Search results for: Maya Lisa Aryanti
41 Revision of Arthroplasty in Rheumatoid and Osteoarthritis: Methotrexate and Radiographic Lucency in RA Patients
Authors: Mike T. Wei, Douglas N. Mintz, Lisa A. Mandl, Arielle W. Fein, Jayme C. Burket, Yuo-Yu Lee, Wei-Ti Huang, Vivian P. Bykerk, Mark P. Figgie, Edward F. Di Carlo, Bruce N. Cronstein, Susan M. Goodman
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Background/Purpose: Rheumatoid arthritis (RA) patients have excellent total hip arthroplasty (THA) survival, and methotrexate (MTX), an anti-inflammatory disease modifying drug which may affect bone reabsorption, may play a role. The purpose of this study is to determine the diagnosis leading to revision THA (rTHA) in RA patients and to assess the association of radiographic lucency with MTX use. Methods: All patients with validated diagnosis of RA in the institution’s THA registry undergoing rTHA from May 2007 - February 2011 were eligible. Diagnosis leading to rTHA and medication use was determined by chart review. Osteolysis was evaluated on available radiographs by measuring maximum lucency in each Gruen zone. Differences within RA patients with/without MTX in osteolysis, demographics, and medications were assessed with chi-squared, Fisher's exact tests or Mann-Whitney U tests as appropriate. The error rate for multiple comparisons of lucency in the different Gruen zones was corrected via false discovery rate methods. A secondary analysis was performed to determine differences in diagnoses leading to revision between RA and matched OA controls (2:1 match by sex age +/- 5 years). OA exclusion criteria included presence of rheumatic diseases, use of MTX, and lack of records. Results: 51 RA rTHA were identified and compared with 103 OA. Mean age for RA was 57.7 v 59.4 years for OA (p = 0.240). 82.4% RA were female v 83.5% OA (p = 0.859). RA had lower BMI than OA (25.5 v 28.2; p = 0.166). There was no difference in diagnosis leading to rTHA, including infection (RA 3.9 v OA 6.8%; p = 0.719) or dislocation (RA 23.5 v OA 23.3%; p = 0.975). There was no significant difference in the length of time the implant was in before revision: RA 11.0 v OA 8.8 years (p = 0.060). Among RA with/without MTX, there was no difference in use of biologics (30.0 v 43.3%, p = 0.283), steroids (47.6 v 50.0%, p = 0.867) or bisphosphonates (23.8 v 33.3%, p = 0.543). There was no difference in rTHA diagnosis with/without MTX, including loosening (52.4 v 56.7%, p = 0.762). There was no significant difference in lucencies with MTX use in any Gruen zone. Patients with MTX had femoral stem subsidence of 3.7mm v no subsidence without MTX (p = 0.006). Conclusion: There was no difference in the diagnosis leading to rTHR in RA and OA, although RA trended longer prior to rTHA. In this small retrospective study, there were no significant differences associated with MTX exposure or radiographic lucency among RA patients. The significance of subsidence is not clear. Further study of arthroplasty survival in RA patients is warranted.Keywords: hip arthroplasty, methotrexate, revision arthroplasty, rheumatoid arthritis
Procedia PDF Downloads 25040 Use of Telehealth for Facilitating the Diagnostic Assessment of Autism Spectrum Disorder: A Scoping Review
Authors: Manahil Alfuraydan, Jodie Croxall, Lisa Hurt, Mike Kerr, Sinead Brophy
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Autism Spectrum Disorder (ASD) is a developmental condition characterised by impairment in terms of social communication, social interaction, and a repetitive or restricted pattern of interest, behaviour, and activity. There is a significant delay between seeking help and a confirmed diagnosis of ASD. This may result in delay in receiving early intervention services, which are critical for positive outcomes. The long wait times also cause stress for the individuals and their families. Telehealth potentially offers a way of improving the diagnostic pathway for ASD. This review of the literature aims to examine which telehealth approaches have been used in the diagnosis and assessment of autism in children and adults, whether they are feasible and acceptable, and how they compare with face-to-face diagnosis and assessment methods. A comprehensive search of following databases- MEDLINE, CINAHL Plus with Full text, Business Sources Complete, Web of Science, Scopus, PsycINFO and trail and systematic review databases including Cochrane Library, Health Technology Assessment, Database of Abstracts and Reviews of Effectiveness and NHS Economic Evaluation was conducted, combining the terms of autism and telehealth from 2000 to 2018. A total of 10 studies were identified for inclusion in the review. This review of the literature found there to be two methods of using telehealth: (a) video conferencing to enable teams in different areas to consult with the families and to assess the child/adult in real time and (b) a video upload to a web portal that enables the clinical assessment of behaviours in the family home. The findings were positive, finding there to be high agreement in terms of the diagnosis between remote methods and face to face methods and with high levels of satisfaction among the families and clinicians. This field is in the very early stages, and so only studies with small sample size were identified, but the findings suggest that there is potential for telehealth methods to improve assessment and diagnosis of autism used in conjunction with existing methods, especially for those with clear autism traits and adults with autism. Larger randomised controlled trials of this technology are warranted.Keywords: assessment, autism spectrum disorder, diagnosis, telehealth
Procedia PDF Downloads 12939 Re-Examining the Distinction between Odour Nuisance and Health Impact: A Community’s Campaign against Landfill Gas Exposure in Shongweni, South Africa
Authors: Colin David La Grange, Lisa Frost Ramsay
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Hydrogen sulphide (H2S) is a minor component of landfill gas, but significant in its distinct odorous quality and its association with landfill-related community complaints. The World Health Organisation (WHO) provides two guidelines for H2S: a health guideline at 150 µg/m3 on a 24-hour average, and a nuisance guideline at 7 µg/m3 on a 30-minute average. Albeit a practical distinction for impact assessment, this paper highlights the danger of the apparent dualism between nuisance and health impact, particularly when it is used to dismiss community concerns of perceived health impacts at low concentrations of H2S, as in the case of a community battle against the impacts of a landfill in Shongweni, KwaZulu-Natal, South Africa. Here community members reported, using a community developed mobile phone application, a range of health symptoms that coincided with, or occurred subsequent to, odour events and localised H2S peaks. Local doctors also documented increased visits for symptoms of respiratory distress, eye and skin irritation, and stress after such odour events. Objectively measured H2S and other pollutant concentrations during these events, however, remained below WHO health guidelines. This case study highlights the importance of the physiological link between the experience of environmental nuisance and overall health and wellbeing, showing these to be less distinct than the WHO guidelines would suggest. The potential mechanisms of impact of an odorous plume, with key constituents at concentrations below traditional health thresholds, on psychologically and/or physiologically sensitised individuals are described. In the case of psychological sensitisation, previously documented mechanisms such as aversive conditioning and odour-triggered panic are relevant. Physiological sensitisation to environmental pollutants, evident as a seemingly disproportionate physical (allergy-type) response to either low concentrations or a short duration exposure of a toxin or toxins, remains extensively examined but still not well understood. The links between a heightened sensitivity to toxic compounds, accumulation of some compounds in the body, and a pre-existing or associated immunological stress disorder are presented as a possible explanation.Keywords: immunological stress disorder, landfill odour, odour nuisance, odour sensitisation, toxin accumulation
