Search results for: equitable assessment

Authors: Aileen Editha

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The legal recognition of property rights over human genes is a divisive topic to which there is no resolution. As a frequently discussed topic, scholars and practitioners often highlight the inadequacies of a proprietary regime. However, little has been said in regard to the nature of human genetic materials (HGMs). This paper proposes approaching the issue of property over HGMs from an alternative perspective that looks at the personal and social value and valuation of HGMs. This paper will highlight how the unique and unresolved status of HGMs is incompatible with the main tenets of property and, consequently, contributes to legal ambiguity and uncertainty in the regulation of property rights over human genes. HGMs are perceived as part of nature and a free-for-all while also being within an individual’s private sphere. Additionally, it is also considered to occupy a unique “not-private-nor-public” status. This limbo-like position clashes with property’s fundamental characteristic that relies heavily on a clear public/private dichotomy. Moreover, as property is intrinsically linked to the legal recognition of one’s personhood, this irresolution benefits some while disadvantages others. In particular, it demands the publicization of once-private genes for the “common good” but subsequently encourages privatization (through labor) of these now-public genes. This results in the gain of some (already privileged) individuals while enabling the disenfranchisement of members of minority groups, such as Indigenous communities. This paper will discuss real and intellectual property rights over human genes, such as the right to income or patent rights, in Canada and the US. This paper advocates for a sui generis approach to governing rights and interests over human genes that would not rely on having a strict public/private dichotomy. Not only would this improve legal certainty and clarity, but it would also alleviate—or, at the very least, minimize—the role that the current law plays in further entrenching existing systemic inequalities. Despite the specificity of this topic, this paper argues that there are broader lessons to be learned. This issue is an insightful case study on the interconnection of various principles in law, society, and property, and what must be done when discordance between one or more of those principles has detrimental societal outcomes. Ultimately, it must be remembered that property is an adaptable and malleable instrument that can be developed to ensure it contributes to equity and flourishing.

Keywords: property rights, human genetic materials, critical legal scholarship, systemic inequalities

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Authors: Takudzwa C. Taruza, Carel B. Schoeman, Ilse M. Schoeman

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The proliferation of informal settlements remains one of the major planning challenges in democratic South Africa. In spite of the various local, national and international initiatives to promote the creation of sustainable human settlements, informal settlements continue to exist as spatially marginalised societies characterised by poverty, unemployment, squalor conditions and disaster risks. It is argued that, in practice, intervention is mainly directed at achieving set quantitative targets and goals rather than improving the lives of the inhabitants. The relevant planning instruments do not adequately address the integration of informal settlements into the broader planning framework. This paper is based on the analysis of the informal settlement intervention within the North West Province. Financial constraints, bureaucracy in housing delivery and lack of horizontal and vertical integration in spatial planning and programme implementation are amongst the major factors that caused stagnation in some of the upgrading programmes which in turn hindered the attainment of the target set as part of the Outcome 8 Delivery Agreement. Moreover, the absence of distinct indicators for the assessment of the qualitative progress of upgrading programmes indicates shortcomings in the intervention policies and programmes to promote the creation of sustainable human settlements. Thus, this paper seeks to proffer an assessment toolkit as well as a framework for the implementation of a Sustainable Informal Settlement Programme.

Keywords: formalization of informal settlements, planning intervention, sustainable formalization indicators, sustainable human settlements

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Authors: Guldana Zhigerbayeva, Ming Yang

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Transportation of hazardous materials (HAZMAT) is inevitable in the process industries. The statistics show a significant number of accidents has occurred during the transportation of HAZMAT. This makes risk management of HAZMAT transportation an important topic. The tree-based methods including fault-trees, event-trees and cause-consequence analysis, and Bayesian network, have been applied to risk management of HAZMAT transportation. However, there is limited work on the development of a systematic approach. The existing approaches fail to build up the linkages between the regulatory requirements and the safety measures development. The analysis of historical data from the past accidents’ report databases would limit our focus on the specific incidents and their specific causes. Thus, we may overlook some essential elements in risk management, including regulatory compliance, field expert opinions, and suggestions. A systematic approach is needed to translate the regulatory requirements of HAZMAT transportation into specified safety measures (both technical and administrative) to support the risk management process. This study aims to first adapt the House of Quality (HoQ) to House of Safety (HoS) and proposes a new approach- Safety Function Deployment (SFD). The results of SFD will be used in a multi-criteria decision-support system to develop find an optimal route for HazMats transportation. The proposed approach will be demonstrated through a hypothetical transportation case in Kazakhstan.

Keywords: hazardous materials, risk assessment, risk management, quality function deployment

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Authors: Ayman M. Arfaj, Jose Lauro M. Llamas, Saleh Y Qahtani

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Sulfur Loading Operation (SLO) is an operation that poses risk of exposure to toxic gases such as Hydrogen Sulfid and Sulfur Dioxide during molten sulfur loading operation. In this operation molten sulfur is loaded into a truck tanker in a liquid state and the temperature of the tanker must maintain liquid sulfur within a 43-degree range — between 266 degrees and 309 degrees Fahrenheit in order for safe loading and unloading to occur. Accordingly, in this study, the e potential risk of occupational exposure to the airborne toxic gases was assessed at three sulfur loading facilities. The concentrations of toxic airborne substances such as Hydrogen Sulfide (H2S) and Sulfur Dioxide (SO2), were monitored during operations at the different locations within the sulfur loading operation facilities. In addition to extensive real-time monitoring, over one hundred and fifty samples were collected and analysed at internationally accredited laboratories. The concentrations of H2S, and SO2 were all found to be well below their respective occupational exposure limits. Very low levels of H2S account for the odours observed intermittingly during mixing and application operations but do not pose a considerable health risk and hence these levels are considered a nuisance. These results were comparable to those reported internationally. Aside from observing the usual general safe work practices such as wearing safety glasses, there are no specific occupational health related concerns at the examined sulfur loading facilities.

