Search results for: feminist legal studies
11543 Empowering and Educating Young People Against Cybercrime by Playing: The Rayuela Method
Authors: Jose L. Diego, Antonio Berlanga, Gregorio López, Diana López
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The Rayuela method is a success story, as it is part of a project selected by the European Commission to face the challenge launched by itself for achieving a better understanding of human factors, as well as social and organisational aspects that are able to solve issues in fighting against crime. Rayuela's method specifically focuses on the drivers of cyber criminality, including approaches to prevent, investigate, and mitigate cybercriminal behavior. As the internet has become an integral part of young people’s lives, they are the key target of the Rayuela method because they (as a victim or as a perpetrator) are the most vulnerable link of the chain. Considering the increased time spent online and the control of their internet usage and the low level of awareness of cyber threats and their potential impact, it is understandable the proliferation of incidents due to human mistakes. 51% of Europeans feel not well informed about cyber threats, and 86% believe that the risk of becoming a victim of cybercrime is rapidly increasing. On the other hand, Law enforcement has noted that more and more young people are increasingly committing cybercrimes. This is an international problem that has considerable cost implications; it is estimated that crimes in cyberspace will cost the global economy $445B annually. Understanding all these phenomena drives to the necessity of a shift in focus from sanctions to deterrence and prevention. As a research project, Rayuela aims to bring together law enforcement agencies (LEAs), sociologists, psychologists, anthropologists, legal experts, computer scientists, and engineers, to develop novel methodologies that allow better understanding the factors affecting online behavior related to new ways of cyber criminality, as well as promoting the potential of these young talents for cybersecurity and technologies. Rayuela’s main goal is to better understand the drivers and human factors affecting certain relevant ways of cyber criminality, as well as empower and educate young people in the benefits, risks, and threats intrinsically linked to the use of the Internet by playing, thus preventing and mitigating cybercriminal behavior. In order to reach that goal it´s necessary an interdisciplinary consortium (formed by 17 international partners) carries out researches and actions like Profiling and case studies of cybercriminals and victims, risk assessments, studies on Internet of Things and its vulnerabilities, development of a serious gaming environment, training activities, data analysis and interpretation using Artificial intelligence, testing and piloting, etc. For facilitating the real implementation of the Rayuela method, as a community policing strategy, is crucial to count on a Police Force with a solid background in trust-building and community policing in order to do the piloting, specifically with young people. In this sense, Valencia Local Police is a pioneer Police Force working with young people in conflict solving, through providing police mediation and peer mediation services and advice. As an example, it is an official mediation institution, so agreements signed by their police mediators have once signed by the parties, the value of a judicial decision.Keywords: fight against crime and insecurity, avert and prepare young people against aggression, ICT, serious gaming and artificial intelligence against cybercrime, conflict solving and mediation with young people
Procedia PDF Downloads 12811542 Forensics Linguistics and Phonetics: The Analysis of Language to Support Investigations
Authors: Andreas Aceranti, Simonetta Vernocchi, Marco Colorato, Kaoutar Filahi
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This study was inspired by the necessity of giving forensic linguistics and phonetics more and more importance and the intention to explore those topics in an attempt to understand what the role of these disciplines really is in investigations of any nature. The goal is to analyze what are the achievements that those subjects have been able to reach, and what contribution they gave to the legal world; the analysis and study of those topics are supported by the recounting of real cases that have included forensic and phonetic linguistics. One of the most relevant cases is that of the Unabomber, an investigation that brought to light the importance and highlighted the importance this matter can have in difficult and time-consuming cases such as the one we have here. We also focus on the areas of expertise of those new branches of applied linguistics, focusing on what is the use of this new discipline in Italy and abroad and showing what could be the possible improvements that the Italian state could apply in order to be able to catch up with countries like Great Britain.Keywords: forensic linguistic, forensic phonetics, investigation, criminalistics
Procedia PDF Downloads 9311541 Modern Proteomics and the Application of Machine Learning Analyses in Proteomic Studies of Chronic Kidney Disease of Unknown Etiology
Authors: Dulanjali Ranasinghe, Isuru Supasan, Kaushalya Premachandra, Ranjan Dissanayake, Ajith Rajapaksha, Eustace Fernando
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Proteomics studies of organisms are considered to be significantly information-rich compared to their genomic counterparts because proteomes of organisms represent the expressed state of all proteins of an organism at a given time. In modern top-down and bottom-up proteomics workflows, the primary analysis methods employed are gel–based methods such as two-dimensional (2D) electrophoresis and mass spectrometry based methods. Machine learning (ML) and artificial intelligence (AI) have been used increasingly in modern biological data analyses. In particular, the fields of genomics, DNA sequencing, and bioinformatics have seen an incremental trend in the usage of ML and AI techniques in recent years. The use of aforesaid techniques in the field of proteomics studies is only beginning to be materialised now. Although there is a wealth of information available in the scientific literature pertaining to proteomics workflows, no comprehensive review addresses various aspects of the combined use of proteomics and machine learning. The objective of this review is to provide a comprehensive outlook on the application of machine learning into the known proteomics workflows in order to extract more meaningful information that could be useful in a plethora of applications such as medicine, agriculture, and biotechnology.Keywords: proteomics, machine learning, gel-based proteomics, mass spectrometry
Procedia PDF Downloads 15111540 Effect of Renin Angiotensin Pathway Inhibition on the Efficacy of Anti-programmed Cell Death (PD-1/L-1) Inhibitors in Advanced Non-small Cell Lung Cancer Patients- Comparison of Single Hospital Retrospective Assessment to the Published Literature
Authors: Esther Friedlander, Philip Friedlander
