack of institutional capacity, shortage of vaccine, and absence of inter-departmental coordination among major stakeholders: federal government, provincial ministry of health, livestock, and local bodies (including local councils). The lack of capacity in health care workers to treat dog bite cases emerges as a critical challenge at the clinical level. Conclusion: Pakistan can learn from the successful international models of Sri Lanka and Mexico as they adopted the One Health Approach to eliminate rabies like RFP. The WHO advised One Health approach provides the policymakers with an interactive and cross-sectoral guide, which involves all the essential elements of the eco system (including animals, humans, and other components).

Keywords: animal birth control, dog population, mass dog vaccination, one health, rabies elimination

Procedia PDF Downloads 179

Authors: O. Zlatkin-Troitschanskaia, J. Fischer, C. Lautenbach, H. A. Pant

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In 21st century higher education (HE), the diversity among students has increased in recent years due to the internationalization and higher mobility. Offering and providing equal and fair opportunities based on students’ individual skills and abilities instead of their social or cultural background is one of the major aims of HE. In this context, valid, objective and transparent assessments of students’ preconditions and academic competencies in HE are required. However, as analyses of the current states of research and practice show, a substantial research gap on assessment practices in HE still exists, calling for the development of effective solutions. These demands lead to significant conceptual and methodological challenges. Funded by the German Federal Ministry of Education and Research, the research program 'Modeling and Measuring Competencies in Higher Education – Validation and Methodological Challenges' (KoKoHs) focusses on addressing these challenges in HE assessment practice by modeling and validating objective test instruments. Including 16 cross-university collaborative projects, the German-wide research program contributes to bridging the research gap in current assessment research and practice by concentrating on practical and policy-related challenges of assessment in HE. In this paper, we present a differentiated overview of existing assessments of HE at the national and international level. Based on the state of research, we describe the theoretical and conceptual framework of the KoKoHs Program as well as results of the validation studies, including their key outcomes. More precisely, this includes an insight into more than 40 developed assessments covering a broad range of transparent and objective methods for validly measuring domain-specific and generic knowledge and skills for five major study areas (Economics, Social Science, Teacher Education, Medicine and Psychology). Computer-, video- and simulation-based instruments have been applied and validated to measure over 20,000 students at the beginning, middle and end of their (bachelor and master) studies at more than 300 HE institutions throughout Germany or during their practical training phase, traineeship or occupation. Focussing on the validity of the assessments, all test instruments have been analyzed comprehensively, using a broad range of methods and observing the validity criteria of the Standards for Psychological and Educational Testing developed by the American Educational Research Association, the American Economic Association and the National Council on Measurement. The results of the developed assessments presented in this paper, provide valuable outcomes to predict students’ skills and abilities at the beginning and the end of their studies as well as their learning development and performance. This allows for a differentiated view of the diversity among students. Based on the given research results practical implications and recommendations are formulated. In particular, appropriate and effective learning opportunities for students can be created to support the learning development of students, promote their individual potential and reduce knowledge and skill gaps. Overall, the presented research on competency assessment is highly relevant to national and international HE practice.

Keywords: 21st century skills, academic competencies, innovative assessments, KoKoHs

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Authors: Maisam Rafiee, Chikashi Deguchi, Akio Odake, Minoru Matsui, Takanori Sata

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Cities in Afghanistan have been rapidly urbanized; however, many parts of these cities have been developed with no detailed land use plan or infrastructure. In other words, they have been informally developed without any government leadership. The new government started the In-situ Upgrading Project in Kabul to upgrade roads, the water supply network system, and the surface water drainage system on the existing street layout in 2002, with the financial support of international agencies. This project is an appropriate emergency improvement for living life, but not an essential improvement of living conditions and infrastructure problems because the life expectancies of the improved facilities are as short as 10–15 years, and residents cannot obtain land tenure in the unplanned areas. The Land Readjustment System (LRS) conducted in Japan has good advantages that rearrange irregularly shaped land lots and develop the infrastructure effectively. This study investigates the effects of the In-situ Upgrading Project on private investment, land prices, and residents’ satisfaction with projects in Kart-e-Char, where properties are registered, and in Afshar-e-Silo Lot 1, where properties are unregistered. These projects are located 5 km and 7 km from the CBD area of Kabul, respectively. This study discusses whether LRS should be applied to the unplanned area based on the questionnaire and interview responses of experts experienced in the In-situ Upgrading Project who have knowledge of LRS. The analysis results reveal that, in Kart-e-Char, a lot of private investment has been made in the construction of medium-rise (five- to nine-story) buildings for commercial and residential purposes. Land values have also incrementally increased since the project, and residents are commonly satisfied with the road pavement, drainage systems, and water supplies, but dissatisfied with the poor delivery of electricity as well as the lack of public facilities (e.g., parks and sport facilities). In Afshar-e-Silo Lot 1, basic infrastructures like paved roads and surface water drainage systems have improved from the project. After the project, a few four- and five-story residential buildings were built with very low-level private investments, but significant increases in land prices were not evident. The residents are satisfied with the contribution ratio, drainage system, and small increase in land price, but there is still no drinking water supply system or tenure security; moreover, there are substandard paved roads and a lack of public facilities, such as parks, sport facilities, mosques, and schools. The results of the questionnaire and interviews with the four engineers highlight the problems that remain to be solved in the unplanned areas if LRS is applied—namely, land use differences, types and conditions of the infrastructure still to be installed by the project, and time spent for positive consensus building among the residents, given the project’s budget limitation.

Keywords: in-situ upgrading, Kabul city, land readjustment, land value, planned area, private investment, residents' satisfaction, unplanned area

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Authors: Prince Chukwuneme Enwereji, Annelien Van Rooyen