Procedia PDF Downloads 12138 Environmental Benefits of Corn Cob Ash in Lateritic Soil Cement Stabilization for Road Works in a Sub-Tropical Region
Authors: Ahmed O. Apampa, Yinusa A. Jimoh
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The potential economic viability and environmental benefits of using a biomass waste, such as corn cob ash (CCA) as pozzolan in stabilizing soils for road pavement construction in a sub-tropical region was investigated. Corn cob was obtained from Maya in South West Nigeria and processed to ash of characteristics similar to Class C Fly Ash pozzolan as specified in ASTM C618-12. This was then blended with ordinary Portland cement in the CCA:OPC ratios of 1:1, 1:2 and 2:1. Each of these blends was then mixed with lateritic soil of ASHTO classification A-2-6(3) in varying percentages from 0 – 7.5% at 1.5% intervals. The soil-CCA-Cement mixtures were thereafter tested for geotechnical index properties including the BS Proctor Compaction, California Bearing Ratio (CBR) and the Unconfined Compression Strength Test. The tests were repeated for soil-cement mix without any CCA blending. The cost of the binder inputs and optimal blends of CCA:OPC in the stabilized soil were thereafter analyzed by developing algorithms that relate the experimental data on strength parameters (Unconfined Compression Strength, UCS and California Bearing Ratio, CBR) with the bivariate independent variables CCA and OPC content, using Matlab R2011b. An optimization problem was then set up minimizing the cost of chemical stabilization of laterite with CCA and OPC, subject to the constraints of minimum strength specifications. The Evolutionary Engine as well as the Generalized Reduced Gradient option of the Solver of MS Excel 2010 were used separately on the cells to obtain the optimal blend of CCA:OPC. The optimal blend attaining the required strength of 1800 kN/m2 was determined for the 1:2 CCA:OPC as 5.4% mix (OPC content 3.6%) compared with 4.2% for the OPC only option; and as 6.2% mix for the 1:1 blend (OPC content 3%). The 2:1 blend did not attain the required strength, though over a 100% gain in UCS value was obtained over the control sample with 0% binder. Upon the fact that 0.97 tonne of CO2 is released for every tonne of cement used (OEE, 2001), the reduced OPC requirement to attain the same result indicates the possibility of reducing the net CO2 contribution of the construction industry to the environment ranging from 14 – 28.5% if CCA:OPC blends are widely used in soil stabilization, going by the results of this study. The paper concludes by recommending that Nigeria and other developing countries in the sub-tropics with abundant stock of biomass waste should look in the direction of intensifying the use of biomass waste as fuel and the derived ash for the production of pozzolans for road-works, thereby reducing overall green house gas emissions and in compliance with the objectives of the United Nations Framework on Climate Change.Keywords: corn cob ash, biomass waste, lateritic soil, unconfined compression strength, CO2 emission
Procedia PDF Downloads 37537 Use of Thrombolytics for Acute Myocardial Infarctions in Resource-Limited Settings, Globally: A Systematic Literature Review
Authors: Sara Zelman, Courtney Meyer, Hiren Patel, Lisa Philpotts, Sue Lahey, Thomas Burke
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Background: As the global burden of disease shifts from infectious diseases to noncommunicable diseases, there is growing urgency to provide treatment for time-sensitive illnesses, such as ST-Elevation Myocardial Infarctions (STEMIs). The standard of care for STEMIs in developed countries is Percutaneous Coronary Intervention (PCI). However, this is inaccessible in resource-limited settings. Before the discovery of PCI, Streptokinase (STK) and other thrombolytic drugs were first-line treatments for STEMIs. STK has been recognized as a cost-effective and safe treatment for STEMIs; however, in settings which lack access to PCI, it has not become the established second-line therapy. A systematic literature review was conducted to geographically map the use of STK for STEMIs in resource-limited settings. Methods: Our literature review group searched the databases Cinhal, Embase, Ovid, Pubmed, Web of Science, and WHO’s Index Medicus. The search terms included ‘thrombolytics’ AND ‘myocardial infarction’ AND ‘resource-limited’ and were restricted to human studies and papers written in English. A considerable number of studies came from Latin America; however, these studies were not written in English and were excluded. The initial search yielded 3,487 articles, which was reduced to 3,196 papers after titles were screened. Three medical professionals then screened abstracts, from which 291 articles were selected for full-text review and 94 papers were chosen for final inclusion. These articles were then analyzed and mapped geographically. Results: This systematic literature review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with 18 of 94 studies taking place in India. Furthermore, 13 studies occurred in Pakistan, followed by Iran (6), Sri Lanka (5), Brazil (4), China (4), and South Africa (4). Conclusion: Our systematic review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with the highest utilization occurring in India. This demonstrates that even though STK has high utility for STEMI treatment in resource-limited settings, it still has not become the standard of care. Future research should investigate the barriers preventing the establishment of STK use as second-line treatment after PCI.Keywords: cardiovascular disease, global health, resource-limited setting, ST-Elevation Myocardial Infarction, Streptokinase
Procedia PDF Downloads 14836 Immersed in Design: Using an Immersive Teaching Space to Visualize Design Solutions
Authors: Lisa Chandler, Alistair Ward
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A significant component of design pedagogy is the need to foster design thinking in various contexts and to support students in understanding links between educational exercises and their potential application in professional design practice. It is also important that educators provide opportunities for students to engage with new technologies and encourage them to imagine applying their design skills for a range of outcomes. Problem solving is central to design so it is also essential that students understand that there can be multiple solutions to a design brief, and are supported in undertaking creative experimentation to generate imaginative outcomes. This paper presents a case study examining some innovative approaches to addressing these elements of design pedagogy. It investigates the effectiveness of the Immerse Lab, a three wall projection room at the University of the Sunshine Coast, Australia, as a learning context for design practice, for generating ideas and for supporting learning involving the comparative display of design outcomes. The project required first year design students to create a simple graphic design derived from an ordinary object and to incorporate specific design criteria. Utilizing custom-designed software, the students’ solutions were projected together onto the Immerse walls to create a large-scale, immersive grid of images, which was used to compare and contrast various responses to the same problem. The software also enabled individual student designs to be transformed, multiplied and enlarged in multiple ways and prompted discussions around the applicability of the designs in real world contexts. Teams of students interacted with their projected designs, brainstorming imaginative applications for their outcomes. Analysis of 77 anonymous student surveys revealed that the majority of students found: learning in the Immerse Lab to be beneficial; comparative review more effective than in standard tutorial rooms; that the activity generated new ideas; it encouraged students to think differently about their designs; it inspired students to develop their existing designs or create new ones. The project demonstrates that curricula involving immersive spaces can be effective in supporting engaging and relevant design pedagogy and might be utilized in other disciplinary areas.Keywords: design pedagogy, immersive education, technology-enhanced learning, visualization