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The use of immunotherapy that inhibits programmed death-1 (PD-1) or its ligand PD-L1 confers survival benefits in patients with non-small cell lung cancer (NSCLC). However, approximately 45% of patients experience primary treatment resistance, necessitating the development of strategies to improve efficacy. While the renin-angiotensin system (RAS) has systemic hemodynamic effects, tissue-specific regulation exists along with modulation of immune activity in part through regulation of myeloid cell activity, leading to the hypothesis that RAS inhibition may improve anti-PD-1/L-1 efficacy. A retrospective analysis was conducted that included 173 advanced solid tumor cancer patients treated at Valley Hospital, a community Hospital in New Jersey, USA, who were treated with a PD-1/L-1 inhibitor in a defined time period showing a statistically significant relationship between RAS pathway inhibition (RASi through concomitant treatment with an ACE inhibitor or angiotensin receptor blocker) and positive efficacy to the immunotherapy that was independent of age, gender and cancer type. Subset analysis revealed strong numerical benefit for efficacy in both patients with squamous and nonsquamous NSCLC as determined by documented clinician assessment of efficacy and by duration of therapy. A PUBMED literature search was now conducted to identify studies assessing the effect of RAS pathway inhibition on anti-PD-1/L1 efficacy in advanced solid tumor patients and compare these findings to those seen in the Valley Hospital retrospective study with a focus on NSCLC specifically. A total of 11 articles were identified assessing the effects of RAS pathway inhibition on the efficacy of checkpoint inhibitor immunotherapy in advanced cancer patients. Of the 11 studies, 10 assessed the effect on survival of RASi in the context of treatment with anti-PD-1/PD-L1, while one assessed the effect on CTLA-4 inhibition. Eight of the studies included patients with NSCLC, while the remaining 2 were specific to genitourinary malignancies. Of the 8 studies, two were specific to NSCLC patients, with the remaining 6 studies including a range of cancer types, of which NSCLC was one. Of these 6 studies, only 2 reported specific survival data for the NSCLC subpopulation. Patient characteristics, multivariate analysis data and efficacy data seen in the 2 NSLCLC specific studies and in the 2 basket studies, which provided data on the NSCLC subpopulation, were compared to that seen in the Valley Hospital retrospective study supporting a broader effect of RASi on anti-PD-1/L1 efficacy in advanced NSLCLC with the majority of studies showing statistically significant benefit or strong statistical trends but with one study demonstrating worsened outcomes. This comparison of studies extends published findings to the community hospital setting and supports prospective assessment through randomized clinical trials of efficacy in NSCLC patients with pharmacodynamic components to determine the effect on immune cell activity in tumors and on the composition of the tumor microenvironment.Keywords: immunotherapy, cancer, angiotensin, efficacy, PD-1, lung cancer, NSCLC
Procedia PDF Downloads 6911539 Integrated Coastal Management for the Sustainable Development of Coastal Cities: The Case of El-Mina, Tripoli, Lebanon
Authors: G. Ghamrawi, Y. Abunnasr, M. Fawaz, S. Yazigi
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Coastal cities are constantly exposed to environmental degradation and economic regression fueled by rapid and uncontrolled urban growth as well as continuous resource depletion. This is the case of the City of Mina in Tripoli (Lebanon), where lack of awareness to preserve social, ecological, and historical assets, coupled with the increasing development pressures, are threatening the socioeconomic status of the city residents, the quality of life and accessibility to the coast. To address these challenges, a holistic coastal urban design and planning approach was developed to analyze the environmental, political, legal, and socioeconomic context of the city. This approach aims to investigate the potential of balancing urban development with the protection and enhancement of cultural, ecological, and environmental assets under an integrated coastal zone management approach (ICZM). The analysis of Mina's different sectors adopted several tools that include direct field observation, interviews with stakeholders, analysis of available data, historical maps, and previously proposed projects. The findings from the analysis were mapped and graphically represented, allowing the recognition of character zones that become the design intervention units. Consequently, the thesis proposes an urban, city-scale intervention that identifies 6 different character zones (the historical fishing port, Abdul Wahab island, the abandoned Port Said, Hammam el Makloub, the sand beach, and the new developable area) and proposes context-specific design interventions that capitalize on the main characteristics of each zone. Moreover, the intervention builds on the institutional framework of ICZM as well as other studies previously conducted for the coast and adopts nature-based solutions with hybrid systems for providing better environmental design solutions for developing the coast. This enables the realization of an all-inclusive, well-connected shoreline with easy and free access towards the sea; a developed shoreline with an active local economy, and an improved urban environment.Keywords: blue green infrastructure, coastal cities, hybrid solutions, integrated coastal zone management, sustainable development, urban planning
Procedia PDF Downloads 15511538 Technologies of Factory Farming: An Exploration of Ongoing Confrontations with Farm Animal Sanctuaries
Authors: Chetna Khandelwal
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This research aims to study the contentions that Farm Animal Sanctuaries pose to human-animal relationships in modernity, which have developed as a result of globalisation of the meat industry and advancements in technology. The sociological history of human-animal relationships in farming is contextualised in order to set a foundation for the follow-up examination of challenges to existing human-(farm)animal relationships by Farm Animal Sanctuaries. The methodology was influenced by relativism, and the method involved three semi-structured small-group interviews, conducted at locations of sanctuaries. The sample was chosen through purposive sampling and varied by location and size of the sanctuary. Data collected were transcribed and qualitatively coded to generate themes. Findings revealed that sanctuary contentions to established human-animal relationships by factory farming could be divided into 4 broad categories – Revealing horrors of factory farming (involving uncovering power relations in agribusiness); transforming relationships with animals (including letting them emotionally heal in accordance with their individual personalities and treating them as partial-pets); educating the public regarding welfare conditions in factory farms as well as animal sentience through practical experience or positive imagery of farm animals, and addressing retaliation made by agribusiness in the form of technologies or discursive strategies. Hence, this research concludes that The human-animal relationship in current times has been characterised by – (ideological and physical) distance from farm animals, commodification due to increased chasing of profits over welfare and exploitation using technological advancements, creating unequal power dynamics that rid animals of any agency. Challenges to this relationship can be influenced by local populations around the sanctuary but not so dependent upon the size of it. This research can benefit from further academic exploration into farm animal sanctuaries and their role in feminist animal rights activism to enrich the ongoing fight against intensive farming.Keywords: animal rights, factory farming, farm animal sanctuaries, human-animal relationships
Procedia PDF Downloads 13711537 The Lack of Female Representation in Senior Positions: An Exploratory Study between South Africa and India
Authors: Dina Maria Smit