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In recent years, technology integration in education has transformed the learning landscape, particularly in online institutions. One technological advancement that has gained popularity is e-tutoring, which offers personalised academic support to students through online platforms. While e-tutoring has become well-known and has been adopted to promote collaborative learning, there are still students who do not use these services for various reasons. However, little attention has been given to understanding the perspectives of students who have not utilized these services. The research objectives include identifying the perceived benefits that non-e-tutoring students believe e-tutoring could offer, such as enhanced academic support, personalized learning experiences, and improved performance. Additionally, the study explored the potential drawbacks or concerns that non-e-tutoring students associate with e-tutoring, such as concerns about efficacy, a lack of face-to-face interaction, and platform accessibility. The study adopted a quantitative research approach with a descriptive design to gather and analyze data on non-e-tutoring students' perspectives. Online questionnaires were employed as the primary data collection method, allowing for the efficient collection of data from many participants. The collected data was analyzed using the Statistical Package for the Social Sciences (SPSS). Ethical concepts such as informed consent, anonymity of responses and protection of respondents against harm were maintained. Findings indicate that non-e-tutoring students perceive a sense of control over their own pace of learning, suggesting a preference for self-directed learning and the ability to tailor their educational experience to their individual needs and learning styles. They also exhibit high levels of motivation, believe in their ability to effectively participate in their studies and organize their academic work, and feel comfortable studying on their own without the help of e-tutors. However, non-e-tutoring students feel that e-tutors do not sufficiently address their academic needs and lack engagement. They also perceive a lack of clarity in the roles of e-tutors, leading to uncertainty about their responsibilities. In terms of communication, students feel overwhelmed by the volume of announcements and find repetitive information frustrating. Additionally, some students face challenges with their internet connection and associated cost, which can hinder their participation in online activities. Furthermore, non-e-tutoring students express a desire for interactions with their peers and a sense of belonging to a group or team. They value opportunities for collaboration, teamwork in their learning experience, the importance of fostering social interactions and creating a sense of community in online learning environments. This study recommended that students seek alternate support systems by reaching out to professors or academic advisors for guidance and clarification. Developing self-directed learning skills is essential, empowering students to take charge of their own learning through setting objectives, creating own study plans, and utilising resources. For HEIs, it was recommended that they should ensure that a variety of support services are available to cater to the needs of all students, including non-e-tutoring students. HEIs should also ensure easy access to online resources, promote a supportive community, and regularly evaluate and adapt their support techniques to meet students' changing requirements.

Keywords: online-tutor;, student support;, online education, educational practices, distance education

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Authors: Alexandra Steed

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Alexandra Steed URBAN was commissioned to undertake the South Essex Green and Blue Infrastructure Study (SEGBI) on behalf of the Association of South Essex Local Authorities (ASELA): a partnership of seven neighboring councils within the Thames Estuary. Located on London’s doorstep, the 70,000-hectare region is under extraordinary pressure for regeneration, further development, and economic expansion, yet faces extreme challenges: sea-level rise and inadequate flood defenses, stormwater flooding and threatened infrastructure, loss of internationally important habitats, significant existing community deprivation, and lack of connectivity and access to green space. The brief was to embrace these challenges in the creation of a document that would form a key part of ASELA’s Joint Strategic Framework and feed into local plans and master plans. Thus, helping to tackle climate change, ecological collapse, and social inequity at a regional scale whilst creating a relationship and awareness between urban communities and the surrounding landscapes and nature. The SEGBI project applied a ‘land-based’ methodology, combined with a co-design approach involving numerous stakeholders, to explore how living infrastructure can address these significant issues, reshape future planning and development, and create thriving places for the whole community of life. It comprised three key stages, including Baseline Review; Green and Blue Infrastructure Assessment; and the final Green and Blue Infrastructure Report. The resulting proposals frame an ambitious vision for the delivery of a new regional South Essex Estuary (SEE) Park – 24,000 hectares of protected and connected landscapes. This unified parkland system will drive effective place-shaping and “leveling up” for the most deprived communities while providing large-scale nature recovery and biodiversity net gain. Comprehensive analysis and policy recommendations ensure best practices will be embedded within planning documents and decisions guiding future development. Furthermore, a Natural Capital Account was undertaken as part of the strategy showing the tremendous economic value of the natural assets. This strategy sets a pioneering precedent that demonstrates how the prioritisation of living infrastructure has the capacity to address climate change and ecological collapse, while also supporting sustainable housing, healthier communities, and resilient infrastructures. It was only achievable through a collaborative and cross-boundary approach to strategic planning and growth, with a shared vision of place, and a strong commitment to delivery. With joined-up thinking and a joined-up region, a more impactful plan for South Essex was developed that will lead to numerous environmental, social, and economic benefits across the region, and enhancing the landscape and natural environs on the periphery of one of the largest cities in the world.

Keywords: climate change, green and blue infrastructure, landscape architecture, master planning, regional planning, social equity

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Authors: Ma Chu Jui

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Culture plays a pivotal role in shaping societal responses to change and fostering adaptability. In the realm of healthcare provision, hospitals serve as dynamic settings molded by the cultural consciousness of healthcare professionals. This intricate interplay extends to their expectations of leadership, communication styles, and attitudes towards patient care. Recognizing the cultural inclinations of healthcare professionals becomes imperative in navigating this complex landscape. This study will utilize Hofstede's Value Survey Module 2013 (VSM 2013) as a comprehensive analytical tool. The targeted participants for this research are in-service nursing professionals with a tenure of at least three months, specifically employed in the nursing department of an Eastern hospital. This quantitative approach seeks to quantify diverse cultural tendencies among the targeted nursing professionals, elucidating not only abstract cultural concepts but also revealing their cultural inclinations across different dimensions. The study anticipates gathering between 400 to 500 responses, ensuring a robust dataset for a comprehensive analysis. The focused approach on nursing professionals within the Eastern hospital setting enhances the relevance and specificity of the cultural insights obtained. The research aims to contribute valuable knowledge to the understanding of cultural tendencies among in-service nursing personnel in the nursing department of this specific Eastern hospital. The VSM 2013 will be initially distributed to this specific group to collect responses, aiming to calculate scores on each of Hofstede's six cultural dimensions—Power Distance Index (PDI), Individualism vs. Collectivism (IDV), Uncertainty Avoidance Index (UAI), Masculinity vs. Femininity (MAS), Long-Term Orientation vs. Short-Term Normative Orientation (LTO), and Indulgence vs. Restraint (IVR). the study unveils a significant correlation between different cultural dimensions and healthcare professionals' tendencies in understanding leadership expectations through PDI, grasping behavioral patterns via IDV, acknowledging risk acceptance through UAI, and understanding their long-term and short-term behaviors through LTO. These tendencies extend to communication styles and attitudes towards patient care. These findings provide valuable insights into the nuanced interconnections between cultural factors and healthcare practices. Through a detailed analysis of the varying levels of these cultural dimensions, we gain a comprehensive understanding of the predominant inclinations among the majority of healthcare professionals. This nuanced perspective adds depth to our comprehension of how cultural values shape their approach to leadership, communication, and patient care, contributing to a more holistic understanding of the healthcare landscape. A profound comprehension of the cultural paradigms embraced by healthcare professionals holds transformative potential. Beyond a mere understanding, it acts as a catalyst for elevating the caliber of healthcare services. This heightened awareness fosters cohesive collaboration among healthcare teams, paving the way for the establishment of a unified healthcare ethos. By cultivating shared values, our study envisions a healthcare environment characterized by enhanced quality, improved teamwork, and ultimately, a more favorable and patient-centric healthcare landscape. In essence, our research underscores the critical role of cultural awareness in shaping the future of healthcare delivery.

