Search results for: key influencing factors

Authors: Megan L. Srinivas

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Individuals with underlying rheumatologic diseases such as dermatomyositis may not adequately respond to tuberculin (PPD) skin tests, creating false negative results. These illnesses are frequently treated with immunosuppressive therapy making proper identification of TB infection imperative. A 59-year-old Filipino man was diagnosed with dermatomyositis on the basis of rash, electromyography, and muscle biopsy. He was initially treated with IVIG infusions and transitioned to oral prednisone and mycophenolate. The patient’s symptoms improved on this regimen. Six months after starting mycophenolate, the patient began having fevers, night sweats, and productive cough without hemoptysis. He moved from the Philippines 5 years prior to dermatomyositis diagnosis, denied sick contacts, and was PPD negative both at immigration and immediately prior to starting mycophenolate treatment. A third PPD was negative following the onset of these new symptoms. He was treated for community-acquired pneumonia, but symptoms worsened over 10 days and he developed watery diarrhea and a growing non-tender, non-mobile mass on the left side of his neck. A chest x-ray demonstrated a cavitary lesion in right upper lobe suspicious for TB that had not been present one month earlier. Chest CT corroborated this finding also exhibiting necrotic hilar and paratracheal lymphadenopathy. Neck CT demonstrated the left-sided mass as cervical chain lymphadenopathy. Expectorated sputum and stool samples contained acid-fast bacilli (AFB), cultures showing TB bacteria. Fine-needle biopsy of the neck mass (scrofula) also exhibited AFB. An MRI brain showed nodular enhancement suspected to be a tuberculoma. Mycophenolate was discontinued and dermatomyositis treatment was switched to oral prednisone with a 3-day course of IVIG. The patient’s infection showed sensitivity to standard RIPE (rifampin, isoniazid, pyrazinamide, and ethambutol) treatment. Within a week of starting RIPE, the patient’s diarrhea subsided, scrofula diminished, and symptoms significantly improved. By the end of treatment week 3, the patient’s sputum no longer contained AFB; he was removed from isolation, and was discharged to continue RIPE at home. He was discharged on oral prednisone, which effectively addressed his dermatomyositis. This case illustrates the unreliability of PPD tests in patients with long-term inflammatory diseases such as dermatomyositis. Other immunosuppressive therapies (adalimumab, etanercept, and infliximab) have been affiliated with conversion of latent TB to disseminated TB. Mycophenolate is another immunosuppressive agent with similar mechanistic properties. Thus, it is imperative that patients with long-term inflammatory diseases and high-risk TB factors initiating immunosuppressive therapy receive a TB blood test (such as a quantiferon gold assay) prior to the initiation of therapy to ensure that latent TB is unmasked before it can evolve into a disseminated form of the disease.

Keywords: dermatomyositis, immunosuppressant medications, mycophenolate, disseminated tuberculosis

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Authors: Ariane Plaisance, Holly O. Witteman, Patrick Michel Archambault

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Upon admission to an intensive care unit (ICU), all patients should discuss their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. We employed user-centered design to adapt an existing decision aid (DA) about CPR to create a novel wiki-based DA adapted to the context of a single ICU and tailored to individual patient’s risk factors. During Phase 1, we conducted three weeks of ethnography of the decision-making context in our ICU to identify clinician and patient needs for a decision aid. During this time, we observed five dyads of intensivists and patients discussing their wishes concerning life-sustaining interventions. We also conducted semi-structured interviews with the attending intensivists in this ICU. During Phase 2, we conducted three rounds of rapid prototyping involving 15 patients and 11 other allied health professionals. We recorded discussions between intensivists and patients and used a standardized observation grid to collect patients’ comments and sociodemographic data. We applied content analysis to field notes, verbatim transcripts and the completed observation grids. Each round of observations and rapid prototyping iteratively informed the design of the next prototype. We also used the programming architecture of a wiki platform to embed the GO-FAR prediction rule programming code that we linked to a risk graphics software to better illustrate outcome risks calculated. During Phase I, we identified the need to add a section in our DA concerning invasive mechanical ventilation in addition to CPR because both life-sustaining interventions were often discussed together by physicians. During Phase II, we produced a context-adapted decision aid about CPR and mechanical ventilation that includes a values clarification section, questions about the patient’s functional autonomy prior to admission to the ICU and the functional decline that they would judge acceptable upon hospital discharge, risks and benefits of CPR and invasive mechanical ventilation, population-level statistics about CPR, a synthesis section to help patients come to a final decision and an online calculator based on the GO-FAR prediction rule. Even though the three rounds of rapid prototyping led to simplifying the information in our DA, 60% (n= 3/5) of the patients involved in the last cycle still did not understand the purpose of the DA. We also identified gaps in the discussion and documentation of patients’ preferences concerning life-sustaining interventions (e.g.,. CPR, invasive mechanical ventilation). The final version of our DA and our online wiki-based GO-FAR risk calculator using the IconArray.com risk graphics software are available online at www.wikidecision.org and are ready to be adapted to other contexts. Our results inform producers of decision aids on the use of wikis and user-centered design to develop DAs that are better adapted to users’ needs. Further work is needed on the creation of a video version of our DA. Physicians will also need the training to use our DA and to develop shared decision-making skills about goals of care.

Keywords: ethnography, intensive care units, life-sustaining therapies, user-centered design

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Authors: Emilia Pietiläinen, Heikki Kyröläinen, Tommi Vasankari, Matti Santtila, Tiina Luukkaala, Kai Parkkola

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Working in the military sets special demands on physical fitness, however, reduced physical activity levels among employees in the Finnish Defence Forces (FDF), a trend also being seen among the working-age population in Finland, is leading to reduced physical fitness levels and increased risk of cardiovascular and metabolic diseases, something which also increases human resource costs. Therefore, the aim of the present study was to develop an eHealth intervention using accelerometer- smartphone app feedback technique, telephone counseling and physical activity recordings to increase physical activity of the personnel and thereby improve their health. Specific aims were to reduce stress, improve quality of sleep and mental and physical performance, ability to work and reduce sick leave absences. Employees from six military brigades around Finland were invited to participate in the study, and finally, 260 voluntary participants were included (66 women, 194 men). The participants were randomized into intervention (156) and control groups (104). The eHealth intervention group used accelerometers measuring daily physical activity and duration and quality of sleep for six months. The accelerometers transmitted the data to smartphone apps while giving feedback about daily physical activity and sleep. The intervention group participants were also encouraged to exercise for two hours a week during working hours, a benefit that was already offered to employees following existing FDF guidelines. To separate the exercise done during working hours from the accelerometer data, the intervention group marked this exercise into an exercise diary. The intervention group also participated in telephone counseling about their physical activity. On the other hand, the control group participants continued with their normal exercise routine without the accelerometer and feedback. They could utilize the benefit of being able to exercise during working hours, but they were not separately encouraged for it, nor was the exercise diary used. The participants were measured at baseline, after the entire intervention period, and six months after the end of the entire intervention. The measurements included accelerometer recordings, biochemical laboratory tests, body composition measurements, physical fitness tests, and a wide questionnaire focusing on sociodemographic factors, physical activity and health. In terms of results, the primary indicators of effectiveness are increased physical activity and fitness, improved health status, and reduced sick leave absences. The evaluation of the present scientific reach is based on the data collected during the baseline measurements. Maintenance of the studied outcomes is assessed by comparing the results of the control group measured at the baseline and a year follow-up. Results of the study are not yet available but will be presented at the conference. The present findings will help to develop an easy and cost-effective model to support the health and working capability of employees in the military and other workplaces.

Keywords: accelerometer, health, mobile applications, physical activity, physical performance

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Authors: Rajkumar Ghosh, Bhabani Prasad Mukhopadhay

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Rice milling is an important activity in agricultural economy of India, particularly the Burdwan district. However, the environmental impact of rice mills is frequently underestimated. The environmental impact of rice mills in the Burdwan district is a major source of concern, given the importance of rice milling in the local economy and food supply. In the Burdwan district, more than fifty (50) rice mills are in operation. The goal of this study is to investigate the effects of rice mills on several environmental components, with a particular emphasis on groundwater, surface water, soil, and vegetation. The research comprises a thorough review of numerous rice mills located around the district, utilising both qualitative and quantitative approaches. Water samples taken from wells near rice mills will be tested for groundwater quality, with an emphasis on factors such as heavy metal pollution and pollutant concentrations. Monitoring rice mill discharge into neighbouring bodies of water and studying the potential impact on aquatic ecosystems will be part of surface water evaluations. Furthermore, soil samples from the surrounding areas will be taken to examine changes in soil characteristics, nutrient content, and potential contamination from milling waste disposal. Vegetation studies will be conducted to investigate the effects of emissions and effluents on plant health and biodiversity in the region. The findings will provide light on the extent of environmental degradation caused by rice mills in the Burdwan district, as well as valuable insight into the effects of such operations on water, soil, and vegetation. The findings will aid in the development of appropriate legislation and regulations to reduce negative environmental repercussions and promote sustainable practises in the rice milling business. In some cases, heavy metals have been related to health problems. Heavy metals (As, Cd, Cu, Pb, Cr, Hg) are linked to skin, lung, brain, kidney, liver, metabolic, spleen, cardiovascular, haematological, immunological, gastrointestinal, testes, pancreatic, metabolic, and bone problems. As a result, this study contributes to a better knowledge of industrial environmental impacts and establishes the framework for future studies aimed at developing a more ecologically balanced and resilient Burdwan district. The following recommendations are offered for reducing the rice mill's environmental impact: To keep untreated effluents out of bodies of water, adequate waste management systems must be established. Use environmentally friendly rice milling processes to reduce pollution. To avoid soil pollution, rice mill by-products should be used as fertiliser in a controlled and appropriate manner. Groundwater, surface water, soil, and vegetation are all regularly monitored in order to study and adapt to environmental changes. By adhering to these principles, the rice milling industry of Burdwan district may achieve long-term growth while lowering its environmental effect and safeguarding the environment for future generations.