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Worldwide, it seems as if women are adequately represented in government and parliament but are almost absent from governing boards of private enterprises. The reasons for this seem to be embedded in perceptions of inadequacy, remnants of patriarchy, glass ceilings and even female choice. Direct or indirect discrimination against females have been found to be one of the reasons that female employees are found in traditionally “softer” roles, whilst the old “Boy’s Club” is still operational to keep women out of senior managerial positions, especially in the private sector. The cultural construct of Indian society, focusing on male preference, patriarchy, divorce laws and low educational levels of females as opposed to men, is indicative of a society wherein high gender inequality still exists. The position in South Africa is similar in that substantive gender equality has not been reached despite a progressive constitution and anti-discrimination laws. There is a strong push to propel women to senior positions in South Africa, but these efforts have not yet translated into females taking up senior positions in private companies. In South Africa, females still earn less than their male counterparts whilst performing doing the same jobs, are overrepresented in parliament, but do not captain the ships in the private sector. The lack of female parity in employment leads to a lack of autonomy and authority in both South Africa and India. The divide between formal and informal work, unpaid work, mainly being done by women, need to be investigated to ensure substantive gender parity. The findings will show that females are still not equal to men in employment, especially in senior private positions; mainly due to the remnants of patriarchy and glass ceilings that still need to be shattered. This article aims to set out the reasons why gender disparity still exists in India and South Africa, seen through a legal lense. Both countries are signatories to the CEDAW Convention and have constitutions that advocate for the right of equality. Although equal rights have been implemented in both countries, equality may not be well implemented. This investigation is comparative in nature and aims to contribute to the growing body of evidence on how to ensure gender parity in all occupational levels and categories. The study is in quantitative in nature. If substantive gender equality, as opposed to formative gender equality, is a key motivator to ensure gender equality, an investigation into the reasons for this disparity is warranted before suggestions can be tendered to effect lasting change. The aim of this comparative study is not to plug the legal system of one country into the other, but to take into account of the autonomy of choice, set against cultural differences and similarities in an effort to shatter the glass ceilings for women who aspire to climb the corporate ladders.Keywords: gender inequality, glass ceilings, patriarchy, female disparity
Procedia PDF Downloads 6411536 Ix Operation for the Concentration of Low-Grade Uranium Leach Solution
Authors: Heba Ahmed Nawafleh
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In this study, two commercial resins were evaluated to concentrate uranium from real solutions that were produced from analkaline leaching process of carbonate deposits. The adsorption was examined using a batch process. Different parameters were evaluated, including initial pH, contact time, temperature, adsorbent dose, and finally, uranium initial concentration. Both resins were effective and selective for uranium ions from the tested leaching solution. The adsorption isotherms data were well fitted for both resins using the Langmuir model. Thermodynamic functions (Gibbs free energy change ΔG, enthalpy change ΔH, and entropy change ΔS) were calculated for the adsorption of uranium. The result shows that the adsorption process is endothermic, spontaneous, and chemisorption processes took place for both resins. The kinetic studies showed that the equilibrium time for uranium ions is about two hours, where the maximum uptake levels were achieved. The kinetics studies were carried out for the adsorption of U ions, and the data was found to follow pseudo-second-order kinetics, which indicates that the adsorption of U ions was chemically controlled. In addition, the reusability (adsorption/ desorption) process was tested for both resins for five cycles, these adsorbents maintained removal efficiency close to first cycle efficiency of about 91% and 80%.Keywords: uranium, adsorption, ion exchange, thermodynamic and kinetic studies
Procedia PDF Downloads 9211535 Minimum-Fuel Optimal Trajectory for Reusable First-Stage Rocket Landing Using Particle Swarm Optimization
Authors: Kevin Spencer G. Anglim, Zhenyu Zhang, Qingbin Gao
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Reusable launch vehicles (RLVs) present a more environmentally-friendly approach to accessing space when compared to traditional launch vehicles that are discarded after each flight. This paper studies the recyclable nature of RLVs by presenting a solution method for determining minimum-fuel optimal trajectories using principles from optimal control theory and particle swarm optimization (PSO). This problem is formulated as a minimum-landing error powered descent problem where it is desired to move the RLV from a fixed set of initial conditions to three different sets of terminal conditions. However, unlike other powered descent studies, this paper considers the highly nonlinear effects caused by atmospheric drag, which are often ignored for studies on the Moon or on Mars. Rather than optimizing the controls directly, the throttle control is assumed to be bang-off-bang with a predetermined thrust direction for each phase of flight. The PSO method is verified in a one-dimensional comparison study, and it is then applied to the two-dimensional cases, the results of which are illustrated.Keywords: minimum-fuel optimal trajectory, particle swarm optimization, reusable rocket, SpaceX
Procedia PDF Downloads 27711534 Influence of the Location of Flood Embankments on the Condition of Oxbow Lakes and Riparian Forests: A Case Study of the Middle Odra River Beds on the Example of Dragonflies (Odonata), Ground Beetles (Coleoptera: Carabidae) and Plant Communities
Authors: Magda Gorczyca, Zofia Nocoń
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Past and current studies from different countries showed that river engineering leads to environmental degradation and extinction of many species - often those protected by local and international wildlife conservation laws. Through the years, the main focus of rivers utilization has shifted from industrial applications to recreation and wildlife preservation with a focus on keeping the biodiversity which plays a significant role in preventing climate changes. Thus an opportunity appeared to recreate flooding areas and natural habitats, which are very rare in the scale of Europe. Additionally, river restoration helps to avoid floodings and periodic droughts, which are usually very damaging to the economy. In this research, the biodiversity of dragonflies and ground beetles was analyzed in the context of plant communities and forest stands structure. Results were enriched with data from past and current literature. A comparison was made between two parts of the Odra river. A part where oxbow lake and riparian forest were separated from the river bed by embankment and a part of the river with floodplains left intact. Validity assessment of embankments relocation was made based on the research results. In the period between May and September, insects were collected, phytosociological analysis were taken, and forest stand structure properties were specified. In the part of the river not separated by the embankments, rare and protected species of plants were spotted (e.g., Trapanatans, Salvinianatans) as well as greater species and quantitive diversity of dragonfly. Ground beetles fauna, though, was richer in the area separated by the embankment. Even though the research was done during only one season and in a limited area, the results can be a starting point for further extended research and may contribute to acquiring legal wildlife protection and restoration of the researched area. During the research, the presence of invasive species Impatiens parviflora, Echinocystislobata, and Procyonlotor were observed, which may lead to loss of the natural values of the researched areas.Keywords: carabidae, floodplains, middle Odra river, Odonata, oxbow lakes, riparian forests