Keywords: hofstede's cultural, cultural dimensions, cultural values in healthcare, cultural awareness in nursing

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Authors: Mohammadreza Nematollahi, Bahareh Mosadegh Sedghy, Alireza Tajbakhsh

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The last two decades have witnessed substantial attention to organic and sustainable agricultural supply chains. Motivated by real-world practices, this paper aims to address two main challenges observed in organic product supply chains: decentralized decision-making process between farmers and their retailers, and competition between organic products and their conventional counterparts. To this aim, an agricultural supply chain consisting of two farmers, a conventional farmer and an organic farmer who offers an organic version of the same product, is considered. Both farmers distribute their products through a single retailer, where there exists competition between the organic and the conventional product. The retailer, as the market leader, sets the wholesale price, and afterward, the farmers set their production quantity decisions. This paper first models the demand functions of the conventional and organic products by incorporating the effect of asymmetric brand equity, which captures the fact that consumers usually pay a premium for organic due to positive perceptions regarding their health and environmental benefits. Then, profit functions with consideration of some characteristics of organic farming, including crop yield gap and organic cost factor, are modeled. Our research also considers both economies and diseconomies of scale in farming production as well as the effects of organic subsidy paid by the government to support organic farming. This paper explores the investigated supply chain in three scenarios: decentralized, centralized, and coordinated decision-making structures. In the decentralized scenario, the conventional and organic farmers and the retailer maximize their own profits individually. In this case, the interaction between the farmers is modeled under the Bertrand competition, while analyzing the interaction between the retailer and farmers under the Stackelberg game structure. In the centralized model, the optimal production strategies are obtained from the entire supply chain perspective. Analytical models are developed to derive closed-form optimal solutions. Moreover, analytical sensitivity analyses are conducted to explore the effects of main parameters like the crop yield gap, organic cost factor, organic subsidy, and percent price premium of the organic product on the farmers’ and retailer’s optimal strategies. Afterward, a coordination scenario is proposed to convince the three supply chain members to shift from the decentralized to centralized decision-making structure. The results indicate that the proposed coordination scenario provides a win-win-win situation for all three members compared to the decentralized model. Moreover, our paper demonstrates that the coordinated model respectively increases and decreases the production and price of organic produce, which in turn motivates the consumption of organic products in the market. Moreover, the proposed coordination model helps the organic farmer better handle the challenges of organic farming, including the additional cost and crop yield gap. Last but not least, our results highlight the active role of the organic subsidy paid by the government as a means of promoting sustainable organic product supply chains. Our paper shows that although the amount of organic subsidy plays a significant role in the production and sales price of organic products, the allocation method of subsidy between the organic farmer and retailer is not of that importance.

Keywords: analytical game-theoretic model, product competition, supply chain coordination, sustainable organic supply chain

Procedia PDF Downloads 109

Authors: Katerina Krizova, Inigo Molina

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The ongoing climate change affects various natural processes resulting in significant changes in human life. Since there is still a growing human population on the planet with more or less limited resources, agricultural production became an issue and a satisfactory amount of food has to be reassured. To achieve this, agriculture is being studied in a very wide context. The main aim here is to increase primary production on a spatial unit while consuming as low amounts of resources as possible. In Europe, nowadays, the staple issue comes from significantly changing the spatial and temporal distribution of precipitation. Recent growing seasons have been considerably affected by long drought periods that have led to quantitative as well as qualitative yield losses. To cope with such kind of conditions, new techniques and technologies are being implemented in current practices. However, behind assessing the right management, there is always a set of the necessary information about plot properties that need to be acquired. Remotely sensed data had gained attention in recent decades since they provide spatial information about the studied surface based on its spectral behavior. A number of space platforms have been launched carrying various types of sensors. Spectral indices based on calculations with reflectance in visible and NIR bands are nowadays quite commonly used to describe the crop status. However, there is still the staple limit by this kind of data - cloudiness. Relatively frequent revisit of modern satellites cannot be fully utilized since the information is hidden under the clouds. Therefore, microwave remote sensing, which can penetrate the atmosphere, is on its rise today. The scientific literature describes the potential of radar data to estimate staple soil (roughness, moisture) and vegetation (LAI, biomass, height) properties. Although all of these are highly demanded in terms of agricultural monitoring, the crop moisture content is the utmost important parameter in terms of agricultural drought monitoring. The idea behind this study was to exploit the unique combination of SAR (Sentinel-1) and optical (Sentinel-2) data from one provider (ESA) to describe potential crop water stress during dry cropping season of 2019 at six winter wheat plots in the central Czech Republic. For the period of January to August, Sentinel-1 and Sentinel-2 images were obtained and processed. Sentinel-1 imagery carries information about C-band backscatter in two polarisations (VV, VH). Sentinel-2 was used to derive vegetation properties (LAI, FCV, NDWI, and SAVI) as support for Sentinel-1 results. For each term and plot, summary statistics were performed, including precipitation data and soil moisture content obtained through data loggers. Results were presented as summary layouts of VV and VH polarisations and related plots describing other properties. All plots performed along with the principle of the basic SAR backscatter equation. Considering the needs of practical applications, the vegetation moisture content may be assessed using SAR data to predict the drought impact on the final product quality and yields independently of cloud cover over the studied scene.