Keywords: groundwater, environmental analysis, biodiversity, rice mill, waste management, diseases, industrial impact

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Authors: Orkide Donma, Mustafa M. Donma

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Obesity is a low-grade inflammatory disease and may lead to health problems such as hypertension, dyslipidemia, diabetes. It is also associated with important risk factors for cardiovascular diseases. This requires the detailed evaluation of obesity, particularly in children. The aim of this study is to enlighten the potential associations between lipid ratios and obesity indices and to introduce those with discriminating features among children with obesity and metabolic syndrome (MetS). A total of 408 children (aged between six and eighteen years) participated in the scope of the study. Informed consent forms were taken from the participants and their parents. Ethical Committee approval was obtained. Anthropometric measurements such as weight, height as well as waist, hip, head, neck circumferences and body fat mass were taken. Systolic and diastolic blood pressure values were recorded. Body mass index (BMI), diagnostic obesity notation model assessment index-II (D2 index), waist-to-hip, head-to-neck ratios were calculated. Total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDLChol), low-density lipoprotein cholesterol (LDLChol) analyses were performed in blood samples drawn from 110 children with normal body weight, 164 morbid obese (MO) children and 134 children with MetS. Age- and sex-adjusted BMI percentiles tabulated by World Health Organization were used to classify groups; normal body weight, MO and MetS. 15^th-to-85^th percentiles were used to define normal body weight children. Children, whose values were above the 99th percentile, were described as MO. MetS criteria were defined. Data were evaluated statistically by SPSS Version 20. The degree of statistical significance was accepted as p≤0.05. Mean±standard deviation values of BMI for normal body weight children, MO children and those with MetS were 15.7±1.1, 27.1±3.8 and 29.1±5.3 kg/m², respectively. Corresponding values for the D2 index were calculated as 3.4±0.9, 14.3±4.9 and 16.4±6.7. Both BMI and D2 index were capable of discriminating the groups from one another (p≤0.01). As far as other obesity indices were considered, waist-to hip and head-to-neck ratios did not exhibit any statistically significant difference between MO and MetS groups (p≥0.05). Diagnostic obesity notation model assessment index-II was correlated with the triglycerides-to-HDL-C ratio in normal body weight and MO (r=0.413, p≤0.01 and r=0.261, (p≤0.05, respectively). Total cholesterol-to-HDL-C and LDL-C-to-HDL-C showed statistically significant differences between normal body weight and MO as well as MO and MetS (p≤0.05). The only group in which these two ratios were significantly correlated with waist-to-hip ratio was MetS group (r=0.332 and r=0.334, p≤0.01, respectively). Lack of correlation between the D2 index and the triglycerides-to-HDL-C ratio was another important finding in MetS group. In this study, parameters and ratios, whose associations were defined previously with increased cardiovascular risk or cardiac death have been evaluated along with obesity indices in children with morbid obesity and MetS. Their profiles during childhood have been investigated. Aside from the nature of the correlation between the D2 index and triglycerides-to-HDL-C ratio, total cholesterol-to-HDL-C as well as LDL-C-to- HDL-C ratios along with their correlations with waist-to-hip ratio showed that the combination of obesity-related parameters predicts better than one parameter and appears to be helpful for discriminating MO children from MetS group.

Keywords: children, lipid ratios, metabolic syndrome, obesity indices

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Authors: Fatima Boutaleb

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Entrepreneurship proves to be crucial for the economic growth and development, since it contributes to job creation and the improvement of the overall productivity thus generating a positive impact upon society at various levels. Promoting entrepreneurship stimulates therefore economic diversity that is key to the betterment and/or maintaining of the standard of living. In fact, recent research suggests that entrepreneurship contributes to development by creating businesses and jobs, stimulating innovation, creating social capital across borders, and channeling political and financial capital. However, different research studies indicate that among the main factors impeding the entrepreneurship are politico-economic as socio-cultural problems, with an intensity for those related to young people and to women. In the MENA region, discrimination inherent in gender is alarming: Only one woman in eight runs her own business against 1 in 3 men. In most countries, young women and young men are facing problems involving access to finance, inadequate infrastructure, lack of support and, in general, an ecosystem that is rather unfavorable. According to the International Labor Organization, North Africa and the Middle East has the highest unemployment rate in all other regions of the world. In other hand, nearly a quarter of the population under 30 is unemployed and youth unemployment costs more than $40 billion each year to the region. In the current context, the situations in the Middle East and North Africa region are singular, both in terms of demographic trends and socio-economic issues around the employment of a large and better trained youth, but still strongly affected by unemployment and under-employment. According to a study published in 2015 by McKinsey, the world gain 26% of additional GDP (47% in the MENA region), more than 28 trillion dollars by 2025, if women came to participate, as well as men, to the economy. Promoting entrepreneurship represents an excellent alternative for the countries whose productive fabric fails to integrate the contingent of young people entering the job market each year. The MENA region, presenting entrepreneurial activity rates below those of other regions in terms of comparable development, has undoubtedly leeway at this level, even though the region displays large national heterogeneity, namely in the priority given to the promotion of entrepreneurship. The objective of this article is therefore to examine the women entrepreneurial vocation in the MENA region, to see to what extent research on the determinant of gender can provide information on the trend of the emerging entrepreneurial activity whether driven by necessity or by opportunity and, on this basis, to submit public policy proposals for the improvement of the mechanisms of inclusion among the youth women people. The objective is not to analyze the causality models but rather to identify the entrepreneurial construct specific to the MENA region via the analysis of GEM data from 2017 to 2019 among adults belonging to 10 countries of the MENA region. Notably, the study shows that inclusion of young women may be enhanced. These disadvantaged segments frequently intend to become entrepreneurs, but they tend not to enact their vocational intentions.

Keywords: economic development, entrepreneurial activity, GEM, gender, informal sector

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Authors: Athanasios Raftopoulos

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In this paper, an attempt is made to explain the evolution or development of human’s representational arsenal from its humble beginnings to its modern abstract symbols. Representations are physical entities that represent something else. To represent a thing (in a general sense of “thing”) means to use in the mind or in an external medium a sign that stands for it. The sign can be used as a proxy of the represented thing when the thing is absent. Representations come in many varieties, from signs that perceptually resemble their representative to abstract symbols that are related to their representata through conventions. Relying the distinction among indices, icons, and symbols, it is explained how symbolic representations gradually emerged from indices and icons. To understand the development or evolution of our representational arsenal, the development of the cognitive capacities that enabled the gradual emergence of representations of increasing complexity and expressive capability should be examined. The examination of these factors should rely on a careful assessment of the available empirical neuroscientific and paleo-anthropological evidence. These pieces of evidence should be synthesized to produce arguments whose conclusions provide clues concerning the developmental process of our representational capabilities. The analysis of the empirical findings in this paper shows that Homo Erectus was able to use both icons and symbols. Icons were used as external representations, while symbols were used in language. The first step in the emergence of representations is that a sensory-motor purely causal schema involved in indices is decoupled from its normal causal sensory-motor functions and serves as a representation of the object that initially called it into play. Sensory-motor schemes are tied to specific contexts of the organism-environment interactions and are activated only within these contexts. For a representation of an object to be possible, this scheme must be de-contextualized so that the same object can be represented in different contexts; a decoupled schema loses its direct ties to reality and becomes mental content. The analysis suggests that symbols emerged due to selection pressures of the social environment. The need to establish and maintain social relationships in ever-enlarging groups that would benefit the group was a sufficient environmental pressure to lead to the appearance of the symbolic capacity. Symbols could serve this need because they can express abstract relationships, such as marriage or monogamy. Icons, by being firmly attached to what can be observed, could not go beyond surface properties to express abstract relations. The cognitive capacities that are required for having iconic and then symbolic representations were present in Homo Erectus, which had a language that started without syntactic rules but was structured so as to mirror the structure of the world. This language became increasingly complex, and grammatical rules started to appear to allow for the construction of more complex expressions required to keep up with the increasing complexity of social niches. This created evolutionary pressures that eventually led to increasing cranial size and restructuring of the brain that allowed more complex representational systems to emerge.

Keywords: mental representations, iconic representations, symbols, human evolution

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Authors: Deborah A. Hollingworth

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The key tenets associated with ‘environmental justice’, were first articulated in a global context in Principle 10 of the United Nations Declaration on Environment and Development at Rio de Janeiro in 1992 (the Rio Declaration). The elements can be conflated to require: public participation in decision-making; the provision of relevant information to those affected about environmental hazards issues; access to judicial and administrative proceeding; and the opportunity for redress where remedy where required. This paper examines the legislative and regulatory arrangements in place for the implementation these elements in a number of industrialised democracies, including Australia. Most have, over time made regulatory provision for these elements – even if they are not directly attributed Principle 10 or the notion of environmental justice. The paper proposes, that of these elements the most critical to the achievement of good environmental governance, is a legislated recognition and role of public participation. However, the paper considers that notwithstanding sound legislative and regulatory practices, environmental regulators frequently struggle, where there is a complex decision-making scenario or long-standing enmity between a community and industry to achieve effective engagement with the public. This study considers the dilemma confronted by environmental regulators to given meaningful effect to the principles enshrined in Principle 10 – that even when the legislative expression of Principle 10 is adhered to – does not prevent adverse outcomes. In particular, it considers, as a case study a prominent environmental incident in 2014 in Australia in which an open-cut coalmine located in the regional township of Morwell caught fire during bushfire season. The fire, which took 45 days to be extinguished had a significant and adverse impact on the community in question, but compounded a complex, and sometime antagonistic history between the mine and township. The case study exemplifies the complex factors that will often be present between industry, the public and regulatory bodies, and which confound the concept of environmental justice, and the elements of enshrined in the Principle 10 of the Rio Declaration. The study proposes that such tensions and complex examples will commonly be the reality of communities and regulators. However, to give practical effect to outcomes contemplated by Principle 10, the paper considers that regulators will may consider public intervention more broadly as including early interventions and formal opportunities for “conferencing” between industry, community and regulators. These initiatives help to develop a shared understanding and identification of issues. It is proposed that although important, options for “alternative dispute resolution” are not sufficiently preventative, as they come into play when a dispute has arise. Similarly “restorative justice” programs, while important once an incident or adverse environmental outcome has occurred, are post event and therefore necessarily limited. The paper considers the examples of how public participation at the outset – at the time of a proposal, before issues arise or eventuate to ensure, is demonstrably the most effective way for building commonality and an agreed methodology for working to resolve issues once they occur.