Procedia PDF Downloads 14111533 Trans and Queer Expressions of Religion in Brazil: How Music and Mission Work Can Be Used As a Tool of Refusal
Authors: Cahlia A. Plett
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Ventura Profana (Unholy Venture) is an Afro-Indigenous Brazilian performance artist, missionary, and advocate for trans or “travestí” issues in Brazil. In this paper, author will discuss how Profana acts as a pastor in aims of constructing possibilities of escape through scripture, congregation and performance art. In confronting religious “recolonization”, which refers to modern Judeo-Christian religions and their re-colonizing properties within Latin American countries, author argue that Profana’s research and art offer an opportunity to both use and decolonize religious-colonial projects through expressions of the self and spirituality based in queer Black, Brown and Indigenous futurities.Keywords: Religious Studies, Music, Queer studies, Decolonial
Procedia PDF Downloads 4811532 Competitive Advantage on the Road Again: Exploring Nuances through a Conceptual Review and Future Research Avenues
Authors: Seyedabdolali Mortazavi Kamalabadi, Faegheh Taheran
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By giving an overview of previous arguments and findings concerned with the concept of competitive advantage, first, we define the overall concept of competitive advantage and discuss nuances of understanding such an important and strategic idea. Finally, by considering the major concerns of marketing academia, including globalization, AI-based technologies, consumer well-being, and internal coopetition between a firm’s units, fruitful avenues to be explored by future studies are presented in the form of research propositions. In the end, relevant gaps mentioned by numerous studies that are worth investigating are demonstrated.Keywords: artificial intelligence, competitive advantage, consumer well-being, coopetition, globalization, literature review, temporary competitive advantage
Procedia PDF Downloads 11311531 Jungle Justice on Emotional Health Challenges of Residents in Lagos Metropolis
Authors: Aaron Akinloye
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this research focuses on the impact of jungle justice on the emotional health challenges experienced by residents in the Lagos metropolitan city in Nigeria. Jungle justice refers to the practice of individuals taking the law into their own hands and administering punishment without proper legal procedures. The aim of this study is to investigate the influence of jungle justice on the emotional challenges faced by residents in Lagos. The specific objectives of the study are to examine the effects of jungle justice on trauma, pressure, fear, and depression among residents. The study adopts a descriptive survey research design and uses a questionnaire as the research instrument. The population of the study consisted of residents in the three senatorial districts that make up Lagos State. A simple random sampling technique was used to select two Local Government Areas (Yaba and Shomolu) from each of the three senatorial districts of Lagos State. Also, a simple random sampling technique was used to select fifty (50) residents from each of the chosen Local Government Areas to make three hundred (300) residents that formed the sample of the study. Accidental sampling technique is employed to select a sample of 300 residents. Data on the variables of interest is collected using a self-developed questionnaire. The research instrument undergoes validation through face, content, and construct validation processes. The reliability coefficient of the instrument is found to be 0.84. The study reveals that jungle justice significantly influences trauma, pressure, fear, and depression among residents in Lagos metropolitan city. The statistical analysis shows significant relationships between jungle justice and these emotional health challenges (df (298) t= 2.33, p< 0.05; df (298) t= 2.16, p< 0.05; df (298) t= 2.20, p< 0.05; df (298) t= 2.14, p< 0.05). This study contributes to the literature by highlighting the negative effects of jungle justice on the emotional well-being of residents. It emphasizes the importance of addressing this issue and implementing measures to prevent such vigilante actions. Data is collected through the administration of the self-developed questionnaire to the selected residents. The collected data is then analyzed using inferential statistics, specifically mean analysis, to examine the relationships between jungle justice and the emotional health challenges experienced by the residents. The main question addressed in this study is how jungle justice affects the emotional health challenges faced by residents in Lagos metropolitan city. Conclusion: The study concludes that jungle justice has a significant influence on trauma, pressure, fear, and depression among residents. To address this issue, recommendations are made, including the implementation of comprehensive awareness campaigns, improvement of law enforcement agencies, development of support systems for victims, and revision of the legal framework to effectively address jungle justice. Overall, this research contributes to the understanding of the consequences of jungle justice and provides recommendations for intervention to protect the emotional well-being of residents in Lagos metropolitan city.Keywords: jungle justice, emotional health, depression, anger
Procedia PDF Downloads 7611530 Harmonization of Accreditation Standards in Education of Central Asian Countries: Theoretical Aspect
Authors: Yskak Nabi, Onolkan Umankulova, Ilyas Seitov
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Tempus project about “Central Asian network for quality assurance – CANQA” had been implemented in 2009-2012. As the result of the project, two accreditation agencies were established: the agency for quality assurance in the field of education, “EdNet” in Kyrgyzstan, center of progressive technologies in Tajikistan. The importance of the research studies of the project is supported by the idea that the creation of Central-Asian network for quality assurance in education is still relevant, and results of the International forum “Global in regional: Kazakhstan in Bologna process and EU projects,” that was held in Nur-Sultan in October 2020, proves this. At the same time, the previous experience of the partnership between accreditation agencies of Central Asia shows that recommendations elaborated within the CANQA project were not theoretically justified. But there are a number of facts and arguments that prove the practical appliance of these recommendations. In this respect, joint activities of accreditation agencies of Kyrgyzstan and Kazakhstan are representative. For example, independent Kazakh agency of accreditation and rating successfully conducts accreditation of Kyrgyz universities; based on the memorandum about joint activity between the agency for quality assurance in the field of education “EdNet” (Kyrgyzstan) and Astana accreditation agency (Kazakhstan), the last one provides its experts for accreditation procedures in EdNet. Exchange of experience among the agencies shows an effective approach towards adaptation of European standards to the reality of education systems of Central Asia with consideration of not only a legal framework but also from the point of European practices view. Therefore, the relevance of the research is identified as there is a practical partnership between accreditation agencies of Central Asian countries, but the absence of theoretical justification of integrational processes in the accreditation field. As a result, the following hypothesis was put forward: “if to develop theoretical aspects for harmonization of accreditation standards, then integrational processes would be improved since the implementation of Bologna process principles would be supported with wider possibilities, and particularly, students and academic mobility would be improved.” Indeed, for example, in Kazakhstan, the total share of foreign students was 5,04% in 2020, and most of them are coming from Kyrgyzstan, Tajikistan, and Uzbekistan, and if integrational processes will be improved, then this share can increase.Keywords: accreditation standards in education, Central Asian countries, pedagogical theory, model