Keywords: precision agriculture, remote sensing, Sentinel-1, SAR, water content

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Authors: Chethana V. Casiker, Jagadishakumara B., Sunil G. M., Chaithra K., M. Soubadra Devy

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A majority of the world’s food crops depends on insects for pollination, among which bees are the most dominant taxon. Bees pollinate vegetables, fruits and oilseeds which are rich in essential micronutrients. Besides being a prerequisite for a nutritionally secure diet, agrarian economies such as India depend heavily on pollination for good yield and quality of the product. As cities all over the world expand rapidly, large tracts of green spaces are being built up. This, along with high usage of agricultural chemicals has reduced floral diversity and shrunk bee habitats. Indeed, pollinator decline is being reported from various parts of the world. Further, the FAO has reported a huge increase in the area of land under cultivation of pollinator-dependent crops. In the light of increasing demand for pollination and disappearing natural habitats, it is critical to understand whether and how urban spaces can support pollinators. To this end, this study investigates the influence of landscape and local habitat quality on bee community dynamics. To capture the dynamics of expanding cityscapes, the study employs a space for time substitution, wherein a transect along the gradient of urbanization substitutes a timeframe of increasing urbanization. This will help understand how pollinators would respond to changes induced by increasing intensity of urbanization in the future. Bengaluru, one of the fastest growing cities of Southern India, is an excellent site to study impacts associated with urbanization. With sites moving away from the Bengaluru’s centre and towards its peripheries, this study captures the changes in bee species diversity and richness along a gradient of urbanization. Bees were sampled under different land use types as well as in different types of vegetation, including plantations, croplands, fallow land, parks, lake embankments, and private gardens. The relationship between bee community metrics and key drivers such as a percentage of built-up area, land use practices, and floral resources was examined. Additionally, data collected using questionnaire interviews were used to understand people’s perceptions towards and level of dependence on pollinators. Our results showed that urban areas are capable of supporting bees. In fact, a greater diversity of bees was recorded in urban sites compared to adjoining rural areas. This suggests that bees are able to seek out patchy resources and survive in small fragments of habitat. Bee abundance and species richness correlated positively with floral abundance and richness, indicating the role of vegetation in providing forage and nesting sites which are crucial to their survival. Bee numbers were seen to decrease with increase in built-up area demonstrating that impervious surfaces could act as deterrents. Findings from this study challenge the popular notion of cities being biodiversity-bare spaces. There is indeed scope for conserving bees in urban landscapes, provided that there are city-scale planning and local initiative. Bee conservation can go hand in hand with efforts such as urban gardening and terrace farming that could help cities urbanize sustainably.

Keywords: bee, landscape ecology, urbanization, urban pollination

Procedia PDF Downloads 166

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

Procedia PDF Downloads 345

Authors: Melanie Grier, Adam Murry

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Objective: Worldwide, Indigenous Peoples experience underemployment and poverty at disproportionately higher rates than non-Indigenous people, despite similar rates of employment seeking. Euro-colonial conquest and genocidal assimilation policies are implicated as perpetuating poverty, which research consistently links to health and wellbeing disparities. Many of the contributors to poverty, such as inadequate income and lack of access to medical care, can be directly or indirectly linked to underemployment. Calls have been made to prioritize Indigenous perspectives in Industrial-Organizational (I/O) psychology research, yet the literature on Indigenous employment remains scarce. What does exist is disciplinarily diverse, topically scattered, and lacking evidence of community-based participatory research (CBPR) practices, a research project approach which prioritizes community leadership, partnership, and betterment and reduces the potential for harm. Due to the harmful colonial legacy of extractive scientific inquiry "on" rather than "with" Indigenous groups, Indigenous leaders and research funding agencies advocate for academic researchers to adopt reparative research methodologies such as CBPR to be used when studying issues pertaining to Indigenous Peoples or individuals. However, the frequency and consistency of CBPR implementation within scholarly discourse are unknown. Therefore, this project’s goal is two-fold: (1) to understand what comprises CBPR in Indigenous research and (2) to determine if CBPR has been historically used in Indigenous employment research. Method: Using a systematic literature review process, sixteen articles about CBPR use with Indigenous groups were selected, and content was analyzed to identify key components comprising CBPR usage. An Indigenous CBPR components framework was constructed and subsequently utilized to analyze the Indigenous employment empirical literature. A similar systematic literature review process was followed to search for relevant empirical articles on Indigenous employment. A total of 120 articles were identified in six global regions: Australia, New Zealand, Canada, America, the Pacific Islands, and Greenland/Norway. Each empirical study was procedurally examined and coded for criteria inclusion using content analysis directives. Results: Analysis revealed that, in total, CBPR elements were used 14% of the time in Indigenous employment research. Most studies (n=69; 58%) neglected to mention using any CBPR components, while just two studies discussed implementing all sixteen (2%). The most significant determinant of overall CBPR use was community member partnership (CP) in the research process. Studies from New Zealand were most likely to use CBPR components, followed by Canada, Australia, and America. While CBPR use did increase slowly over time, meaningful temporal trends were not found. Further, CBPR use did not directly correspond with the total number of topical articles published that year. Conclusions: Community-initiated and engaged research approaches must be better utilized in employment studies involving Indigenous Peoples. Future research efforts must be particularly attentive to community-driven objectives and research protocols, emphasizing specific areas of concern relevant to the field of I/O psychology, such as organizational support, recruitment, and selection.

Keywords: community-based participatory research, content analysis, employment, indigenous research, international, reconciliation, recruitment, reparative research, selection, systematic literature review

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Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

Procedia PDF Downloads 122

Authors: Nilki Upathissa, Torin Wirasinghe

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This solution addresses the challenges faced by traditional bookstores and the limitations of digital media, striking a balance between the tactile experience of printed books and the convenience of modern technology. The book exchange system offers a sustainable alternative, empowering users to access a diverse range of books while promoting community engagement. The user-friendly interfaces incorporated into the book exchange system ensure a seamless and enjoyable experience for users. Intuitive features for book management, search, and messaging facilitate effortless exchanges and interactions between users. By streamlining the process, the system encourages readers to explore new books aligned with their interests, enhancing the overall reading experience. Central to the system's success is the hybrid recommendation engine, which leverages advanced technologies such as Long Short-Term Memory (LSTM) models. By analyzing user input, the engine accurately predicts genre preferences, enabling personalized book recommendations. The hybrid approach integrates multiple technologies, including user interfaces, machine learning models, and recommendation algorithms, to ensure the accuracy and diversity of the recommendations. The evaluation of the book exchange system with the hybrid recommendation engine demonstrated exceptional performance across key metrics. The high accuracy score of 0.97 highlights the system's ability to provide relevant recommendations, enhancing users' chances of discovering books that resonate with their interests. The commendable precision, recall, and F1score scores further validate the system's efficacy in offering appropriate book suggestions. Additionally, the curve classifications substantiate the system's effectiveness in distinguishing positive and negative recommendations. This metric provides confidence in the system's ability to navigate the vast landscape of book choices and deliver recommendations that align with users' preferences. Furthermore, the implementation of this book exchange system with a hybrid recommendation engine has the potential to revolutionize the way readers interact with printed books. By facilitating book exchanges and providing personalized recommendations, the system encourages a sense of community and exploration within the reading community. Moreover, the emphasis on sustainability aligns with the growing global consciousness towards eco-friendly practices. With its robust technical approach and promising evaluation results, this solution paves the way for a more inclusive, accessible, and enjoyable reading experience for book lovers worldwide. In conclusion, the developed book exchange system with a hybrid recommendation engine represents a progressive solution to the challenges faced by traditional bookstores and the limitations of digital media. By promoting sustainability, widening access to printed books, and fostering engagement with reading, this system addresses the evolving needs of book enthusiasts. The integration of user-friendly interfaces, advanced machine learning models, and recommendation algorithms ensure accurate and diverse book recommendations, enriching the reading experience for users.

