Search results for: clinical decision support sytem

Authors: Gabriel G. Gaft, Xayvinay Xiong, Amanda Sunday

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The emergent pandemic from COVID-19 virus has forced people to adjust to major changes. These changes include all elements of family and work life and required people to engage in novel behaviors. For many people, the social norms to which they have been accustomed no longer prevail. Not surprisingly, such enormous changes in daily life have been associated with greater problems in mental health; and research regarding ways in which mental health professionals can support people is more necessary than ever before. It is often useful to assess people’s reactions through surveys and utilize quantitative data to answer questions about coping strategies etc. It is also likely, however, that a host of individual factors are going to contribute to what might be considered 'good' or 'bad' coping mechanisms to a worldwide pandemic. To this end, qualitative studies—where the individual’s subjective experience is highlighted—are likely to provide more vital information for mental health professionals interested in supporting the particular person in front of them. This study reports on qualitative data, where X participants were asked questions about social distancing, coping strategies, and general attitudes towards social changes resulting from the COVID-19 pandemic. Informal interviews were conducted during the months of June-July 2020. Data were analyzed using Interpretative Phenomenological Analyses. Themes were identified first for each participant and then compared across different individual participants. Several findings emerged. First, all participants understood major health messages being imparted by governing bodies such as the CDC and WHO. The researchers feel this finding is important as it suggests health messages are at least being effectively communicated. Second, there was a clear trend for themes which highlighted the conflicting emotions participants felt about the changes they were expected to endure: positive and negative elements were identified, although a participant who had pre-existing conditions placed greater emphasis on the negative elements. One participant who was particularly interested in impression management also exclusively emphasized negative emotions. Third, participants who were able to reevaluate priorities—what Lazarus might call secondary appraisals—experienced social distancing as a positive rather than negative phenomenon. Finally, participants who were able to develop specific strategies—such as boundaries for work and self-care—reported themes of adjustment and contentment. Taken together, these findings suggest mental health practitioners can assist people to adjust more positively through specific techniques focusing on re-evaluation of life priorities and strategic coping skills.

Keywords: COVID-19, pandemic, phenomenology, virus

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Authors: Lydia Ouma Radoli

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The paradox of documenting history through visuals that objectify gruesome images to depict the prominence of stories intrigues media researchers. In East Africa, the topic has been captured in a variety of media frames, but scantly in scholarly work. This paper adopts Visual Rhetoric and Framing Theories to tease out the drivers behind the criteria for the selection of violent visuals. The paper projects that quantitative and qualitative literature regarding journalists’ personal and work-related exposure to PSTD will give insights into the concept of trauma journalism - reporting of horrific events, e.g., violent crime and terror. The data will be collected through methods such as document analysis (photographs and videos) and in-depth interviews to summarize the informational contents with respect to the research objectives and questions. The study is hinged on the background that the criterion for news production is constructed from the idea that ‘if there’s violence, conflict, and death involved, the story gets top priority.’ The anticipated outcome is to establish trauma experiences of visual rhetors, suggest mitigations, and address gaps in academic research. The findings of the study will sustain the critical role of visual rhetors. Further, media practitioners may find the study useful in assessing the effects and values of visual witnessing. Historically, the criterion for visual news production has been that if there’s violence, conflict, and death involved, the story gets top priority. To capture the goriness of the images, media theorists and sociologists have used the expression: “If it bleeds, it leads.” The statement assumes that audiences are attracted to pictures that show violent images. Further, research on visual aspects of Television news has shown its ability to hold viewers’ attention and cause aggression. This paper samples images and narratives from Journalists who have covered trauma-related events. The samples are indicative of the problem under study, which depicts journalists exposed to traumatic events as not receiving any Psycho-social support within newsrooms. It is hoped that the study could inform policy and practice within developing countries through the interpretations of theoretical and empirical explanations of existing trauma phenomena among journalists.

Keywords: visual-witnessing, media culture, visual rhetoric, imaging violence in East Africa

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Authors: Zehra Gencel Efe, Fatma Susam Ozsayın, Satı Tas

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Background and Aim: It is not possible to teach all the knowledge related to operating room nursing in the nursing education process. Certified courses are organized by the Ministry of Health to compensate the lack of postgraduate training and the theoretical and practical training needs of working nurses. In this study; It is aimed to investigate the participants’ opinions and recommendations attending the certified course of operating room nursing that organized in İKCU AtaturkTraining and Research Hospital. Method: Two operating room nursing courses were organized in 2016. The 1st Operating Room Nursing Certified Course Program was organized between March 07, 2016 and April 6, 2016and the 2nd Operating Room Nursing Certified Course Program was organized between 07 November 2016 - 06 December 2016 at the İKCU Ataturk Training and Research Hospital. The first program was accepted for 29 participants, the second program was accepted for 30 participants. In the collection of the data, the 'Operating Room Nursing Certified Training Program Evaluation Form', 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' were used. Three point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Evaluation Form’ (1=verygood, 2=good, 3=poor). Data is collected in five areas related to training program, operation room practice, communication, responsibility, experiences of learning. Four point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' (1=verysatisfied, 2=quitesatisfied, 3=satisfied, 4=dissatisfied). Data is collected in two areas include presentation and content. Data were analyzed with SPSS 16 program. Findings and Conclusion: It was found that 93,22% of participants were female in addition, 62,7% had bachelor degree. It was seen that 33,87% of the work group had 1-5 years of experience in their field. It was found that; 88% of trainees participating in the first group to the operating room nursing-certified course program stated the training program was very good, 12% of them stated the training program was good. Nobody was signed the ‘poor’ choice. 81% of the trainees who participated in the 2nd group to the operating room nursing-certified course program stated the training program was very good, 19% of them stated the training program was good. Nobody was signed the ‘poor’ choice. It was found that there was no meaningful difference between the achievement ratios of the trainees and the learning status of the trainees when compared with the t test in the groups with success level of the operating room nursing certified course program according to the learning status of the participants (p ˃ 0,05). The trainees noted that the course was satisfied with theoretical and practical steps but the support services (lunch, coffee breaks etc.) were in adequate.

Keywords: certified courses, nursing certified courses, operating room nursing, training program

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Authors: Pavel H. Llamocca, Victoria Lopez

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The main objective of our work is the comparative analysis of environmental data from Open Data bases, belonging to different governments. This means that you have to integrate data from various different sources. Nowadays, many governments have the intention of publishing thousands of data sets for people and organizations to use them. In this way, the quantity of applications based on Open Data is increasing. However each government has its own procedures to publish its data, and it causes a variety of formats of data sets because there are no international standards to specify the formats of the data sets from Open Data bases. Due to this variety of formats, we must build a data integration process that is able to put together all kind of formats. There are some software tools developed in order to give support to the integration process, e.g. Data Tamer, Data Wrangler. The problem with these tools is that they need data scientist interaction to take part in the integration process as a final step. In our case we don’t want to depend on a data scientist, because environmental data are usually similar and these processes can be automated by programming. The main idea of our tool is to build Hadoop procedures adapted to data sources per each government in order to achieve an automated integration. Our work focus in environment data like temperature, energy consumption, air quality, solar radiation, speeds of wind, etc. Since 2 years, the government of Madrid is publishing its Open Data bases relative to environment indicators in real time. In the same way, other governments have published Open Data sets relative to the environment (like Andalucia or Bilbao). But all of those data sets have different formats and our solution is able to integrate all of them, furthermore it allows the user to make and visualize some analysis over the real-time data. Once the integration task is done, all the data from any government has the same format and the analysis process can be initiated in a computational better way. So the tool presented in this work has two goals: 1. Integration process; and 2. Graphic and analytic interface. As a first approach, the integration process was developed using Java and Oracle and the graphic and analytic interface with Java (jsp). However, in order to open our software tool, as second approach, we also developed an implementation with R language as mature open source technology. R is a really powerful open source programming language that allows us to process and analyze a huge amount of data with high performance. There are also some R libraries for the building of a graphic interface like shiny. A performance comparison between both implementations was made and no significant differences were found. In addition, our work provides with an Official Real-Time Integrated Data Set about Environment Data in Spain to any developer in order that they can build their own applications.