Procedia PDF Downloads 25935 Satellite Multispectral Remote Sensing of Ozone Pollution
Authors: Juan Cuesta
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Satellite observation is a fundamental component of air pollution monitoring systems, such as the large-scale Copernicus Programme. Next-generation satellite sensors, in orbit or programmed in the future, offer great potential to observe major air pollutants, such as tropospheric ozone, with unprecedented spatial and temporal coverage. However, satellite approaches developed for remote sensing of tropospheric ozone are based solely on measurements from a single instrument in a specific spectral range, either thermal infrared or ultraviolet. These methods offer sensitivity to tropospheric ozone located at the lowest at 3 or 4 km altitude above the surface, thus limiting their applications for ozone pollution analysis. Indeed, no current observation of a single spectral domain provides enough information to accurately measure ozone in the atmospheric boundary layer. To overcome this limitation, we have developed a multispectral synergism approach, called "IASI+GOME2", at the Laboratoire Interuniversitaire des Systèmes Atmosphériques (LISA) laboratory. This method is based on the synergy of thermal infrared and ultraviolet observations of respectively the Infrared Atmospheric Sounding Interferometer (IASI) and the Global Ozone Monitoring Experiment-2 (GOME-2) sensors embedded in MetOp satellites that have been in orbit since 2007. IASI+GOME2 allowed the first satellite observation of ozone plumes located between the surface and 3 km of altitude (what we call the lowermost troposphere), as it offers significant sensitivity in this layer. This represents a major advance for the observation of ozone in the lowermost troposphere and its application to air quality analysis. The ozone abundance derived by IASI+GOME2 shows a good agreement with respect to independent observations of ozone based on ozone sondes (a low mean bias, a linear correlation larger than 0.8 and a mean precision of about 16 %) around the world during all seasons. Using IASI+GOME2, lowermost tropospheric ozone pollution plumes are quantified both in terms of concentrations and also in the amounts of ozone photo-chemically produced along transport and also enabling the characterization of the ozone pollution, such as what occurred during the lockdowns linked to the COVID-19 pandemic. The current paper will show the IASI+GOME2 multispectral approach to observe the lowermost tropospheric ozone from space and an overview of several applications on different continents and at a global scale.Keywords: ozone pollution, multispectral synergism, satellite, air quality
Procedia PDF Downloads 8134 Design of a Low-Cost, Portable, Sensor Device for Longitudinal, At-Home Analysis of Gait and Balance
Authors: Claudia Norambuena, Myissa Weiss, Maria Ruiz Maya, Matthew Straley, Elijah Hammond, Benjamin Chesebrough, David Grow
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The purpose of this project is to develop a low-cost, portable sensor device that can be used at home for long-term analysis of gait and balance abnormalities. One area of particular concern involves the asymmetries in movement and balance that can accompany certain types of injuries and/or the associated devices used in the repair and rehabilitation process (e.g. the use of splints and casts) which can often increase chances of falls and additional injuries. This device has the capacity to monitor a patient during the rehabilitation process after injury or operation, increasing the patient’s access to healthcare while decreasing the number of visits to the patient’s clinician. The sensor device may thereby improve the quality of the patient’s care, particularly in rural areas where access to the clinician could be limited, while simultaneously decreasing the overall cost associated with the patient’s care. The device consists of nine interconnected accelerometer/ gyroscope/compass chips (9-DOF IMU, Adafruit, New York, NY). The sensors attach to and are used to determine the orientation and acceleration of the patient’s lower abdomen, C7 vertebra (lower neck), L1 vertebra (middle back), anterior side of each thigh and tibia, and dorsal side of each foot. In addition, pressure sensors are embedded in shoe inserts with one sensor (ESS301, Tekscan, Boston, MA) beneath the heel and three sensors (Interlink 402, Interlink Electronics, Westlake Village, CA) beneath the metatarsal bones of each foot. These sensors measure the distribution of the weight applied to each foot as well as stride duration. A small microntroller (Arduino Mega, Arduino, Ivrea, Italy) is used to collect data from these sensors in a CSV file. MATLAB is then used to analyze the data and output the hip, knee, ankle, and trunk angles projected on the sagittal plane. An open-source program Processing is then used to generate an animation of the patient’s gait. The accuracy of the sensors was validated through comparison to goniometric measurements (±2° error). The sensor device was also shown to have sufficient sensitivity to observe various gait abnormalities. Several patients used the sensor device, and the data collected from each represented the patient’s movements. Further, the sensors were found to have the ability to observe gait abnormalities caused by the addition of a small amount of weight (4.5 - 9.1 kg) to one side of the patient. The user-friendly interface and portability of the sensor device will help to construct a bridge between patients and their clinicians with fewer necessary inpatient visits.Keywords: biomedical sensing, gait analysis, outpatient, rehabilitation
Procedia PDF Downloads 28933 Site-based Internship Experiences: From Research to Implementation and Community Collaboration
Authors: Jamie Sundvall, Lisa Jennings