Keywords: recommendation systems, hybrid recommendation systems, machine learning, data science, long short-term memory, recurrent neural network

Procedia PDF Downloads 92

Authors: Michael Picard

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This proposal offers to shed light on the changing legal geography of the global waste economy. Global waste recycling has become a multi-billion-dollar industry. NASDAQ predicts the emergence of a worldwide 1,296G$ waste management market between 2017 and 2022. Underlining this evolution, a new generation of preferential waste-trade agreements has emerged in the Pacific. In the last decade, Japan has concluded a series of bilateral treaties with Asian countries, and most recently with China. An agreement between Tokyo and Beijing was formalized on 7 May 2008, which forged an economic partnership on waste transfer and mining. The agreement set up International Recycling Zones, where certified recycling plants in China process industrial waste imported from Japan. Under the joint venture, Chinese companies salvage the embedded value from Japanese industrial discards, reprocess them and send them back to Japanese manufacturers, such as Mitsubishi and Panasonic. This circular economy is designed to convert surplus garbage into surplus value. Ever since the opening of Sino-Japanese eco-parks, millions of tons of plastic and e-waste have been exported from Japan to China every year. Yet, quite unexpectedly, China has recently closed its waste market to imports, jeopardizing Japan’s billion-dollar exports to China. China notified the WTO that, by the end of 2017, it would no longer accept imports of plastics and certain metals. Given China’s share of Japanese waste exports, a complete closure of China’s market would require Japan to find new uses for its recyclable industrial trash generated domestically every year. It remains to be seen how China will effectively implement its ban on waste imports, considering the economic interests at stake. At this stage, what remains to be clarified is whether China's ban on waste imports will negatively affect the recycling trade between Japan and China. What is clear, though, is the rapid transformation in the legal geography of waste mining in East-Asia. For decades, East-Asian waste trade had been tied up in an ‘ecologically unequal exchange’ between the Japanese core and the Chinese periphery. This global unequal waste distribution could be measured by the Environmental Stringency Index, which revealed that waste regulation was 39% weaker in the Global South than in Japan. This explains why Japan could legally export its hazardous plastic and electronic discards to China. The asymmetric flow of hazardous waste between Japan and China carried the colonial heritage of international law. The legal geography of waste distribution was closely associated to the imperial construction of an ecological trade imbalance between the Japanese source and the Chinese sink. Thus, China’s recent decision to ban hazardous waste imports is a sign of a broader ecological shift. As a global economic superpower, China announced to the world it would no longer be the planet’s junkyard. The policy change will have profound consequences on the global circulation of waste, re-routing global waste towards countries south of China, such as Vietnam and Malaysia. By the time the Berlin Conference takes place in May 2018, the presentation will be able to assess more accurately the effect of the Chinese ban on the transboundary movement of waste in Asia.

Keywords: Asia, ecological unequal exchange, global waste trade, legal geography

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Authors: C. Bel, J. Nevado, F. Ciceri, M. Ropacki, T. Hoffmann, P. Lapunzina, C. Buesa

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Background: The Phelan-McDermid syndrome (PMS) is a genetic disorder caused by the deletion of the terminal region of chromosome 22 or mutation of the SHANK3 gene. Shank3 disruption in mice leads to dysfunction of synaptic transmission, which can be restored by epigenetic regulation with both Lysine Specific Demethylase 1 (LSD1) inhibitors. PMS subjects result in a variable degree of intellectual disability, delay or absence of speech, autistic spectrum disorders symptoms, low muscle tone, motor delays and epilepsy. Vafidemstat is an LSD1 inhibitor in Phase II clinical development with a well-established and favorable safety profile, and data supporting the restoration of memory and cognition defects as well as reduction of agitation and aggression in several animal models and clinical studies. Therefore, vafidemstat has the potential to become a first-in-class precision medicine approach to treat PMS patients. Aims: The goal of this research is to perform an observational trial to psychometrically characterize individuals carrying deletions in SHANK3 and build a foundation for subsequent precision psychiatry clinical trials with vafidemstat. Methodology: This study is characterizing the clinical profile of 20 to 40 subjects, > 16-year-old, with genotypically confirmed PMS diagnosis. Subjects will complete a battery of neuropsychological scales, including the Repetitive Behavior Questionnaire (RBQ), Vineland Adaptive Behavior Scales, Escala de Observación para el Diagnostico del Autismo (Autism Diagnostic Observational Scale) (ADOS)-2, the Battelle Developmental Inventory and the Behavior Problems Inventory (BPI). Results: By March 2021, 19 patients have been enrolled. Unsupervised hierarchical clustering of the results obtained so far identifies 3 groups of patients, characterized by different profiles of cognitive and behavioral scores. The first cluster is characterized by low Battelle age, high ADOS and low Vineland, RBQ and BPI scores. Low Vineland, RBQ and BPI scores are also detected in the second cluster, which in contrast has high Battelle age and low ADOS scores. The third cluster is somewhat in the middle for the Battelle, Vineland and ADOS scores while displaying the highest levels of aggression (high BPI) and repeated behaviors (high RBQ). In line with the observation that female patients are generally affected by milder forms of autistic symptoms, no male patients are present in the second cluster. Dividing the results by gender highlights that male patients in the third cluster are characterized by a higher frequency of aggression, whereas female patients from the same cluster display a tendency toward higher repetitive behavior. Finally, statistically significant differences in deletion sizes are detected comparing the three clusters (also after correcting for gender), and deletion size appears to be positively correlated with ADOS and negatively correlated with Vineland A and C scores. No correlation is detected between deletion size and the BPI and RBQ scores. Conclusions: Precision medicine may open a new way to understand and treat Central Nervous System disorders. Epigenetic dysregulation has been proposed to be an important mechanism in the pathogenesis of schizophrenia and autism. Vafidemstat holds exciting therapeutic potential in PMS, and this study will provide data regarding the optimal endpoints for a future clinical study to explore vafidemstat ability to treat shank3-associated psychiatric disorders.