Keywords: environmental justice, alternative dispute resolution, domestic environmental law, international environmental law

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Authors: Milena Nanova, Radul Shishkov, Martin Georgiev, Damyan Damov

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This research paper presents an in-depth exploration of the use of generative design in urban residential architecture, with a dual focus on aligning aesthetic values with legal and environmental constraints. The study aims to demonstrate how generative design methodologies can innovate residential building designs that are not only legally compliant and environmentally conscious but also aesthetically compelling. At the core of our research is a specially developed generative design framework tailored for urban residential settings. This framework employs computational algorithms to produce diverse design solutions, meticulously balancing aesthetic appeal with practical considerations. By integrating site-specific features, urban legal restrictions, and environmental factors, our approach generates designs that resonate with the unique character of urban landscapes while adhering to regulatory frameworks. The paper explores how modern digital tools, particularly computational design, and algorithmic modelling, can optimize the early stages of residential building design. By creating a basic parametric model of a residential district, the paper investigates how automated design tools can explore multiple design variants based on predefined parameters (e.g., building cost, dimensions, orientation) and constraints. The paper aims to demonstrate how these tools can rapidly generate and refine architectural solutions that meet the required criteria for quality of life, cost efficiency, and functionality. The study utilizes computational design for database processing and algorithmic modelling within the fields of applied geodesy and architecture. It focuses on optimizing the forms of residential development by adjusting specific parameters and constraints. The results of multiple iterations are analysed, refined, and selected based on their alignment with predefined quality and cost criteria. The findings of this research will contribute to a modern, complex approach to residential area design. The paper demonstrates the potential for integrating BIM models into the design process and their application in virtual 3D Geographic Information Systems (GIS) environments. The study also examines the transformation of BIM models into suitable 3D GIS file formats, such as CityGML, to facilitate the visualization and evaluation of urban planning solutions. In conclusion, our research demonstrates that a generative parametric approach based on real geodesic data and collaborative decision-making could be introduced in the early phases of the design process. This gives the designers powerful tools to explore diverse design possibilities, significantly improving the qualities of the investment during its entire lifecycle.

Keywords: architectural design, residential buildings, urban development, geodesic data, generative design, parametric models, workflow optimization

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Authors: Jessica Raven Gates, Gemma Wilson-Menzfeld, Professor Alison Steven

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In 2019, the Primary Care system in the UK National Health Service (NHS) was subject to reform and restructuring. Primary Care Networks (PCNs) were established, which aligned with a trend towards integrated care both within the NHS and internationally. The introduction of PCNs brought groups of GP practices in a locality together, to operate as a network, build on existing services and collaborate at a larger scale. PCNs were expected to bring a range of benefits to patients and address some of the workforce pressures in the NHS, through an expanded and collaborative workforce. The early establishment of PCNs was disrupted by the emerging COVID-19 pandemic. This study, set in the context of the pandemic, aimed to explore experiences of the PCN workforce, and their perceptions of the establishment of PCNs. Specific objectives focussed on examining factors perceived as enabling or hindering the success of a PCN, the impact on day-to-day work, the approach to implementing change, and the influence of the COVID-19 pandemic upon PCN development. This study is part of a three-phase PhD project that utilized qualitative approaches and was underpinned by social constructionist philosophy. Phase 1: a systematic narrative review explored the provision of preventative healthcare services in UK primary settings and examined facilitators and barriers to delivery as experienced by the workforce. Phase 2: informed by the findings of phase 1, semi-structured interviews were conducted with fifteen participants (PCN workforce). Phase 3: follow-up interviews were conducted with original participants to examine any changes to their experiences and perceptions of PCNs. Three main themes span across phases 2 and 3 and were generated through a Framework Analysis approach: 1) working together at scale, 2) network infrastructure, and 3) PCN leadership. Findings suggest that through efforts to work together at scale and collaborate as a network, participants have broadly accepted the concept of PCNs. However, the workforce has been hampered by system design and system complexity. Operating against such barriers has led to a negative psychological impact on some PCN leaders and others in the PCN workforce. While the pandemic undeniably increased pressure on healthcare systems around the world, it also acted as a disruptor, offering a glimpse into how collaboration in primary care can work well. Through the integration of findings from all phases, a new theoretical model has been developed, which conceptualises the findings from this Ph.D. study and demonstrates how the workforce has experienced change associated with the establishment of PCNs. The model includes a contextual component of the COVID-19 pandemic and has been informed by concepts from Complex Adaptive Systems theory. This model is the original contribution to knowledge of the PhD project, alongside recommendations for practice, policy and future research. This study is significant in the realm of health services research, and while the setting for this study is the UK NHS, the findings will be of interest to an international audience as the research provides insight into how the healthcare workforce may experience imposed policy and service changes.

Keywords: health services research, qualitative research, NHS workforce, primary care

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Authors: Iacopo Odoardi, Emanuele Felice, Dario D'Ingiullo

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We investigate the role of human capital in the Chinese inland-coastal inequality and how the consequences of the 2007-2008 crisis may induce China to refocus its development path on human capital. We compare panel data analyses for two periods for the richer/coastal and the relatively poor/inland provinces. Considering the rapid evolution of the Chinese economy and the changes forced by the international crisis, we wonder if these events can lead to rethinking local development paths, fostering greater attention on the diffusion of higher education. We expect that the consequences on human capital may, in turn, have consequences on the inland/coastal dualism. The focus on human capital is due to the fact that the growing differences between inland and coastal areas can be explained by the different local endowments. In this respect, human capital may play a major role and should be thoroughly investigated. To assess the extent to which human capital has an effect on economic growth, we consider a fixed-effects model where differences among the provinces are considered parametric shifts in the regression equation. Data refer to the 31 Chinese provinces for the periods 1998-2008 and 2009-2017. Our dependent variable is the annual variation of the provincial gross domestic product (GDP) at the prices of the previous year. Among our regressors, we include two proxies of advanced human capital and other known factors affecting economic development. We are aware of the problem of conceptual endogeneity of variables related to human capital with respect to GDP; we adopt an instrumental variable approach (two-stage least squares) to avoid inconsistent estimates. Our results suggest that the economic strengths that influenced the Chinese take-off and the dualism are confirmed in the first period. These results gain relevance in comparison with the second period. An evolution in local economic endowments is taking place: first, although human capital can have a positive effect on all provinces after the crisis, not all types of advanced education have a direct economic effect; second, the development path of the inland area is changing, with an evolution towards more productive sectors which can favor higher returns to human capital. New strengths (e.g., advanced education, transport infrastructures) could be useful to foster development paths of inland-coastal desirable convergence, especially by favoring the poorer provinces. Our findings suggest that in all provinces, human capital can be useful to promote convergence in growth paths, even if investments in tertiary education seem to have a negative role, most likely due to the inability to exploit the skills of highly educated workers. Furthermore, we observe important changes in the economic characteristics of the less developed internal provinces. These findings suggest an evolution towards more productive economic sectors, a greater ability to exploit both investments in fixed capital and the available infrastructures. All these aspects, if connected with the improvement in the returns to human capital (at least at the secondary level), lead us to assume a better reaction (i.e., resilience) of the less developed provinces to the crisis effects.

Keywords: human capital, inland-coastal inequality, Great Recession, China

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Authors: B. Umaru Mohammed, Faris A. Al-Maziad, Mohammad Y. Numan

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One of the most important factors affecting the energy performance within a building is a carefully and efficiently designed facade. The primary aim of this research was to identify and present the potentiality of utilising Double-Skin Facade (DSF) construction and critically examine its effect on the energy consumption of an office building located within a maritime desert climate as to the conventional single-skin curtain wall system. A comparative analysis of the effect on the overall energy consumption within an office building was investigated in which a combination of various Double-Skin Facade configurations, systems, and cavity depths, glazing types and orientations were utilised. A computer dynamic modelling was utilised in order to ensure accurate calculations and efficient simulations of the various DSF systems due to the complex nature of the various functions within the Facade cavity. Through the use of the dynamic thermal modelling simulations, the best cavity size glazed type and orientation were determined to lead to a detailed analysis of the efficiency of each respective combination of Double-Skin Facade construction. As such the optimal facade combination for use within an office building located in a maritime desert climate was identified. Results demonstrated that a multi-story Facade, depending on its configuration, save up to 5% on annual cooling loads respect to a Corridor Facade and while vented can save unto 12% when compared to the single skin façade, on annual cooling load in the maritime desert climate. The selected configuration of the DSF from SSF saves an overall annual cooling load of 32%.A comparative analysis of the effect on the overall energy consumption within an office building was investigated in which a combination of various Double-Skin Facade configurations, systems, and cavity depths, glazing types and orientations were utilized. A computer dynamic modelling was utilized in order to ensure accurate calculations and efficient simulations of the various DSF systems due to the complex nature of the various functions within the Facade cavity. Through the use of the dynamic thermal modelling simulations, the best cavity size glazed type and orientation were determined to lead to a detailed analysis of the efficiency of each respective combination of Double-Skin Facade construction. As such the optimal facade combination for use within an office building located in a maritime desert climate was identified. Results demonstrated that a multi-story Facade, depending on its configuration, save up to 5% on annual cooling loads respect to a Corridor Facade and while vented can save unto 12% when compared to the single skin facade, on annual cooling load in the maritime desert climate. The selected configuration of the DSF from SSF saves an overall annual cooling load of 32%.