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Site based field internship learning (SBL) is an educational approach within a Master’s of Social Work (MSW) university field placement department that promotes a more streamlined approach to the integration of theory and evidence based practices for social work students. The SBL model is founded on research in the field, consideration of current work force needs, United States national trends of MSW graduate skill and knowledge deficits, educational trends in students pursing a master’s degree in social work, and current social problems that require unique problem solving skills. This study explores the use of site-based learning in a hybrid social work program. In this setting, site based learning pairs online education courses and social work field education to create training opportunities for social work students within their own community and cultural context. Students engage in coursework in an online setting with both synchronous and asynchronous features that facilitate development of core competencies for MSW students. Through the SBL model, students are then partnered with faculty in a virtual course room and a university vetted site within their community. The study explores how this model of learning creates community partnerships, through which students engage in a learning loop to develop social work skills, while preparing students to address current community, social, and global issues with the engagement of technology. The goal of SBL is to more effectively equip social work students for practice according to current workforce demands, provide access to education and care to populations who have limited access, and create self-sustainable partnerships. Further, the model helps students learn integration of evidence based practices and helps instructors more effectively teach integration of ethics into practice. The study found that the SBL model increases the influence and professional relevance of the social work profession, and ultimately facilitates stronger approaches to integrating theory into practice. Current implementation of the practice in the United States will be presented in the study. dditionally, future research conceptualization of SBL models will be presented, in order to collaborate on advancing best approaches of translating theory into practice, according to the current needs of the profession and needs of social work students.Keywords: collaboration, fieldwork, research, site-based learning, technology
Procedia PDF Downloads 12632 Other Cancers in Patients With Head and Neck Cancer
Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern
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Introduction: Head and neck cancers (HNC) are often associated with the development of non-HNC primaries, as the risk factors that predispose patients to HNC are often risk factors for other cancers. Aim: We sought to evaluate whether there was an increased risk of smoking and alcohol-related cancers and also other cancers in HNC patients and to evaluate whether there is a difference between the rates of non-HNC primaries in Aboriginal compared with non-Aboriginal HNC patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single center in Western Australia, identifying 80 Aboriginal and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, treatments, outcomes, and past and subsequent HNCs and non-HNC primaries. Results: In the overall study population, there were 86 patients (26.9%) with a metachronous or synchronous non-HNC primary. Non-HNC primaries were actually significantly more common in the non-Aboriginal population compared with the Aboriginal population (30% vs. 17.5%, p=0.02); however, half of these were patients with cutaneous squamous or basal cell carcinomas (cSCC/BCC) only. When cSCC/BCCs were excluded, non-Aboriginal patients had a similar rate as Aboriginal patients (16.7% vs. 15%, p=0.73). There were clearly more cSCC/BCCs in non-Aboriginal patients compared with Aboriginal patients (16.7% vs. 2.5%, p=0.001) and more patients with melanoma (2.5% vs. 0%, p value not significant (p=NS). Rates of most cancers were similar between non-Aboriginal and Aboriginal patients, including prostate (2.9% vs. 3.8%), colorectal (2.9% vs. 2.5%), kidney (1.2% vs. 1.2%), and these rates appeared comparable to Australian Age Standardised Incidence Rates (ASIR) in the general community. Oesophageal cancer occurred at double the rate in Aboriginal patients (3.8%) compared with non-Aboriginal patients (1.7%), which was far in excess of ASIRs which estimated a lifetime risk of 0.59% in the general population. Interestingly lung cancer rates did not appear to be significantly increased in our cohort, with 2.5% of Aboriginal patients and 3.3% of non-Aboriginal patients having lung cancer, which is in line with ASIRs which estimates a lifetime risk of 5% (by age 85yo). Interestingly the rate of Glioma in the non-Aboriginal population was higher than the ASIR, with 0.8% of non-Aboriginal patients developing Glioma, with Australian averages predicting a 0.6% lifetime risk in the general population. As these are small numbers, this finding may well be due to chance. Unsurprisingly, second HNCs occurred at an increased incidence in our cohort, in 12.5% of Aboriginal patients and 11.2% of non-Aboriginal patients, compared to an ASIR of 17 cases per 100,000 persons, estimating a lifetime risk of 1.70%. Conclusions: Overall, 26.9% of patients had a non-HNC primary. When cSCC/BCCs were excluded, Aboriginal and non-Aboriginal patients had similar rates of non-HNC primaries, although non-Aboriginal patients had a significantly higher rate of cSCC/BCCs. Aboriginal patients had double the rate of oesophageal primaries; however, this was not statistically significant, possibly due to small case numbers.Keywords: head and neck cancer, synchronous and metachronous primaries, other primaries, Aboriginal
Procedia PDF Downloads 7831 Internet-Delivered Cognitive Behaviour Therapy for Depression Comorbid with Diabetes: Preliminary Findings
Authors: Lisa Robins, Jill Newby, Kay Wilhelm, Therese Fletcher, Jessica Smith, Trevor Ma, Adam Finch, Lesley Campbell, Jerry Greenfield, Gavin Andrews
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Background:Depression treatment for people living with depression comorbid with diabetes is of critical importance for improving quality of life and diabetes self-management, however depression remains under-recognised and under-treated in this population. Cost—effective and accessible forms of depression treatment that can enhance the delivery of mental health services in routine diabetes care are needed. Provision of internet-delivered Cognitive Behaviour Therapy (iCBT) provides a promising way to deliver effective depression treatment to people with diabetes. Aims:To explore the outcomes of the clinician assisted iCBT program for people with comorbid Major Depressive Disorder (MDD) and diabetes compared to those who remain under usual care. The main hypotheses are that: (1) Participants in the treatment group would show a significant improvement on disorder specific measures (Patient Health Questionnaire; PHQ-9) relative to those in the control group; (2) Participants in the treatment group will show a decrease in diabetes-related distress relative to those in the control group. This study will also examine: (1) the effect of iCBT for MDD on disability (as measured by the SF-12 and SDS), general distress (as measured by the K10), (2) the feasibility of these treatments in terms of acceptability to diabetes patients and practicality for clinicians (as measured by the Credibility/Expectancy Questionnaire; CEQ). We hypothesise that associated disability, and general distress will reduce, and that patients with comorbid MDD and diabetes will rate the program as acceptable. Method:Recruit 100 people with MDD comorbid with diabetes (either Type 1 or Type 2), and randomly allocate to: iCBT (over 10 weeks) or treatment as usual (TAU) for 10 weeks, then iCBT. Measure pre- and post-intervention MDD severity, anxiety, diabetes-related distress, distress, disability, HbA1c, lifestyle, adherence, satisfaction with clinicians input and the treatment. Results:Preliminary results comparing MDD symptom levels, anxiety, diabetes-specific distress, distress, disability, HbA1c levels, and lifestyle factors from baseline to conclusion of treatment will be presented, as well as data on adherence to the lessons, homework downloads, satisfaction with the clinician's input and satisfaction with the mode of treatment generally.Keywords: cognitive behaviour therapy, depression, diabetes, internet
Procedia PDF Downloads 49130 Challenging Weak Central Coherence: An Exploration of Neurological Evidence from Visual Processing and Linguistic Studies in Autism Spectrum Disorder
Authors: Jessica Scher Lisa, Eric Shyman
