Search results for: medical discourse

Authors: Kevin Soubly, Kaysara Khatun

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This study applies the existing Middle-Out Perspective (MOP) as a complementing analytical alternative to the customary dichotomous options of top-down vs. bottom-up strategies of international development and commons governance. It expands the framework by applying it to a new context of land management and environmental change, enabling fresh understandings of decision making around land use. Using a case study approach in Central Kalimantan, Indonesia among a village of indigenous Dayak, this study explores influences from both internal and external middle actors, utilizing qualitative empirical evidence and incorporating responses across 25 village households and 11 key stakeholders. Applying the factors of 'agency' and 'capacity' specific to the MOP, this study demonstrates middle actors’ unique capabilities and criticality to change due to their influence across various levels of decision-making. Study results indicate that middle actors play a large role, both passively and actively, both directly and indirectly, across various levels of decision-making, perception-shaping, and commons governance. In addition, the prominence of novel 'passive' middle actors, such as the internet, can provide communities themselves with a level of agency beyond that provided by other middle actors such as NGOs and palm oil industry entities – which often operate at the behest of the 'top' or out of self-interest. Further, the study posits that existing development and decision-making frameworks may misidentify the 'bottom' as the 'middle,' raising questions about traditional development and livelihood discourse, strategies, and support, from agricultural production to forest management. In conclusion, this study provides recommendations including that current policy preconceptions be reevaluated to engage middle actors in locally-adapted, integrative manners in order to improve governance and rural development efforts more broadly.

Keywords: environmental management, governance, Indonesia, land use, middle actors, middle-out perspective

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Authors: Dalia Kubiliūtė

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Lithuania is known as a trusted location for global business institutions, and it attracts investors with it’s competitive environment for financial service providers. Along with the aspiration to offer a strong results-oriented and innovations-driven environment for financial service providers, Lithuanian regulatory authorities consistently implement the European Union's high regulatory standards for financial activities, including sustainability-related disclosures. Since European Union directed its policy towards transition to a climate-neutral, green, competitive, and inclusive economy, additional regulatory requirements for financial market participants are adopted: disclosure of sustainable activities, transparency, prevention of greenwashing, etc. The financial sector is one of the key factors influencing the implementation of sustainability objectives in European Union policies and mitigating the negative effects of climate change –public funds are not enough to make a significant impact on sustainable investments, therefore directing public and private capital to green projects may help to finance the necessary changes. The topic of the study is original and has not yet been widely analyzed in Lithuanian legal discourse. There are used quantitative and qualitative methodologies, logical, systematic, and critical analysis principles; hence the aim of this study is to reveal the problem of the implementation of the regulation on sustainability in the Lithuanian financial sector. Additional regulatory requirements could cause serious changes in financial business operations: additional funds, employees, and time have to be dedicated in order for the companies could implement these regulations. Lack of knowledge and data on how to implement new regulatory requirements towards sustainable reporting causes a lot of uncertainty for financial market participants. And for some companies, it might even be an essential point in terms of business continuity. It is considered that the supervisory authorities should find a balance between financial market needs and legal regulation.

Keywords: financial, legal, regulatory, sustainability

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Authors: Soon-Mi Park, Ihn Sook Jeong

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This retrospective study was aimed to identify risk factors of intravenous (IV) infiltration for hospitalized children. The participants were 1,174 children for test and 424 children for validation, who admitted to a general hospital, received peripheral intravenous injection therapy at least once and had complete records. Data were analyzed with frequency and percentage or mean and standard deviation were calculated, and decision tree analysis was used to screen for the most important risk factors for IV infiltration for hospitalized children. The decision tree analysis showed that the most important traditional risk factors for IV infiltration were the use of ampicillin/sulbactam, IV insertion site (lower extremities), and medical department (internal medicine) both in the test sample and validation sample. The correct classification was 92.2% in the test sample and 90.1% in the validation sample. More careful attention should be made to patients who are administered ampicillin/sulbactam, have IV site in lower extremities and have internal medical problems to prevent or detect infiltration occurrence.

Keywords: decision tree analysis, intravenous infiltration, child, validation

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Authors: Adel Edwar Waheeb Louka

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Purpose AI-driven solutions are at the forefront of many pathology and medical imaging methods. Using algorithms designed to better the experience of medical professionals within their respective fields, the efficiency and accuracy of diagnosis can improve. In particular, X-rays are a fast and relatively inexpensive test that can diagnose diseases. In recent years, X-rays have not been widely used to detect and diagnose COVID-19. The under use of Xrays is mainly due to the low diagnostic accuracy and confounding with pneumonia, another respiratory disease. However, research in this field has expressed a possibility that artificial neural networks can successfully diagnose COVID-19 with high accuracy. Models and Data The dataset used is the COVID-19 Radiography Database. This dataset includes images and masks of chest X-rays under the labels of COVID-19, normal, and pneumonia. The classification model developed uses an autoencoder and a pre-trained convolutional neural network (DenseNet201) to provide transfer learning to the model. The model then uses a deep neural network to finalize the feature extraction and predict the diagnosis for the input image. This model was trained on 4035 images and validated on 807 separate images from the ones used for training. The images used to train the classification model include an important feature: the pictures are cropped beforehand to eliminate distractions when training the model. The image segmentation model uses an improved U-Net architecture. This model is used to extract the lung mask from the chest X-ray image. The model is trained on 8577 images and validated on a validation split of 20%. These models are calculated using the external dataset for validation. The models’ accuracy, precision, recall, f1-score, IOU, and loss are calculated. Results The classification model achieved an accuracy of 97.65% and a loss of 0.1234 when differentiating COVID19-infected, pneumonia-infected, and normal lung X-rays. The segmentation model achieved an accuracy of 97.31% and an IOU of 0.928. Conclusion The models proposed can detect COVID-19, pneumonia, and normal lungs with high accuracy and derive the lung mask from a chest X-ray with similarly high accuracy. The hope is for these models to elevate the experience of medical professionals and provide insight into the future of the methods used.