Keywords: exposure assessment, sulfur loading operation, health risk study, molten sulfur, toxic airborne substances, air contaminants monitoring

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Authors: Beng Yew Low, Cher Liang Cha, Cheng Yong Teoh

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Due to a lack of continual assessment or grade related data, identifying first-year engineering students in a polytechnic education at risk of failing is challenging. Our experience over the years tells us that there is no strong correlation between having good entry grades in Mathematics and the Sciences and excelling in hardcore engineering subjects. Hence, identifying students at risk of failure cannot be on the basis of entry grades in Mathematics and the Sciences alone. These factors compound the difficulty of early identification and intervention. This paper describes the development of a predictive analytics model in the early detection of students at risk of failing and evaluates its effectiveness. Data from continual assessments conducted in term one, supplemented by data of student psychological profiles such as interests and study habits, were used. Three classification techniques, namely Logistic Regression, K Nearest Neighbour, and Random Forest, were used in our predictive model. Based on our findings, Random Forest was determined to be the strongest predictor with an Area Under the Curve (AUC) value of 0.994. Correspondingly, the Accuracy, Precision, Recall, and F-Score were also highest among these three classifiers. Using this Random Forest Classification technique, students at risk of failure could be identified at the end of term one. They could then be assigned to a Learning Support Programme at the beginning of term two. This paper gathers the results of our findings. It also proposes further improvements that can be made to the model.

Keywords: continual assessment, predictive analytics, random forest, student psychological profile

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Authors: Afsaneh Jasmine Majidi

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Language testing is an important part of language teaching experience and language learning process as it presents assessment strategies for teachers to evaluate the efficiency of teaching and for learners to examine their outcomes. However, language testing is demanding and challenging because it should provide the opportunity for proper and objective decision. In addition to all the efforts test designers put to design valid and reliable tests, there are some other determining factors which are even more complex and complicated. These factors affect the educational system, individuals, and society, and the impact of the tests vary according to the scope of the test. Seemingly, the impact of a simple classroom assessment is not the same as that of high stake tests such as International English Language Testing System (IELTS). As the importance of the test increases, it affects wider domain. Accordingly, the impacts of high stake tests are reflected not only in teaching, learning strategies but also in society. Testing experts use the term ‘washback’ or ‘impact’ to define the different effects of a test on teaching, learning, and community. This paper first looks at the theoretical background of ‘washback’ and ‘impact’ in language testing by reviewing of relevant literature in the field and then investigates washback effects of IELTS test of on Iranian IELTS teachers and students. The study found significant relationship between the washback effect of IELTS test and teaching strategies of Iranian IELTS teachers as well as performance of Iranian IELTS candidates and their community.

Keywords: high stake tests, IELTS, Iranian Candidates, language testing, test impact, washback

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Authors: Nur Afiqah Mohd Kamal, Khamarrul Azahari Razak

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The earthquake aftermath has become a major concern, especially in high seismicity region. In Kundasang, Sabah, the earthquake on 5th June 2015 resulted in several catastrophes; landslides, rockfalls, mudflows and major slopes affected regardless of the series of the aftershocks. Certainly, the consequences of earthquake generate and induce the episodic disaster, not only life-threatening but it also affects infrastructure and economic development. Therefore, a need for investigating the change in land use and land cover (LULC) of post-earthquake geohazard is essential for identifying the extent of disastrous effects towards the development in Kundasang. With the advancement of remote sensing technology, post-earthquake geohazards (landslides, mudflows, rockfalls, debris flows) assessment can be evaluated by the employment of object-based image analysis in investigating the LULC change which consists of settlements, public infrastructure and vegetation cover. Therefore, this paper discusses the preliminary results on post-earthquakes geohazards distribution in Kundasang and evaluates the LULC classification effect upon the occurrences of geohazards event. The result of this preliminary analysis will provide an overview to determine the extent of geohazard impact on LULC. This research also provides beneficial input to the local authority in Kundasang about the risk of future structural development on the geohazard area.

Keywords: geohazard, land use land cover, object-based image analysis, remote sensing

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Authors: Sabita Subedi, Bhojan Dhakal, Shankar Raj Pant, Naba Raj Devkota

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An assessment was made about the available feed resources, its utilization pattern, specifically, roughage and concentrate, produced from the Manaslu Conservation Area (MCA) of Nepal to formulate the appropriate strategies in satisfying the annual dietary requirements of the livestock covering its present production and management scenarios. A comparative study was done by employing a purposively conducted survey to deduct the distribution of forage sources in the area. Findings revealed that natural vegetation, seasonally available crop residues, and dried grasses were major feed resources, whereas their contribution to the total supply varied significantly (p < 0.01). The amount of feed obtained from various sources was calculated by standard conversion and using primary household data. Findings revealed that farmers practice significantly higher (p < 0.01) number of grazing days and hours per day for large ruminants such as Yak and Chauries as compared to small ruminants such as goats and sheep. The findings also indicated seasonal variations of feed supply, whereas January to March is the period of short supply (p < 0.01). It was relatively in good supply from June to September though average roughage and crude protein supplement for the animals was far below than optimum requirements. These scenarios suggest the need for immediate attention to improve the range productivity in the MCA as the deteriorating situations of the rangelands may raise questions on the sustainability of livestock herders.