Keywords: open data, R language, data integration, environmental data

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Authors: Wasantha Pushpakumara Hitihami Mudiyanselage

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Since recent past, Sri Lanka is highly vulnerable to reoccurring climate shocks that severely impact the food security, loss of human & animal lives, destructions of human settlements, displacement of people and damaging properties. Hence, the Government of Sri Lanka has taken important steps towards strengthening legal and institutional arrangements for Disaster Risks management in the country in May 2005. Puttalam administrative district is one of the disaster prone districts in Sri Lanka which constantly face the devastating consequences of the increasing natural disasters annually. Therefore disaster risk management will be a timely intervention in the area to minimize the adverse impacts of the disasters. The few functioning Disaster Risk management networks do not take children’s specific needs and vulnerabilities during emergencies into account. The most affected children and their families were evacuated to the government schools and temples and it was observed that children were left to roaming around as their parents were busy queuing up for relief goods and other priorities. In this sense, VOICE understands that the community has vital role that has to be played in facing challenges of disaster management in the area. During and after the disaster, it was viewed that some children were having psychological disorders which could be impacted negatively to children well–being. Need of child friendly space at emergency is a must action in the area to turn away negative impact coming from the hazards. VOICE with the support of national & international communities have established safer places for the children (Child Centered Spaces – CCS) and their families at emergencies. Village religious venues and schools were selected and equipped with necessary materials to be used for the children at emergency. Materials such as tools, stationeries, play materials, which couldn’t be easily found in surrounding environment, were provided for CCS centers. Village animators, youth and elders were given comprehensive training on Disaster management and their role at CCS. They did the facilitation in keeping children without fear and stress at flooding occurred in 2015 as well as they were able to improve their skills when working with children. Flooding in 2016, the government agencies have taken service of these village animators at early stage of flooding to make all disaster-related recovery actions productively & efficiently. This mechanism is sustained at village level that can be used for disaster events.

Keywords: child centered space, impacts, psychological disorders, village animators

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Authors: Nino Damenia

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The paper discusses the risks arising in agriculture in Georgia, the possibilities of their acceptance and prevention, the threat created by the pandemic crisis, and the state programs for overcoming them. The share of agriculture in the country's GDP is 8.3%. Over the past five years, Georgia has imported $ 5.9 billion worth of agri-food products. Despite these figures, agriculture has become an important sector for the Georgian government since 2012, as evidenced by the more than 1.5 billion GEL spent from the 2012-2020 budget for agricultural development. Any field of agriculture, be it poultry, livestock, cereals, fruits, or vegetables, is very sensitive to various climatic and viral risks. Avoiding these risks requires additional investment. It is noteworthy that small farms are mainly affected by the risks, while relatively large farms face fewer problems because they are relatively prepared to face the problems and can avoid them more easily. An example of viral risk in the article is the export of hazelnuts, which has quite a lot of potential. Due to the spoilage of the crop caused by Brown Marmorated Stink Bug (BMSB), hazelnut exports have declined considerably over the years. If the volume of hazelnuts exported in 2016 was 179 378 thousand USD, due to the deficit caused by Brown Marmorated Stink Bug (BMSB) in 2018, it became 57 124 thousand USD. And after the situation was relatively settled, hazelnut seedlings were poisoned. By 2020, this figure improved to 91,088 thousand US dollars. The development of the agricultural sector and the reduction of risks require technological development, investor interest, and even more state support to enable more small farms to have the potential for greater production and sustainable development. The aim of the study is to identify the risks arising in the agricultural sector of Georgia before and after the pandemic, to evaluate them, compare them with the agriculture of some European countries, and to develop the necessary recommendations to avoid the emerging risks. The research uses methods of analysis and synthesis, observation, induction, deduction, and analysis of statistics. The paper is based on both Georgian and foreign scientific research, as well as state-published documentation on agricultural assistance programs. The research is based on the analysis of data published by the European Statistics Office, the National Statistics Office of Georgia, and many other organizations. The results of the study and the recommendations will help reduce the risks in agriculture in Georgia and, in general, to identify the existing potential and the development of the sector as a whole.

Keywords: risk, agriculture, pandemi, brown marmorated stink bug (BMSB)

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Authors: Darshana Sharma

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Distance Education has emerged as a viable alternative to serve the higher educational needs of the socially and economically disadvantaged people of the remote, rural areas of Jammu region. The University of Jammu is a National Accreditation, and Assessment Council accredited, A+ university and has been accorded graded autonomy by the University Grants Commission. It is a dual mode university offering academic programmes through the regular departments and through the Directorate of Distance Education. The Directorate of Distance Education, University of Jammu still uses printed study material as a mode of instructional delivery. The development of technologies has assured increased interaction and communication for distance learners throughout the distance open learning institutions. Though it is tempting and convenient to adopt technology already being used by others, it may not prove effective for the simple reason that two institutions may be unlike in some respect. The use of technology must be conceived in view of the needs of the learners; geographical socio-economic-cultural and technological contexts and financial, administrative and academic resources of the institution. Mobile learning (m-learning) is a novel approach to knowledge acquisition and dissemination and is gaining global attention. It has evolved as one of the useful channels of distance learning promoting interaction between learners and teachers. It is felt that the Directorate of Distance Education, University of Jammu also needs to adopt new technologies to provide more effective academic and information support to distance learners in order to keep them motivated and also to develop self-learning skills. The chief objective of the research on which this paper is based was to measure the opinion of the distance learners of the DDE, the University of Jammu about the merits of mobile learning. It also explores their preferences for implementing mobile learning. The survey research design of descriptive research has been used. The data was collected from 400 distance learners enrolled with undergraduate and post-graduate programmes using self-constructed questionnaire containing five-point Likert scale items arranging from strongly agree, agree, indifferent, disagree and strongly disagree. Percentages were used to analyze the data. The findings lead to conclude that mobile learning has a great potential for the DDE for reaching out to the rural, remotely located distance learners of the Jammu region and also to improve the teaching-learning environment. The paper also finds out the challenges in the implementation of mobile learning in the region and further makes suggestions for effective implementation of mobile learning in DDE, University of Jammu.

Keywords: directorate of distance education, mobile learning, national accreditation and assessment council, university of Jammu

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Authors: Jessica Scher Lisa, Eric Shyman

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Autism spectrum disorder (ASD) is a neuro-developmental disorder that is characterized by persistent deficits in social communication and social interaction (i.e. deficits in social-emotional reciprocity, nonverbal communicative behaviors, and establishing/maintaining social relationships), as well as by the presence of repetitive behaviors and perseverative areas of interest (i.e. stereotyped or receptive motor movements, use of objects, or speech, rigidity, restricted interests, and hypo or hyperactivity to sensory input or unusual interest in sensory aspects of the environment). Additionally, diagnoses of ASD require the presentation of symptoms in the early developmental period, marked impairments in adaptive functioning, and a lack of explanation by general intellectual impairment or global developmental delay (although these conditions may be co-occurring). Over the past several decades, many theories have been developed in an effort to explain the root cause of ASD in terms of atypical central cognitive processes. The field of neuroscience is increasingly finding structural and functional differences between autistic and neurotypical individuals using neuro-imaging technology. One main area this research has focused upon is in visuospatial processing, with specific attention to the notion of ‘weak central coherence’ (WCC). This paper offers an analysis of findings from selected studies in order to explore research that challenges the ‘deficit’ characterization of a weak central coherence theory as opposed to a ‘superiority’ characterization of strong local coherence. The weak central coherence theory has long been both supported and refuted in the ASD literature and has most recently been increasingly challenged by advances in neuroscience. The selected studies lend evidence to the notion of amplified localized perception rather than deficient global perception. In other words, WCC may represent superiority in ‘local processing’ rather than a deficit in global processing. Additionally, the right hemisphere and the specific area of the extrastriate appear to be key in both the visual and lexicosemantic process. Overactivity in the striate region seems to suggest inaccuracy in semantic language, which lends itself to support for the link between the striate region and the atypical organization of the lexicosemantic system in ASD.