Keywords: artificial intelligence, convolutional neural networks, deeplearning, image processing, machine learningSarapin, intraarticular, chronic knee pain, osteoarthritisFNS, trauma, hip, neck femur fracture, minimally invasive surgery

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Authors: Logan Carmichael

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As the world’s governments seek to increasingly digitize their service provisions, there exists a subsequent and fully valid concern about the security underpinning these digital governance provisions. Estonia, a small and innovative Baltic nation, has been refining both its digital governance structure and cybersecurity mechanisms for over three decades and has been praised as global ‘best practice’ in both fields. However, the security of the Estonian digital governance system has been ever-evolving and significantly shaped by cybersecurity crises. This paper examines said crises – 2007 cyberattacks on Estonian government, banks, and news media; the 2017 e-ID crisis; the ongoing COVID-19 pandemic; and the 2022 Russian invasion of Ukraine – and how governance decision-making following these crises has shaped the cybersecurity of the digital governance structure in Estonia. This paper employs a blended constructivist and historical institutionalist theoretical approach as a useful means to view governance and decision-making in the wake of cybersecurity incidents affecting the Estonian digital governance structure. Together, these theoretical groundings frame the topics of cybersecurity and digital governance in an Estonian context through a lens of ideation and experience, as well as institutional path dependencies over time and cybersecurity crises as critical junctures to study. Furthermore, this paper takes a qualitative approach, employing discourse analysis, policy analysis, and elite interviewing of Estonian officials involved in digital governance and cybersecurity in order to glean nuanced perspectives into the processes that followed these four crises. Ultimately, the results of this paper will offer insight into how governments undertake policy-driven change following cybersecurity crises to ensure sufficient security of their digitized service provisions. This paper’s findings are informative not only in continued decision-making in the Estonian system but also in other states currently implementing a digital governance structure, for which security mechanisms are of the utmost importance.

Keywords: cybersecurity, digital governance, Estonia, crisis management, governance in crisis

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Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh

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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.

Keywords: e-pharmacist, self-health management, medication reminder, value-added service

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Authors: Bihan Qaimari

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In many areas of the world there are political conflicts the consequences of which have an inevitable impact on the educational system. Palestine is one such country where the experience of political conflict, going back over many years, has had a devastating effect on the development and maintenance of a stable educational environment for children and their teachers. Up to now there have been few studies that have focussed on the effects of living and working in a war zone on the professional identity of teachers. The aim of this study is to explore how the formation of Palestinian teachers’ professional identity is affected by their experience of the current political conflict its impact on the school social culture. In order to gain an in-depth understanding of the impact of political violence on the formation of the professional identity of Palestinian teachers, a qualitative multiple case-study approach was adopted which draws on sociocultural theories of identity formation. An initial study was first conducted in six schools and this was followed by an in-depth study of teachers working in three further primary schools. Data sources included participant observation, a research diary, semi-structured group and individual interviews. Grounded theory, constant-comparative methods, and discourse analysis procedures were used to interpret the data. The findings suggest that the Palestinian primary school teachers negotiate multiple conflicting identities through their every day experiences of political conflict and the schools’ social culture. This tension is formed as a result of the historical cultural meaning that teachers construct about themselves and within the current unstable and unsettling conditions that exist in their country. In addition, the data indicate that the geographical location of the schools in relation of their proximity to the events of the political conflict also had an influence on the degree of tension inherent in teachers’ professional identity. The study makes significant theoretical, practical, and methodical contributions to the study of the formation of teachers’ professional identity in countries affected by political conflict.

Keywords: identity, political conflict, Palestine, teacher's professional identity

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Authors: Angelis P. Barlampas

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Purpose or Learning Objective It is well known that previous examinations play a major role in futural diagnosis, thus avoiding unnecessary new exams that cost in time and money both for the patient and the health system. A case is presented in which past patient’s results, in combination with the least needed new tests, give an easy final diagnosis. Methods or Background A middle aged man visited the emergency department complaining of hard controlled, persisting fever for the last few days. Laboratory tests showed an elevated number of white blood cells with neutrophil shift and abnormal CRP. The patient was admitted to hospital a month ago for continuing lungs symptomatology after a recent covid-19 infection. Results or Findings Computed tomography scanning showed a solid mass with spiculating margins in right lower lobe. After intravenous iodine contrast administration, there was mildly peripheral enhancement and eccentric non enhancing area. A pneumonic cancer was suspected. Comparison with the patient’s latest computed tomography revealed no mass in the area of interest but only signs of recent post covid-19 lung parenchyma abnormalities. Any new mass that appears in a month’s time span can not be a cancer but a benign lesion. It was obvious that an abscess was the most suitable explanation. The patient was admitted to hospital, and antibiotic therapy was given, with very good results. After a few days, the patient was afebrile and in good condition. Conclusion In this case , a PET scan or a biopsy was avoided, thanks to the patient’s medical history and the availability of previous examinations. It is worthy encouraging the patients to keep their medical records and organizing more efficiently the health system with the current technology of archiving the medical examinations, too.