Keywords: altitude, carrying capacity, dietary requirement, feed resources, rangeland, ruminant

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Authors: Ofelia A. Damag

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The study was focused on the development and assessment of the illustrated language activities of the 1996 Edition of the Portage Guide to Early Education. It determined the extent of appropriateness, applicability, time efficiency and aesthetics of the illustrated language activities to be used as instructional material not only by teachers, but parents and caregivers as well. The eclectic research design was applied in this study using qualitative and quantitative methods. To determine the applicability and time efficiency of the study, a try out was done. Since the eclectic research design was used, it made use of a researcher-made survey questionnaire and focus group discussion. Analysis of the data was done through weighted mean and ANOVA. The respondents of the study were representatives of Special Education (SPED) teachers, caregivers and parents of a special-needs child, particularly with difficulties in learning basic language skills. The results of the study show that a large number of respondents are SPED teachers and caregivers and are mostly college graduates. Many of them have earned units towards Master’s studies. Moreover, a majority of the respondents have not attended seminars or in-service training in early intervention for them to be more competent in the area of specialization. It is concluded that the illustrated language activities under review in this study are appropriate, applicable, time efficient and aesthetic for use as a tool in teaching. The recommendations are focused on the advocacy for SPED teachers, caregivers and parents of special-needs children to be more consistent in the implementation of the new instructional materials as an aid in an intervention program.

Keywords: illustrated language activities, inclusion, portage guide to early education, special educational needs

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Authors: A. Falenski, A. Kaesbohrer, M. Filter

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Introduction: Risk assessments can be performed in various ways and in different degrees of complexity. In order to assess risks associated with imported foods additional information needs to be taken into account compared to a risk assessment on regional products. The present review is an overview on currently available best practise approaches and data sources used for food import risk assessments (IRAs). Methods: A literature review has been performed. PubMed was searched for articles about food IRAs published in the years 2004 to 2014 (English and German texts only, search string “(English [la] OR German [la]) (2004:2014 [dp]) import [ti] risk”). Titles and abstracts were screened for import risks in the context of IRAs. The finally selected publications were analysed according to a predefined questionnaire extracting the following information: risk assessment guidelines followed, modelling methods used, data and software applied, existence of an analysis of uncertainty and variability. IRAs cited in these publications were also included in the analysis. Results: The PubMed search resulted in 49 publications, 17 of which contained information about import risks and risk assessments. Within these 19 cross references were identified to be of interest for the present study. These included original articles, reviews and guidelines. At least one of the guidelines of the World Organisation for Animal Health (OIE) and the Codex Alimentarius Commission were referenced in any of the IRAs, either for import of animals or for imports concerning foods, respectively. Interestingly, also a combination of both was used to assess the risk associated with the import of live animals serving as the source of food. Methods ranged from full quantitative IRAs using probabilistic models and dose-response models to qualitative IRA in which decision trees or severity tables were set up using parameter estimations based on expert opinions. Calculations were done using @Risk, R or Excel. Most heterogeneous was the type of data used, ranging from general information on imported goods (food, live animals) to pathogen prevalence in the country of origin. These data were either publicly available in databases or lists (e.g., OIE WAHID and Handystatus II, FAOSTAT, Eurostat, TRACES), accessible on a national level (e.g., herd information) or only open to a small group of people (flight passenger import data at national airport customs office). In the IRAs, an uncertainty analysis has been mentioned in some cases, but calculations have been performed only in a few cases. Conclusion: The current state-of-the-art in the assessment of risks of imported foods is characterized by a great heterogeneity in relation to general methodology and data used. Often information is gathered on a case-by-case basis and reformatted by hand in order to perform the IRA. This analysis therefore illustrates the need for a flexible, modular framework supporting the connection of existing data sources with data analysis and modelling tools. Such an infrastructure could pave the way to IRA workflows applicable ad-hoc, e.g. in case of a crisis situation.

Keywords: import risk assessment, review, tools, food import

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Authors: Lucy Patricia Onundo, Wilfred Njoroge Mwema

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The tidal power potential available for electricity generation from Mombasa and Lamu sites in Kenya will be examined. Several African countries in the Western Indian Ocean endure insufficiencies in the power sector, including both generation and distribution. One important step towards increasing energy security and availability is to intensify the use of renewable energy sources. The access to cost-efficient hydropower is low in Mombasa and Lamu hence Ocean energy will play an important role. Global-Level resource assessments and oceanographic literature and data have been compiled in an analysis between technology-specific requirements for ocean energy technologies (salinity, tide, tidal current, wave, Ocean thermal energy conversion, wind and solar) and the physical resources in Lamu and Mombasa. The potential for tide and tidal current power is more restricted but may be of interest at some locations. The theoretical maximum power produced over a tidal cycle is determined by the product of the forcing tide and the undisturbed volumetric flow-rate. The extraction of the maximum power reduces the flow-rate, but a significant portion of the maximum power can be extracted with little change to the tidal dynamics. Two-dimensional finite-element, numerical simulations designed and developed agree with the theory. Temporal variations in resource intensity, as well as the differences between small-scale and large-scale applications, are considered.