Procedia PDF Downloads 19911529 Endometrial Ablation and Resection Versus Hysterectomy for Heavy Menstrual Bleeding: A Systematic Review and Meta-Analysis of Effectiveness and Complications
Authors: Iliana Georganta, Clare Deehan, Marysia Thomson, Miriam McDonald, Kerrie McNulty, Anna Strachan, Elizabeth Anderson, Alyaa Mostafa
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Context: A meta-analysis of randomized controlled trials (RCTs) comparing hysterectomy versus endometrial ablation and resection in the management of heavy menstrual bleeding. Objective: To evaluate the clinical efficacy, satisfaction rates and adverse events of hysterectomy compared to more minimally invasive techniques in the treatment of HMB. Evidence Acquisition: A literature search was performed for all RCTs and quasi-RCTs comparing hysterectomy with either endometrial ablation endometrial resection of both. The search had no language restrictions and was last updated in June 2020 using MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, PubMed, Google Scholar, PsycINFO, Clinicaltrials.gov and Clinical trials. EU. In addition, a manual search of the abstract databases of the European Haemophilia Conference on women's health was performed and further studies were identified from references of acquired papers. The primary outcomes were patient-reported and objective reduction in heavy menstrual bleeding up to 2 years and after 2 years. Secondary outcomes included satisfaction rates, pain, adverse events short and long term, quality of life and sexual function, further surgery, duration of surgery and hospital stay and time to return to work and normal activities. Data were analysed using RevMan software. Evidence synthesis: 12 studies and a total of 2028 women were included (hysterectomy: n = 977 women vs endometrial ablation or resection: n = 1051 women). Hysterectomy was compared with endometrial ablation only in five studies (Lin, Dickersin, Sesti, Jain, Cooper) and endometrial resection only in five studies (Gannon, Schulpher, O’Connor, Crosignani, Zupi) and a mixture of the Ablation and Resection in two studies (Elmantwe, Pinion). Of the 1² studies, 10 reported women’s perception of bleeding symptoms as improved. Meta-analysis showed that women in the hysterectomy group were more likely to show improvement in bleeding symptoms when compared with endometrial ablation or resection up to 2-year follow-up (RR 0.75, 95% CI 0.71 to 0.79, I² = 95%). Objective outcomes of improvement in bleeding also favored hysterectomy. Patient satisfaction was higher after hysterectomy within the 2 years follow-up (RR: 0.90, 95%CI: 0.86 to 0.94, I²:58%), however, there was no significant difference between the two groups at more than 2 years follow up. Sepsis (RR: 0.03, 95% CI 0.002 to 0.56; 1 study), wound infection (RR: 0.05, 95% CI: 0.01 to 0.28, I²: 0%, 3 studies) and Urinary tract infection (UTI) (RR: 0.20, 95% CI: 0.10 to 0.42, I²: 0%, 4 studies) all favoured hysteroscopic techniques. Fluid overload (RR: 7.80, 95% CI: 2.16 to 28.16, I² :0%, 4 studies) and perforation (RR: 5.42, 95% CI: 1.25 to 23.45, I²: 0%, 4 studies) however favoured hysterectomy in the short term. Conclusions: This meta-analysis has demonstrated that endometrial ablation and endometrial resection are both viable options when compared with hysterectomy for the treatment of heavy menstrual bleeding. Hysteroscopic procedures had better outcomes in the short term with fewer adverse events including wound infection, UTI and sepsis. The hysterectomy performed better when measuring more long-term impacts such as recurrence of symptoms, overall satisfaction at two years and the need for further treatment or surgery.Keywords: menorrhagia, hysterectomy, ablation, resection
Procedia PDF Downloads 15511528 Needs-Gap Analysis on Culturally and Linguistically Diverse Grandparent Carers ‘Hidden Issues’: An Insight for Community Nurses
Authors: Mercedes Sepulveda, Saras Henderson, Dana Farrell, Gaby Heuft
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In Australia, there is a significant number of Culturally and Linguistically Diverse (CALD) Grandparent Carers who are sole carers for their grandchildren. Services in the community such as accessible healthcare, financial support, legal aid, and transport to services can assist Grandparent Carers to continue to live in their own home whilst caring for their grandchildren. Community nurses can play a major role by being aware of the needs of these grandparents and link them to services via information and referrals. The CALD Grandparent Carer experiences have only been explored marginally and may be similar to the general Grandparent Carer population, although cultural aspects may add to their difficulties. This Needs-Gap Analysis aimed to uncover ‘hidden issues’ for CALD Grandparent Carers such as service gaps and actions needed to address these issues. The stakeholders selected for this Needs-Gap Analysis were drawn from relevant service providers such as community and aged care services, child and/or grandparents support services and CALD specific services. One hundred relevant service providers were surveyed using six structured questions via face to face, phone interviews, or email correspondence. CALD Grandparents who had a significant or sole role of being a carer for grandchildren were invited to participate through their CALD community leaders. Consultative Forums asking five questions that focused on the caring role, issues encountered, and what needed to be done, were conducted with the African, Asian, Spanish-Speaking, Middle Eastern, European, Pacific Islander and Maori Grandparent Carers living in South-east Queensland, Australia. Data from the service provider survey and the CALD Grandparent Carer forums were content analysed using thematic principles. Our findings highlighted social determinants of health grouped into six themes. These were; 1) service providers and Grandparent Carer perception that there was limited research data on CALD grandparents as carers; 2) inadequate legal and financial support; 3) barriers to accessing information and advice; 4) lack of childcare options in the light of aging and health issues; 5) difficulties around transport; and 6) inadequate technological skills often leading to social isolation for both carer and grandchildren. Our Needs-Gap Analysis provides insight to service providers especially health practitioners such as doctors and community nurses, particularly on the impact of caring for grandchildren on CALD Grandparent Carers. Furthermore, factors such as cultural differences, English language difficulties, and migration experiences also impacted on the way CALD Grandparent Carers are able to cope. The findings of this Need-Gap Analysis signposts some of the ‘ hidden issues’ that CALD Grandparents Carers face and draws together recommendations for the future as put forward by the stakeholders themselves.Keywords: CALD grandparents, carer needs, community nurses, grandparent carers
Procedia PDF Downloads 31311527 There Is Nothing "BASIC" about Numeracy in Higher Education-a Case Study from an Accounting Programme
Authors: Shoba Rathilal
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Numeracy, like Literacy is considered to be a core value of modern societies. Most higher education institutions in South Africa include being numerate as an important graduate attribute. It is argued that a suitability numerate society contributes to social justice, empowerment, financial and environmental sustainability and a lack of numeracy practices can contribute to disempowerment. Numeracy is commonly misconstrued as a basic and simple practice, similar in nature to basic arithmetic. This study highlights the complexities of higher education numeracy practices by analyzing a programme in a higher education institution in South Africa using the New Literacies Studies perspective.Keywords: higher education, new literacy studies, numeracy practices, BASIC