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Autism spectrum disorder (ASD) is a neuro-developmental disorder that is characterized by persistent deficits in social communication and social interaction (i.e. deficits in social-emotional reciprocity, nonverbal communicative behaviors, and establishing/maintaining social relationships), as well as by the presence of repetitive behaviors and perseverative areas of interest (i.e. stereotyped or receptive motor movements, use of objects, or speech, rigidity, restricted interests, and hypo or hyperactivity to sensory input or unusual interest in sensory aspects of the environment). Additionally, diagnoses of ASD require the presentation of symptoms in the early developmental period, marked impairments in adaptive functioning, and a lack of explanation by general intellectual impairment or global developmental delay (although these conditions may be co-occurring). Over the past several decades, many theories have been developed in an effort to explain the root cause of ASD in terms of atypical central cognitive processes. The field of neuroscience is increasingly finding structural and functional differences between autistic and neurotypical individuals using neuro-imaging technology. One main area this research has focused upon is in visuospatial processing, with specific attention to the notion of ‘weak central coherence’ (WCC). This paper offers an analysis of findings from selected studies in order to explore research that challenges the ‘deficit’ characterization of a weak central coherence theory as opposed to a ‘superiority’ characterization of strong local coherence. The weak central coherence theory has long been both supported and refuted in the ASD literature and has most recently been increasingly challenged by advances in neuroscience. The selected studies lend evidence to the notion of amplified localized perception rather than deficient global perception. In other words, WCC may represent superiority in ‘local processing’ rather than a deficit in global processing. Additionally, the right hemisphere and the specific area of the extrastriate appear to be key in both the visual and lexicosemantic process. Overactivity in the striate region seems to suggest inaccuracy in semantic language, which lends itself to support for the link between the striate region and the atypical organization of the lexicosemantic system in ASD.Keywords: autism spectrum disorder, neurology, visual processing, weak coherence
Procedia PDF Downloads 12929 Experimental Recovery of Gold, Silver and Palladium from Electronic Wastes Using Ionic Liquids BmimHSO4 and BmimCl as Solvents
Authors: Lisa Shambare, Jean Mulopo, Sehliselo Ndlovu
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One of the major challenges of sustainable development is promoting an industry which is both ecologically durable and economically viable. This requires processes that are material and energy efficient whilst also being able to limit the production of waste and toxic effluents through effective methods of process synthesis and intensification. In South Africa and globally, both miniaturisation and technological advances have substantially increased the amount of electronic wastes (e-waste) generated annually. Vast amounts of e-waste are being generated yearly with only a minute quantity being recycled officially. The passion for electronic devices cannot ignore the scarcity and cost of mining the noble metal resources which contribute significantly to the efficiency of most electronic devices. It has hence become imperative especially in an African context that sustainable strategies which are environmentally friendly be developed for recycling of the noble metals from e-waste. This paper investigates the recovery of gold, silver and palladium from electronic wastes, which consists of a vast array of metals, using ionic liquids which have the potential of reducing the gaseous and aqueous emissions associated with existing hydrometallurgical and pyrometallurgical technologies while also maintaining the economy of the overall recycling scheme through solvent recovery. The ionic liquids 1-butyl-3-methyl imidazolium hydrogen sulphate (BmimHSO4) which behaves like a protic acid and was used in the present research for the selective leaching of gold and silver from e-waste. Different concentrations of the aqueous ionic liquid were used in the experiments ranging from 10% to 50%. Thiourea was used as the complexing agent in the investigation with Fe3+ as the oxidant. The pH of the reaction was maintained in the range of 0.8 to 1.5. The preliminary investigations conducted were successful in the leaching of silver and palladium at room temperature with optimum results being at 48hrs. The leaching results could not be explained because of the leaching of palladium with the absence of gold. Hence a conclusion could not be drawn and there was the need for further experiments to be run. The leaching of palladium was carried out with hydrogen peroxide as oxidant and 1-butyl-3-methyl imidazolium chloride (BmimCl) as the solvent. The experiments at carried out at a temperature of 60 degrees celsius and a very low pH. The chloride ion was used to complex with palladium metal. From the preliminary results, it could be concluded that pretreatment of the treatment e-waste was necessary to improve the efficiency of the metal recovery process. A conclusion could not be drawn for the leaching experiments.Keywords: BmimCl, BmimHSO4, gold, palladium, silver
Procedia PDF Downloads 29128 Enhancing African Students’ Learning Experience by Creating Multilingual Resources at a South African University of Technology
Authors: Lisa Graham, Kathleen Grant
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South Africa is a multicultural country with eleven official languages, yet most of the formal education at institutions of higher education in the country is in English. It is well known that many students, irrespective of their home language, struggle to grasp difficult scientific concepts and the same is true for students enrolled in the Extended Curriculum Programme at the Cape Peninsula University of Technology (CPUT), studying biomedical sciences. Today we are fortunate in that there is a plethora of resources available to students to research and better understand subject matter online. For example, the students often use YouTube videos to supplement the formal education provided in our course. Unfortunately, most of this material is presented in English. The rationale behind this project lies in that it is well documented that students think and grasp concepts easier in their home language and addresses the fact that the lingua franca of instruction in the field of biomedical science is English. A project aimed at addressing the lack of available resources in most of the South African languages is planned, where students studying Bachelor of Health Science in Medical Laboratory Science will collaborate with those studying Film and Video Technology to create educational videos, explaining scientific concepts in their home languages. These videos will then be published on our own YouTube channel, thereby making them accessible to fellow students, future students and anybody with interest in the subject. Research will be conducted to determine the benefit of the project as well as the published videos to the student community. It is suspected that the students engaged in making the videos will benefit in such a way as to gain further understanding of their course content, a broader appreciation of the discipline, an enhanced sense of civic responsibility, as well as greater respect for the different languages and cultures in our classes. Indeed, an increase in student engagement has been shown to play a central role in student success, and it is well noted that deeper learning and more innovative solutions take place in collaborative groups. We aim to make a meaningful contribution towards the production and repository of knowledge in multilingual teaching and learning for the benefit of the diverse student population and staff. This would strengthen language development, multilingualism, and multiculturalism at CPUT and empower and promote African languages as languages of science and education at CPUT, in other institutions of higher learning, and in South Africa as a whole.Keywords: educational videos, multiculturalism, multilingualism, student engagement