Keywords: autism spectrum disorder, neurology, visual processing, weak coherence

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Authors: Gulcin Satir, Ahmet Yildirim

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Globally, including Turkey, health problems associated with malnutrition and nutrient deficiencies in childhood will remain major public health problems in future. Nutrition is a major environmental influence on physical and mental growth and development in early life. Many studies support the fact that nutritional knowledge makes contribution to wellbeing of children and their school performance. The purpose of this study was to examine nutritional knowledge and eating habits of primary school children and to investigate differences in these variables by socioeconomic status. A quasi-experimental one group pretest/posttest design study was conducted in five primary schools totaling 200 children aging 9-10 years in grade 4 to determine the effect of nutritional awareness programme on eating habits of primary school children. The schools were chosen according to parents’ social and demographic characteristics. The implemented nutritional awareness education programme focused on healthy lifestyle such as beneficial foods, eating habits, personal hygiene, physical activity and the programme consisted of eight lessons. The teaching approaches used included interactive teaching, role-playing, demonstration, small group discussions, questioning, and feedback. The lessons were given twice a week for four weeks totaling eight lessons. All lessons lasted 45-60 minutes and first 5 minutes of this was pre-assessment and last 5 minutes post assessment evaluation. The obtained data were analyzed for normality, and the distribution of the variables was tested by the Kolmogorov-Smirnov test. Paired t-test was used to evaluate the effectiveness of education programme and to compare the above-mentioned variables in each school separately before and after the lessons. The result of the paired t-test conducted separately for each school showed that on average after eight lessons, there was a 25-32% increase in nutritional knowledge of students regardless of the school they attend to and this rate was significant (P < 0.01). This shows that increase in nutritional awareness in these five schools having different socio-economic status was similar to each other. This study suggests that having children involved directly in lessons help to achieve nutritional awareness leading to healthy eating habits. It is concluded that nutritional awareness is a valuable tool to change eating habits. Study findings will provide information for developing nutrition education programmes for the healthy life and obesity prevention in children.

Keywords: children, nutritional awareness, obesity, socioeconomic status

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Authors: J. Knight, E. Barberà

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Language learning strategies have been defined as thoughts and actions, consciously chosen and operationalized by language learners, to help them in carrying out a multiplicity of tasks from the very outset of learning to the most advanced levels of target language performance. While research in the field of Second Language Acquisition has focused on ‘good’ language learners, the effectiveness of strategy-use and orchestration by effective learners in face-to-face classrooms much less research has attended to learner strategies in online contexts, particular strategies in relation to technological tool use which can be part of a task design. In addition, much research on learner strategies and strategy use has been explored focusing on cognitive, attitudinal and metacognitive behaviour with less research focusing on the social aspect of strategies. This study focuses on how learners mediate with a technological tool designed to support synchronous spoken interaction and how this shape their spoken interaction in the opening of their talk. A case study approach is used incorporating notions from communities of practice theory to analyse and understand learner strategies of dyads carrying out a role play task. The study employs analysis of transcripts of spoken interaction in the openings of the talk along with log files of tool use. The study draws on results of previous studies pertaining to the same tool as a form of triangulation. Findings show how learners gain pre-task planning time through technological tool control. The strategies involving learners’ choices to enter and exit the tool shape their spoken interaction qualitatively, with some cases demonstrating long silences whilst others appearing to start the pedagogical task immediately. Who/what learners orientate to in the openings of the talk: an audience (i.e. the teacher), each other and/or screen-based signifiers in the opening moments of the talk also becomes a focus. The study highlights how tool use as a social practice should be considered a learning strategy in online contexts whereby different usages may be understood in the light of the more usual asynchronous social practices of the online community. The teachers’ role in the community is also problematised as the evaluator of the practices of that community. Results are pertinent for task design for synchronous speaking tasks. The use of community of practice theory supports an understanding of strategy use that involves both metacognition alongside social context revealing how tool-use strategies may need to be orally (socially) negotiated by learners and may also differ from an online language community.

Keywords: learner strategy, tool use, community of practice, speaking task

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Authors: Heather Fulford, Melanie Liddell

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The recruitment and retention of high quality employees can prove to be challenging for social enterprises, particularly in some of the core business support functions such as marketing, communications, IT and finance. This holds true for social enterprises in urban contexts, where roles with more attractive remuneration in these business functions can often be found quite readily in the private sector. For social enterprises situated in rural locations, the challenges of staff recruitment and retention are even more acute. Such challenges can lead to a skills deficit in rural social enterprises, which can, at best, hinder their growth potential, and worse, jeopardise their chances of survival. This in turn, can have a negative impact on the sustainability and resilience of the surrounding rural community in which the social enterprise is located. The purpose of this paper is to report on aspects of a collaborative initiative established to stimulate innovation and business growth in remote rural businesses in Scotland. Launched in 2010, this initiative was designed to attract young students and graduates from the region to stay in the region upon completion of their studies, and to attract others from outside the region to re-locate there post-university. To facilitate this, SMEs in the region were offered wage subsidies to encourage them to recruit a student or graduate on a work placement for up to one year to participate in an innovation or business growth-oriented project. A number of the employers offering work placements were social enterprises. Through analysis of the placement project and role specifications devised by the participating social enterprises, an overview is provided of their business development needs and the skills they require to stimulate innovation and growth. Scrutiny of the reflective accounts compiled by the students and graduates at the close of their work placements highlights the benefits they derived from being able to put their academic knowledge and skills into action within a social enterprise. Examination of interviews conducted with a sample of placement employers reveals the contribution the students and graduates made during the business development projects with the social enterprises. The challenges of hosting such placements are also discussed. The paper concludes with indications of the lessons learned and an outline of the wider implications for other remote rural locations in which social enterprises play an important role in the local economy and life of the community.

Keywords: resilience, rural development, regeneration, regional development, recruitment, resource management, retention, remuneration

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Authors: Medan Isaeva, Anna Degtyareva

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Context: Biliary atresia is a common reason for liver transplants in children, and the Kasai procedure can potentially be successful in avoiding the need for transplantation. However, it is important to identify factors that influence surgical outcomes in order to optimize treatment and improve patient outcomes. Research aim: The aim of this study was to develop prognostic models to assess the outcomes of the Kasai procedure in children with biliary atresia. Methodology: This retrospective study analyzed data from 166 children with biliary atresia who underwent the Kasai procedure between 2002 and 2021. The effectiveness of the operation was assessed based on specific criteria, including post-operative stool color, jaundice reduction, and bilirubin levels. The study involved a comparative analysis of various parameters, such as gestational age, birth weight, age at operation, physical development, liver and spleen sizes, and laboratory values including bilirubin, ALT, AST, and others, measured pre- and post-operation. Ultrasonographic evaluations were also conducted pre-operation, assessing the hepatobiliary system and related quantitative parameters. The study was carried out by two experienced specialists in pediatric hepatology. Comparative analysis and multifactorial logistic regression were used as the primary statistical methods. Findings: The study identified several statistically significant predictors of a successful Kasai procedure, including the presence of the gallbladder and levels of cholesterol and direct bilirubin post-operation. A detectable gallbladder was associated with a higher probability of surgical success, while elevated post-operative cholesterol and direct bilirubin levels were indicative of a reduced chance of positive outcomes. Theoretical importance: The findings of this study contribute to the optimization of treatment strategies for children with biliary atresia undergoing the Kasai procedure. By identifying early predictive signs of success, clinicians can modify treatment plans and manage patient care more effectively and proactively. Data collection and analysis procedures: Data for this analysis were obtained from the health records of patients who received the Kasai procedure. Comparative analysis and multifactorial logistic regression were employed to analyze the data and identify significant predictors. Question addressed: The study addressed the question of identifying predictive factors for the success of the Kasai procedure in children with biliary atresia. Conclusion: The developed prognostic models serve as valuable tools for early detection of patients who are less likely to benefit from the Kasai procedure. This enables clinicians to modify treatment plans and manage patient care more effectively and proactively. Potential limitations of the study: The study has several limitations. Its retrospective nature may introduce biases and inconsistencies in data collection. Being single centered, the results might not be generalizable to wider populations due to variations in surgical and postoperative practices. Also, other potential influencing factors beyond the clinical, laboratory, and ultrasonographic parameters considered in this study were not explored, which could affect the outcomes of the Kasai operation. Future studies could benefit from including a broader range of factors.