Keywords: covid-19, chest ct, cancer, abscess, fever

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Authors: M. Aruna, Uma Gunasilan

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Hospitals play an ample role in securing the health of a country. Nevertheless, they also have an unhealthy side. Ecological issues strengthen ill-health throughout the domain which subsequently puts pressure on hospital supply chains. Medical waste indeed is hazardous for environment and subsequently for human. The hospital waste management is of immense prominence due to its infectious and hazardous nature that can source many effects on human health and the environment. Government regulations and public cognizance regarding hospital waste issues have imposed hospital units to admit these strategies. The innovative technologies and instruments have been developed to handle hospital wastes. Green supply chain management practices are common in the United States. In India, Green Supply Chain management (GSCM) has just started to be recognized and practiced. GSCM are green, integrated and ecologically optimized. In Green supply chain management environmental sustainability is found to be an important driver. Eleven barriers are identified in this work. Interpretive Structural Modeling (ISM) technique is used for ranking the obstructions.

Keywords: green supply chain management (GSCM), hospital waste management (HWM), interpretive structural modeling (ISM), medical waste (MW)

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Authors: Barbara Janari

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This paper focuses on temporality in J.M. Coetzee’s first novel, Dusklands, to argue that the novel’s fractured, disjointed temporality is intricately linked to the representations of the war in Vietnam and the colonial project in South Africa. The disrupted temporalities in the novel eschew chronological plots and linear time in favour of narratives that subvert the notion of historical progress to suggest instead the coextensive, multivalent ways in which the past and present interpenetrate one another. The disruption of temporal flow in the novel is evident in its form – the novel comprises two novellas that are juxtaposed, with the first part (‘The Vietnam War’) set centuries before the second part (‘The Narrative of Jacobus Coetzee’). The juxtaposition of the two novellas suggests history’s sometimes overlapping and lateral, rather than linear, movement. The novel’s form is extended in its montage narrative structure, which works to extend its temporal range. The temporal disjunction is reinforced, firstly, by Coetzee’s textual strategies, which include the subversion and critique of realism, parody, repetition, and the narrative technique of montage, and secondly, by the novel’s thematic concerns, which focus on the ways in which American domination can be linked to the colonial quest from earlier times. The complex structure of various strands and levels of authorship slows down the narrative’s temporal flow, requiring the reader to spend a fair amount of time unraveling the various parts of the narrative and relating them to each other. The structure epitomizes reflexive referencing, in which the reader can only make sense of the narrative by going back and forth and connecting various parts of it. The narrative structure also emphasizes the underlying similarities in the brutality that marked these two distinct historical events, epitomized by the drive towards subjection and domination by the novel’s two protagonists, Eugene Dawn and Jacobus Coetzee. The links and overlapping strands between the two novellas emphasize the ways in which the historical truth of colonial discourse becomes as much a myth as the propaganda program in Vietnam.

Keywords: disjunction, juxtaposition, montage, temporality

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Authors: Domenica L. DelPrete

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Viewed as a type of rapport-talk, troubles telling is a common conversational practice among female friends who wish to establish connection, show empathy, or share a disconcerting experience. This study shows how troubles talk between a mother and her adolescent daughter has a different interactional outcome. Specifically, it reveals how discursive interaction with an adolescent daughter becomes increasingly volatile when the mother steps out of the role of nurturer and into the role of troubles teller. Naturally occurring interactions between a mother and her 15-year-old daughter were videotaped in their family home over a two-week period. The data were primarily analyzed from an interactional sociolinguistic perspective, using conversation analytic techniques for transcriptions and discursive analysis. The following questions guided this research: (1) How are troubles telling discursively accomplished in the everyday talk of a mother and her adolescent daughter? and (2) What topic prompts the mother to engage in troubles talk? The data show that the mother engages her daughter in troubles to talk on issues related to body image and physical appearance and does so by (1) repeated questioning, (2) not accepting the daughter’s response as adequate, and (3) proffering self-deprecation. Findings reveal that engaging an adolescent daughter in a conversational practice reserved for female friendship groups creates a negative connection and relational disharmony. Since 'telling one’s troubles' assumes an egalitarian relationship between individuals, mother’s trouble telling creates a peer-like interaction that the adolescent daughter repeatedly resists. This study also proposes a discursive consciousness raising, which hopes to enhance communication between mothers and daughters by revealing the signals that show an adolescent daughter’s unwillingness to participate in troubles talk. Being in tune to these cues may prompt mothers to hesitate before pursuing a topic that will not garner the positive interactional outcome they seek.

Keywords: discursive interaction, maternal roles, mother-daughter interaction, troubles telling

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Authors: A. Al Hajeri, M. E. Minton, B. Haskins, F. H. Cummins

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The pre-hospital endotracheal intubation is fraught with difficulties; one solution offered has been video laryngoscopy (VL) which permits better visualization of the glottis than the standard method of direct laryngoscopy (DL). This method has resulted in a higher first attempt success rate and fewer failed intubations. However, VL has mainly been evaluated by experienced providers (experienced anesthetists), and as such the utility of this device for those whom infrequently intubate has not been thoroughly assessed. We sought to evaluate this equipment to determine whether in the hands of novice providers this equipment could prove an effective airway management adjunct. DL and two VL methods (C-Mac with distal screen/C-Mac with attached screen) were evaluated by simulating practice on a Laerdal airway management trainer manikin. Twenty Emergency Medical Technicians (basics) were recruited as novice practitioners. This group was used to eliminate bias, as these clinicians had no pre-hospital experience of intubation (although they did have basic airway skills). The following areas were assessed: Time taken to intubate, number of attempts required to successfully intubate, ease of use of equipment VL (attached screen) took on average longer for novice clinicians to successfully intubate and had a lower success rate and reported higher rating of difficulty compared to DL. However, VL (with distal screen) and DL were comparable on intubation times, success rate, gastric inflation rate and rating of difficulty by the user. This study highlights the routine use of VL by inexperienced clinicians would be of no added benefit over DL. Further studies are required to determine whether Emergency Medical Technicians (Paramedics) would benefit from this airway adjunct, and ascertain whether after initial mastery of VL (with a distal screen), lower intubation times and difficulty rating may be achievable.