Procedia PDF Downloads 15727 Consumer Reactions to Hospitality Social Robots Across Cultures
Authors: Lisa C. Wan
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To address customers’ safety concerns, more and more hospitality companies are using service robots to provide contactless services. For many companies, the switch from human employees to service robots to lower the contagion risk during and after the pandemic may be permanent. The market size for hospitality service robots is estimated to reach US$3,083 million by 2030, registering a CAGR of 25.5% from 2021 to 2030. While service robots may effectively reduce interpersonal contacts and health risk, it also eliminates the social interactions desired by customers. A recent survey revealed that more than 60% of Americans feel lonely during the pandemic. People who are traveling can also feel isolated when they are at a hotel far away from home. It is therefore important for the hospitality companies to understand whether and how social robots can remedy deprived social connection not only due to a pandemic but also for a trip away from home in the post-pandemic future. This study complements extant hospitality literature regarding service robots by examining how service robots can forge social connections with customers. The service robots we are concerned with are those that can interact and communicate with humans; we broadly refer to them as social robots. We define a social robot as one that is equipped with interaction capabilities – it can either be one that directly interacts with the consumer or one through which the consumer can interact with other humans. Drawing on the theories of mind perception, we propose that service robots can foster social connectedness and increase the perception of social competence of the robot, but these effects will vary across cultures. By applying theories of mind perception and cultural dimension to the hospitality setting, this study shows that service robots that are equipped with social connection function will receive a more favorable evaluation from the consumers and enhance their intention to visit a hotel. The more favorable reaction to social robots is stronger for collectivists (i.e., Asians) than individualists (i.e., Westerners). To our knowledge, this is among the first studies to investigate the impact of culture on consumer reactions to social robots in the hospitality and tourism context. Moreover, this research extends the literature by examining whether people imbue non-human entities (i.e., telepresence social robots) with social competence. Because social robots that foster social connection with humans are still rare in hospitality and tourism, this aspect is an underexplored research area. Our study is the first to propose that, just like their human counterparts that possess relevant social skills, social robots’ interaction capabilities (e.g., telepresence robots) are used to infer social competence. More studies will be conducted to examine consumer reactions to humanoid (vs. non-humanoid) robot in the hospitality settings to generalize our research findings.Keywords: service robots, COVID-19, social connection, cultures
Procedia PDF Downloads 10326 Coping Strategies among Caregivers of Children with Autism Spectrum Disorders: A Cluster Analysis
Authors: Noor Ismael, Lisa Mische Lawson, Lauren Little, Murad Moqbel
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Background/Significance: Caregivers of children with Autism Spectrum Disorders (ASD) develop coping mechanisms to overcome daily challenges to successfully parent their child. There is variability in coping strategies used among caregivers of children with ASD. Capturing homogeneity among such variable groups may help elucidate targeted intervention approaches for caregivers of children with ASD. Study Purpose: This study aimed to identify groups of caregivers of children with ASD based on coping mechanisms, and to examine whether there are differences among these groups in terms of strain level. Methods: This study utilized a secondary data analysis, and included survey responses of 273 caregivers of children with ASD. Measures consisted of the COPE Inventory and the Caregiver Strain Questionnaire. Data analyses consisted of cluster analysis to group caregiver coping strategies, and analysis of variance to compare the caregiver coping groups on strain level. Results: Cluster analysis results showed four distinct groups with different combinations of coping strategies: Social-Supported/Planning (group one), Spontaneous/Reactive (group two), Self-Supporting/Reappraisal (group three), and Religious/Expressive (group four). Caregivers in group one (Social-Supported/Planning) demonstrated significantly higher levels than the remaining three groups in the use of the following coping strategies: planning, use of instrumental social support, and use of emotional social support, relative to the other three groups. Caregivers in group two (Spontaneous/Reactive) used less restraint relative to the other three groups, and less suppression of competing activities relative to the other three groups as coping strategies. Also, group two showed significantly lower levels of religious coping as compared to the other three groups. In contrast to group one, caregivers in group three (Self-Supporting/Reappraisal) demonstrated significantly lower levels of the use of instrumental social support and the use of emotional social support relative to the other three groups. Additionally, caregivers in group three showed more acceptance, positive reinterpretation and growth coping strategies. Caregivers in group four (Religious/Expressive) demonstrated significantly higher levels of religious coping relative to the other three groups and utilized more venting of emotions strategies. Analysis of Variance results showed no significant differences between the four groups on the strain scores. Conclusions: There are four distinct groups with different combinations of coping strategies: Social-Supported/Planning, Spontaneous/Reactive, Self-Supporting/Reappraisal, and Religious/Expressive. Each caregiver group engaged in a combination of coping strategies to overcome the strain of caregiving.Keywords: autism, caregivers, cluster analysis, coping strategies
Procedia PDF Downloads 28225 Queer Social Realism and Architecture in British Cinema: Tenement Housing, Unions and the Affective Body
Authors: Christopher Pullen