Procedia PDF Downloads 45211526 Synthesis of Pendent Compartmental Ligand Derived from Polymethacrylate of 3-Formylsalicylic Acid Schiff Base and Its Application Studies
Authors: Dhivya Arumugam, Kaliyappan Thananjeyan
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The monomer of (3-((4-(methacryloyloxy)phenylimino)methyl)-2-hydroxybenzoic acid) schiff base polymer was prepared by reacting methacryloyl chloride with imine compound derived from 3-formylsalisylic acid and 4- aminophenol. The monomer was polymerized in DMF at 70oC using benzoyl peroxide as free radical initiator. Polymer metal complex was obtained in DMF solution of polymer with aqueous solution of metal ions. The polymer and the polymer metal complex were characterized by elemental analysis and spectral studies. The elemental analysis data suggest that the metal to ligand ratio is 1:1 and hence, it acts as a binucleating compartmental ligand. The IR spectral data of these complexes suggest that the metals are coordinated through nitrogen of the imine group, the oxygen of carboxylate ion and the oxygen of the phenolic –OH group which also acts as the bridging ligand. The electronic spectra and magnetic moments of the polychelates shows that octahedral and square planar structure for Ni(II) and Cu(II) complexes respectively. X-ray diffraction studies revealed that polychelates are highly crystalline. The thermal and electrical properties, catalytic activity, structure property relationships are discussed. Further the synthesized polymer was used for metal uptake studies from waste water, which is one of the effective waste water treatment strategies. And also, the polymers and polychelates were investigated for antimicrobial activity with various microorganisms by using agar well diffusion method and the results have been discussed.Keywords: acyclic compartmental ligands, binucleating ligand, 3-formylsalicylic acid, free radical polymerization, polluting ions, polychelate
Procedia PDF Downloads 12511525 Pauline ‘Pistis Christou’ in Coptic Sources: Re-Examining Outdated Conclusions
Authors: Beniamin Zakhary
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The Pistis Christou in the Pauline letters has sparked a scholarly discussion in the past few decades. Although some have suggested exploring ancient translations for clues regarding the phrase's reception, prior scholarship has been very sparse regarding the translation and interpretation of the Pistis Christou within Coptic sources. Some have hastily remarked that the Coptic translation is inconclusive when it comes to the phrase of interest. This paper challenges that position, extracting clear conclusions by positioning the Coptic translation in the proper liturgical context, looking at both the Sahidic and Bohairic traditions. In using the Pauline Pistis Christou, Coptic sources suggest a definition of Faith as the domain that belongs to Christ (God), in which the faithful reside and participate.Keywords: biblical studies, Coptic studies, Christian faith, Pauline theology
Procedia PDF Downloads 7211524 Comparison of the Effect of Strand Diameters, Providing Beam to Column Connection
Authors: Mustafa Kaya
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In this study, the effect of pre-stressed strand diameters, providing the beam-to-column connections, was investigated from both experimental, and analytical aspects. In the experimental studies, the strength and stiffness, the capacities of the precast specimens were compared. The precast specimen with strands of 15.24 mm reached an equal strength of the reference specimen. Parallel results were obtained during the analytical studies from the aspects of strength, and behavior, but in terms of stiffness, it was seen that the initial stiffness of the analytical models was lower than that of the tested specimen.Keywords: post-tensioned connections, beam to column connections, finite element method, strand diameter
Procedia PDF Downloads 33311523 The Experience of Grandparenthood among Grandparents of Children with Autism in the Arab–Bedouin Society
Authors: Binoun Chaki Hagar
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Studies have investigated grandparents' perceptions relating to their grandchildren with disabilities. Literature on grandparenthood focuses on the Western grandparents. Autism within the Arab populations has also being investigated. Moreover, the Bedouin population can also be seen in various studies related to different experiences and different perceptions about disabilities in general and among children in particular. However, as far as we know, no studies were found on grand parenting a child with autism in Bedouin society. This study combines three areas of knowledge, to create another knowledge domain. The aim of this study was to learn about the experience of grand parenting an autistic child in the Bedouin Arab society, to examine how it affects the grandparents' relationships, feelings, and functioning within the family, and as individuals, as well as to examine their coping mechanisms and their social support networks. This study is significant and as it examines autism and grandparents among the Bedouin Arab population in Israel, a population that has unique socio-demographic, cultural and traditional characteristics. The study revealed three themes concerning the meaning of grandparenthood to be associated with family continuity, how autism is perceived, and the importance of religion. It also suggests another category – the status of the elderly in the Arab-Bedouin family. It is recognized that the role of the elderly is held in high esteem, and can be affected by the grandchild’s’ autism.Keywords: Arab–Bedouin family, autism, grandparents, family relationships
Procedia PDF Downloads 29211522 Port Governance in Santos, Brazil: A Qualitative Approach
Authors: Guilherme B. B. Vieira, Rafael M. da Silva, Eliana T. P. Senna, Luiz A. S. Senna, Francisco J. Kliemann Neto
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Given the importance of ports as links in the global supply chains and because they are key elements to induce competitiveness in their hinterlands, the number of studies devoted to port governance, management and operations has increased in the last decades. Some of these studies address the port governance model as an element to improve coordination among the actors of the port logistics chain and to generate a better port performance. In this context, the present study analyzes the governance of Port of Santos through individual interviews with port managers, based on a conceptual model that considers the key dimensions associated with port governance. The results reinforce the usefulness of the applied model and highlight some existing improvement opportunities in the port studied.Keywords: port governance, model, Port of Santos, managers’ perception
Procedia PDF Downloads 53511521 Corruption in India: Causes and Remedial Measures
Authors: Ghulam Nabi Naz
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After independence, the popular belief that Gandhian will not indulge in corruption got a setback, post-independence setup paved the way for heavy corruption. The menace which would have dealt with strong legal provisions has become a way of life of Indian society. Corruption is recognized as the single biggest problem facing the country today. It undermines democracy and rule of law, violates human rights, distorts market and corrodes the moral fibre of people. The paper discusses the causes and possible remedial measures of corruption and response of people in Indian society. It emphasizes the factors which provide fertile ground for growth of corruption like, degradation of moral values, absence of a strong anti-corruption law and its effective enforcement, accountability, consistency and a defective system of fighting elections. The paper also highlights the reforms necessary for fighting corruption in India.Keywords: embezzlement, colonial, licence Raj, good governance, misappropriation, Sangh ideologue, Anna movement