Keywords: energy assessment, marine tidal power, renewable energy, tidal dynamics

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Authors: Rosemary E. Huntriss, Lucy Jones

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Obesity and excess weight continue to be significant health problems in England. Traditional weight management programmes offer face-to-face support or group education. Remote care is recognised as a viable means of support; however, its effectiveness has not previously been evaluated in a tier 3 weight management setting. This service evaluation explored the effectiveness of online coaching, telephone support, and face-to-face support as optional management strategies within a tier 3 weight management programme. Outcome data were collected for adults with a BMI ≥ 45 or ≥ 40 with complex comorbidity who were referred to a Tier 3 weight management programme from January 2018 and had been discharged before October 2018. Following an initial 45-minute consultation with a specialist weight management dietitian, patients were offered a choice of follow-up support in the form of online coaching supported by an app (8 x 15 minutes coaching), face-to-face or telephone appointments (4 x 30 minutes). All patients were invited to a final 30-minute face-to-face assessment. The planned intervention time was between 12 and 24 weeks. Patients were offered access to adjunct face-to-face or telephone psychological support. One hundred and thirty-nine patients were referred into the programme from January 2018 and discharged before October 2018. One hundred and twenty-four patients (89%) attended their initial assessment. Out of those who attended their initial assessment, 110 patients (88.0%) completed more than half of the programme and 77 patients (61.6%) completed all sessions. The average length of the completed programme (all sessions) was 17.2 (SD 4.2) weeks. Eighty-five (68.5%) patients were coached online, 28 (22.6%) patients were supported face-to-face support, and 11 (8.9%) chose telephone support. Two patients changed from online coaching to face-to-face support due to personal preference and were included in the face-to-face group for analysis. For those with data available (n=106), average weight loss across the programme was 4.85 (SD 3.49)%; average weight loss was 4.70 (SD 3.19)% for online coaching, 4.83 (SD 4.13)% for face-to-face support, and 6.28 (SD 4.15)% for telephone support. There was no significant difference between weight loss achieved with face-to-face vs. online coaching (4.83 (SD 4.13)% vs 4.70 (SD 3.19) (p=0.87) or face-to-face vs. remote support (online coaching and telephone support combined) (4.83 (SD 4.13)% vs 4.85 (SD 3.30)%) (p=0.98). Remote support has been shown to be as effective as face-to-face support provided by a dietitian in the short-term within a tier 3 weight management setting. The completion rates were high compared with another tier 3 weight management services suggesting that offering remote support as an option may improve completion rates within a weight management service.

Keywords: dietitian, digital health, obesity, weight management

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Authors: Ana Ferreira, Ines Costa, Patricia Polónia, Josué Pereira, Olinda Faria, Pedro Alberto Silva

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Introduction: Optical coherence tomography (OCT) and visual field tools are pivotal in evaluating neurological deficits and predicting potential visual improvement following surgical decompression in neurosurgical patients. Despite their clinical significance, a comprehensive understanding of their utility in this context is lacking in the literature. This study aims to elucidate the applications of OCT and visual field assessment, delineating distinct patterns of visual deficit presentations within the studied cohort. Methods: This retrospective analysis considered all adult patients who underwent a single surgery for pituitary adenoma or anterior skull base meningioma with optic nerve involvement, coupled with neuro-ophthalmology evaluation, between July 2020 and January 2023. A minimum follow-up period of 6 months was deemed essential. Results: A total of 24 patients, with a median age of 61, were included in the analysis. Three primary patterns emerged: 1) Low visual field involvement with compromised OCT, 2) High visual field involvement with relatively unaffected OCT, and 3) Significant compromise observed in both OCT and visual fields. Conclusion: This study delineates various findings in OCT and visual field assessments with illustrative examples. Based on the current findings, a prospective cohort will be systematically collected to further investigate and validate these patterns and their prognostic significance, enhancing our understanding of the utility of OCT and visual fields in neurosurgical patients.

Keywords: OCT, neurosurgery, visual field, optic nerve

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Authors: Mohammad Ali Fteiha, Ghanem Al Bustami

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The study aimed to identify the assessment of parents of children with Autism for services provided by the Center for special care in the United Arab Emirates, in terms of quality, comprehensive and the impact of some factors related to the diagnosis and place of service provision and efficient working procedures of service and the child age. In order to achieve the objective of the study, researchers used Parent’s Satisfaction Scale, and Parents Evaluation of Services Effectiveness, both the scale and the parents reports provided with accepted level of validity and reliability. Sample includes 300 families of children with Autism receiving educational and rehabilitation services, treatment and support services in both governmental and private centers in United Arab Emirates. ANOVA test was used through SPSS program to analyze the collected data. The results of the study have indicated that there are significant differences in the assessment of services provided by centers due to a place of service, the nature of the diagnosis, child's age at the time of the study, as well as statistically significance differences due to age when first diagnosed. The results also showed positive evaluation for the good level of services as international standard, and the quality of these services provided by autism centers in the United Arab Emirates, especially in governmental centers. At the same time, the results showed the presence of many needs problems faced by the parents do not have appropriate solutions. Based on the results the recommendations were stated.

Keywords: autism, evaluation, diagnosis, parents, autism programs, supportive services, government centers, private centers

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Authors: Marta Fernández Batalla, José María Santamaría García, Maria Lourdes Jiménez Rodríguez, Roberto Barchino Plata, Adriana Cercas Duque, Enrique Monsalvo San Macario