Keywords: biliary atresia, kasai operation, prognostic model, native liver survival

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Authors: Seppo Kittilä, Sonja Dahlgren

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In this paper, a (morpho)phonological typology of proximal and distal demonstratives is proposed. Only the most basic proximal (‘this’) and distal (‘that’) forms have been considered, potential more fine-grained distinctions based on proximity are not relevant to our discussion, nor are the other functions the discussed demonstratives may have. The sample comprises 82 languages that represent the linguistic diversity of the world’s languages, although the study is not based on a systematic sample. Four different major types are distinguished; (1) Vowel type: front vs. back; high vs. low vowel (2) Consonant type: front-back consonants (3) Additional element –type (4) Varia. The proposed types can further be subdivided according to whether the attested difference concern only, e.g., vowels, or whether there are also other changes. For example, the first type comprises both languages such as Betta Kurumba, where only the vowel changes (i ‘this’, a ‘that’) and languages like Alyawarra (nhinha vs. nhaka), where there are also other changes. In the second type, demonstratives are distinguished based on whether the consonants are front or back; typically front consonants (e.g., labial and dental) appear on proximal demonstratives and back consonants on distal demonstratives (such as velar or uvular consonants). An example is provided by Bunaq, where bari marks ‘this’ and baqi ‘that’. In the third type, distal demonstratives typically have an additional element, making it longer in form than the proximal one (e.g., Òko òne ‘this’, ònébé ‘that’), but the type also comprises languages where the distal demonstrative is simply phonologically longer (e.g., Ngalakan nu-gaʔye vs. nu-gunʔbiri). Finally, the last type comprises cases that do not fit into the three other types, but a number of strategies are used by the languages of this group. The two first types can be explained by iconicity; front or high phonemes appear on the proximal demonstratives, while back/low phonemes are related to distal demonstratives. This means that proximal demonstratives are pronounced at the front and/or high part of the oral cavity, while distal demonstratives are pronounced lower and more back, which reflects the proximal/distal nature of their referents in the physical world. The first type is clearly the most common in our data (40/82 languages), which suggests a clear association with iconicity. Our findings support earlier findings that proximal and distal demonstratives have an iconic phonemic manifestation. For example, it has been argued that /i/ is related to smallness (small distance). Consonants, however, have not been considered before, or no systematic correspondences have been discovered. The third type, in turn, can be explained by markedness; the distal element is more marked than the proximal demonstrative. Moreover, iconicity is relevant also here: some languages clearly use less linguistic substance for referring to entities close to the speaker, which is manifested in the longer (morpho)phonological form of the distal demonstratives. The fourth type contains different kinds of cases, and systematic generalizations are hard to make.

Keywords: demonstratives, iconicity, language typology, phonology

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Authors: Neil Singla, Derek Muse, Karen DiDonato, Pamela Palmer

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Introduction: Pain is the most common reason people visit emergency rooms. Studies indicate however, that Emergency Department (ED) physicians often do not provide adequate analgesia to their patients as a result of gender and age bias, opiophobia and insufficient knowledge of and formal training in acute pain management. Novel classes of analgesics have recently been introduced, but many patients suffer from acute pain in settings where the availability of intravenous (IV) access may be limited, so there remains a clinical need for rapid-acting, potent analgesics that do not require an invasive route of delivery. A sublingual sufentanil tablet (SST), dispensed using a single-dose applicator, is in development for treatment of moderate-to-severe acute pain in a medically-supervised setting. Objective: The primary objective of this study was to demonstrate the repeat-dose efficacy, safety and tolerability of sufentanil 20 mcg and 30 mcg sublingual tablets compared to placebo for the management of acute pain as determined by the time-weighted sum of pain intensity differences (SPID) to baseline over the 12-hour study period (SPID12). Key secondary efficacy variables included SPID over the first hour (SPID1), Total pain relief over the 12-hour study period (TOTPAR12), time to perceived pain relief (PR) and time to meaningful PR. Safety variables consisted of adverse events (AE), vital signs, oxygen saturation and early termination. Methods: In this Phase 2, double-blind, dose-finding study, an equal number of male and female patients were randomly assigned in a 2:2:1 ratio to SST 20 mcg, SS 30 mcg or placebo, respectively, following bunionectomy. Study drug was dosed as needed, but not more frequently than hourly. Rescue medication was available as needed. The primary endpoint was the Summed Pain Intensity Difference to baseline over 12h (SPIDI2). Safety was assessed by continuous oxygen saturation monitoring and adverse event reporting. Results: 101 patients (51 Male/50 Female) were randomized, 100 received study treatment (intent-to-treat [ITT] population), and 91 completed the study. Reasons for early discontinuation were lack of efficacy (6), adverse events (2) and drug-dosing error (1). Mean age was 42.5 years. For the ITT population, SST 30 mcg was superior to placebo (p=0.003) for the SPID12. SPID12 scores in the active groups were superior for both male (ANOVA overall p-value =0.038) and female (ANOVA overall p-value=0.005) patients. Statistically significant differences in favour of sublingual sufentanil were also observed between the SST 30mcg and placebo group for SPID1(p<0.001), TOTPAR12(p=0.002), time to perceived PR (p=0.023) and time to meaningful PR (p=0.010). Nausea, vomiting and somnolence were more frequent in the sufentanil groups but there were no significant differences between treatment arms for the proportion of patients who prematurely terminated due to AE or inadequate analgesia. Conclusions: Sufentanil tablets dispensed sublingually using a single-dose applicator is in development for treatment of patients with moderate-to-severe acute pain in a medically-supervised setting where immediate IV access is limited. When administered sublingually, sufentanil’s pharmacokinetic profile and non-invasive delivery makes it a useful alternative to IM or IV dosing.

Keywords: acute pain, pain management, sublingual, sufentanil

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Authors: Jessica Kate Simonds

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The last successful hijacking perpetrated by Somali pirates in 2012 represented a critical turning point for the identity and brand of Indian Ocean (IO) insecurity, coined in this paper as the era of the post-piratical. This paper explores the broadening of the PMSC business model to account and contribute to the design of a new IO security environment that prioritises foreign and insurgency drone activity and Houthi rebel operations as the main threat to merchant shipping in the post-2012 era. This study is situated within a longer history of analysing maritime insecurity and also contributes a bespoke conceptual framework that understands the sea as a space that is produced and reproduced relative to existing and emerging threats to merchant shipping based on bespoke models of information sharing and intelligence acquisition. This paper also makes a prominent empirical contribution by drawing on a post-positivist methodology, data drawn from original semi-structured interviews with senior maritime insurers and active merchant seafarers that is triangulated with industry-produced guidance such as the BMP series as primary data sources. Each set is analysed through qualitative discourse and content analysis and supported by the quantitative data sets provided by the IMB Piracy Reporting center and intelligence networks. This analysis reveals that mechanisms such as the IGP&I Maritime Security Committee and intelligence divisions of PMSC’s have driven the exchanges of knowledge between land and sea and thus the reproduction of the maritime security environment through new regulations and guidance to account dones, rebels and bombs as the key challenges in the IO, beyond piracy. A contribution of this paper is the argument that experts who may not be in the highest-profile jobs are the architects of maritime insecurity based on their detailed knowledge and connections to vessels in transit. This paper shares the original insights of those who have served in critical decision making spaces to demonstrate that the development and refinement of industry produced deterrence guidance that has been accredited to the mitigation of piracy, have shaped new editions such as BMP 5 that now serve to frame a new security environment that prioritises the mitigation of risks from drones and WBEID’s from both state and insurgency risk groups. By highlighting the experiences and perspectives of key players on both land and at sea, the key finding of this paper is outlining that as pirates experienced a financial boom by profiteering from their bespoke business model during the peak of successful hijackings, the private security market encountered a similar level of financial success and guaranteed risk environment in which to prospect business. Thus, the reproduction of the Indian Ocean as a maritime security environment reflects a new found purpose for PMSC’s as part of the broader conglomerate of maritime insurers, regulators, shipowners and managers who continue to redirect the security consciousness and IO brand of insecurity.