Procedia PDF Downloads 29311520 The Announcer Trainee Satisfaction by National Broadcasting and Telecommunications Commission of Thailand
Authors: Nareenad Panbun
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The objective is to study the knowledge utilization from the participants of the announcer training program by National Broadcasting and Telecommunications Commission (NBTC). This study is a quantitative research based on surveys and self-answering questionnaires. The population of this study is 100 participants randomly chosen by non-probability sampling method. The results have shown that most of the participants were satisfied with the topics of general knowledge about the broadcasting and television business for 37 people representing 37%, followed by the topics of broadcasting techniques. The legal issues, consumer rights, television business ethics, and credibility of the media are, in addition to the media's role and responsibilities in society, the use of language for successful communication. Therefore, the communication language skills are the most important for all of the trainees and will also build up the image of the broadcasting center.Keywords: announcer training program, participant, requirements announced, theory of utilization
Procedia PDF Downloads 22211519 'Sex, Work and Sex-Work': The Clandestine Tale of a Tabooed Industry in Bangladesh
Authors: Parvez Sattar
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There are around 150,000 female sex workers in Bangladesh, and the country hosts one of the largest brothels in the world. There are 20 brothel-villages in the country, of which 14 are recognized to be ‘official’, and at least 11 are currently operational. Although the national Constitution adopts a preventive policy against prostitution, law does not, as such, prohibit commercial sex work by an adult woman working in a brothel having made an affidavit in this regard. But, at the same time, the law renders at least some forms of floating and hotel based sex work illegal, while sex between males has been termed as sodomy and made culpable offence even on its own. All forms of sex works by MSM and Hijra are thus branded as criminal acts. Observations and findings drawn in this article are based on both primary and secondary sources collecting data from a series of field-based empirical studies conducted by the author through questionnaire survey, FGDs, key informant consultations and other PRA/PLA tools. General and specific conclusions have been based on analysis guided by international standards of human and labour rights approaches. It has been noted that neither the community attitudes nor the cultural mind-sets, or the State's institutional set up is supportive of the causes of sex workers engaged in the most exploitative forms of labour. Lack of respect for fundamental rights continues to diminish any chances of sex workers' reintegration to the mainstream of the society, perpetuates poverty, and increases their vulnerability to HIV/AIDS. To aggravate the scenario, the endemic practice of a complex debt-bondage masked by the so-called 'entry-cost' and ‘legal license’ to the industry is considered to be a somewhat accepted 'open secret' and that the police and administration keep their eyes off from such practices treating these as 'their internal affairs'. Often these practices are used by the Sardarni/Khala (landlady) and other 'managing' actors as the tool for further exploitation of the sex workers as well as a 'control strategy'. The paper concludes with the observation that the tabooed truths of commercial sex and sex workers are inherently embedded in the very factors that compel them into this endemically ostracised profession itself. While denial of both recognition and enjoyment of the fundamental human rights of sex workers is widespread, it is the same cycle of social vulnerability and economic exclusion that often confines these people within a continuous process of servitude and modern day slavery.Keywords: commercial sex work and human rights, Labor protection in sex industry, Prostitution Law in Bangladesh, Sex work as modern day slavery
Procedia PDF Downloads 10811518 Effect of Graphene Oxide Nanoparticles on a Heavy Oilfield: Interfacial Tension, Wettability and Oil Displacement Studies
Authors: Jimena Lizeth Gomez Delgado, Jhon Jairo Rodriguez, Nicolas Santos, Enrique Mejia Ospino
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Nanotechnology has played an important role in the hydrocarbon industry, recently , due to the unique properties of graphene oxide nanoparticles, they have been incorporated in different studies enhanced oil recovery. Nonetheless, very few studies have used graphene oxide nanoparticles in coreflooding experiments. Herein, the use of Graphene oxide (GO) nanoparticle was explored, exploited and evaluated. The performance of Graphene oxide nanoparticles on the interfacial properties in the presence of different electrolyte concentrations representative of field brine and pH conditions was investigated. Moreover, wettability behavior of the nanofluid at the oil/sand interface was studied used contact angle and Amott Harvey evaluation. Experimental result shows that the adsorption of GO on the sandstone surface changes the wettability of the sandstone from being strongly crude oil-wet to intermediate crude oil-wettability. At 900 ppm formation brine with 8 pH solution and 0.09 wt% nanoparticles concentration, Graphene oxide nanofluid exhibited better performance under the different electrolyte concentration studied. Finally, heavy oil displacement test in sandstone cores showed that oil recovery of Graphene oxide nanofluid had 7% incremental oil recovery over conventional waterflooding.Keywords: nanoparticle, graphene oxide, nanotechnology, wettability, enhanced oil recovery, coreflooding
Procedia PDF Downloads 10811517 The Gender Equality within the European Union Reconciliation of Work and Family Life Policies: Tackling Gender Inequality or Tackling Unemployment
Authors: Nazli Kazanoglu
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Reconciliation of work and family life has been an area of interest within the academic as well as in the political debate for more than three decades. With the dramatic changes in the extent to which women and men contribute to unpaid domestic work and paid employment, the reconciliation of work and family life issues have become more prominent than ever before. And they have begun to enjoy an increased attention of policy makers both at the EU and national levels. Over the last three decades the EU has initiated numerous equality programs and strategies and roadmaps regarding reconciliation of work and family life, though particularly because of the crisis and increasing willingness of achieving the EUs target of seventy five per cent of men and women in employment by 2020, those programs, strategies and roadmaps emphasized on eradicating womens familial burdens while entering labor market and providing them as equal opportunities as their male counterparts have. Reconciliation of work and family life policies thus bit by bit moved away from the objectives with a strong commitment to ensuring gender equality towards employment objectives. This paper is thus an endeavor to look at the nature of EU reconciliation of work and family life policies from the angle of gender equality. More precisely relying on the feminist literature, this paper rests on the assumption that reconciliation of work and family policies should provide the sufficient measures indeed with a more emphasis on endorsing gender equality rather than economic concerns and prioritizes two inter-related aspects while evaluating the gender equality of reconciliation of work and family life policies. First providing free choice to women in terms of their family and work lives and second challenge the unequal division of labor at home. In that sense, it investigates the nature of the changing uses and meanings of gender equality in reconciliation of work and family life policies in different stages of the EU social policy development particularly after the introduction of European Employment Strategy which gave a tremendous importance to reconciliation of work and family life during their collaborations with other issues on the EU agenda as well as the major rationale behind their development and implementation and locates them in terms of two inter-related parameters mentioned above.Keywords: European Union, division of unpaid work, gender equality, rhetoric of free choice