Keywords: computer dynamics modelling, comparative analysis, energy computation, double skin facade, single skin curtain wall, maritime desert climate

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Authors: Haftay Abraha Tadesse

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Background: Staphylococcus is a genus of worldwide distributed bacteria correlated to several infectious of different sites in human and animals. They are among the most important causes of infection that are associated with the consumption of contaminated food. Objective: The objective of this study was to determine the isolates, antimicrobial susceptibility patterns and public health significance for Staphylococcus aureus in raw meat from butchery and abattoir houses of Mekelle, Northern Ethiopia. Methodology: A cross-sectional study was conducted from April to October 2019. Sociodemographic data and public health significance were collected using predesigned questionnaire. The raw meat samples were collected aseptically in the butchery and abattoir houses and transported using ice box to Mekelle University, College of Veterinary Sciences for isolating and identification of Staphylococcus aureus. Antimicrobial susceptibility tests were determined by disc diffusion method. Data obtained were cleaned and entered in to STATA 22.0 and logistic regression model with odds ratio were calculated to assess the association of risk factors with bacterial contamination. P-value < 0.05 was considered as statistically significant. Results: In present study, 88 out of 250 (35.2%) were found to be contamination with Staphylococcus aureus. Among the raw meat specimens to be positivity rate of Staphylococcus aureus were 37.6% (n=47) and (32.8% (n=41), butchery and abattoir houses, respectively. Among the associated risk factories not using gloves reduces risk was found to (AOR=0.222; 95% CI: 0.104-0.473), Strict Separation b/n clean & dirty (AOR= 1.37; 95% CI: 0.66-2.86) and poor habit of hand washing (AOR=1.08; 95%CI: 0.35-3.35) were found to be statistically significant and ha ve associated with Staphylococcus aureus contamination. All isolates thirty sevevn of Staphyloco ccus aureus were checked displayed (100%) sensitive to doxycycline, trimethoprim, gentamicin, sulphamethoxazole, amikacin, CN, Co trimoxazole and nitrofurantoi. whereas the showed resistance of cefotaxime (100%), ampicillin (87.5%), Penicillin (75%), B (75%), and nalidixic acid (50%) from butchery houses. On the other hand, all isolates of Staphylococcus aur eu isolate 100% (n= 10) showed sensitive chloramphenicol, gentamicin and nitrofurantoin whereas the showed 100% resistance of Penicillin, B, AMX, ceftriaxone, ampicillin and cefotaxime from abattoirs houses. The overall multi drug resistance pattern for Staphylococcus aureus were 90% and 100% of butchery and abattoirs houses, respectively. Conclusion: 35.3% Staphylococcus aureus isolated were recovered from the raw meat samples collected from the butchery and abattoirs houses. More has to be done in the developed of hand washing behavior, and availability of safe water in the butchery houses to reduce burden of bacterial contamination. The results of the present finding highlight the need to implement protective measures against the levels of food contamination and alternative drug options. The development of antimicrobial resistance is nearly always as a result of repeated therapeutic and/or indiscriminate use of them. Regular antimicrobial sensitivity testing helps to select effective antibiotics and to reduce the problems of drug resistance development towards commonly used antibiotics. Key words: abattoir houses, antimicrobial resistance, butchery houses, Ethiopia,

Keywords: abattoir houses, antimicrobial resistance, butchery houses, Ethiopia, staphylococcus aureuse, MDR

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Authors: Lamia Bouzgarrou, Amira Omrane, Malika Azzouzi, Asma Kheder, Amira Saadallah, Ilhem Boussarsar, Kamel Rejeb

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Introduction: Increasing the women’s labor force participation is a political issue in countries with developed economies and those with low growth prospects. However, in the labor market, women continue to face several obstacles, either for the integration or for the maintenance at work. This study aims to assess the prevalence of premature withdrawal from working life -due to invalidity or medical justified early retirement- among active women in the Tunisian center and to identify its determinants. Material and methods: We conducted a cross-sectional study, over one year, focusing on the agreement for invalidity or early retirement for premature usury of the body- delivered by the medical commission of the National Health Insurance Fund (CNAM) in the central Tunisian district. We exhaustively selected women's files. Data related to Socio-demographic characteristics, professional and medical ones, were collected from the CNAM's administrative and medical files. Results: During the period of one year, 222 women have had an agreement for premature departure of their professional activity. Indeed, 149 women (67.11%) benefit of from invalidity agreement and 20,27% of them from favorable decision for early retirement. The average age was 50 ± 6 years with extremes of 23 and 62 years, and 18.9% of women were under 45 years. Married women accounted for 69.4% and 59.9% of them had at least one dependent child in charge. The average professional seniority in the sector was 23 ± 8 years. The textile-clothing sector was the most affected, with 70.7% of premature departure. Medical reasons for withdrawal from working life were mainly related to neuro-degenerative diseases in 46.8% of cases, rheumatic ones in 35.6% of cases and cardiovascular diseases in 22.1% of them. Psychiatric and endocrine disorders motivated respectively 17.1% and 13.5% of these departures. The evaluation of the sequels induced by these pathologies concluded to an average permanent partial disability equal to 61.4 ± 17.3%. The analytical study concluded that the agreement of disability or early retirement was correlated with the insured ‘age (p = 10-3), the professional seniority (p = 0.003) and the permanent partial incapacity (PPI) rate assessed by the expert physician (p = 0.04). No other social or professional factors were correlated with this decision. Conclusion: Despite many advances in labour law and Tunisian legal text on employability, women still exposed to several social and professional inequalities (payment inequality, precarious work ...). Indeed, women are often pushed to accept working in adverse conditions, thus they are more vulnerable to develop premature wear on the body and being forced to premature departures from the world of work. These premature withdrawals from active life are not only harmful to the concerned women themselves, but also associated with considerable costs for the insurance organism and the society. In order to ensure maintenance at work for women, a political commitment is imperative in the implementation of global prevention strategies and the improvement of working conditions, particularly in our socio-cultural context.

Keywords: Active Women , Early Retirement , Invalidity , Maintenance at Work

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Authors: Arif Ahmed Mohammed Al-Ahdal

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Poetry, tales, and fables have always been a part of the L1 repertoire and one that takes the learners to another amazing and fascinating world of imagination. The storytelling class and the genre of poems are activities greatly enjoyed by all age groups. The very significant idea behind their inclusion in the language curriculum is to sensitize young minds to a wide range of human emotions that are believed to greatly contribute to building their social resilience, emotional stability, empathy towards fellow creatures, and literacy. Quite certainly, the learning objective at this stage is not language acquisition (though it happens as an automatic process) but getting the young learners to be acquainted with an entire spectrum of what may be called the ‘noble’ abilities of the human race. They enrich their very existence, inspiring them to unearth ‘selves’ that help them as adults and enable them to co-exist fruitfully and symbiotically with their fellow human beings. By extension, ‘higher’ training in these literature genres shows the universality of human emotions, sufferings, aspirations, and hopes. The current study is anchored on the Reader-Response-Theory in literature learning, which suggests that the reader reconstructs work and re-enacts the author's creative role. Reiteratingly, literary works provide clues or verbal symbols in a linguistic system, widely accepted by everyone who shares the language, but everyone reads their own life experiences and situations into them. The significance of words depends on the reader, even if they have a typical relationship. In every reading, there is an interaction between the reader and the text. The process of reading is an experience in which the reader tries to comprehend the literary work, which surpasses its full potential since it provides emotional and intellectual reactions that are not anticipated from the document but cannot be affirmed just by the reader as a part of the text. The idea is that the text forms the basis of a unifying experience. A reinterpretation of the literary text may transform it into a guiding principle to respond to actual experiences and personal memories. The impulses delivered to the reader vary according to poetry or texts; nevertheless, the readers differ considerably even with the same material. Previous studies confirm that poetry is a useful tool for learning a language. This present paper works on these hypotheses and proposes to study the impetus given to L2 learning as a factor of exposure to poetry and meaningful stories in L1. The driving force behind the choice of this topic is the first-hand experience that the researcher had while teaching a literary text to a group of BA students who, as a reaction to the text, initially burst into tears and ultimately turned the class into an interactive session. The study also intends to compare the performance of male and female students post intervention using pre and post-tests, apart from undertaking a detailed inquiry via interviews with college learners of English to understand how L1 literature plays a great role in the acquisition of L2.