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Background: Primary Care Nursing is taking more autonomy in clinical decisions. One of the most frequent therapies to solve is related to the problems of maintaining a sufficient supply of food. Nursing diagnoses related to food are addressed by the nurse-family and community as the first responsible. Objectives and interventions are set according to each patient. To improve the goal setting and the treatment of these care problems, a technological tool is developed to help nurses. Objective: To evaluate the computational tool developed to support the clinical decision in feeding problems. Material and methods: A cross-sectional descriptive study was carried out at the Meco Health Center, Madrid, Spain. The study population consisted of four specialist nurses in primary care. These nurses tested the tool on 30 people with ‘need for nutritional therapy’. Subsequently, the usability of the tool and the satisfaction of the professional were sought. Results: A simple and convenient computational tool is designed for use. It has 3 main entrance fields: age, size, sex. The tool returns the following information: BMI (Body Mass Index) and caloric consumed by the person. The next step is the caloric calculation depending on the activity. It is possible to propose a goal of BMI or weight to achieve. With this, the amount of calories to be consumed is proposed. After using the tool, it was determined that the tool calculated the BMI and calories correctly (in 100% of clinical cases). satisfaction on nutritional assessment was ‘satisfactory’ or ‘very satisfactory’, linked to the speed of operations. As a point of improvement, the options of ‘stress factor’ linked to weekly physical activity. Conclusion: Based on the results, it is clear that the computational tools of decision support are useful in the clinic. Nurses are not only consumers of computational tools, but can develop their own tools. These technological solutions improve the effectiveness of nutrition assessment and intervention. We are currently working on improvements such as the calculation of protein percentages as a function of protein percentages as a function of stress parameters.

Keywords: feeding behavior health, nutrition therapy, primary care nursing, technology assessment

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Authors: Jean De Dieu Ayabagabo, Paul A.Onjoro, Karubiu P. Migwi, Marie C. Dusingize

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This study investigated the effects of feed on milk yield and quality through feed monitoring and quality assessment, and the consequent enteric methane gas emissions from smallholder dairy farms in drier areas of Rwanda, using the Tier II approach for four seasons in three zones, namely; Mayaga and peripheral Bugesera (MPB), Eastern Savanna and Central Bugesera (ESCB), and Eastern plateau (EP). The study was carried out using 186 dairy cows with a mean live weight of 292 Kg in three communal cowsheds. The milk quality analysis was carried out on 418 samples. Methane emission was estimated using prediction equations. Data collected were subjected to ANOVA. The dry matter intake was lower (p<0.05) in the long dry season (7.24 Kg), with the ESCB zone having the highest value of 9.10 Kg, explained by the practice of crop-livestock integration agriculture in that zone. The Dry matter digestibility varied between seasons and zones, ranging from 52.5 to 56.4% for seasons and from 51.9 to 57.5% for zones. The daily protein supply was higher (p<0.05) in the long rain season with 969 g. The mean daily milk production of lactating cows was 5.6 L with a lower value (p<0.05) during the long dry season (4.76 L), and the MPB zone having the lowest value of 4.65 L. The yearly milk production per cow was 1179 L. The milk fat varied from 3.79 to 5.49% with a seasonal and zone variation. No variation was observed with milk protein. The seasonal daily methane emission varied from 150 g for the long dry season to 174 g for the long rain season (p<0.05). The rain season had the highest methane emission as it is associated with high forage intake. The mean emission factor was 59.4 Kg of methane/year. The present EFs were higher than the default IPPC value of 41 Kg from developing countries in African, the Middle East, and other tropical regions livestock EFs using Tier I approach due to the higher live weight in the current study. The methane emission per unit of milk production was lower in the EP zone (46.8 g/L) due to the feed efficiency observed in that zone. Farmers should use high-quality feeds to increase the milk yield and reduce the methane gas produced per unit of milk. For an accurate assessment of the methane produced from dairy farms, there is a need for the use of the Life Cycle Assessment approach that considers all the sources of emissions.

Keywords: footprint, forage, girinka, tier

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Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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Authors: Seyedtaghi Mirmohammadi, J. Yazdani, S. M. Asadi, M. Rokni, A. Toosi

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There are many indoor air quality studies with an emphasis on indoor particulate matters (PM2.5) monitoring. Whereas, there is a lake of data about indoor PM2.5 concentrations in rural area schools (especially in classrooms), since preliminary children are assumed to be more defenseless to health hazards and spend a large part of their time in classrooms. The objective of this study was indoor PM2.5 concentration quality assessment. Fifteen preliminary schools by time-series sampling were selected to evaluate the indoor air quality in the rural district of Sari city, Iran. Data on indoor air climate parameters (temperature, relative humidity and wind speed) were measured by a hygrometer and thermometer. Particulate matters (PM2.5) were collected and assessed by Real Time Dust Monitor, (MicroDust Pro, Casella, UK). The mean indoor PM2.5 concentration in the studied classrooms was 135µg/m3 in average. The multiple linear regression revealed that a correlation between PM2.5 concentration and relative humidity, distance from city center and classroom size. Classroom size yields reasonable negative relationship, the PM2.5 concentration was ranged from 65 to 540μg/m3 and statistically significant at 0.05 level and the relative humidity was ranged from 70 to 85% and dry bulb temperature ranged from 28 to 29°C were statistically significant at 0.035 and 0.05 level, respectively. A statistical predictive model was obtained from multiple regressions modeling for PM2.5 and indoor psychrometric parameters.