Procedia PDF Downloads 30011516 Application of Computational Chemistry for Searching Anticancer Derivatives of 2-Phenazinamines as Bcr-Abl Tyrosine Kinase Inhibitors
Authors: Gajanan M. Sonwane
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The computational studies on 2-phenazinamines with their protein targets have been carried out to design compounds with potential anticancer activity. This strategy of designing compounds possessing selectivity over specific tyrosine kinase has been achieved through G-QSAR and molecular docking studies. The objective of this research has been to design newer 2-phenazinamine derivatives as Bcr-Abl tyrosine kinase inhibitors by G-QSAR, molecular docking studies followed by wet-lab studies along with evaluation of their anticancer potential. Computational chemistry was done by using VLife MDS 4.3 and Autodock 4.2 followed by wet-lab experiments for synthesizing 2-phenazinamine derivatives. The chemical structures of ligands in 2D were drawn by employing Chemdraw 2D Ultra 8.0 and were converted into 3D. These were optimized by using a semi-empirical method called MOPAC. The protein structure was retrieved from RCSC protein data bank as a PDB file. The binding interactions of protein and ligands were done by using PYMOL. The molecular properties of the designed compounds were predicted in silico by using Osiris property explorer. The parent compound 2-phenazinamine was synthesized by reduction of 2, 4-dinitro-N-phenyl-benzenamine in the presence of tin chloride followed by cyclization in the presence of nitrobenzene and magnesium sulfate. The derivatization at the amino function of 2-phenazinamine was performed by treating parent compound with various aldehydes in the presence of dicyclohexylcarbodiimide (DCC) and urea to afford 2-(2-chlorophenyl)-3-(phenazine-2-yl) thiazolidine-4-one. Synthesized 39 novel derivatives of 2-phenazinamine and performed antioxidant activity, anti antiproliferative on the bulb of onion and anticancer activity on cell line showing significant competition with marked blockbuster drug imatinib.Keywords: computer-aided drug design, tyrosin kinases, anticancer, docking
Procedia PDF Downloads 14011515 A Review of Accuracy Optical Surface Imaging Systems for Setup Verification During Breast Radiotherapy Treatment
Authors: Auwal Abubakar, Ahmed Ahidjo, Shazril Imran Shaukat, Noor Khairiah A. Karim, Gokula Kumar Appalanaido, Hafiz Mohd Zin
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Background: The use of optical surface imaging systems (OSISs) is increasingly becoming popular in radiotherapy practice, especially during breast cancer treatment. This study reviews the accuracy of the available commercial OSISs for breast radiotherapy. Method: A literature search was conducted and identified the available commercial OSISs from different manufacturers that are integrated into radiotherapy practice for setup verification during breast radiotherapy. Studies that evaluated the accuracy of the OSISs during breast radiotherapy using cone beam computed tomography (CBCT) as a reference were retrieved and analyzed. The physics and working principles of the systems from each manufacturer were discussed together with their respective strength and limitations. Results: A total of five (5) different commercially available OSISs from four (4) manufacturers were identified, each with a different working principle. Six (6) studies were found to evaluate the accuracy of the systems during breast radiotherapy in conjunction with CBCT as a goal standard. The studies revealed that the accuracy of the system in terms of mean difference ranges from 0.1 to 2.1 mm. The correlation between CBCT and OSIS ranges between 0.4 and 0.9. The limit of agreements obtained using bland Altman analysis in the studies was also within an acceptable range. Conclusion: The OSISs have an acceptable level of accuracy and could be used safely during breast radiotherapy. The systems are non-invasive, ionizing radiation-free, and provide real-time imaging of the target surface at no extra concomitant imaging dose. However, the system should only be used to complement rather than replace x-ray-based image guidance techniques such as CBCT.Keywords: optical surface imaging system, Cone beam computed tomography (CBCT), surface guided radiotherapy, Breast radiotherapy
Procedia PDF Downloads 6611514 A Mixed Method Systematic Review of the Experience of Communication in the Care of Children with Palliative Care Needs
Authors: Maha Atout, Pippa Hemingway, Jane Seymour
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Background: A mixed method systematic review was undertaken in order to explore issues related to the experiences of health care providers and parents in the care of children with palliative care needs. The aims of this systematic review were to identify existing evidence about the experiences of communication in the care of children with palliative care needs, to appraise the research conducted in this area and to identify gaps in the literature in order to recommend for future related studies. Method: A mixed method systematic review of research on the experience of communication in the care of children with palliative care needs, conducted with parents and health professionals was undertaken. The electronic databases of CINAHL, Cochrane, PubMed, OVID, Social Care Online, Web of Science, Scopus, and ProQuest were searched for the period of 2000-2016. Inclusion was limited to studies of communication experience in the care of children with palliative care needs. Result: Thirty-eight studies were found. The studies were conducted in a variety of countries: Uganda, Jordan, USA, UK, Taiwan, Turkey, Ireland, Poland, Brazil, Australia, Switzerland, Sweden, Netherland, Lebanon, Spain, Greece, and China. The current review shows that parents tend to protect their children when they are discussing their illnesses with them, particularly where they have a life-threatening or life-limiting condition. The approach of parents towards the discussion of sensitive issues concerning death with their children is significantly affected by the cultural background of the families. Conservative cultures encourage collusion behaviours which tend to keep children unaware of the incurable nature of the disease. The major communication challenges reported by health professionals are facing difficulties in judging how much information should be given to parents, responding to difficult questions, conflicts with families and inadequate skills to support grieving families. Conclusion: It is probably significant for the future studies to consider the change of parent-child communication experience over time in order to understand how the parents could change their interaction styles with their children according to the different stages of their children’s disease. Moreover, further studies are required to investigate the experience of communication of parents of children with non-malignant life-threatening and life-limiting illnesses.Keywords: children with life-threatening or life- limiting illnesses, end of life, experience of communication, healthcare care providers, paediatric palliative care
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