Keywords: SLA, literary text, poetry, tales, affective factors

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Authors: J. Roberto Lopez, Hened Saade, Graciela Morales, Javier Enriquez, Raul G. Lopez

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Implementation of systems based on nanostructures for drug delivery applications have taken relevance in recent studies focused on biomedical applications. Although there are several nanostructures as drugs carriers, the use of polymeric nanoparticles (PNP) has been widely studied for this purpose, however, the main issue for these nanostructures is the size control below 50 nm with a narrow distribution size, due to they must go through different physiological barriers and avoid to be filtered by kidneys (< 10 nm) or the spleen (> 100 nm). Thus, considering these and other factors, it can be mentioned that drug-loaded nanostructures with sizes varying between 10 and 50 nm are preferred in the development and study of PNP/drugs systems. In this sense, the Semicontinuous Heterophase Polymerization (SHP) offers the possibility to obtain PNP in the desired size range. Considering the above explained, methacrylic copolymer nanoparticles were obtained under SHP. The reactions were carried out in a jacketed glass reactor with the required quantities of water, ammonium persulfate as initiator, sodium dodecyl sulfate/sodium dioctyl sulfosuccinate as surfactants, methyl methacrylate and methacrylic acid as monomers with molar ratio of 2/1, respectively. The monomer solution was dosed dropwise during reaction at 70 °C with a mechanical stirring of 650 rpm. Nanoparticles of poly(methyl methacrylate-co-methacrylic acid) were loaded with acetylsalicylic acid (ASA, aspirin) by a chemical adsorption technique. The purified latex was put in contact with a solution of ASA in dichloromethane (DCM) at 0.1, 0.2, 0.4 or 0.6 wt-%, at 35°C during 12 hours. According to the boiling point of DCM, as well as DCM and water densities, the loading process is completed when the whole DCM is evaporated. The hydrodynamic diameter was measured after polymerization by quasi-elastic light scattering and transmission electron microscopy, before and after loading procedures with ASA. The quantitative and qualitative analyses of PNP loaded with ASA were measured by infrared spectroscopy, differential scattering calorimetry and thermogravimetric analysis. Also, the molar mass distributions of polymers were determined in a gel permeation chromatograph apparatus. The load capacity and efficiency were determined by gravimetric analysis. The hydrodynamic diameter results for methacrylic PNP without ASA showed a narrow distribution with an average particle size around 10 nm and a composition methyl methacrylate/methacrylic acid molar ratio equal to 2/1, same composition of Eudragit S100, which is a commercial compound widely used as excipient. Moreover, the latex was stabilized in a relative high solids content (around 11 %), a monomer conversion almost 95 % and a number molecular weight around 400 Kg/mol. The average particle size in the PNP/aspirin systems fluctuated between 18 and 24 nm depending on the initial percentage of aspirin in the loading process, being the drug content as high as 24 % with an efficiency loading of 36 %. These average sizes results have not been reported in the literature, thus, the methacrylic nanoparticles here reported are capable to be loaded with a considerable amount of ASA and be used as a drug carrier.

Keywords: aspirin, biocompatibility, biodegradable, Eudragit S100, methacrylic nanoparticles

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Authors: Elaine Y. L. Ng

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Elizabeth Gilbert’s (2006) biography Eat, Pray, Love describes her travels to Italy, India, and Indonesia after a painful divorce. The author’s experiences with love, loss, search for happiness, and meaning have resonated with a huge readership. As regards the translation of Gilbert’s (2006) Eat, Pray, Love into Chinese, it was first translated by a Taiwanese translator He Pei-Hua and published in Taiwan in 2007 by Make Boluo Wenhua Chubanshe with the fairly catching title “Enjoy! Traveling Alone.” The same translation was translocated to China, republished in simplified Chinese characters by Shanxi Shifan Daxue Chubanshe in 2008 and renamed in China, entitled “To Be a Girl for the Whole Life.” Later on, the same translation in simplified Chinese characters was reprinted by Hunan Wenyi Chubanshe in 2013. This study employs Munday’s (2002) systemic model for descriptive translation studies to investigate the translation of Gilbert’s (2006) Eat, Pray, Love into Chinese by the Taiwanese translator Hu Pei-Hua. It employs an interdisciplinary approach, combining systemic functional linguistics and corpus stylistics with sociohistorical research within a descriptive framework to study the translator’s discursive presence in the text. The research consists of three phases. The first phase is to locate the target text within its socio-cultural context. The target-text context concerning the para-texts, readers’ responses, and the publishers’ orientation will be explored. The second phase is to compare the source text and the target text for the categorization of translation shifts by using the methodological tools of systemic functional linguistics and corpus stylistics. The investigation concerns the rendering of mental clauses and speech and thought presentation. The final phase is an explanation of the causes of translation shifts. The linguistic findings are related to the extra-textual information collected in an effort to ascertain the motivations behind the translator’s choices. There exist sets of possible factors that may have contributed to shaping the textual features of the given translation within a specific socio-cultural context. The study finds that the translator generally reproduces the mental clauses and speech and thought presentation closely according to the original. Nevertheless, the language of the translation has been widely criticized to be unidiomatic and stiff, losing the elegance of the original. In addition, the several Chinese translations of the given text produced by one Taiwanese and two Chinese publishers are basically the same. They are repackaged slightly differently, mainly with the change of the book cover and its captions for each version. By relating the textual findings to the extra-textual data of the study, it is argued that the popularity of the Chinese translation of Gilbert’s (2006) Eat, Pray, Love may not be attributed to the quality of the translation. Instead, it may have to do with the way the work is promoted strategically by the social media manipulated by the four e-bookstores promoting and selling the book online in China.

Keywords: chinese translation of eat pray love, corpus stylistics, motivations for translation shifts, systemic approach to translation studies

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Authors: Ammar Alali, Mahmoud Abughaban, William Contreras Otalvora

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Optimizing the drilling process for cost and efficiency requires the optimization of the rate of penetration (ROP). ROP is the measurement of the speed at which the wellbore is created, in units of feet per hour. It is the primary indicator of measuring drilling efficiency. Maximization of the ROP can indicate fast and cost-efficient drilling operations; however, high ROPs may induce unintended events, which may lead to nonproductive time (NPT) and higher net costs. The proposed ROP optimization solution is a hybrid, data-driven system that aims to improve the drilling process, maximize the ROP, and minimize NPT. The system consists of two phases: (1) utilizing existing geological and drilling data to train the model prior, and (2) real-time adjustments of the controllable dynamic drilling parameters [weight on bit (WOB), rotary speed (RPM), and pump flow rate (GPM)] that direct influence on the ROP. During the first phase of the system, geological and historical drilling data are aggregated. After, the top-rated wells, as a function of high instance ROP, are distinguished. Those wells are filtered based on NPT incidents, and a cross-plot is generated for the controllable dynamic drilling parameters per ROP value. Subsequently, the parameter values (WOB, GPM, RPM) are calculated as a conditioned mean based on physical distance, following Inverse Distance Weighting (IDW) interpolation methodology. The first phase is concluded by producing a model of drilling best practices from the offset wells, prioritizing the optimum ROP value. This phase is performed before the commencing of drilling. Starting with the model produced in phase one, the second phase runs an automated drill-off test, delivering live adjustments in real-time. Those adjustments are made by directing the driller to deviate two of the controllable parameters (WOB and RPM) by a small percentage (0-5%), following the Constrained Random Search (CRS) methodology. These minor incremental variations will reveal new drilling conditions, not explored before through offset wells. The data is then consolidated into a heat-map, as a function of ROP. A more optimum ROP performance is identified through the heat-map and amended in the model. The validation process involved the selection of a planned well in an onshore oil field with hundreds of offset wells. The first phase model was built by utilizing the data points from the top-performing historical wells (20 wells). The model allows drillers to enhance decision-making by leveraging existing data and blending it with live data in real-time. An empirical relationship between controllable dynamic parameters and ROP was derived using Artificial Neural Networks (ANN). The adjustments resulted in improved ROP efficiency by over 20%, translating to at least 10% saving in drilling costs. The novelty of the proposed system lays is its ability to integrate historical data, calibrate based geological formations, and run real-time global optimization through CRS. Those factors position the system to work for any newly drilled well in a developing field event.

Keywords: drilling optimization, geological formations, machine learning, rate of penetration

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Authors: Pi Hsia Liang

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The rise of Facebook, Twitter, and other social networks significantly changes in interconnections between people, enhancing the process of information dissemination and amplify the influence of that information. Therefore, to develop informational efficiency or signaling equilibrium type of information environment among social networks, without adverse selection effects, becomes an important issue. Thus, someone may post a piece of intentional information in relation to personal interest for trying to create marginal influence. Therefore, economists are seeking to establish theories of informational efficiency under social network environment in order to resolve adverse selection issues. Reputation could be one of the important factors in the process of creating informational efficiency. Additionally, investors how to process green information, or information of corporate social responsibility is a very important study. This study essentially employs experimental study for examining how investors use stock relevant green information in Facebook and various Taiwan local networks. Facebook, and blogs of Money DJ, Technews and cnYES, respectively, are the primary sites for this examination that also allow to differentiate effects between Facebook and other local social networks. Questionnaire is developed for such an experimental testing. Note that questionnaire allows this study to group, for example, decision frequency and length of time duration focusing on social networks that are used for discriminating investor type and competence of informed investor. This study selects 500 investors that can be separated into two respective 250 samples as the control group and 250 samples in such an experimental. The quantity of sample investor sufficiently results in statistic significance of this experimental study. The empirical results of this study can be used for explaining how financial information in relation to corporate social responsibility would be disseminated in social websites. Therefore, we can lead to better interpretation of price/earnings relationship type of study and empirical studies of green information usefulness or informational efficiency Note that the above mentioned empirical studies did not exist any social network and annual report of corporate social responsibility. This study expects to find the results that both network degree and network cluster significantly affected green information dissemination frequency. In other words, investors with more connections and with high clustered connections might exert a greater influence on their green information dissemination process. The preferred users of financial social networks could make better stock decision that could amplify effects of green information. In addition, Facebook would be more influential than other local Taiwan financial social networks, although Facebook is not a specialized financial social network. In other words, the popularity and reputation effects of Facebook significantly contribute to usefulness of green information and influence of green information. Third, it has a better chance to find rumor or cheating information in local Taiwan financial social networks than Facebook. In other words, Facebook possesses reputation effect, or a better informational efficiency. Or, even though Taiwan local financial social networks have marginal informational effects on stock price, because of shortage of informational efficiency or monitoring system, information could be a tool for those whom owning superior information.