Keywords: particulate matters, classrooms, regression, concentration, humidity

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Authors: K. V. Venugopalan

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Micro, Small and Medium Enterprises (MSMEs) have been accepted as the engine of economic growth and for promoting equitable development. The major advantage of the sector is its employment potential at low capital cost. The labour intensity of the MSME sector is much higher than that of the large enterprises. The MSMEs constitute over 90% of total enterprises in most of the economies and are credited with generating the highest rates of employment growth and account for a major share of industrial production and exports. Kerala is a small state in India with the limited land area with high potential in educated human resources need micro, small and medium enterprises for development. Kerala has the highest Physical Quality of Life Index (PQLI) in India and the highest Human Development Index (HDI) at par with the developed countries SME play an important role in alleviating poverty and contribute significantly towards the growth of developing economies. Financial institutions can play a vital role for the promotion of micro, small and medium enterprises in Kerala. The study entitled “Financial Institutions and its role in the promotion of Small and Medium Enterprises in Kerala “examine the progress of MSME in Kerala and India and also the role of financial institutions and the problems faced by entrepreneurs for getting advances with reference to ‘Kerala Financial Corporation’-an agency set up by the government for promoting small and medium enterprises in the state. This study is based on both secondary and primary data. Primary data for the study was collected from those entrepreneurs who availed advances from financial institutions. The secondary data include the investment made, goods and services provided, the employment generated and the number of units registered in MSME sector for the last 10 years in Kerala. The study concluded that financial institutions providing finance with simple procedures and charging smaller interest rates will increase the number of MSME's and also contribute gross state domestic product and reduce the unemployment problem and poverty in the economy.

Keywords: gross state domestic product, human development index, micro, small and medium enterprises

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Authors: Florim Grajcevci, Flamur Grajcevci, Fatos Tahiri, Hamdi Kurteshi

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The territory of Kosova is actually included in one of the most seismic-prone regions in Europe. Therefore, the earthquakes are not so rare in Kosova; and when they occurred, the consequences have been rather destructive. The importance of assessing the seismic resistance of existing masonry structures has drawn strong and growing interest in the recent years. Engineering included those of Vulnerability, Loss of Buildings and Risk assessment, are also of a particular interest. This is due to the fact that this rapidly developing field is related to great impact of earthquakes on the socioeconomic life in seismic-prone areas, as Kosova and Prishtina are, too. Such work paper for Prishtina city may serve as a real basis for possible interventions in historic buildings as are museums, mosques, old residential buildings, in order to adequately strengthen and/or repair them, by reducing the seismic risk within acceptable limits. The procedures of the vulnerability assessment of building structures have concentrated on structural system, capacity, and the shape of layout and response parameters. These parameters will provide expected performance of the very important existing building structures on the vulnerability and the overall behavior during the earthquake excitations. The structural systems of existing historical buildings in Pristina, Kosovo, are dominantly unreinforced brick or stone masonry with very high risk potential from the expected earthquakes in the region. Therefore, statistical analysis based on the observed damage-deformation, cracks, deflections and critical building elements, would provide more reliable and accurate results for the regional assessments. The analytical technique was used to develop a preliminary evaluation methodology for assessing seismic vulnerability of the respective structures. One of the main objectives is also to identify the buildings that are highly vulnerable to damage caused from inadequate seismic performance-response. Hence, the damage scores obtained from the derived vulnerability functions will be used to categorize the evaluated buildings as “stabile”, “intermediate”, and “unstable”. The vulnerability functions are generated based on the basic damage inducing parameters, namely number of stories (S), lateral stiffness (LS), capacity curve of total building structure (CCBS), interstory drift (IS) and overhang ratio (OR).

Keywords: vulnerability, ductility, seismic microzone, ductility, energy efficiency

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Authors: Karolina Mazur, Stanislaw Kuciel

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Polylactides (PLA) and polyhydroxyalkanoates (PHA) are the two groups of biodegradable and biocompatible thermoplastic polymers most commonly utilised in medicine and rehabilitation. The aim of this work is to determine the changes in the strength properties and the microstructures taking place in biodegradable polymer composites during their long-term storage in a highly cooled environment (i.e. a freezer at -24ºC) and to initially assess the durability of such biocomposites when used as single-use elements of rehabilitation or medical equipment. It is difficult to find any information relating to the feasibility of long-term storage of technical products made of PLA or PHA, but nonetheless, when using these materials to make products such as casings of hair dryers, laptops or mobile phones, it is safe to assume that without storing in optimal conditions their degradation time might last even several years. SEM images and the assessment of the strength properties (tensile, bending and impact testing) were carried out and the density and water sorption of two polymers, PLA and PHA (NaturePlast PLE 001 and PHE 001), filled with cellulose fibres (corncob grain – Rehofix MK100, Rettenmaier&Sohne) up to 10 and 20% mass were determined. The biocomposites had been stored at a temperature of -24ºC for 4 years. In order to find out the changes in the strength properties and the microstructure taking place after such a long time of storage, the results of the assessment have been compared with the results of the same research carried out 4 years before. Results shows a significant change in the manner of fractures – from ductile with developed surface for the PHA composite with corncob grain when the tensile testing was performed directly after the injection into a more brittle state after 4 years of storage, which is confirmed by the strength tests, where a decrease of deformation is observed at point of fracture. The research showed that there is a way of storing medical devices made out of PLA or PHA for a reasonably long time, as long as the required temperature of storage is met. The decrease of mechanical properties found during tensile testing and bending for PLA was less than 10% of the tensile strength, while the modulus of elasticity and deformation at fracturing slightly rose, which may implicate the beginning of degradation processes. The strength properties of PHA are even higher after 4 years of storage, although in that case the decrease of deformation at fracturing is significant, reaching even 40%, which suggests its degradation rate is higher than that of PLA. The addition of natural particles in both cases only slightly increases the biodegradation.