Keywords: maritime security, private security, risk intelligence, political geography, international relations, political economy, maritime law, security studies

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Authors: Isabella Maria Beil

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The International Geosciences and Geoparks Programme (IGGP) were officially created in 2015 by the United Nations Educational, Scientific and Cultural Organization (UNESCO) to enhance the protection of the geological heritage and fill the gaps on the World Heritage Convention. According to UNESCO, a Global Geopark is an unified area where sites and landscapes of international geological significance are managed based on a concept of sustainable development. Tourism is seen as a main activity to develop new sources of revenue. Currently (November 2022), UNESCO recognized 177 Global Geoparks, of which more than 50% are in Europe, 40% in Asia, 6% in Latin America, and the remaining 4% are distributed between Africa and Anglo-Saxon America. This picture shows the existence of a much uneven geographical distribution of these areas across the planet. Currently, there are three Geoparks in Brazil; however, the first of them was accepted by the Global Geoparks Network in 2006 and, just fifteen years later, two other Brazilian Geoparks also obtained the UNESCO title. Therefore, this paper aims to provide an overview of the current geopark situation in Brazil and to identify the main challenges faced by the implementation of these areas in the country. To this end, the Brazilian history and its main characteristics regarding the development of geoparks over the years will be briefly presented. Then, the results obtained from interviews with those responsible for each of the current 29 aspiring geoparks in Brazil will be presented. Finally, the main challenges related to the implementation of Geoparks in the country will be listed. Among these challenges, the answers obtained through the interviews revealed conflicts and problems that pose hindrances both to the start of the development of a Geopark project and to its continuity and implementation. It is clear that the task of getting multiple social actors, or stakeholders, to engage with the Geopark, one of UNESCO’s guidelines, is one of its most complex aspects. Therefore, among the main challenges, stand out the difficulty of establishing solid partnerships, what directly reflects divergences between the different social actors and their goals. This difficulty in establishing partnerships happens for a number of reasons. One of them is that the investment in a Geopark project can be high and investors often expect a short-term financial return. In addition, political support from the public sector is often costly as well, since the possible results and positive influences of a Geopark in a given area will only be experienced during future mandates. These results demonstrate that the research on Geoparks goes far beyond the geological perspective linked to its origins, and is deeply embedded in political and economic issues.

Keywords: Brazil, geoparks, tourism, UNESCO

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Authors: Dinesh Kumar Srivastava

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After liberalization of the economy, technical education has seen rapid growth in India. A large number of institutions are offering various engineering and management programmes. Every year, a number of students complete B. Tech/M. Tech and MBA programmes of different institutes, universities in India and search for jobs in the industry. A large number of companies visit educational institutes for campus placements. These companies are interested in hiring competent managers. Most students show preference for jobs from reputed companies and jobs having high compensation. In this context, this study was conducted to understand career preference of postgraduate students and junior executives. Personality characteristics influence work life as well as personal life. In the last two decades, five factor model of personality has been found to be a valid predictor of job performance and job satisfaction. This approach has received support from studies conducted in different countries. It includes neuroticism, extraversion, and openness to experience, agreeableness, and conscientiousness. Similarly three social needs, namely, achievement, affiliation and power influence motivation and performance in certain job functions. Both approaches have been considered in the study. The objective of the study was first, to analyse the relationship between personality characteristics and career preference of students and executives. Secondly, the study analysed the relationship between personality characteristics and skills of students. Three managerial skills namely, conceptual, human and technical have been considered in the study. The sample size of the study was 266 including postgraduate students and junior executives. Respondents have completed BE/B. Tech/MBA programme. Three dimensions of career preference namely, identity, variety and security and three managerial skills were considered as dependent variables. The results indicated that neuroticism was not related to any dimension of career preference. Extraversion was not related to identity, variety and security. It was positively related to three skills. Openness to experience was positively related to skills. Conscientiousness was positively related to variety. It was positively related to three skills. Similarly, the relationship between social needs and career preference was examined using correlation. The results indicated that need for achievement was positively related to variety, identity and security. Need for achievement was positively related to managerial skills Need for affiliation was positively related to three dimensions of career preference as well as managerial skills Need for power was positively related to three dimensions of career preference and managerial skills Social needs appear to be stronger predictor of career preference and managerial skills than big five traits. Findings have implications for selection process in industry.

Keywords: big five traits, career preference, personality, social needs

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Authors: Arzu Karahan, Loriano Ballarin, Baruch Rinkevich

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Marine invertebrates, the highly diverse phyla of multicellular organisms, represent phenomena that are either not found or highly restricted in the vertebrates. These include phenomena like budding, fission, a fusion of ramets, and high regeneration power, such as the ability to create whole new organisms from either tiny parental fragment, many of which are controlled by totipotent, pluripotent, and multipotent stem cells. Thus, there is very much that can be learned from these organisms on the practical and evolutionary levels, further resembling Darwin's words, “It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change”. The ‘stem cell’ notion highlights a cell that has the ability to continuously divide and differentiate into various progenitors and daughter cells. In vertebrates, adult stem cells are rare cells defined as lineage-restricted (multipotent at best) with tissue or organ-specific activities that are located in defined niches and further regulate the machinery of homeostasis, repair, and regeneration. They are usually categorized by their morphology, tissue of origin, plasticity, and potency. The above description not always holds when comparing the vertebrates with marine invertebrates’ stem cells that display wider ranges of plasticity and diversity at the taxonomic and the cellular levels. While marine/aquatic invertebrates stem cells (MISC) have recently raised more scientific interest, the know-how is still behind the attraction they deserve. MISC, not only are highly potent but, in many cases, are abundant (e.g., 1/3 of the entire animal cells), do not locate in permanent niches, participates in delayed-aging and whole-body regeneration phenomena, the knowledge of which can be clinically relevant. Moreover, they have massive hidden potential for the discovery of new bioactive molecules that can be used for human health (antitumor, antimicrobial) and biotechnology. The MARISTEM COST action (Stem Cells of Marine/Aquatic Invertebrates: From Basic Research to Innovative Applications) aims to connect the European fragmented MISC community. Under this scientific umbrella, the action conceptualizes the idea for adult stem cells that do not share many properties with the vertebrates’ stem cells, organizes meetings, summer schools, and workshops, stimulating young researchers, supplying technical and adviser support via short-term scientific studies, making new bridges between the MISC community and biomedical disciplines.

Keywords: aquatic/marine invertebrates, adult stem cell, regeneration, cell cultures, bioactive molecules

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Authors: Emilie Vandevelde, Ellen Claes

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This study aims to develop a comprehensive model for the civic socialization process of teachers. Citizenship has become one of the main objectives for the European education systems. It is expected that teachers are well prepared and equipped with the necessary knowledge, skills, and attitudes to also engage students in democratic citizenship. While a lot is known about young peoples’ civic competence development and how schools and teachers (don’t) support this process, less is known about how teachers themselves engage with (the teaching of) civics. Other than the civic socialization process of young adolescents that focuses on personal competence development, the civic socialization process of teachers includes the development of professional, civic competences. These professional competences make that they are able to prepare pupils to carry out their civic responsibilities in thoughtful ways. Existing models for the civic socialization process of young adolescents do not take this dual purpose into account. Based on these observations, this paper will investigate (1)What personal and professional civic competences teachers need to effectively teach civic education and (2) how teachers acquire these personal and professional civic competences. To answer the first research question, a systematic review of literature of existing civic education frameworks was carried out and linked to literature on teacher training. The second research question was addressed by adapting the Octagon model, developed by the International Association for the Evaluation of Educational Achievement (IEA), to the context of teachers. This was done by carrying out a systematic review of the recent literature linking three theoretical topics involved in teachers’ civic competence development: theories about the civic socialization process of young adolescents, Schulmans (1987) theoretical assumptions on pedagogical content knowledge (PCK), and Nogueira & Moreira’s (2012) framework for civic education teachers’ knowledge and literature on teachers’ professional development. This resulted in a comprehensive conceptual framework describing the personal and professional civic competences of civic education teachers. In addition, this framework is linked to the OctagonT model: a model that describes the processes through which teachers acquire these personal and professional civic competences. This model recognizes that teachers’ civic socialization process is influenced by interconnected variables located at different levels in a multi-level structure (the individual teacher (e.g., civic beliefs), everyday contacts (e.g., teacher educators, the intended, informal and hidden curriculum of the teacher training program, internship contacts, participation opportunities in teacher training, etc.) and the influence of the national educational context (e.g., vision on civic education)). Furthermore, implications for teacher education programs are described.