Keywords: network effect on financial services, informational efficiency theory, social networks, social websites

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Authors: Poulomi Bhadra, Manjushree Palit, Sanjeev P. Sahni

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Forensic science uses all branches of science for criminal investigation and trial and has increasingly emerged as an important tool in the administration of justice. However, the growth and development of this field in India has not been as rapid or widespread as compared to the more developed Western countries. For successful administration of justice, it is important that all agencies involved in law enforcement adopt an inter-professional approach towards forensic science, which is presently lacking. In light of the alarmingly high average acquittal rate in India, this study aims to examine the lack of understanding and appreciation of the importance and scope of forensic evidence and expert opinions amongst law professionals such as lawyers and judges. Based on a study of trial court cases from Delhi and surrounding areas, the study underline the areas in forensics where the criminal justice system has noticeably erred. Using this information, the authors examine the extent of forensic understanding amongst legal professionals and attempt to conclusively identify the areas in which they need further appraisal. A cross-sectional study done using a structured questionnaire was conducted amongst law professionals across age, gender, type and years of experience in court, to determine their understanding of DNA, fingerprints and other interdisciplinary scientific materials used as forensic evidence. In our study, we understand the levels of understanding amongst lawyers with regards to DNA and fingerprint evidence, and how it affects trial outcomes. We also aim to understand the factors that prevent credible and advanced awareness amongst legal personnel, amongst others. The survey identified the areas in modern and advanced forensics, such as forensic entomology, anthropology, cybercrime etc., in which Indian legal professionals are yet to attain a functional understanding. It also brings to light, what is commonly termed as the ‘CSI-effect’ in the Western courtrooms, and provides scope to study the existence of this phenomenon and its effects on the Indian courts and their judgements. This study highlighted the prevalence of unchallenged expert testimony presented by the prosecution in criminal trials and impressed upon the judicial system the need for independent analysis and evaluation of the scientist’s data and/or testimony by the defense. Overall, this study aims to define a clearer and rigid understanding of why legal professionals should have basic understanding of the interdisciplinary nature of forensic sciences. Based on the aforementioned findings, the author suggests various measures by which judges and lawyers might obtain an extensive knowledge of the advances and promising potentialities of forensic science. This includes promoting a forensic curriculum in legal studies at Bachelor’s and Master’s level as well as in mid-career professional courses. Formation of forensic-legal consultancies, in consultation with the Department of Justice, will not only assist in training police, military and law personnel but will also encourage legal research in this field. These suggestions also aim to bridge the communication gap that presently exists between law practitioners, forensic scientists and the general community’s awareness of the criminal justice system.

Keywords: forensic science, Indian legal professionals, interdisciplinary awareness, legal education

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Authors: Iliuta Cumpanasu, Veronica Oana Cumpanasu

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This paper focuses on studying the conjunction between the new emerged theory of “Memory Effect” in Irregular Migration and Related Criminality and the notion of securitization, and its impact on border management, bringing about a scientific advancement in the field by identifying the patterns corresponding to the linkage of the two concepts, for the first time, and developing a theoretical explanation, with respect to the effects of the non-military threats on border security. Over recent years, irregular migration has experienced a significant increase worldwide. The U.N.'s refugee agency reports that the number of displaced people is at its highest ever - surpassing even post-World War II numbers when the world was struggling to come to terms with the most devastating event in history. This is also the fresh reality within the core studied coordinate, the Balkan Route of Irregular Migration, which starts from Asia and Africa and continues to Turkey, Greece, North Macedonia or Bulgaria, Serbia, and ends in Romania, where thousands of migrants find themselves in an irregular situation concerning their entry to the European Union, with its important consequences concerning the related criminality. The data from the past six years was collected by making use of semi-structured interviews with experts in the field of migration and desk research within some organisations involved in border security, pursuing the gathering of genuine insights from the aforementioned field, which was constantly addressed the existing literature and subsequently subjected to the mixed methods of analysis, including the use of the Vector Auto-Regression estimates model. Thereafter, the analysis of the data followed the processes and outcomes in Grounded Theory, and a new Substantive Theory emerged, explaining how the phenomena of irregular migration and cross-border criminality are the decisive impetus for implementing the concept of securitization in border management by using the proposed pattern. The findings of the study are therefore able to capture an area that has not yet benefitted from a comprehensive approach in the scientific community, such as the seasonality, stationarity, dynamics, predictions, or the pull and push factors in Irregular Migration, also highlighting how the recent ‘Pandemic’ interfered with border security. Therefore, the research uses an inductive revelatory theoretical approach which aims at offering a new theory in order to explain a phenomenon, triggering a practically handy contribution for the scientific community, research institutes or Academia and also usefulness to organizational practitioners in the field, among which UN, IOM, UNHCR, Frontex, Interpol, Europol, or national agencies specialized in border security. The scientific outcomes of this study were validated on June 30, 2021, when the author defended his dissertation for the European Joint Master’s in Strategic Border Management, a two years prestigious program supported by the European Commission and Frontex Agency and a Consortium of six European Universities and is currently one of the research objectives of his pending PhD research at the West University Timisoara.

Keywords: migration, border, security, memory effect

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Authors: E Tolufase

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The demand, high costs and health implications of using energy derived from hydrocarbon compound have necessitated the continuous search for alternative source of energy. The World energy market is facing some challenges viz: depletion of fossil fuel reserves, population explosion, lack of energy security, economic and urbanization growth and also, in Nigeria some rural areas still depend largely on wood, charcoal, kerosene, petrol among others, as the sources of their energy. To overcome these short falls in energy supply and demand, as well as taking into consideration the risks from global climate change due to effect of greenhouse gas emissions and other pollutants from fossil fuels’ combustion, brought a lot of attention on efficiently harnessing the renewable energy sources. A very promising among the renewable energy resources for a clean energy technology for power production, vehicle and domestic usage is biogas. Therefore, optimization of biogas yield and quality is imperative. Hence, this study investigated yield and quality of biogas using low cost bio-digester and combination of various feed stocks referred to as co-digestion. Batch/Discontinuous Bio-digester type was used because it was cheap, easy, plausible and appropriate for different substrates used to get the desired results. Three substrates were used; cow dung, chicken droppings and lemon grass digested in five separate 21 litre digesters, A, B, C, D, and E and the gas collection system was designed using locally available materials. For single digestion we had; cow dung, chicken droppings, lemon grass, in Bio-digesters A, B, and C respectively, the co-digested three substrates in different mixed ratio 7:1:2 in digester D and E in ratio 5:3:2. The respective feed-stocks materials were collected locally, digested and analyzed in accordance with standard procedures. They were pre-fermented for a period of 10 days before being introduced into the digesters. They were digested for a retention period of 28 days, the physiochemical parameters namely; pressure, temperature, pH, volume of the gas collector system and volume of biogas produced were all closely monitored and recorded daily. The values of pH and temperature ranged 6.0 - 8.0, and 220C- 350C respectively. For the single substrate, bio-digester A(Cow dung only) produced biogas of total volume 0.1607m3(average volume of 0.0054m3 daily),while B (Chicken droppings ) produced 0.1722m3 (average of 0.0057m3 daily) and C (lemon grass) produced 0.1035m3 (average of 0.0035m3 daily). For the co-digested substrates in bio-digester D the total biogas produced was 0.2007m³ (average volume of 0.0067m³ daily) and bio-digester E produced 0.1991m³ (average volume of 0.0066m³ daily) It’s obvious from the results, that combining different substrates gave higher yields than when a singular feed stock was used and also mixing ratio played some roles in the yield improvement. Bio-digesters D and E contained the same substrates but mixed with different ratios, but higher yield was noticed in D with mixing ratio of 7:1:2 than in E with ratio 5:3:2.Therefore, co-digestion of substrates and mixing proportions are important factors for biogas production optimization.

Keywords: anaerobic, batch, biogas, biodigester, digestion, fermentation, optimization

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Authors: Tamrat Girma Biru

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Multidrug-resistant tuberculosis (MDR-TB) is defined as resistant to at least Refampicin and Isoniazed: the most two power full TB drugs. It is a leading cause of high rates of morbidity and mortality, and increasing psychosocial challenges to patients, especially when co-infected with Human Immunodeficiency Virus (HIV). Ethiopia faces the highest rates of MDR-TB infection in the world. Objectives: The main objective of this study was to identify the psychosocial challenges of MDR-TB patients, to investigate the extent of the psychosocial challenges on (self-esteem, depression, and stigma) that MDR-TB patients encounter, to examine whether there is a sex difference in experiencing psychosocial challenges and assess the counseling needs of MDR-TB patients. Methodology: A cross-sectional study was conducted at St. Peter TB Specialized Hospital, Addis Ababa on 40 patients (25 males and 15 females) who are hospitalized for treatment. The patients were identified by using purposive sampling and made fill a questionnaire measuring their level of self-esteem, depression and stigma. Besides, data were collected from 16 participants, 28 care providers and 8 guardians, using semi-structured interview. The obtained data were analyzed using SPSS statistical program, descriptive statistics, independent t-test, and qualitative description. Results and Discussion: The results of the study showed that the majority (80%) of the respondents had suffered psychological challenges and social discriminations. Thus, the significance of MDR-TB and its association with HIV/AIDS problems is considered. Besides the psychosocial challenges, various aggravating factors such as length of treatment, drug burden and insecurity in economy together highly challenges the life of patients. In addition, 60% of participants showed low level of self-esteem. The patients also reported that they experienced high self-stigma and stigma by other members of the society. The majority of the participants (75%) showed moderate and severe level of depression. In terms of sex there is no difference between the mean scores of males and females in the level of depression and stigmatization by others and by themselves. But females showed lower level of self-esteem than males. The analysis of the t-test also shows that there were no statistically significant sex difference on the level of depression and stigma. Based on the qualitative data MDR-TB patients face various challenges in their life sphere such as: Psychological (depression, low self value, lowliness, anxiety), social (stigma, isolation from social relations, self-stigmatization,) and medical (drug side effect, drug toxicity, drug burden, treatment length, hospital stays). Recommendations: Based on the findings of this study possible recommendations were forwarded: develop and extend MDR-TB disease awareness creation through by media (printing and electronic), school net TB clubs, and door to door community education. Strengthen psychological wellbeing and social relationship of MDR-TB patients using proper and consistent psychosocial support and counseling. Responsible bodies like Ministry of Health (MOH) and its stakeholders and Non Governmental Organizations (NGOs) need to assess the challenges of patients and take measures on this pressing issue.