Keywords: biocomposites, PLA, PHA, storage

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Authors: A. Erragh, K. Amanzoui, M. Elharit, H. Salem, M. Ababneh, K. Elfakhr, S. Kalouch, A. Chlilek

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Guillain-Barre syndrome (GBS) is the most common form of acute polyradiculoneuritis (PRNA). It is a medical emergency in pediatrics that requires rapid diagnosis and immediate assessment of the severity criteria for the implementation of appropriate treatment. Retrospective, descriptive study in 24 patients under the age of 18 who presented with GBS between September 2017 and July 2021 and were hospitalized in the multipurpose pediatric intensive care unit of the Abderrahim EL Harouchi children's hospital in Casablanca. The average age was 7.91 years, with extremes ranging from 18 months and 14 years and a male predominance of 75%. After a prodromal event, most often infectious (80%) and a free interval of 12 days on average, 2 types of motor disorders begin either hypo or arereflectic flaccid paralysis of the lower limbs (45.8%) or flaccid quadriplegia hypo or arereflectic (54.2%). During GBS, the most formidable complication is respiratory distress, which can occur at any time. In our study, respiratory impairment was observed in 70.8% of cases. In addition, other signs of severity, such as swallowing disorders (75%) and dysautonomic disorders (8.33%), were also observed, which justified care in the intensive care unit for all of our patients. The use of invasive ventilation was necessary in 76.5% of cases, and specific treatments based on immunoglobulins were administered in all our patients. Despite everything, the death rate remains high (25%) and is mainly due to complications related to hospitalization. Guillain Barré syndrome is, therefore, a pediatric emergency that requires rapid diagnosis and immediate assessment of severity criteria for the implementation of appropriate treatment.

Keywords: guillain barre syndrome, emergency, children, medical

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Authors: Surasak Khamkhong

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This study aimed to investigate the use of the PISA reading literacy assessment framework (PRF) to improve EFL learners’ critical reading and thinking skills. The sample group, selected by the purposive sampling technique, included 36 EFL learners from a university in Northeastern Thailand. The instruments consisted of 8 PRF-based reading lessons, a 27-item-PRF-based reading test which was used as a pre-test and a post-test, and an attitude questionnaire toward the designed lessons. The statistics used for data analysis were percentage, mean, standard deviation, and the Wilcoxon signed-rank test. The results revealed that before the intervention, the students’ English reading proficiency were low as is evident from their low pre-test scores (M=14.00). They did fairly well for the access-and-retrieve questions (M=6.11), but poorly for the integrate-and-interpret questions (M=4.89) and the reflect-and-evaluate questions (M=3.00), respectively. This means that the students could comprehend the texts but they could hardly interpret or evaluate them. However, after the intervention, they could do better as their post-test scores were higher (M=18.01). They could comprehend (M=6.78), interpret (M=6.00) and evaluate (M=5.25) well. This means that after the intervention, their critical reading skills had improved. In terms of their attitude towards the designed lessons and instruction, most students were satisfied with the lessons and the instruction. It may thus be concluded that the designed lessons can help improve students’ English critical reading proficiency and may be used as a teaching model for improving EFL learners’ critical reading skills.

Keywords: second language reading, critical reading and thinking skills, PISA reading literacy framework, English L2 reading development

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Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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Authors: Yun Ma, Jiajun Lu

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President Xi Jinping has clearly stated the need to more effectively advance the process of urbanization centered on people, striving to shape cities into spaces that are healthier, safer, and more livable. However, during the development and construction of mountainous cities, numerous uncertain disruptive factors have emerged, one after another, posing severe challenges to the city's overall development. Therefore, building resilient cities and creating high-quality urban ecosystems and safety systems have become the core and crux of achieving sustainable urban development. This paper takes the central urban area of Chongqing as the research object and establishes an urban resilience assessment indicator system from four dimensions: society, economy, ecology, and infrastructure. It employs the entropy weight method and TOPSIS model to assess the urban resilience level of the central urban area of Chongqing from 2019 to 2022. The results indicate that i. the resilience level of the central urban area of Chongqing is unevenly distributed, showing a spatial pattern of "high in the middle and low around"; it also demonstrates differentiation across different dimensions; ii. due to the impact of the COVID-19 pandemic, the overall resilience level of the central urban area of Chongqing has declined significantly, with low recovery capacity and slow improvement in urban resilience. Finally, based on the four selected dimensions, this paper proposes optimization strategies for urban resilience in mountainous cities, providing a basis for Chongqing to build a safe and livable new city.

Keywords: mountainous urban areas, central urban area of Chongqing, entropy weight method, TOPSIS model, ArcGIS

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Authors: Tannistha Dasgupta

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This study explores the aspects of second language (L2) spoken fluency that are related to L2 linguistic knowledge and processing skill. It draws on Levelt’s ‘blueprint’ of the L2 speaker which discusses the cognitive issues underlying the act of speaking. However, L2 speaking assessments have largely neglected the underlying mechanism involved in language production; emphasis is given on the relationship between subjective ratings of L2 speech sample and objectively measured aspects of fluency. Hence, in this study, the relation between L2 linguistic knowledge and processing skill i.e. Cognitive Fluency (CF), and objectively measurable aspects of L2 spoken fluency i.e. Utterance Fluency (UF) is examined. The participants of the study are L2 learners of English, studying at high school level in Hyderabad, India. 50 participants with intermediate level of proficiency in English performed several lexical retrieval tasks and attention-shifting tasks to measure CF, and 8 oral tasks to measure UF. Each aspect of UF (speed, pause, and repair) were measured against the scores of CF to find out those aspects of UF which are reliable indicators of CF. Quantitative analysis of the data shows that among the three aspects of UF; speed is the best predictor of CF, and pause is weakly related to CF. The study suggests that including the speed aspect of UF could make L2 fluency assessment more reliable, valid, and objective. Thus, incorporating the assessment of psycholinguistic mechanisms into L2 spoken fluency testing, could result in fairer evaluation.