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This paper explores the significance of British cinema in the late 1950s and early 1960s as offering a renaissance of realist discourse, in the representation of everyday social issues. Offering a rejection of Hollywood cinema and the superficially of the middle classes, these ‘kitchen sink dramas’ often set within modest and sometimes squalid domestic and social environments, focused on the political struggle of the disenfranchised examining poverty, the oppressed and the outsider. While films like Look Back in Anger and Room at the Top looked primarily at male heterosexual subjectivity, films like A Taste of Honey and Victim focused on female and queer male narratives. Framing the urban landscape as a discursive architectural arena, representing basic living conditions and threatening social worlds, these iconic films established new storytelling processes for the outsider. This paper examines this historical context foregrounding the contemporary films Beautiful Thing (Hettie Macdonald, 1996), Weekend (Andrew Haigh, 2011) and Pride (Marcus Warchus, 2014), while employing the process of textual analysis in relation to theories of affect, defined by writers such as Lisa U. Marks and Sara Ahmed. Considering both romance narratives and public demonstrations of unity, where the queer ‘affective’ body is placed within architectural and social space, Beautiful Thing tells the story of gay male teenagers falling in love despite oppression from family and school, Weekend examines a one-night stand between young gay men and the unlikeliness of commitment, but the drive for sensitivity, and Pride foregrounds an historical relationship between queer youth activists and the miner’s union, who were on strike between 1984-5. These films frame the queer ‘affective’ body within politicized public space, evident in lower class men’s working clubs, tenement housing and brutal modernist tower blocks, focusing on architectural features such as windows, doorways and staircases, relating temporality, desire and change. Through such an examination a hidden history of gay male performativity is revealed, framing the potential of contemporary cinema to focus on the context of the outsider in encouraging social change.Keywords: queer, affect, cinema, architecture, life chances
Procedia PDF Downloads 36124 Development of an Ecological Binder by Geopolymerization of Untreated Dredged Sediments
Authors: Lisa Monteiro, Jacqueline Saliba, Nadia Saiyouri, Humberto Y. Godoy
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Theevolution of the global environmental context incites companies to reduce their impact by reusing local materials and promoting circular economy. Dredged sediments represent a potential source of materials due to their large volume. Indeed, the dredging operations carried out in Gironde alone generated an annual volume of sediment of approximately 9 million m³. Moreover, on the eve of the evolution of laws concerning dredging practices, the recovery of sediments is necessary to create a viable economy for their management. This thesis work is oriented towards the development of an ecological binder from the fine fraction of untreated dredged sediments. In fact, their physico-chemical properties make them favorable for the synthesis of geopolymer, current competitor of cement, thanks to its lower carbon footprint and environmental impact. However, several obstacles must be overcome before implementing this new family of materials: the use of sediments without thermal or chemical treatment, the absence of a formulation approach, ignorance of the reactions produced, etc. During the first year of the thesis, a physico-chemical characterization of the sediments made it possible to validate their use as precursors forgeopolymerization according to three criteria: their fineness, their mineralogical composition, and the percentage of amorphous phase. Following these results, several formulations have been defined, taking into account the environmental impact. The sediments were activated with an alkaline solution of sodium hydroxide and sodium silicate. Two other formulations with cement and blast furnace slag have been defined for comparison. The results highlighted the possibility of forming geopolymers from untreated and still wet dredged sediments. The development of structural bonds through the formation of hydrated sodium aluminosilicate thus leads to higher strengths at 90 days (4.78 MPa) than a mixture with cement (0.75 MPa). A 30% gain in CO₂ emissions has also been obtained compared to cement. In order to reduce the uncertainties linked to the absence of a formulation approach, to optimize the number of experiments to be carried out in the laboratory, and to obtain an optimal formulation, an analysis by mixing plan was conducted in order to frame the responses according to the proportions of the constituents. Following the obtaining of an optimal binder, the work will focus on the study of the durability and the interspecific variability of the sediments on the mechanical properties by testing the binder developed with different sediments dredged from the Bordeaux estuary. , the Grand Port Maritime of Bayonne, La Rochelle, and the Bassinsd'Arcachon.Keywords: compressive strength, dredged sediments, ecological binder, geopolymers
Procedia PDF Downloads 10023 On implementing Sumak Kawsay in Post Bellum Principles: The Reconstruction of Natural Damage in the Aftermath of War
Authors: Lisa Tragbar
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In post-war scenarios, reconstruction is a principle towards creating a Just Peace in order to restore a stable post-war society. Just peace theorists explore normative behaviour after war, including the duties and responsibilities of different actors and peacebuilding strategies to achieve a lasting, positive peace. Environmental peace ethicists have argued for including the role of nature in the Ethics of War and Peace. This text explores the question of why and how to rethink the value of nature in post-war scenarios. The aim is to include the rights of nature within a maximalist account of reconstruction by highlighting sumak kawsay in the post-war period. Destruction of nature is usually considered collateral damage in war scenarios. Common universal standards for post-war reconstruction are restitution, compensation and reparation programmes, which is mostly anthropocentric approach. The problem of reconstruction in the aftermath of war is the instrumental value of nature. The responsibility to rebuild needs to be revisited within a non-anthropocentric context. There is an ongoing debate about a minimalist or maximalist approach to post-war reconstruction. While Michael Walzer argues for minimalist in-and-out interventions, Alex Bellamy argues for maximalist strategies such as the responsibility to protect, a UN-concept on how face mass atrocity crimes and how to reconstruct peace. While supporting the tradition of maximalist responsibility to rebuild, these normative post-Bellum concepts do not yet sufficiently consider the rights of nature in the aftermath of war. While reconstruction of infrastructures seems important and necessary, concepts that strengthen the intrinsic value of nature in post-bellum measures must also be included. Peace is not Just Peace without a thriving nature that provides the conditions and resources to live and guarantee human rights. Ecuador's indigenous philosophy of life can contribute to the restoration of nature after war by changing the perspective on the value of nature. The sumak kawsay includes the de-hierarchisation of humans and nature and the principle of reciprocity towards nature. Transferring this idea of life and interconnectedness to post-war reconstruction practices, post bellum perpetrators have restorative obligations not only to people but also to nature. This maximalist approach would include both a restitutive principle, by restoring the balance between humans and nature, and a retributive principle, by punishing the perpetrators through compensatory duties to nature. A maximalist approach to post-war reconstruction that takes into account the rights of nature expands the normative post-war questions to include a more complex field of responsibilities. After a war, Just Peace is restored once not only human rights but also the rights of nature are secured. A minimalist post-bellum approach to reconstruction does not locate future problems at their source and does not offer a solution for the inclusion of obligations to nature. There is a lack of obligations towards nature after a war, which can be changed through a different perspective: The indigenous philosophy of life provides the necessary principles for a comprehensive reconstruction of Just Peace.Keywords: normative ethics, peace, post-war, sumak kawsay, applied ethics
Procedia PDF Downloads 7922 Assessment the Implications of Regional Transport and Local Emission Sources for Mitigating Particulate Matter in Thailand