Keywords: psychosocial challenges, counseling, multi-drug resistant tuberculosis (MDR-TB), tuberculosis therapy

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Authors: Kavitha Puthanveedu, Kasi Sekar, Preeti Jacob, Kavita Jangam

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In India, The Juvenile Justice (Care and Protection of Children) Act, 2015, the law related to children alleged and found to be in conflict with law, proposes to address to the rehabilitation of children in conflict with law by catering to the basic rights by providing care and protection, development, treatment, and social re-integration. A major concern in addressing the issues of children in conflict with law in Kerala the southernmost state in India identified were: 1. Lack of psychological assessment for children in conflict with law, 2. Poor psychosocial intervention for children in conflict with law on bail, 3. Lack of psychosocial intervention or proper care and protection of CCL residing at observation and special home, 4. Lack convergence with systems related with mental health care. Aim: To develop individual care plan for children in conflict with law. Methodology: NIMHANS a premier Institute of Mental Health and Neurosciences, collaborated with Social Justice Department, Govt. of Kerala to address this issue by developing a participatory methodology to implement psychosocial care in the existing services by integrating the activities through multidisciplinary and multisectoral approach as per the Sec. 18 of JJAct 2015. Developing individual care plan: Key informant interviews, focus group discussion with multiple stakeholders consisting of legal officers, police, child protection officials, counselors, and home staff were conducted. Case studies were conducted among children in conflict with law. A checklist on 80 psychosocial problems among children in conflict with law was prepared with eight major issues identified through the quantitative process such as family and parental characteristic, family interactions and relationships, stressful life event, social and environmental factors, child’s individual characteristics, education, child labour and high-risk behavior. Standardised scales were used to identify the anxiety, caseness, suicidality and substance use among the children. This provided a background data understand the psychosocial problems experienced by children in conflict with law. In the second stage, a detailed plan of action was developed involving multiple stakeholders that include Special juvenile police unit, DCPO, JJB, and NGOs. The individual care plan was reviewed by a panel of 4 experts working in the area of children, followed by the review by multiple stakeholders in juvenile justice system such as Magistrates, JJB members, legal cum probation officers, district child protection officers, social workers and counselors. Necessary changes were made in the individual care plan in each stage which was pilot tested with 45 children for a period of one month and standardized for administering among children in conflict with law. Result: The individual care plan developed through scientific process was standardized and currently administered among children in conflict with law in the state of Kerala in the 3 districts that will be further implemented in other 14 districts. The program was successful in developing a systematic approach for the psychosocial intervention of children in conflict with law that can be a forerunner for other states in India.

Keywords: psychosocial care, individual care plan, multidisciplinary, multisectoral

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Authors: Nuno Biga

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Continuous processes’ improvement is a permanent challenge for managers of any organization. Lean management means that efficiency gains can be obtained through a systematic framework able to explore synergies between processes, eliminate waste of time, and other resources. Leaderships in organizations determine the efficiency of the teams through their influence on collaborators, their motivation, and consolidation of ownership (group) feeling. The “organization health” depends on the leadership style, which is directly influenced by the intrinsic characteristics of each personality and leadership ability (leadership competencies). Therefore, it’s important that managers can correct in advance any deviation from expected leadership exercises. Top management teams must assume themselves as regulatory agents of leadership within the organization, ensuring monitoring of actions and the alignment of managers in accordance with the humanist standards anchored in a visible Code of Ethics and Conduct. This article is built around an innovative model of “Business Interactive Games” (BI GAMES) that simulates a real-life management environment. It shows that the strategic management of operations depends on a complex set of endogenous and exogenous variables to the intervening agents that require specific skills and a set of critical processes to monitor. BI GAMES are designed for each management reality and have already been applied successfully in several contexts over the last five years comprising the educational and enterprise ones. Results from these experiences are used to demonstrate how serious games in working living labs contributed to improve the organizational environment by focusing on the evaluation of players’ (agents’) skills, empower its capabilities, and the critical factors that create value in each context. The implementation of the BI GAMES simulator highlights that leadership skills are decisive for the performance of teams, regardless of the sector of activity and the specificities of each organization whose operation is intended to simulate. The players in the BI GAMES can be managers or employees of different roles in the organization or students in the learning context. They interact with each other and are asked to decide/make choices in the presence of several options for the follow-up operation, for example, when the costs and benefits are not fully known but depend on the actions of external parties (e.g., subcontracted enterprises and actions of regulatory bodies). Each team must evaluate resources used/needed in each operation, identify bottlenecks in the system of operations, assess the performance of the system through a set of key performance indicators, and set a coherent strategy to improve efficiency. Through the gamification and the serious games approach, organizational managers will be able to confront the scientific approach in strategic decision-making versus their real-life approach based on experiences undertaken. Considering that each BI GAME’s team has a leader (chosen by draw), the performance of this player has a direct impact on the results obtained. Leadership skills are thus put to the test during the simulation of the functioning of each organization, allowing conclusions to be drawn at the end of the simulation, including its discussion amongst participants.

Keywords: business interactive games, gamification, management empowerment skills, simulation living labs

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Authors: Emma Worley, Mhairi De Sainte Croix, Savneet Lochab, Christopher Roberts, Mark Stroud, Mo Salehan, Kevin Jones

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Awareness about the importance of teaching about diversity at medical school is growing. In the realm of diversity includes discussion around the LGBTQ+ community. At Bristol, diversity is taught in first or second year. However, echoing and expanding that teaching throughout the curriculum is needed. This feeds into the spiral curriculum but also highlights the relevance of the topic. It is well known that some people in the LGBTQ+ community struggle the access healthcare due to previous negative experiences. In 2019, 1 in 7 LGBTQ+ people avoided seeking medical care due to fears about discrimination. If people have fears about seeking medical help, then seeking help from Palliative care when they are at their most vulnerable situation can be even harder. To improve positive healthcare situations for people who identify as LGBTQ+ needs to start with talking. Along with some of our CTAs (clinical teaching assistants) we created a teaching session to explore the barriers faced by LGBTQ+ and incorporated communication stations into this. Our plan is to run this session as a three-hour session first discussing different topics: ethnical diversity, ‘coming out’, LGBTQ+ in the older generation, transgender. This will be followed by looking more closely at the barriers to accessing the hospice. The next part of the session will encompass two or three communication scenarios hopefully prompting further discussion and reflection on ways to improve our communication. The first scenario outline is a gay man/lesbian woman with lung cancer discussing options around the hospice. The second scenario is a transgender person with female genitalia who now has cervical cancer (as was not followed up on pap smears after the change of name). The third scenario is a HIV homosexual male patient who has been admitted with dementia. He has a partner but is not married. His next of kin is down as his parents but his parents do not know about his sexuality and HIV status. It allows discussion around confidentiality as well as broaching the meaning of ‘family’ in the LGBTQ+ community. We have chosen to pitch this teaching session to Bristol Year 4 students. They will be currently doing their 6-week Palliative care block, which fits in well. Each session will have four students attend. We have been lucky enough to have two CTAs (clinical teaching assistants) who identify as LGBTQ+ offer their experiences and help. They have been able to help us with the preparation and delivery of the session. Given anecdotal evidence and stories helps to highlight the importance and relevance of this session. The aim is to increase awareness of some factors that may contribute to people who identify as LGBTQ+ having a negative healthcare experience. By starting to talk about it allows awareness and only then will we be able to start to change and improve. Our aim, if the sessions run well, is to expand these sessions to different academy hospitals. Therefore, all Bristol 4th year students would have the opportunity to take part in the teaching session. We would like to expand our portfolio of case scenarios, to address so tricker topics such as a transgender person with dementia who reverts back to a different gender. We would also like to recruit a diverse range of actors, ideally people who identify as the patient in the scenario does. For example, a transgender person acts the transgender scenario. This would give authenticity and enhance the student’s learning experience.