Keywords: direct laryngoscopy, endotracheal intubation, pre-hospital, video laryngoscopy

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Authors: Aditaya Narayan Mishra

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Unequal distribution of environmental resources as a possible cause of conflict has been the topic of substantial research, and these connections have ruled the post-Cold War attention in the discourse of environmental security. In this category, considerable concentration has been given to water resources, on account of their important standing for human existence. Thus, water is considered to be one of the most important non-conventional security issues. As per this consideration, the case of India-Bangladesh is one of the most critical examples of disputes over transboundary water sharing. The concern regarding sharing of trans-boundary rivers has been the main focus of Bangladesh and India‘s relationship for the last forty-five years. Both countries share fifty-four rivers, most of which have originated in the Himalayan range. The main causes for problems in the sharing of the waters of trans-boundary rivers between India and Bangladesh include the: Farakka Barrage, Teesta river sharing issue, River linking project and Tipaimukh Dam. The construction of Farakka barrage across the Ganga River was the beginning of water dispute. Attempts at unilateral exploitation of the trans-boundary water resources led to inter-state conflicts that spilled over into other areas of bilateral disputes between India and Bangladesh. Apart from Farakka, Barrage, the disputes over Teesta River sharing, River linking project and Tipaimukh Dam are also vital contents for the both countries bilateral diplomacy. Till date, India and Bangladesh have signed five treaties regarding water sharing. However, all these treaties have been rendered worthless due to mistrust and political upheaval in both countries. The current paper would address all these water sharing disputes between India and Bangladesh with focus on the various policy responses (both bilateral and multilateral initiatives) to deal with these water sharing disputes. It will try to analyze the previous agreements and their drawbacks and loopholes. In addition, it will mention the reasons for water sharing cooperation between India and Bangladesh.

Keywords: India and Bangladesh relations, water disputes, Teesta, river linking project, Tipaimukh Dam, Farakka, policy responses

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Authors: Hind Hassan Arruwaite

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Conceptual metaphor is a cognitive semantic tool that provides access to people's conceptual systems. The correlation in the human conceptual system surpasses limited time and specific cultures. The universal associations provide universal schemas that organize people's conceptualization of the world. The study aims to explore how the cultural associations used in conceptual metaphors create commonalities and harmony between people of the world. In the research methodology, the researcher implemented Critical Metaphor Analysis, Metaphor Candidate Identification and Metaphor Identification Procedure models to deliver qualitative and descriptive findings. The semantic tension was the key criterion in identifying metaphorically used words in the headlines. The research materials are the oil trade conceptual metaphors used in the headlines of Arab News and Saudi Gazette Newspapers. The data will be uploaded to the self-constructed corpus to examine electronic lists for identifying conceptual metaphors. The study investigates the types of conceptual metaphors used in the headlines of the newspapers, the cultural associations identified in the conceptual metaphors, and whether the identified cultural associations in conceptual metaphors create universal conceptual schemas. The study aligned with previous seminal works on conceptual metaphor theory in emphasizing the distinctive power of conceptual metaphors in exposing the cultural associations that unify people's perceptions. The correlation of people conceptualization provides universal schemas that involve elements of human sensorimotor experiences. The study contributes to exposing the shared cultural associations that ensure the commonality of all humankind's thinking mechanism.

Keywords: critical discourse analysis, critical metaphor analysis, conceptual metaphor theory, primary and specific metaphors, corpus-driven approach, universal associations, image schema, sensorimotor experience, oil trade

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Authors: Amandeep Kaur

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All religions enlighten truth which provides spiritual tranquility. But, the language of these holy books is not easy to understand because these have divine language. That's why hermeneutical Study is necessary to understand these Scriptures. There is a separate theoretical framework to study all the disciplines of language, literature, religion etc. Similarly the discipline of interpretation has its own theoretical framework known as hermeneutics. It is a science of interpretation that put forward the best ways and methods of interpretation. But in this modern world, hermeneutics is considered as a theoretical-cum-philosophical discipline. It is vast study of understanding texts. Hermeneutics is especially related to the study of religious scriptures like the Bible, the Qur'an, the Vedas and the Shri Guru Granth Sahib and many more. It is mainly the Western concept which has a great old tradition because it used the Bible as the foremost holy scripture for definition and interpretation. The Discipline of the Indian hermeneutics was led by Mimamsa School. The reference of the word hermeneutics in works of Ancient Greek philosophers indicates towards the antiquity of this word. Shri Guru Granth Sahib's schools of interpretation like Udasi, Nirmala, Sevapanthi and Gyani came into existence to interpret the discourse of Shri Guru Granth Sahib. These are sects of Sikhism and have great contribution to interpret and preach Guru Granth Sahib's revelation. This research paper will represent the comparative study of these sects methods, tools and styles of interpreting the meaning of this holy book. Interpretation is basically textual based process. So, all these schools have chosen Guru Granth Sahib for textual study. Some of the schools have done a whole interpretation of Guru Granth Sahib. But, some of them have done only interpretation of prominent banies i.e Japuji Sahib, Anand Sahib, Assa-di-war etc. This study will also throw lights on sect's historical background and contribution. At last conclusion of this paper is that all the schools have done gurbani interpretation according to their own philosophical and theological point of view. These schools have many similarities and differences among their way of interpretation. It will be discussed briefly.