Keywords: civic education, civic competences, civic socialization, octagon model, teacher training

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Authors: Aiydh Aljeddani, Fran Martin

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The critical time in which we live requires rethinking of many potential ways in order to make the concept of sustainability and its principles an integral part of our daily life. One of these potential approaches is how to attract community institutions, such as the private sector, to participate effectively in the sustainability industry by supporting public schools to fulfill their duties. A collaborative community of practice can support this purpose and can provide a flexible framework, which allows the members of the community to participate effectively. This study, conducted in Saudi Arabia, aimed to understand the process of a collaborative community of practice of involving the private sector as a member of this community to integrate the sustainability concept in school activities and projects. This study employed a qualitative methodology to understand this authentic and complex phenomenon. A case study approach, ethnography and some elements of action research were followed in this study. The methods of unstructured interviews, artifacts, observation, and teachers’ field notes were used to collect the data. The participants were three secondary teachers, twelve chief executive officers, and one school administrative officer. Certain contextual conditions, as shown by the data, should be taken into consideration when policy makers and school administrations in Saudi Arabia desire to integrate sustainability into school activities. The first of these was the acknowledgement of the valuable role of the members’ personality, efforts, abilities, and experiences, which played vital roles in integrating sustainability. Second, institutional culture, which was not expected to emerge as an important factor in this study, has a significant role in the integration of sustainability. Credibility among the members of the community towards the integration of the sustainability concept and its principles through school activities is another important condition. Fourth, some chief executive officers’ understanding of Corporate Social Responsibility (CSR) towards contribution to sustainability agenda was shallow and limited and this could impede the successful integration of sustainability. Fifth, a shared understanding between the members of the community about integrating sustainability was a vital condition in the integration process. The study also revealed that the integration of sustainability could not be an ongoing process if implemented in isolation of the other community institutions such as the private sector. The study finally offers a number of recommendations to improve on the current practices and suggests areas for further studies.

Keywords: community of practice, public schools, private sector, sustainable development

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Authors: Everard van Kemenade

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Many quality improvement activities are planned. Leaders are strongly involved in missions, visions and strategic planning. They use, consciously or unconsciously, the PDCA-cycle, also know as the Deming cycle. After the planning, the plans are carried out and the results or effects are measured. If the results show that the goals in the plan have not been achieved, adjustments are made in the next plan or in the execution of the processes. Then, the cycle is run through again. Traditionally, the PDCA-cycle is advocated as a means to an end. However, PDCA is especially fit for planned, ordered, certain contexts. It fits with the empirical and referential quality paradigm. For uncertain, unordered, unplanned processes, something else might be needed instead of Plan-Do-Check-Act. Due to the complexity of our society, the influence of the context, and the uncertainty in our world nowadays, not every activity can be planned anymore. At the same time organisations need to be more innovative than ever. That provides leaders with ‘wicked tendencies’. However, that raises the question how one can innovate without being able to plan? Complexity science studies the interactions of a diverse group of agents that bring about change in times of uncertainty, e.g. when radical innovation is co-created. This process is called emergence. This research study explores the role of leadership in the emergence paradigm. Aim of the article is to study the way that leadership can support the emergence of innovation in a complex context. First, clarity is given on the concepts used in the research question: complexity, emergence, innovation and leadership. Thereafter a literature search is conducted to answer the research question. The topics ‘emergent leadership’ or ‘complexity leadership’ are chosen for an exploratory search in Google and Google Scholar using the berry picking method. Exclusion criterion is emergence in other disciplines than organizational development or in the meaning of ‘arising’. The literature search conducted gave 45 hits. Twenty-seven articles were excluded after reading the title and abstract because they did not research the topic of emergent leadership and complexity. After reading the remaining articles as a whole one more was excluded because the article used emergent in the limited meaning of ‗arising‘ and eight more were excluded because the topic did not match the research question of this article. That brings the total of the search to 17 articles. The useful conclusions from the articles are merged and grouped together under overarching topics, using thematic analysis. The findings are that 5 topics prevail when looking at possibilities for leadership to facilitate innovation: enabling, sharing values, dreaming, interacting, context sensitivity and adaptivity. Together they form In Dutch the acronym Medusa.

Keywords: complexity science, emergence, leadership in the emergence paradigm, innovation, the Medusa principles

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Authors: Jasmin Cowin, Amany Alkhayat

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This paper will concentrate on a comparative analysis of both the advantages and limitations of using digital learning resources (DLRs). DLRs covered will be Virtual Reality (VR), Mobile Learning (M-learning) and Computer-Assisted Language Learning (CALL) together with their subset, Mobile Assisted Language Learning (MALL) in language education. In addition, best practices for language teaching and the application of established language teaching methodologies such as Communicative Language Teaching (CLT), the audio-lingual method, or community language learning will be explored. Education has changed dramatically since the eruption of the pandemic. Traditional face-to-face education was disrupted on a global scale. The rise of distance learning brought new digital tools to the forefront, especially web conferencing tools, digital storytelling apps, test authoring tools, and VR platforms. Language educators raced to vet, learn, and implement multiple technology resources suited for language acquisition. Yet, questions remain on how to harness new technologies, digital tools, and their ubiquitous availability while using established methods and methodologies in language learning paired with best teaching practices. In M-learning language, learners employ portable computing devices such as smartphones or tablets. CALL is a language teaching approach using computers and other technologies through presenting, reinforcing, and assessing language materials to be learned or to create environments where teachers and learners can meaningfully interact. In VR, a computer-generated simulation enables learner interaction with a 3D environment via screen, smartphone, or a head mounted display. Research supports that VR for language learning is effective in terms of exploration, communication, engagement, and motivation. Students are able to relate through role play activities, interact with 3D objects and activities such as field trips. VR lends itself to group language exercises in the classroom with target language practice in an immersive, virtual environment. Students, teachers, schools, language institutes, and institutions benefit from specialized support to help them acquire second language proficiency and content knowledge that builds on their cultural and linguistic assets. Through the purposeful application of different language methodologies and teaching approaches, language learners can not only make cultural and linguistic connections in DLRs but also practice grammar drills, play memory games or flourish in authentic settings.

Keywords: language teaching methodologies, computer-assisted language learning, mobile learning, virtual reality

Procedia PDF Downloads 238

Authors: Shobrina Silmi Qori Tarlita, Fariz Kukuh Harwinda

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Indonesia has 81.000 kilometers coastal line and 70% water surface which is known as the country who has a huge potential in fisheries sector and also which is able to support more than 50 % of Gross Domestic Product. But according to Department of Marine and Fisheries data, fisheries sector supported only 20% of Total GDP in 1998. Not only that, the highest decline in fisheries sector income occured in 2009. Those conditions occur, because of some factors contributed to the lack of integrated working platform for the fisheries and marine management in some areas which have a high productivity to increase the economical profit every year for the country, especially Indonesia, besides the labor requirement for every company, whether a big company or smaller one, depends on the natural condition that makes a lot of people become unemployed if the weather condition or any other conditions dealing with the natural condition is bad for creating fisheries and marine management, especially in aquaculture and fish – captured operation. Not only those, a lot of fishermen, especially in Indonesia, mostly make their job profession as an additional job or side job to fulfill their own needs, although they are averagely poor. Another major problem are the lack of the sustainable developmental program to stabilize the productivity of fisheries and marine natural source, like protecting the environment for fish nursery ground and migration channel, that makes the low productivity of fisheries and marine natural resource, even though the growth of the society in Indonesia has increased for years and needs more food resource to comply the high demand nutrition for living. The development of Minapolitan Area is one of the alternative solution to build a better place for aqua-culturist as well as the fishermen which focusing on systemic and business effort for fisheries and marine management. Minapolitan is kind of integration area which gathers and integrates the ones who is focusing their effort and business in fisheries sector, so that Minapolitan is capable of triggering the fishery activity on the area which using Minapolitan management intensively. From those things, finally, Minapolitan is expected to reinforce the sustainable development through increasing the productivity of fish – capturing operation as well as aquaculture, and it is also expected that Minapolitan will be able to increase GDP, the earning for a lot of people and also will be able to bring prosperity around the world. From those backgrounds, this paper will explain more about the Minapolitan Area and the design of reinforcing the Minapolitan Area by zonation in the Fishery and Marine exploitation area with high productivity as well as low productivity. Hopefully, this solution will be able to answer the economical and social issue for declining food resource, especially fishery and marine resource.