Keywords: communication skills, healthcare barriers, LGBTQ+, palliative care

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Authors: Paula Marín, Mohammad Saffari, Alvaro de Gracia, Luisa F. Cabeza, Svetlana Ushak

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Climate control represents an important issue when referring to energy consumption of buildings and associated expenses, both in installation or operation periods. The climate control of a building relies on several factors. Among them, localization, orientation, architectural elements, sources of energy used, are considered. In order to study the thermal behaviour of a building set up, the present study proposes the use of energy simulation program Energy Plus. In recent years, energy simulation programs have become important tools for evaluation of thermal/energy performance of buildings and facilities. Besides, the need to find new forms of passive conditioning in buildings for energy saving is a critical component. The use of phase change materials (PCMs) for heat storage applications has grown in importance due to its high efficiency. Therefore, the climatic conditions of Northern Chile: high solar radiation and extreme temperature fluctuations ranging from -10°C to 30°C (Calama city), low index of cloudy days during the year are appropriate to take advantage of solar energy and use passive systems in buildings. Also, the extensive mining activities in northern Chile encourage the use of large numbers of containers to harbour workers during shifts. These containers are constructed with lightweight construction systems, requiring heating during night and cooling during day, increasing the HVAC electricity consumption. The use of PCM can improve thermal comfort and reduce the energy consumption. The objective of this study was to evaluate the thermal and energy performance of containers of 2.5×2.5×2.5 m3, located in four cities of Chile: Antofagasta, Calama, Santiago, and Concepción. Lightweight envelopes, typically used in these building prototypes, were evaluated considering a container without PCM inclusion as the reference building and another container with PCM-enhanced envelopes as a test case, both of which have a door and a window in the same wall, orientated in two directions: North and South. To see the thermal response of these containers in different seasons, the simulations were performed considering a period of one year. The results show that higher energy savings for the four cities studied are obtained when the distribution of door and window in the container is in the north direction because of higher solar radiation incidence. The comparison of HVAC consumption and energy savings in % for north direction of door and window are summarised. Simulation results show that in the city of Antofagasta 47% of heating energy could be saved and in the cities of Calama and Concepción the biggest savings in terms of cooling could be achieved since PCM reduces almost all the cooling demand. Currently, based on simulation results, four containers have been constructed and sized with the same structural characteristics carried out in simulations, that are, containers with/without PCM, with door and window in one wall. Two of these containers will be placed in Antofagasta and two containers in a copper mine near to Calama, all of them will be monitored for a period of one year. The simulation results will be validated with experimental measurements and will be reported in the future.

Keywords: energy saving, lightweight construction, PCM, simulation

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Authors: Erfan Abdeldaim Mohamed Ahmed Abdalla

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The complexity of Arabic grammar poses challenges for learners, particularly in relation to its arrangement, classification, abundance, and bifurcation. The challenge at hand is a result of the contextual factors that gave rise to the grammatical rules in question, as well as the pedagogical approach employed at the time, which was tailored to the needs of learners during that particular historical period. Consequently, modern-day students encounter this same obstacle. This requires a thorough examination of the arrangement and categorization of Arabic grammatical rules based on particular criteria, as well as an assessment of their objectives. Additionally, it is necessary to identify the prevalent and renowned grammatical rules, as well as those that are infrequently encountered, obscure and disregarded. This paper presents a compilation of grammatical rules that require arrangement and categorization in accordance with the standards outlined in the Common European Framework of Reference for Languages (CEFR). In addition to facilitating comprehension of the curriculum, accommodating learners' requirements, and establishing the fundamental competencies for achieving proficiency in Arabic, it is imperative to ascertain the conventions that language learners necessitate in alignment with explicitly delineated benchmarks such as the CEFR criteria. The aim of this study is to reduce the quantity of grammatical rules that are typically presented to non-native Arabic speakers in Arabic textbooks. This reduction is expected to enhance the motivation of learners to continue their Arabic language acquisition and to approach the level of proficiency of native speakers. The primary obstacle faced by learners is the intricate nature of Arabic grammar, which poses a significant challenge in the realm of study. The proliferation and complexity of regulations evident in Arabic language textbooks designed for individuals who are not native speakers is noteworthy. The inadequate organisation and delivery of the material create the impression that the grammar is being imparted to a student with the intention of memorising "Alfiyyat-Ibn-Malik." Consequently, the sequence of grammatical rules instruction was altered, with rules originally intended for later instruction being presented first and those intended for earlier instruction being presented subsequently. Students often focus on learning grammatical rules that are not necessarily required while neglecting the rules that are commonly used in everyday speech and writing. Non-Arab students are taught Arabic grammar chapters that are infrequently utilised in Arabic literature and may be a topic of debate among grammarians. The aforementioned findings are derived from the statistical analysis and investigations conducted by the researcher, which will be disclosed in due course of the research. To instruct non-Arabic speakers on grammatical rules, it is imperative to discern the most prevalent grammatical frameworks in grammar manuals and linguistic literature (study sample). The present proposal suggests the allocation of grammatical structures across linguistic levels, taking into account the guidelines of the CEFR, as well as the grammatical structures that are necessary for non-Arabic-speaking learners to generate a modern, cohesive, and comprehensible language.

Keywords: grammar, Arabic, functional, framework, problems, standards, statistical, popularity, analysis

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Authors: Desere Kokt

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Hospitality establishments worldwide are bearing the brunt of the effects of Covid-19. As the hospitality industry is looking to recover, emphasis is placed on rejuvenating the industry. This is especially pertinent for economic development in areas of high unemployment, such as the Free State province of South Africa. The province is not a main tourist area and thus depends on the influx of tourists. The province has great scenic beauty with many accommodation establishments that provide job opportunities to the local population. The two main economic hubs of the Free State province namely Bloemfontein and Clarens, were the focus of the investigation. The emphasis was on graded accommodation establishments as they must adhere to the quality principles of the Tourism Grading Council of South Africa (TGCSA) to obtain star grading. The hospitality industry is known for being labour intensive, and employees need to be available to cater for the needs of paying customers. This is referred to as ‘emotional labour’ and implies that employees need to manage their feelings and emotions as part of performing their jobs. The focus of this study was thus on psychological factors related to working in the hospitality industry – specifically psychological contract and psychological capital and its impact on the commitment of employees in graded accommodation establishments. Employee commitment can be explained as a psychological state that binds the individual to the organisation and involves a set of psychological relationships that include affective (emotions), normative (perceived obligation) and continuance (staying with the organisation) dimensions. Psychological contract refers to the reciprocal beliefs and expectations between the employer and the employee and consists of transactional and rational contracts. Transactional contracts are associated with the economic exchange, and contractional issues related to the employment contract and rational contracts relate to the social exchange between the employee and the organisation. Psychological capital refers to an individual’s positive psychology state of development that is characterised by self-efficiency (having confidence in doing one’s job), optimism (being positive and persevering towards achieving one’s goals), hope (expectations for goals to succeed) and resilience (bouncing back to attain success when beset by problems and adversity). The study employed a quantitative research approach, and a structured questionnaire was used to gather data from respondents. The study was conducted during the Covid-19 pandemic, which hampered the data gathering efforts of the researchers. Many accommodation establishments were either closed or temporarily closed, which meant that data gathering was an intensive and laborious process. The main researcher travelled to the various establishments to collect the data. Nine hospitality establishments participated in the study, and around 150 employees were targeted for data collection. Ninety-two (92) questionnaires were completed, which represents a response rate of 61%. Data were analysed using descriptive and inferential statistics, and partial least squares structural equation modelling (PLS-SEM) was applied to examine the relationship between the variables.

Keywords: employee commitment, hospitality industry, psychological contract, psychological capital

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Authors: N. F. Mikhailova, M. E. Fattakhova, M. A. Mironova, E. V. Vyacheslavova

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For the mental and social adaptation of the deaf and hard-of-hearing people, cultural and social aspects - the formation of identity (acculturation) and educational conditions – are highly significant. We studied 137 deaf and hard-of-hearing students in different educational situations. We used these methods: Big Five (Costa & McCrae, 1997), TRF (Becker, 1989), WCQ (Lazarus & Folkman, 1988), self-esteem, and coping strategies (Jambor & Elliott, 2005), self-stigma scale (Mikhailov, 2008). Type of self-identification of students depended on the degree of deafness, type of education, method of communication in the family: large hearing loss, education in schools for deaf, and gesture communication increased the likelihood of a 'deaf' acculturation. Less hearing loss, inclusive education in public school or school for the hearing-impaired, mixed communication in the family contributed to the formation of 'hearing' acculturation. The choice of specific coping depended on the degree of deafness: a large hearing loss increased coping 'withdrawal into the deaf world' and decreased 'bicultural skills' coping. People with mild hearing loss tended to cover-up it. In the context of ongoing discussion, we researched personality characteristics in deaf and hard on-hearing students, coping and other deafness associated factors depending on their acculturation type. Students who identified themselves with the 'hearing world' had a high self-esteem, a higher level of extraversion, self-awareness, personal resources, willingness to cooperate, better psychological health, emotional stability, higher ability to empathy, a greater satiety of life with feelings and sense and high sense of self-worth. They also actively used strategies, problem-solving, acceptance of responsibility, positive revaluation. Student who limited themselves within the culture of deaf people had more severe hearing loss and accordingly had more communication barriers. Lack of use or seldom use of coping strategies by these students point at decreased level of stress in their life. Their self-esteem have not been challenged in the specific social environment of the students with the same severity of defect, and thus this environment provided sense of comfort (we can assume that from the high scores on psychological health, personality resources, and emotional stability). Students with bicultural acculturation had higher level of psychological resources - they used Positive Reappraisal coping more often and had a higher level of psychological health. Lack of belonging to certain culture (marginality) leads to personality disintegration, social and psychological disadaptation: deaf and hard-of-hearing students with marginal identification had a lower self-estimation level, worse psychological health and personal resources, lower level of extroversion, self-confidence and life satisfaction. They, in fact, become 'risk group' (many of them dropped out of universities, divorced, and one even ended up in the ranks of ISIS). All these data argue the importance of cultural 'anchor' for people with hearing deprivation. Supported by the RFBR No 19-013-00406.

Keywords: acculturation, coping, deafness, marginality

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