Keywords: Gyani, hermeneutics, Mimamsa, Nirmala, Sevapanthi, Udasi

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Authors: Sangeeta Palekar, Neeraj Rangwani, Akash Poddar, Jayu Kalambe

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The bio-medical analysis is an indispensable procedure for identifying health-related diseases like diabetes. Monitoring the glucose level in our body regularly helps us identify hyperglycemia and hypoglycemia, which can cause severe medical problems like nerve damage or kidney diseases. This paper presents a method for predicting the glucose concentration in blood samples using image processing and machine learning algorithms. The glucose solution is prepared by the glucose oxidase (GOD) and peroxidase (POD) method. An experimental database is generated based on the colorimetric technique. The image of the glucose solution is captured by the raspberry pi camera and analyzed using image processing by extracting the RGB, HSV, LUX color space values. Regression algorithms like multiple linear regression, decision tree, RandomForest, and XGBoost were used to predict the unknown glucose concentration. The multiple linear regression algorithm predicts the results with 97% accuracy. The image processing and machine learning-based approach reduce the hardware complexities of existing platforms.

Keywords: artificial intelligence glucose detection, glucose oxidase, peroxidase, image processing, machine learning

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Authors: Reem Saad Alqahtani

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Drawing on minority literature, this research highlights the role of three contemporary Arab American writers, considering the significance of the historical and cultural contexts of the brutal attacks of 9/11. The focus of the research is to draw attention to the poetry of Samuel Hazo, Nathalie Handal, and Naomi Shihab Nye as representatives of the identity crisis, whose experiences left them feeling marginalized and alienated in both societies, and reflected as one of the ethnic American minority groups, as demonstrated in their poetry, with a special focus on hybridity, resistance, identity, and empowerment. The study explores the writers’ post-9/11 experience, affected by the United States’ long history of marginalization and discrimination against people of colour, placing Arab American literature with that of other ethnic American groups who share the same experience and contribute to composing literature characterized by the aesthetics of cultural hybridity, cultural complexity, and the politics of minorities to promote solidarity and coalition building. Indeed, the three selected Arab American writers have found a link between their narration and the identity of the exiled by establishing an identity that is a kind of synthesis of diverse identities of Western reality and Eastern nostalgia. The approaches applied in this study will include historical/biographical, postcolonial, and discourse analysis. The first will be used to emphasize the influence of the biographical aspects related to the community, identity, and resistance of the three poets on their poetry. The second is used to investigate the effects of postcolonialism on the poets and their responses to it, while the third understand the sociocultural, political, and historical dimensions of the texts, establishing these poets as representative of the Arab American experience. This study is significant because it will help shed light on the importance of the Arabic hybrid identity in creating resistance to minority communities within American society.

Keywords: Arab American, identity, hybridity, post-9/11

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Authors: Nuur Insan Tangkelangi

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Needs on academic writing competence as the primary focus in higher education encourage the university institutions around the world to provide academic writing courses to support their students dealing with their tasks pertaining to this competence. However, a pilot study conducted previously in one of the universities in Palopo, a city in South Sulawesi, revealed that even though the institution has provided academic writing courses, supported by some workshops related to academic writing and some supporting facilities at campus, the students still face difficulties in completing their assignments related to academic writing, particularly in writing their theses. The present study focuses on investigating the specific needs of the students in the same institution in terms of competences required in academic writing. It is also carried out to examine whether the syllabus exists and accommodates the students’ needs or not. Questionnaire and interview were used to collect data from sixty students of sixth semester and two lecturers of the academic courses. The results reveal that the students need to learn all aspects of linguistic competence (language features, lexical phrases, academic language and vocabulary, and proper language) and some aspects in discourse competence (how to write introduction, search for appropriate literature, design research method, write coherent paragraphs, refer to sources, summarize and display data, and link sentences smoothly). Regarding the syllabus, it is found that the academic writing courses provided in the institution, where this study takes place, do not have syllabus. This condition is different from other institutions which provide syllabi for all courses. However, at the commencement of the course, the students and the lecturers have negotiated their learning goals, topics discussed, learning activities, and assessment criteria for the course. Therefore, even though the syllabus does not exist, but the elements of the syllabus are there. The negotiation between the students and the lecturers contributes to the students’ attitude toward the courses. The students are contented with the course and they feel that their needs in academic writing have been accommodated. However, some suggestions for the next academic writing courses are stated by the students. Considering the results of this study, a syllabus is then proposed which is expected to accommodate the specific needs of students in that institution.