Keywords: autism, epigenetics, LSD1, personalized medicine

Procedia PDF Downloads 163

Authors: Tuyuan Cheng

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As we age, many things become more difficult. Among the abilities are the linguistic and cognitive ones. Competing theories have shown that these two functions could diminish together or that one is selectively affected by the other. In other words, some proposes aging affects sentence production in the same way it affects sentence comprehension and other cognitive functions, while some argues it does not.To address this question, the current investigation is conducted into the critical aspect of sentences as well as cognitive abilities – the syntactic complexity and the number of perspective shifts being contained in the elicited production. Healthy non-pathological aging is often characterized by a cognitive and neural decline in a number of cognitive abilities. Although the language is assumed to be of the more stable domain, a variety of findings in the cognitive aging literature would suggest otherwise. Older adults often show deficits in language production and multiple aspects of comprehension. Nevertheless, while some age differences likely reflect cognitive decline, others might reflect changes in communicative goals, and some even display cognitive advantages. In the domain of language processing, research efforts have been made in tests that probed a variety of communicative abilities. In general, there exists a distinction: Comprehension seems to be selectively unaffected, while production does not. The current study raises a novel question and investigates whether aging affects the production of relative clauses (RCs) under the cognitive factor of perspective shifts. Based on Perspective Hypothesis (MacWhinney, 2000, 2005), our cognitive processes build upon a fundamental system of perspective-taking, and language provides a series of cues to facilitate the construction and shifting of perspectives. These cues include a wide variety of constructions, including RCs structures. In this regard, linguistic complexity can be determined by the number of perspective shifts, and the processing difficulties of RCs can be interpreted within the theory of perspective shifting. Two experiments were conducted to study language production under controlled conditions. In Experiment 1, older healthy participants were tested on standard measures of cognitive aging, including MMSE (Mini-Mental State Examination), ToMI-2 (a simplified Theory of Mind Inventory-2), and a perspective-shifting comprehension task programmed with E-Prime. The results were analyzed to examine if/how they are correlated with aging people’s subsequent production data. In Experiment 2, the production profile of differing RCs, SRC vs. ORC, were collected with healthy aging participants who perform a picture elicitation task. Variable containing 0, 1, or 2 perspective shifts were juxtaposed respectively to the pictures and counterbalanced presented for elicitation. In parallel, a controlled group of young adults were recruited to examine the linguistic and cognitive abilities in question. The results lead us to the discussion whetheraging affects RCs production in a manner determined by its semantic structure or the number of perspective shifts it contains or the status of participants’ mental understanding. The major findingsare: (1) Elders’ production on Chinese RCtypes did not display intrinsic difficulty asymmetry. (2) RC types (the linguistic structural features) and the cognitiveperspective shifts jointly play important roles in the elders’ RCproduction. (3) The production of RC may defy the aging in the case offlexibly preserved cognitive ability.

Keywords: cognition aging, perspective hypothesis, perspective shift, relative clauses, sentence complexity

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Authors: Vladimir Smirnov, Roman Tominov, Vadim Avilov, Oleg Ageev

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The creation of a new generation micro- and nanoelectronics elements opens up unlimited possibilities for electronic devices parameters improving, as well as developing neuromorphic computing systems. Interest in the latter is growing up every year, which is explained by the need to solve problems related to the unstructured classification of data, the construction of self-adaptive systems, and pattern recognition. However, for its technical implementation, it is necessary to fulfill a number of conditions for the basic parameters of electronic memory, such as the presence of non-volatility, the presence of multi-bitness, high integration density, and low power consumption. Several types of memory are presented in the electronics industry (MRAM, FeRAM, PRAM, ReRAM), among which non-volatile resistive memory (ReRAM) is especially distinguished due to the presence of multi-bit property, which is necessary for neuromorphic systems manufacturing. ReRAM is based on the effect of resistive switching – a change in the resistance of the oxide film between low-resistance state (LRS) and high-resistance state (HRS) under an applied electric field. One of the methods for the technical implementation of neuromorphic systems is cross-bar structures, which are ReRAM cells, interconnected by cross data buses. Such a structure imitates the architecture of the biological brain, which contains a low power computing elements - neurons, connected by special channels - synapses. The choice of the ReRAM oxide film material is an important task that determines the characteristics of the future neuromorphic system. An analysis of literature showed that many metal oxides (TiO2, ZnO, NiO, ZrO2, HfO2) have a resistive switching effect. It is worth noting that the manufacture of nanocomposites based on these materials allows highlighting the advantages and hiding the disadvantages of each material. Therefore, as a basis for the neuromorphic structures manufacturing, it was decided to use ZnₓTiᵧHfzOᵢ nanocomposite. It is also worth noting that the ZnₓTiᵧHfzOᵢ nanocomposite does not need an electroforming, which degrades the parameters of the formed ReRAM elements. Currently, this material is not well studied, therefore, the study of the effect of resistive switching in forming-free ZnₓTiᵧHfzOᵢ nanocomposite is an important task and the goal of this work. Forming-free nanocomposite ZnₓTiᵧHfzOᵢ thin film was grown by pulsed laser deposition (Pioneer 180, Neocera Co., USA) on the SiO2/TiN (40 nm) substrate. Electrical measurements were carried out using a semiconductor characterization system (Keithley 4200-SCS, USA) with W probes. During measurements, TiN film was grounded. The analysis of the obtained current-voltage characteristics showed a resistive switching from HRS to LRS resistance states at +1.87±0.12 V, and from LRS to HRS at -2.71±0.28 V. Endurance test shown that HRS was 283.21±32.12 kΩ, LRS was 1.32±0.21 kΩ during 100 measurements. It was shown that HRS/LRS ratio was about 214.55 at reading voltage of 0.6 V. The results can be useful for forming-free nanocomposite ZnₓTiᵧHfzOᵢ films in neuromorphic systems manufacturing. This work was supported by RFBR, according to the research project № 19-29-03041 mk. The results were obtained using the equipment of the Research and Education Center «Nanotechnologies» of Southern Federal University.