Keywords: Minapolitan, fisheries, economy, Indonesia

Procedia PDF Downloads 463

Authors: Adiba Matin, Daniel Cabrera, Javiera Bellolio, Jasmine Stewart, Dana Gerberi (librarian), Nathan Cummins, Fernanda Bellolio

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OBJECTIVES: Artificial intelligence (AI) tools are becoming more prevalent in healthcare settings, particularly for diagnostic and therapeutic recommendations, with an expected surge in the incoming years. The bedside use of this technology for clinicians opens the possibility of disagreements between the recommendations from AI algorithms and clinicians’ judgment. There is a paucity in the literature analyzing nature and possible outcomes of these potential conflicts, particularly related to ethical considerations. The goal of this scoping review is to identify, analyze and classify current themes and potential strategies addressing ethical conflicts originating from the conflict between AI and human recommendations. METHODS: A protocol was written prior to the initiation of the study. Relevant literature was searched by a medical librarian for the terms of artificial intelligence, healthcare and liability, ethics, or conflict. Search was run in 2021 in Ovid Cochrane Central Register of Controlled Trials, Embase, Medline, IEEE Xplore, Scopus, and Web of Science Core Collection. Articles describing the role of AI in healthcare that mentioned conflict between humans and AI were included in the primary search. Two investigators working independently and in duplicate screened titles and abstracts and reviewed full-text of potentially eligible studies. Data was abstracted into tables and reported by themes. We followed methodological guidelines for Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). RESULTS: Of 6846 titles and abstracts, 225 full texts were selected, and 48 articles included in this review. 23 articles were included as original research and review papers. 25 were included as editorials and commentaries with similar themes. There was a lack of consensus in the included articles on who would be held liable for mistakes incurred by following AI recommendations. It appears that there is a dichotomy of the perceived ethical consequences depending on if the negative outcome is a result of a human versus AI conflict or secondary to a deviation from standard of care. Themes identified included transparency versus opacity of recommendations, data bias, liability of outcomes, regulatory framework, and the overall scope of artificial intelligence in healthcare. A relevant issue identified was the concern by clinicians of the “black box” nature of these recommendations and the ability to judge appropriateness of AI guidance. CONCLUSION AI clinical tools are being rapidly developed and adopted, and the use of this technology will create conflicts between AI algorithms and healthcare workers with various outcomes. In turn, these conflicts may have legal, and ethical considerations. There is limited consensus about the focus of ethical and liability for outcomes originated from disagreements. This scoping review identified the importance of framing the problem in terms of conflict between standard of care or not, and informed by the themes of transparency/opacity, data bias, legal liability, absent regulatory frameworks and understanding of the technology. Finally, limited recommendations to mitigate ethical conflicts between AI and humans have been identified. Further work is necessary in this field.

Keywords: ethics, artificial intelligence, emergency medicine, review

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Authors: Natchaphon Auampradit, Patama Vapattanawong, Sureeporn Punpuing, Malee Sunpuwan, Tawanchai Jirapramukpitak

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Longitudinal studies related to cognitive impairment in elderly are necessary for health promotion and development. The purposes of this study were (1) to examine changes in cognition of elderly over time and (2) to examine the impacts of changes in social determinants of health (SDH) toward changes in cognition of elderly by using the secondary data derived from the Kanchanaburi Demographic Surveillance System (KDSS) by the Institute for Population and Social Research (IPSR) which contained longitudinal data on individuals, households, and villages. Two selected projects included the Health and Social Support for Elderly in KDSS in 2007 and the Population, Economic, Social, Cultural, and Long-term Care Surveillance for Thai Elderly People’s Health Promotion in 2011. The samples were 586 elderly participated in both projects. SDH included living arrangement, social relationships with children, relatives, and friends, household asset-based wealth index, household monthly income, loans for livings, loans for investment, and working status. Cognitive impairment was measured by category fluency and delayed recall. This study employed Generalized Estimating Equation (GEE) model to investigate changes in cognition by taking SDH and other variables such as age, gender, marital status, education, and depression into the model. The unstructured correlation structure was selected to use for analysis. The results revealed that 24 percent of elderly had cognitive impairment at baseline. About 13 percent of elderly still had cognitive impairment during 2007 until 2011. About 21 percent and 11 percent of elderly had cognitive decline and cognitive improvement, respectively. The cross-sectional analysis showed that household asset-based wealth index, social relationship with friends, working status, age, marital status, education, and depression were significantly associated with cognitive impairment. The GEE model revealed longitudinal effects of household asset-based wealth index and working status against cognition during 2007 until 2011. There was no longitudinal effect of social conditions against cognition. Elderly living with richer household asset-based wealth index, still being employed, and being younger were less likely to have cognitive impairment. The results strongly suggested that poorer household asset-based wealth index and being unemployed were served as a risk factor for cognitive impairment over time. Increasing age was still the major risk for cognitive impairment as well.

Keywords: changes in cognition, cognitive impairment, elderly, KDSS, longitudinal study

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Authors: Murray Anderson, Galina Freed, Karli Jahn

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Trauma is increasingly recognized as an important construct that has health implications for those who struggle with various mental health issues. For those individuals who meet the criteria for a diagnosis of hoarding disorder (HD), many have experienced some form of trauma. Further, some of the therapeutic interventions for those with HD can further perpetuate or magnify the experience of trauma. Therefore, the aim of this scoping review is to identify and document the nature and extent of research evidence related to trauma as it connects with HD. This review was guided by the questions, ‘How can our understanding of the trauma cycle help us to better appreciate the experiences of individuals who hoard, and how will a trauma informed lens inform the interventions for hoarding disorder? A comprehensive literature search was performed to identify original studies that contained the words “hoarding” and “trauma.” PsychINFO”,''EBSCO host,” “CINAHL” and “PubMed” were searched between January 2005 and April 2021. Articles were screened by three reviewers. Data extracted included publication date, demographics, study design, type of analysis, and noted connections between hoarding and trauma. Of the 329 articles, all duplicates, articles on hoardings of animals, articles not in English, and those without full-text availability were removed. Five categories were found in the remaining 45 articles, including (a) traumatic and stressful life events; (b) the link between posttraumatic stress disorder, trauma, and hoarding; (c) the relationships between different comorbidities, trauma, and hoarding; (d) the lack of early emotional expression and other forms of parental deprivation; and (e) the role of attachment. Lastly, the literature explains how the links between hoarding and trauma are difficult to study due to the highly stigmatized identities with this population. The review provided strong support for the connections between the experience of trauma and HD. What is missing from the literature is the use of a trauma-informed lens to better account for the ways in which hoarding disorder is understood. Other missing pieces in the literature are the potential uses of a trauma-informed lens to enhance the therapeutic process, to understand and reduce treatment attrition, and to improve treatment outcomes. The application of a trauma informed lens could improve our understanding of effective interactions among clients, families, and communities and improve the education around hoarding-related matters. Exploring the connections between trauma and HD can improve therapeutic delivery and destigmatize the experience of dealing with clutter and hoarding concerns. This awareness can also provide health care professionals with both the language and skills to liberate them from a reductionist view on HD.