Keywords: Students' needs, academic writing, syllabus design for instruction, case study

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Authors: Racheli Magnezi, Inbal Gazit, Michal Rassin, Joseph Barr, Orna Tal

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An effective process for transmitting patient critical information is essential for patient safety and for improving communication among healthcare staff. Previous studies have discussed handover tools such as SBAR (Situation, Background, Assessment, Recommendation) or SOFI (Short Observational Framework for Inspection). Yet, these formats lack flexibility, and require special training. In addition, nurses and physicians have different procedures for handing over information. The objectives of this study were to establish a universal, structured tool for handover, for both physicians and nurses, based on parameters that were defined as ‘important’ and ‘appropriate’ by the medical team, and to implement this tool in various hospital departments, with flexibility for each ward. A questionnaire, based on established procedures and on the literature, was developed to assess attitudes towards the most important information for effective handover between shifts (Cronbach's alpha 0.78). It was distributed to 150 senior physicians and nurses in 62 departments. Among senior medical staff, 12 physicians and 66 nurses responded to the questionnaire (52% response rate). Based on the responses, a handover form suitable for all hospital departments was designed and implemented. Important information for all staff included: Patient demographics (full name and age); Health information (diagnosis or patient complaint, changes in hemodynamic status, new medical treatment or equipment required); and Social Information (suspicion of violence, mental or behavioral changes, and guardianship). Additional information relevant to each unit included treatment provided, laboratory or imaging required, and change in scheduled surgery in surgical departments. ICU required information on background illnesses, Pediatrics required information on diet and food provided and Obstetrics required the number of days after cesarean section. Based on the model described, a flexible tool was developed that enables handover of both common and unique information. In addition, it includes general logistic information that must be transmitted to the next shift, such as planned disruptions in service or operations, staff training, etc. Development of a simple, clear, comprehensive, universal, yet flexible tool designed for all medical staff for transmitting critical information between shifts was challenging. Physicians and nurses found it useful and it was widely implemented. Ongoing research is needed to examine the efficiency of this tool, and whether the enthusiasm that accompanied its initial use is maintained.

Keywords: handover, nurses, hospital, critical information

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Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper

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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.

Keywords: medical training, simulations, ultrasound, Simultech

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Authors: Humberto Foyaca Sibat, Lourdes de Fátima Ibañez Valdés

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Background Cysticercosis (Ct) is a preventable and eradicable zoonotic parasitic disease secondary to a cestode infection by the larva form of pig tapeworm Taenia solium (Ts), mainly seen in people living in developing countries. When the cysticercus is in the brain parenchymal, intraventricular system, subarachnoid space (SAS), cerebellum, brainstem, optic nerve, or spinal cord, then it has named neurocysticercosis (NCC), and the often-clinical manifestations are headache and epileptic seizures/epilepsy among other less frequent symptoms and signs. In this study, we look for a manuscript related to the role played by oligodendrocytes in the pathogenesis of NCC. We review this issue and formulate some hypotheses regarding its role and the role played in the pathogenesis of calcified NCC and epileptic seizures, and secondary epilepsy. Method: We searched the medical literature comprehensively, looking for published medical subject heading (MeSH) terms like "neurocysticercosis", "pathogenesis of neurocysticercosis", "comorbidity in NCC"; OR "oligodendrocytes"; OR "oligodendrocyte precursor cells(OPC/NG2)"; OR "epileptic seizures(ES)/Epilepsy(Ep)/NCC" OR "oligodendrocytes(OLG)/ES/Ep”; OR "calcified NCC/OLG"; OR “OLG Ca2+.” Results: All selected manuscripts were peer-reviewed, and we did not find publications related to OLG/NCC.

Keywords: oligodendrocytes, neurocysticercosis, oligodendrocytes, oligodendrocyte precursor cell, KG2, calcified neurocysticercosis, cellular calcium influx.

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Authors: Portia Muehlbauer

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This paper examines the evolving landscape of preventing and countering violent extremism (PCVE) by delving into the growing importance of integrating human rights principles into violence prevention strategies on the local, community level. This study sheds light on the underlying theoretical frameworks of violent extremism and the influence of gender while investigating the intersection between human rights preservation and violent extremism prevention. To gain practical insight, the research focuses on two prominent international non-governmental organizations, Women without Borders (WwB) and Hedayah, and their distinct PCVE initiatives. WwB adopts a gender-sensitive approach, implementing parental education programs that empower mothers in at-risk communities to prevent the spread of violent extremism. In contrast, Hedayah takes an indirect route, employing capacity building programs that enhance the capabilities of educators, social workers, and psychologists in early intervention, rehabilitation and reintegration efforts. Qualitative data for this comparative analysis was collected through an extensive four-month internship at WwB during the fall of 2020, a three-month internship at Hedayah in the spring of 2021, a thought-provoking semi-structured interview with the executive director of WwB, personal field notes, and a comprehensive discourse analysis of the prevailing literature on human rights considerations in PCVE practices. This study examines the merits and challenges of integrating human rights into PCVE programming through the lens of both organizations, WwB and Hedayah. The findings of this study will inform policymakers, practitioners, and researchers on the intricate relationship between human rights protection and effective PCVE strategies.

Keywords: preventing and countering violent extremism, human rights, counterterrorism, peacebuilding, capacity building programs, gender studies

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Authors: Manish Pandey, Gurinderjit Kaur, Meenu Talwar, Sachin Chauhan, Jagbir Gill

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Health-care management systems are a unit of nice connection as a result of the supply a straightforward and fast management of all aspects relating to a patient, not essentially medical. What is more, there are unit additional and additional cases of pathologies during which diagnosing and treatment may be solely allotted by victimization medical imaging techniques. With associate ever-increasing prevalence, medical pictures area unit directly acquired in or regenerate into digital type, for his or her storage additionally as sequent retrieval and process. Data Mining is the process of extracting information from large data sets through using algorithms and Techniques drawn from the field of Statistics, Machine Learning and Data Base Management Systems. Forecasting may be a prediction of what's going to occur within the future, associated it's an unsure method. Owing to the uncertainty, the accuracy of a forecast is as vital because the outcome foretold by foretelling the freelance variables. A forecast management should be wont to establish if the accuracy of the forecast is within satisfactory limits. Fuzzy regression strategies have normally been wont to develop shopper preferences models that correlate the engineering characteristics with shopper preferences relating to a replacement product; the patron preference models offer a platform, wherever by product developers will decide the engineering characteristics so as to satisfy shopper preferences before developing the merchandise. Recent analysis shows that these fuzzy regression strategies area units normally will not to model client preferences. We tend to propose a Testing the strength of Exponential Regression Model over regression toward the mean Model.