Keywords: nanotechnology, nanocomposites, neuromorphic systems, RRAM, pulsed laser deposition, resistive switching effect

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Authors: Shana Malio-Satele, Lemalu Silao Vaisola Sefo

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Introductory Statement: South Seas Healthcare is Ōtara’s largest Pacific health provider in South Auckland, New Zealand. Our vision is excellent health and well-being for Pacific people and all communities through strong Pacific values. During the DELTA and Omicron outbreak of COVID-19, our Pacific people, indigenous Māori, and the community of South Auckland were disproportionately affected and faced significant hardship with existing inequities magnified. This study highlights the community-based learnings of harnessing community-based strengths such as indigenous resilience, family-informed experiences and stories that provide critical insights that inform health reform changes that will be sustainable and equitable for all indigenous populations. This study is based on critical learnings acquired during COVID-19 that challenge the deficit narrative common in healthcare about indigenous populations. This study shares case studies of marginalised groups and religious groups and the successful application of indigenous cultural strengths, such as collectivism, positive protective factors, and using trusted relationships to create meaningful change in the way healthcare is delivered. The significance of this study highlights the critical conditions needed to adopt a community-informed way of creating integrated healthcare that works and the role that the community can play in being part of the solution. Methodologies: Key methodologies utilised are indigenous and Pacific-informed. To achieve critical learnings from the community, Pacific research methodologies, heavily informed by the Polynesian practice, were applied. Specifically, this includes; Teu Le Va (Understanding the importance of trusted relationships as a way of creating positive health solutions); The Fonofale Methodology (A way of understanding how health incorporates culture, family, the physical, spiritual, mental and other dimensions of health, as well as time, context and environment; The Fonua Methodology – Understanding the overall wellbeing and health of communities, families and individuals and their holistic needs and environmental factors and the Talanoa methodology (Researching through conversation, where understanding the individual and community is through understanding their history and future through stories). Major Findings: Key findings in the study included: 1. The collectivist approach in the community is a strengths-based response specific to populations, which highlights the importance of trusted relationships and cultural values to achieve meaningful outcomes. 2. The development of a “village model” which identified critical components to achieving health reform change; system navigation, a sense of service that was culturally responsive, critical leadership roles, culturally appropriate support, and the ability to influence the system enablers to support an alternative way of working. Concluding Statement: There is a strong connection between community-based strengths being implemented into healthcare strategies and reforms and the sustainable success of indigenous populations and marginalised communities accessing services that are cohesive, equitably resourced, accessible and meaningful for families. This study highlights the successful community-informed approaches and practices used during the COVID-19 response in New Zealand that are now being implemented in the current health reform.

Keywords: indigenous voice, community voice, health reform, New Zealand

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Authors: Francisco Julio Batle Lorente

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The present paper aims at presenting a new category of role for academia: proactive creator/promoter of communities of practice in emerging areas of innovation. It is based in research among practitioners in three different areas: social entrepreneurship, alumni engaged in entrepreneurship and innovation, and digital nomads. The concept of CoP is related to an intentionally created space to share experiences and collectively reflect on the cases arising from practice. Such an endeavour is not contemplated in the literature on academic roles in an explicit way. The goal of the paper is providing a framework for this function and throw some light on the perception and priorities of members of emerging communities (78 alumni, 154 social entrepreneurs, and 231 digital nomads) regarding community, learning, engagement, and networking, areas in which the university can help and, by doing so, contributing to signal the emerging area and creating new opportunities for the academia. The research methodology was based in Survey research. It is a specific type of field study that involves the collection of data from a sample of elements drawn from a well-defined population through the use of a questionnaire. It was considered that survey research might be valuable to the present project and help outline the utility of various study designs and future projects with the emerging communities that are the object of the investigation. Open questions were used for different topics, as well as critical incident technique. It was used a standard technique for survey sampling and questionnaire design. Finally, it was defined a procedure for pretesting questionnaires and for data collection. The questionnaire was channelled by means of google forms. The results indicate that the members of emerging, innovative CoPs and learning such the ones that were selected for this investigation lack cohesion, inspiration, networking, opportunities for creation of social capital, opportunities for collaboration beyond their existing and close network. The opportunity that arises for the academia from proactively helping articulate CoP (and Communities of learning) are related to key elements of any CoP/ CoL: community construction approaches, technological infrastructure, benefits, participation issues and urgent challenges, trust, networking, technical ability/training/development and collaboration. Beyond training, other three areas (networking, collaboration and urgent challenges) were the ones in which the contribution of universities to the communities were considered more interesting and workable to practitioners. The analysis of the responses for the open questions related to perception of the universities offer options for terra incognita to be explored for universities (signalling new areas, establishing broader collaborations with research, government, media and corporations, attracting investment). Based on the findings from this research, there is some evidence that CoPs can offer a formal and informal method of professional and interprofessional development for member of any emerging and innovative community and can decrease social and professional isolation. The opportunity that it offers to academia can increase the entrepreneurial and engaged university identity. It also moves to academia into a realm of civic confrontation of present and future challenges in a more proactive way.

Keywords: social innovation, new roles of academia, community of learning, community of practice

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Authors: Xu Qian

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This abstract explores the importance of building resilience within families and offers evidence-based strategies for promoting positive parenting and enhancing emotional well-being. It emphasizes the role of effective communication, conflict resolution, and fostering a supportive environment to strengthen family bonds and promote healthy child development. Introduction: The well-being and resilience of families play a crucial role in fostering healthy child development and promoting overall emotional well-being. This abstract highlights the significance of nurturing resilient families and provides evidence-based strategies for positive parenting. By focusing on effective communication, conflict resolution, and creating a supportive environment, families can strengthen their bonds and enhance emotional well-being for both parents and children. Methods: This abstract draws upon a comprehensive review of existing research and literature on resilient families, positive parenting, and emotional well-being. The selected studies employ various methodologies, including surveys, interviews, and longitudinal observations, to investigate the factors contributing to family resilience and the strategies that promote positive parenting practices. The findings from these studies serve as the foundation for the strategies discussed in this abstract. Results: The results of the reviewed studies demonstrate that effective communication within families is a key factor in building resilience and promoting emotional well-being. Open and honest communication allows family members to express their thoughts, feelings, and concerns, fostering trust and understanding. Conflict resolution skills, such as active listening, compromise, and problem-solving, are vital in managing conflicts constructively and preventing negative consequences on family dynamics and children's well-being. Creating a supportive environment that nurtures emotional well-being is another critical aspect of promoting resilient families. This includes providing emotional support, setting clear boundaries, and promoting positive discipline strategies. Research indicates that consistent and responsive parenting approaches contribute to improved self-regulation skills, emotional intelligence, and overall mental health in children. Discussion: The discussion centers on the implications of these findings for promoting positive parenting and emotional well-being. It emphasizes the need for parents to prioritize self-care and seek support when facing challenges. Parental well-being directly influences the quality of parenting and the overall family environment. By attending to their own emotional needs, parents can better meet the needs of their children and create a nurturing atmosphere. Furthermore, the importance of fostering resilience in children is highlighted. Resilient children are better equipped to cope with adversity, adapt to change, and thrive in challenging circumstances. By cultivating resilience through supportive relationships, encouragement of independence, and providing opportunities for growth, parents can foster their children's ability to bounce back from setbacks and develop essential life skills. Conclusion: In conclusion, nurturing resilient families is crucial for positive parenting and enhancing emotional well-being. This abstract presents evidence-based strategies that emphasize effective communication, conflict resolution, and creating a supportive environment. By implementing these strategies, parents can strengthen family bonds, promote healthy child development, and enhance overall family resilience. Investing in resilient families not only benefits individual family members but also contributes to the well-being of the broader community.