Keywords: hoarding, attachment, parental deprivation, trauma

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Authors: Jimoh Abiodun Alaba

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Context: In many traditional African societies, sex education is often considered a taboo topic. However, the importance of sex education is becoming increasingly evident. This study aims to investigate the challenges faced in teaching sex education in selected secondary schools in the Akoko region of Ondo state, Nigeria. Research Aim: The aim of this study is to identify and examine the problems confronting the teaching of sex education in selected secondary schools in the Akoko region of Ondo state, Nigeria. Methodology: The study utilized a multi-stage sampling method. The first stage involved a purposive selection of ten (10) secondary schools in the Akoko region of Ondo State, while the second stage was a random selection of twenty (20) students, each in the selected secondary schools of the study area. This makes a total of two (200) hundred students that were considered for the survey. Descriptive analysis using percentages was employed to analyze the collected data. Factor analysis was also used to identify the most significant problems. Findings: The study revealed that sex education has been neglected in the sampled secondary schools due to traditional African beliefs that do not support the teaching and learning of this subject. Furthermore, there was evidence to suggest that parents also displayed reluctance towards the teaching of sex education, fearing that it might expose students to inappropriate behavior. Consequently, students were deprived of this essential aspect of education necessary for self-awareness and development. Theoretical Importance: This study contributes to the understanding of the challenges faced in teaching sex education in traditional African societies, specifically in the selected secondary schools in the Akoko region of Ondo state, Nigeria. Data Collection: Data were collected through the administration of 200 questionnaires in ten selected secondary schools. Additionally, information was gathered from federal, state, and local government authorities. Analysis Procedures: The collected data were analyzed using descriptive analysis, employing percentage calculations for better interpretation. Furthermore, factor analysis was conducted to isolate the most significant problems identified. Conclusion: The study concludes that sex education in the sampled secondary schools in the Akoko region of Ondo state, Nigeria, has suffered neglect due to traditional African beliefs and parental concerns. Consequently, students are denied an important aspect of education necessary for their self-awareness and development. Recommendations are made to change the negative perception of sex education, enrich the curriculum, and employ qualified personnel for its teaching. Additionally, it is suggested that sex education should be integrated with moral instruction.

Keywords: African traditional belief, sex, sex education, sexual misdemeanor, morality

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Authors: Suman Chaudhary, Rupinder K. Kanwar, Jagat R. Kanwar

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Azadirachta indica, also known as Neem belonging to the mahogany family is actively gaining interest in the era of modern day medicine due to its extensive applications in homeopathic medicine such as Ayurveda and Unani. More than 140 phytochemicals have been extracted from neem leaves, seed, bark and flowers for agro-medicinal applications. Among the various components, neem leaf protein (NLP) is currently the most investigated active ingredient, due to its immunomodulatory activities against tumor growth. However, these therapeutic ingredients of neem are susceptible to degradation and cannot withstand the drastic pH changes under physiological environment, and therefore, there is an urgent need of an alternative strategy such as a nano-delivery system to exploit its medicinal benefits. This study hypothesizes that guar gum (GG) derived biodegradable nano-carrier based encapsulation of NLP will improve its stability, specificity and sensitivity, thus facilitating targeted anti-cancer therapeutics. GG is a galactomannan derived from the endosperm of the guar beans seeds. Synthesis of guar nanocapsules (NCs) was performed using nanoprecipitation technique where the GG was encapsulated with NLP. Preliminary experiments conducted to characterize the NCs confirmed spherical morphology with a narrow size distribution of 30-40 nm. Differential scanning colorimetric analysis (DSC) validated the stability of these NCs even at a temperature range of 50-60°C which was well within the physiological and storage conditions. Thermogravimetric (TGA) analysis indicated high decomposition temperature of these NCs ranging upto 350°C. Additionally, Fourier Transform Infrared spectroscopy (FTIR) and the SDS-PAGE data acquired confirmed the successful encapsulation of NLP in the NCs. The anti-cancerous therapeutic property of this NC was tested on colon cancer cells (caco-2) as they are one of the most prevalent form of cancer. These NCs (both NLP loaded and void) were also tested on human intestinal epithelial cells (FHs 74) cells to evaluate their effect on normal cells. Cytotoxicity evaluation of the NCs in the cell lines confirmed that the IC50 for NLP in FHs 74 cells was ~2 fold higher than in caco-2 cells, indicating that this nanoformulation system possessed biocompatible anti-cancerous properties Immunoconfocal microscopy analysis confirmed the time dependent internalization of the NCs within 6h. Recent findings performed using Annexin V and PI staining indicated a significant increase (p ≤ 0.001) in the early and late apoptotic cell population when treated with the NCs signifying the role of NLP in inducing apoptosis in caco-2 cells. This was further validated using Western blot, Polymerase chain reaction (PCR) and Fluorescence activated cell sorter (FACS) aided protein expressional analysis which presented a downregulation of survivin, an anti-apoptotic cell marker and upregulation of Bax/Bcl-2 ratio (pro-apoptotic indicator). Further, both the NLP NC and unencapsulated NLP treatment destabilized the mitochondrial membrane potential subsequently facilitating the release of the pro-apoptotic caspase cascade initiator, cytochrome-c. Future studies will be focused towards granting specificity to these NCs towards cancer cells, along with a comprehensive analysis of the anti-cancer potential of this naturally occurring compound in different cancer and in vivo animal models, will validate the clinical application of this unprecedented protein therapeutic.

Keywords: anti-tumor, guar gum, nanocapsules, neem leaf protein

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Authors: Inje Cho

Abstract:

The leading health risks threatening the world today are associated with a modern lifestyle characterized by sedentary behavior, stress, anxiety, and an obesogenic food environment. To counter this alarming trend, the Centers for Disease Control and Prevention have proffered Physical Activity guidelines to bolster physical engagement. Concurrently, the burgeon of smartphones and mobile applications has witnessed a proliferation of fitness applications aimed at invigorating exercise adherence and real-time activity monitoring. Grounded in the Uses and gratification theory, this study delves into the technological affordances of mobile fitness applications, discerning the mediating influences of escapism and social outcome expectations on attitudes and exercise intention. The theory explains how individuals employ distinct communication mediums to satiate their exigencies and desires. Technological affordances manifest as attributes of emerging technologies that galvanize personal engagement in physical activities. Several features of mobile fitness applications include affordances for goal setting, virtual rewards, peer support, and exercise information. Escapism, denoting the inclination to disengage from normal routines, has emerged as a salient motivator for the consumption of new media. This study postulates that individual’s perceptions technological affordances within mobile fitness applications, can affect escapism and social outcome expectations, potentially influencing attitude, and behavior formation. Thus, the integrated model has been developed to empirically examine the interrelationships between technological affordances, escapism, social outcome expectations, and exercise intention. Structural Equation Modelling serves as the methodological tool, and a cohort of 400 Fitbit users shall be enlisted from the Prolific, data collection platform. A sequence of multivariate data analyses will scrutinize both the measurement and hypothesized structural models. By delving into the effects of mobile fitness applications, this study contributes to the growing of new media studies in sport management. Moreover, the novel integration of the uses and gratification theory, technological affordances, via the prism of escapism, illustrates the dynamics that underlies mobile fitness user’s attitudes and behavioral intentions. Therefore, the findings from this study contribute to theoretical understanding and provide pragmatic insights to developers and practitioners in optimizing the impact of mobile fitness applications.

Keywords: technological affordances, uses and gratification, mobile fitness apps, escapism, physical activity

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Authors: Jia Guo, Qinyuan Huang, Qinyi Zhong, Yanjing Zeng, Yimeng Li, James Wiley, Kin Cheung, Jyu-Lin Chen

Abstract:

Context: Mothers with abdominal obesity, particularly in China, face challenges in managing their health due to family responsibilities. Existing diabetes prevention programs do not cater specifically to this demographic. Research Aim: To assess the feasibility, acceptability, and efficacy of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in reducing weight-related variables and diabetes risk. Methodology: A randomized controlled trial was conducted in Changsha, China, where the mHealth group received personalized modules and health messages, while the control group received general health education. Data were collected at baseline, 3 months, and 6 months. Findings: The mHealth intervention significantly improved waist circumference, modifiable diabetes risk scores, daily steps, self-efficacy for physical activity, social support for physical activity, and physical health satisfaction compared to the control group. However, no differences were found in BMI and certain other variables. Theoretical Importance: The study demonstrates the feasibility and efficacy of a tailored mHealth intervention for Chinese mothers with abdominal obesity, emphasizing the potential for such programs to improve health outcomes in this population. Data Collection: Data on various variables including weight-related measures, diabetes risk scores, behavioral and psychological factors were collected at baseline, 3 months, and 6 months from participants in the mHealth and control groups. Analysis Procedures: Generalized estimating equations were used to analyze the data collected from the mHealth and control groups at different time points during the study period. Question Addressed: The study addressed the effectiveness of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in improving various health outcomes compared to traditional general health education approaches. Conclusion: The tailored mHealth intervention proved to be feasible and effective in improving weight-related variables, physical activity, and physical health satisfaction among Chinese mothers with abdominal obesity, highlighting its potential for delivering diabetes prevention programs to this population.

Keywords: type 2 diabetes, mHealth, obesity, prevention, mothers

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