Keywords: health-care management systems, fuzzy regression, data mining, forecasting, fuzzy membership function

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Authors: Steven J. Singer, Julianna F. Kamenakis, Allison R. Shapiro, Kimberly M. Cacciato

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Communication and language are topics frequently studied among deaf children. However, there is limited research that focuses specifically on the communication and language experiences of Deaf-Disabled children. In this ethnography, researchers investigated the language experiences of six sets of parents with Deaf-Disabled children who chose American Sign Language (ASL) as the preferred mode of communication for their child. Specifically, the researchers were interested in the factors that influenced the parents’ decisions regarding their child’s communication options, educational placements, and social experiences. Data collection in this research included 18 hours of semi-structured interviews, 20 hours of participant observations, over 150 pages of reflexive journals and field notes, and a 2-hour focus group. The team conducted constant comparison qualitative analysis using NVivo software and an inductive coding procedure. The four researchers each read the data several times until they were able to chunk it into broad categories about communication and social influences. The team compared the various categories they developed, selecting ones that were consistent among researchers and redefining categories that differed. Continuing to use open inductive coding, the research team refined the categories until they were able to develop distinct themes. Two team members developed each theme through a process of independent coding, comparison, discussion, and resolution. The research team developed three themes: 1) early medical needs provided time for the parents to explore various communication options for their Deaf-Disabled child, 2) without intervention from medical professionals or educators, ASL emerged as a prioritized mode of communication for the family, 3) atypical gender roles affected familial communication dynamics. While managing the significant health issues of their Deaf-Disabled child at birth, families and medical professionals were so fixated on tending to the medical needs of the child that the typical pressures of determining a mode of communication were deprioritized. This allowed the families to meticulously research various methods of communication, resulting in an informed, rational, and well-considered decision to use ASL as the primary mode of communication with their Deaf-Disabled child. It was evident that having a Deaf-Disabled child meant an increased amount of labor and responsibilities for parents. This led to a shift in the roles of the family members. During the child’s development, the mother transformed from fulfilling the stereotypical roles of nurturer and administrator to that of administrator and champion. The mother facilitated medical proceedings and educational arrangements while the father became the caretaker and nurturer of their Deaf-Disabled child in addition to the traditional role of earning the family’s primary income. Ultimately, this research led to a deeper understanding of the critical role that time plays in parents’ decision-making process regarding communication methods with their Deaf-Disabled child.

Keywords: American Sign Language, deaf-disabled, ethnography, sociolinguistics

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Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister

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In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.

Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care

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Authors: Fernando Antonio Bacchim Neto, Allan Felipe Fattori Alves, Maria Eugênia Dela Rosa, Regina Moura, Diana Rodrigues De Pina

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Interventional Radiology is the radiology modality that provides the highest dose values to medical staff. Recent researches show that personal dosimeters may underestimate dose values in interventional physicians, especially in extremities (hands and feet) and eye lens. The aim of this work was to study radiation exposure levels of medical staff in different interventional radiology procedures and estimate the annual maximum numbers of procedures (AMN) that each physician could perform without exceed the annual limits of dose established by normative. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were positioned in different body regions of the interventional physician (eye lens, thyroid, chest, gonads, hand and foot) above the radiological protection vests as lead apron and thyroid shield. Attenuation values for lead protection vests were based on international guidelines. Based on these data were chosen as 90% attenuation of the lead vests and 60% attenuation of the protective glasses. 25 procedures were evaluated: 10 diagnostics, 10 angioplasty, and 5-aneurysm treatment. The AMN of diagnostic procedures was 641 for the primary interventional radiologist and 930 for the assisting interventional radiologist. For the angioplasty procedures, the AMN for primary interventional radiologist was 445 and for assisting interventional radiologist was 1202. As for the procedures of aneurism treatment, the AMN for the primary interventional radiologist was 113 and for the assisting interventional radiologist were 215. All AMN were limited by the eye lens doses already considering the use of protective glasses. In all categories evaluated, the higher dose values are found in gonads and in the lower regions of professionals, both for the primary interventionist and for the assisting, but the eyes lens dose limits are smaller than these regions. Additional protections as mobile barriers, which can be positioned between the interventionist and the patient, can decrease the exposures in the eye lens, providing a greater protection for the medical staff. The alternation of professionals to perform each type of procedure can reduce the dose values received by them over a period. The analysis of dose profiles proposed in this work showed that personal dosimeters positioned in chest might underestimate dose values in other body parts of the interventional physician, especially in extremities and eye lens. As each body region of the interventionist is subject to different levels of exposure, dose distribution in each region provides a better approach to what actions are necessary to ensure the radiological protection of medical staff.