Keywords: childrearing families, family education, children's mental health, positive parenting, emotional health

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Authors: M. Doudi, M. H. Pazandeh, L. Rahimzadeh Torabi

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Bedsores are pressure ulcers that occur on the skin or tissue due to being immobile and lying in bed for extended periods. Bedsores have the potential to progress into open ulcers, increasing the possibility of variety of bacterial infection. Acinetobacter baumannii, a pathogen of considerable clinical importance, exhibited a significant correlation with Bedsores (pressure ulcers) infections, thereby manifesting a wide spectrum of antibiotic resistance. The emergence of drug resistance has led researchers to focus on alternative methods, particularly phage therapy, for tackling bacterial infections. Phage therapy has emerged as a novel therapeutic approach to regulate the activity of these agents. The management of bacterial infections greatly benefits from the clinical utilization of bacteriophages as a valuable antimicrobial intervention. The primary objective of this investigation consisted of isolating and discerning potent bacteriophage capable of targeting multi drug-resistant (MDR) and extensively drug-resistant (XDR) bacteria obtained from pressure ulcers. In present study, analyzed and isolated A. baumannii strains obtained from a cohort of patients suffering from pressure ulcers at Taleghani Hospital in Ahvaz, Iran. An approach that included biochemical and molecular identification techniques was used to determine the taxonomic classification of bacterial isolates at the genus and species levels. The molecular identification process was facilitated by using the 16S rRNA gene in combination with universal primers 27 F, and 1492 R. Bacteriophage was obtained through the isolation process conducted on treatment plant sewage located in Isfahan, Iran. The main goal of this study was to evaluate different characteristics of phage, such as their appearance, range of hosts they can infect, how quickly they can enter a host, their stability at varying temperatures and pH levels, their effectiveness in killing bacteria, the growth pattern of a single phage stage, mapping of enzymatic digestion, and identification of proteomics patterns. The findings demonstrated that an examination was conducted on a sample of 50 specimens, wherein 15 instances of A. baumannii were identified. These microorganisms are the predominant Gram-negative agents known to cause wound infections in individuals suffering from bedsores. The study's findings indicated a high prevalence of antibiotic resistance in the strains isolated from pressure ulcers, excluding the clinical strains that exhibited responsiveness to colistin.According to the findings obtained from assessments of host range and morphological characteristics of bacteriophage VbɸAB-1, it can be concluded that this phage possesses specificity towards A. Baumannii BAH_Glau1001 was classified as a member of the Plasmaviridae family. The bacteriophage mentioned earlier showed the strongest antibacterial effect at a temperature of 18 °C and a pH of 6.5. Through the utilization of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis on protein fragments, it was established that the bacteriophage VbɸAB-1 exhibited a size range between 50 and 75 kilodaltons (KDa). The numerous research findings on the effectiveness of phages and the safety studies conducted suggest that the phages studied in this research can be considered as a practical solution and recommended approach for controlling and treating stubborn pathogens in burn wounds among hospitalized patients.

Keywords: acinetobacter baumannii, extremely drug- resistant, phage therapy, surgery wound

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Authors: Ram Chandra Sah

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Few years back, naturally a very beautiful country Nepal was facing a lot of problems related to the practice of open defecation (having no toilet) by almost 98% people of the country. Now, the scenario is changed. Government of Nepal set the target of achieving the situation of basic level sanitation (toilets) facilities by 2017 AD for which the Sanitation and Hygiene Master Plan (SHMP) was brought in 2011 AD with the major beauty as institutional set up formation, local formal authority leadership, locally formulated strategic plan; partnership, harmonized and coordinated approach to working; no subsidy or support at a blanket level, community and local institutions or organizations mobilization approaches. Now, the Open Defecation Free (ODF) movement in the country is at a full swing. The Sanitation and Hygiene Master Plan (SHMP) has clearly defined Total Sanitation which is accepted to be achieved if all the households of the related boundary have achieved the 6 indicators such as the access and regular use of toilet(s), regular use of soap and water at the critical moments, regular practice of use of food hygiene behavior, regular practice of use of water hygiene behavior including household level purification of locally available drinking water, maintenance of regular personal hygiene with household level waste management and the availability of the state of overall clean environment at the concerned level of boundary. Nepal has 3158 Village Development Committees (VDC's) in the rural areas. Amarapuri VDC was selected for the purpose of achieving Total Sanitation. Based on the SHMP; different methodologies such as updating of Village Water Sanitation and Hygiene Coordination Committee (V-WASH-CC), Total Sanitation team formation including one volunteer for each indicator, campaigning through settlement meetings, midterm evaluation which revealed the need of ward level 45 (5 for all 9 wards) additional volunteers, ward wise awareness creation with the help of the volunteers, informative notice boards and hoarding boards with related messages at important locations, management of separate waste disposal rings for decomposable and non-decomposable wastes, related messages dissemination through different types of local cultural programs, public toilets construction and management by community level; mobilization of local schools, offices and health posts; reward and recognition to contributors etc. were adopted for achieving 100 % coverage of each indicator. The VDC was in a very worse situation in 2010 with just 50, 30, 60, 60, 40, 30 percent coverage of the respective indicators and became the first VDC of the country declared with Total Sanitation. The expected result of 100 percent coverage of all the indicators was achieved in 2 years 10 months and 19 days. Experiences of Amarapuri were replicated successfully in different parts of the country and many VDC's have been declared with the achievement of Total Sanitation. Thus, Community Mobilized Total Sanitation Movement in Nepal has supported a lot for achieving a Total Sanitation situation of the country with a minimal cost and it is believed that the approach can be very useful for other developing or under developed countries of the world.

Keywords: community mobilized, open defecation free, sanitation and hygiene master plan, total sanitation

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