Keywords: attention-shifting, cognitive fluency, lexical retrieval, utterance fluency

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Authors: Nima Pirhadi, Shao Yong Bo, Xusheng Wan, Jianguo Lu, Jilei Hu

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Although gravels and gravelly soils are assumed to be non-liquefiable because of high conductivity and small modulus; however, the occurrence of this phenomenon in some historical earthquakes, especially recently earthquakes during 2008 Wenchuan, Mw= 7.9, 2014 Cephalonia, Greece, Mw= 6.1 and 2016, Kaikoura, New Zealand, Mw = 7.8, has been promoted the essential consideration to evaluate risk assessment and hazard analysis of seismic gravelly soil liquefaction. Due to the limitation in sampling and laboratory testing of this type of soil, in situ tests and site exploration of case histories are the most accepted procedures. Of all in situ tests, dynamic penetration test (DPT), Which is well known as the Chinese dynamic penetration test, and shear wave velocity (Vs) test, have been demonstrated high performance to evaluate seismic gravelly soil liquefaction. However, the lack of a sufficient number of case histories provides an essential limitation for developing new models. This study at first investigates recent earthquakes that caused liquefaction in gravelly soils to collect new data. Then, it adds these data to the available literature’s dataset to extend them and finally develops new models to assess seismic gravelly soil liquefaction. To validate the presented models, their results are compared to extra available models. The results show the reasonable performance of the proposed models and the critical effect of gravel content (GC)% on the assessment.

Keywords: liquefaction, gravel, dynamic penetration test, shear wave velocity

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Authors: Xuan Linh Nguyen, Tien Yin Chou, Yao Min Fang, Feng Cheng Lin, Thanh Van Hoang, Yin Min Huang

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In Vietnam, land use planning is the most important and powerful tool of the government for sustainable land use and land management. Nevertheless, many of land use planning locations are facing protests from surrounding households due to environmental impacts. In addition, locations are planned completely based on the subjective decisions of planners who are unsupported by tools or scientific methods. Hence, this research aims to assist the decision-makers in evaluating the rationality of planning locations by developing a Spatial Decision Support System (SDSS) using approaches of Geographic Information System (GIS)-based technology, Analytic Hierarchy Process (AHP) multi-criteria-based technique and Fuzzy set theory. An ArcGIS Desktop add-ins named SDSS-LUPA was developed to support users analyzing data and presenting results in friendly format. The Fuzzy-AHP method has been utilized as analytic model for this SDSS. There are 18 planned locations in Hung Ha district (Thai Binh province, Vietnam) as a case study. The experimental results indicated that the assessment threshold higher than 0.65 while the 18 planned locations were irrational because of close to residential areas or close to water sources. Some potential sites were also proposed to the authorities for consideration of land use planning changes.

Keywords: analytic hierarchy process, fuzzy set theory, land use planning, spatial decision support system

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Authors: Tomohiro Uchida, Noriaki Satake, Toshimichi Nakaho, Akira Inoue, Hidemitsu Saito

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In this study, we assessed the bereavement risk of family caregivers of patients with cancer. In the palliative care unit of Tohoku University Hospital, we conducted a family psychoeducation session to support the family caregivers of patients with cancer. A total of 50 participants (8 males and 42 females; mean age = 62.98 years, SD = 11.10) were assessed after the session for bereavement risk using the Japanese version of the Bereavement Risk Assessment Tool (BRAT-J). According to the BRAT-J scores, eight participants were considered to be having no known risk (Level 1), seventeen had minimal risk (Level 2), twenty had a low risk (Level 3), four had a moderate risk (Level 4), and one had a high risk (Level 5). Of these participants, seven participants had completed the follow-up postal survey that assessed their psychological distress (the Kessler Psychological Distress Scale: K6) to compare the bereavement risk. According to the K6 scores, three-fourth of the individuals, who were considered to be at Level 3 on the BRAT-J, scored higher than the cutoff point (>10) for the detection of depressive disorder. On the other hand, one-third of the individuals, who were considered to be at Level 2 on the BRAT-J, scored higher than the cutoff point. Therefore, it appears that the BRAT-J can predict the likelihood of difficulties or complications in bereaved family caregivers. This research was approved by the Ethics Committee of Tohoku University Graduate School of Medicine and Tohoku University Hospital.

Keywords: palliative care, family caregivers, bereavement risk, BRAT, post-loss psychological distress

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Authors: Shara Toibayeva, Irbulat Utepbergenov, Lyazzat Issabekova, Aidana Bodesova

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The article discusses the importance of quality assessment as a strategic tool in business and emphasizes the significance of the effectiveness of quality management systems (QMS) for enterprises. The evaluation of these systems takes into account the specificity of quality indicators, the multilevel nature of the system, and the need for optimal selection of the number of indicators and evaluation of the system state, which is critical for making rational management decisions. Methods and models of automated enterprise quality management are proposed, including an intelligent automated quality management system integrated with the Management Information and Control System. These systems make it possible to automate the implementation and support of QMS, increasing the validity, efficiency, and effectiveness of management decisions by automating the functions performed by decision makers and personnel. The paper also emphasizes the use of recurrent neural networks to improve automated quality management. Recurrent neural networks (RNNs) are used to analyze and process sequences of data, which is particularly useful in the context of document quality assessment and non-conformance detection in quality management systems. These networks are able to account for temporal dependencies and complex relationships between different data elements, which improves the accuracy and efficiency of automated decisions. The project was supported by a grant from the Ministry of Education and Science of the Republic of Kazakhstan under the Zhas Galym project No. AR 13268939, dedicated to research and development of digital technologies to ensure consistency of QMS regulatory documents.

Keywords: automated control system, quality management, document structure, formal language

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