Keywords: interventional radiology, radiation protection, occupationally exposed individual, hemodynamic

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Authors: Reena Aggarwal

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The use of textile chemicals in the various pre and post-textile manufacturing processes has made the textile industry conscious of its negative contribution to environmental pollution. Popular environmentally friendly fibers such as recycled polyester and organic cotton have been now increasingly used by fabrics and apparel manufacturers. However, after these textiles or the finished apparel are manufactured, they have to be dyed in the same chemical dyes that are harmful and toxic to the environment. Dyeing is a major area of concern for the environment as well as for people who have chemical sensitivities as it may cause nausea, breathing difficulties, seizures, etc. Ayurvastra or herbal medical textiles are one step ahead of the organic lifestyle, which supports the core concept of holistic well-being and also eliminates the impact of harmful chemicals and pesticides. There is a wide range of herbs that can be used not only for dyeing but also for providing medicinal properties to the textiles like antibacterial, antifungal, antiseptic, antidepressant and for treating insomnia, skin diseases, etc. The concept of herbal dyeing of fabric is to manifest herbal essence in every aspect of clothing, i.e., from production to end-use, additionally to eliminate the impact of harmful chemical dyes and chemicals which are known to result in problems like skin rashes, headache, trouble concentrating, nausea, diarrhea, fatigue, muscle and joint pain, dizziness, difficulty breathing, irregular heartbeat and seizures. Herbal dyeing or finishing on textiles will give an extra edge to the textiles as it adds an extra function to the fabric. The herbal extracts can be applied to the textiles by a simple process like the pad dry cure method and mainly acts on the human body through the skin for aiding in the treatment of disease or managing the medical condition through its herbal properties. This paper, therefore, delves into producing Ayurvastra, which is a perfect amalgamation of cloth and wellness. The aim of the paper is to design and create herbal disposable and non-disposable medical textile products acting mainly topically (through the skin) for providing medicinal properties/managing medical conditions. Keeping that in mind, a range of antifungal socks and antibacterial napkins treated with turmeric and aloe vera were developed, which are recommended for the treatment of fungal and bacterial infections, respectively. Both Herbal Antifungal socks and Antibacterial napkins have proved to be efficient enough in managing and treating fungal and bacterial infections of the skin, respectively.

Keywords: ayurvastra, ayurveda, herbal, pandemic, sustainable

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Authors: S. Jeyarajan

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Concept of knowledge is discovered from conducted study for successive Competition in Sri Lankan Non-State Higher Educational Institutes. The Concept discovered out of collected Knowledge Management Practices from Emerald inside likewise reputed literatures and of Non-State Higher Educational sector. A test is conducted to reveal existences and its reason behind of these collected practices in Sri Lankan Non-State Higher Education Institutes. Further, unavailability of such study and uncertain on number of participants for data collection in the Sri Lankan context contributed selection of research method as qualitative method, which used attributes of Delphi Method to manage those likewise uncertainty. Data are collected under Dramaturgical Method, which contributes efficient usage of the Delphi method. Grounded theory is selected as data analysis techniques, which is conducted in intermixed discourse to manage different perspectives of data that are collected systematically through perspective and modified snowball sampling techniques. Data are then analysed using Grounded Theory Development Techniques in Intermix discourses to manage differences in Data. Consequently, Agreement in the results of Grounded theories and of finding in the Foreign Study is discovered in the analysis whereas present study conducted as Qualitative Research and The Foreign Study conducted as Quantitative Research. As such, the Present study widens the discovery in the Foreign Study. Further, having discovered reason behind of the existences, the Present result shows Concept for Knowledge from Sri Lankan Non-State sector to manage higher educational Institutes in successful manner.

Keywords: adherence of snowball sampling into perspective sampling, Delphi method in qualitative method, grounded theory development in intermix discourses of analysis, knowledge management for success of higher educational institutes

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Authors: Seyed Ziya Tabatabaei, Azimi Bin Hj Hamzah, Fatemeh Ebrahimi

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The increase in proportion of older people in Malaysia has led to a significant growth of health care demands. The aim of this study is to explore how perceived health care needs influence on quality of life among elderly Malay residents who reside in a Malaysian residential home. This study employed a method known as ethnographic research from May 2011 to January 2012. Four data collection strategies were selected as the main data-collecting tools including participant observation, field notes, in-depth interviews, and review of related documents. The nine knowledgeable participants for the present study were selected using the purposive sampling method. Two themes were identified: (1) Medical concerns: Feeling secure, lack of information, inadequate medical staff; and (2) Health promotion: Body condition, health education, physiotherapy and rehabilitation. These results could evoke the attention of policy-makers and care providers to better meet elderly residents’ health care needs.

Keywords: ethnographic study, health care needs, Malay elderly people, Malaysia, Quality of life, Residential home

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Authors: Lewis Wallace, William Dempster, David Nash, Alexandros Boukis, Craig Maclean

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This paper, through traditional test methods and close adherence to international standards, presents a characterization study of a woven Polyethylene Terephthalate (PET). Testing is undergone in the axial, shear, and out-of-plane (bend) directions, and the results are fitted to the *FABRIC material model with ABAQUS FEA. The non-linear behaviors of the fabric in the axial and shear directions and behaviors on the macro scale are explored at the meso scale level. The medical grade bio-fabric is tested in untreated and heat-treated forms, and deviations are closely analyzed at the micro, meso, and macro scales to determine the effects of the process. The heat-treatment process was found to increase the stiffness of the fabric during axial and bending stiffness testing but had a negligible effect on the shear response. The ability of *FABRIC to capture behaviors unique to fabric deformation is discussed, whereby the unique phenomenological input can accurately represent the experimentally derived inputs.

Keywords: experimental techniques, FEA modelling, materials characterization, post-processing techniques

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