Authors: Ruchirek Ratchaburi, W. Kevin. Hicks, Christopher S. Malley, Lisa D. Emberson
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Air pollution problems in Thailand have improved over the last few decades, but in some areas, concentrations of coarse particulate matter (PM₁₀) are above health and regulatory guidelines. It is, therefore, useful to investigate how PM₁₀ varies across Thailand, what conditions cause this variation, and how could PM₁₀ concentrations be reduced. This research uses data collected by the Thailand Pollution Control Department (PCD) from 17 monitoring sites, located across 12 provinces, and obtained between 2011 and 2015 to assess PM₁₀ concentrations and the conditions that lead to different levels of pollution. This is achieved through exploration of air mass pathways using trajectory analysis, used in conjunction with the monitoring data, to understand the contribution of different months, an hour of the day and source regions to annual PM₁₀ concentrations in Thailand. A focus is placed on locations that exceed the national standard for the protection of human health. The analysis shows how this approach can be used to explore the influence of biomass burning on annual average PM₁₀ concentration and the difference in air pollution conditions between Northern and Southern Thailand. The results demonstrate the substantial contribution that open biomass burning from agriculture and forest fires in Thailand and neighboring countries make annual average PM₁₀ concentrations. The analysis of PM₁₀ measurements at monitoring sites in Northern Thailand show that in general, high concentrations tend to occur in March and that these particularly high monthly concentrations make a substantial contribution to the overall annual average concentration. In 2011, a > 75% reduction in the extent of biomass burning in Northern Thailand and in neighboring countries resulted in a substantial reduction not only in the magnitude and frequency of peak PM₁₀ concentrations but also in annual average PM₁₀ concentrations at sites across Northern Thailand. In Southern Thailand, the annual average PM₁₀ concentrations for individual years between 2011 and 2015 did not exceed the human health standard at any site. The highest peak concentrations in Southern Thailand were much lower than for Northern Thailand for all sites. The peak concentrations at sites in Southern Thailand generally occurred between June and October and were associated with air mass back trajectories that spent a substantial proportion of time over the sea, Indonesia, Malaysia, and Thailand prior to arrival at the monitoring sites. The results show that emissions reductions from biomass burning and forest fires require action on national and international scales, in both Thailand and neighboring countries, such action could contribute to ensuring compliance with Thailand air quality standards.Keywords: annual average concentration, long-range transport, open biomass burning, particulate matter
Procedia PDF Downloads 18421 Road Map to Health: Palestinian Workers in Israel's Construction Sector
Authors: Maya de Vries Kedem, Abir Jubran, Diana Baron
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Employment in Israel offers Palestinian workers an income double what they can earn in the West Bank. The need to support their families leads many educated Palestinians to forgo finding work in their profession in the Palestinian Authority and instead look for employment in those sectors open to them in Israel, particularly the construction, agriculture, and industry sectors. The International Labor Organization estimated that about 1,200 workers in Israel die every year because of occupational diseases (diseases caused by working conditions). Construction workers in Israel are constantly exposed to dust, noise, chemical materials, and work in awkward postures, which require prolonged bending, repetitive motion, and other risk factors that can lead to illnesses and death. Occupational health is vastly neglected in Israel and construction workers are particularly at risk . As of June 2022, the Israeli quota in the construction sector for Palestinian workers stood at 80,000. Kav LaOved released a new study on the state of occupational health among Palestinian workers employed in construction in Israel. The study Roadmap to Health: Palestinian Workers in Israel's Construction Sector reviews the extent to which the health of Palestinian workers is protected at work in Israel. The report includes analysis of a survey administered to 256 workers as well as interviews with 10 workers and with 5 Israeli occupational health experts. Report highlights: • Among survey respondents, 63.9% stated that safety procedures to protect their health are rarely followed in their workplace (e.g., taking breaks, using protective gear, following restrictions on lifting heavy items, and having inspectors regularly on site to monitor safety). • All 256 Palestinian workers who participated to the survey said that their health has been directly or indirectly harmed by working in Israel and reported suffering from the following problems: orthopedic problems such as joint, hand, leg or knee problems (100%); headaches (75%); back problems (36.3%); eye problems (23.8%); breathing problems (17.6%); chronic pain (14.8%); heart problems (7.8%); and skin problems (3.5%). • Workers who are injured or do not feel well often continue working for fear of losing their payment for that day. About half of the 256 survey respondents reported that they pay brokerage fees to find an employer with a work permit, often paying between 2,000 and 3,000 NIS per month. “I have an obligation—I pay about NIS 120 a day for my permit, [and] I have to pay for it whether I work or not" a worker said. • Most Palestinian construction workers suffer from stress and mental health problems. Workers pointed to several issues that greatly affect their mood and mental state: daily crossings at crowded checkpoints where workers stand for hours; lack of sleep due to leaving home daily at 3:00-3:30 am; commuting two to four hours to work in each direction; and abusive work environments. A worker told KLO that the sight of thousands of workers standing together at the checkpoint causes “high blood pressure and the feeling that you are going to be squeezed.” Another said, “I felt that my bones would break.” In the survey workers reported suffering from insomnia (70.1%), breathing difficulties (35.8%), chest pressure (27.6%), or rapid pulse rate (12.2%).Keywords: construction sector, palestinian workers, occupational health, Israel, occupation
Procedia PDF Downloads 8920 Frequency of Tube Feeding in Aboriginal and Non-aboriginal Head and Neck Cancer Patients and the Impact on Relapse and Survival Outcomes
Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern
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Introduction: Head and neck cancer and treatments are known for their profound effect on nutrition and tube feeding is a common requirement to maintain nutrition. Aim: We aimed to evaluate the frequency of tube feeding in Aboriginal and non-Aboriginal patients, and to examine the relapse and survival outcomes in patients who require enteral tube feeding. Methods: We performed a retrospective cohort analysis of 320 head and neck cancer patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. Data collected included patient demographics, tumour features, treatment details, and cancer and survival outcomes. Results: Aboriginal and non-Aboriginal patients required feeding tubes at similar rates (42.5% vs 46.2% respectively), however Aboriginal patients were far more likely to fail to return to oral nutrition, with 26.3% requiring long-term tube feeding versus only 15% of non-Aboriginal patients. In the overall study population, 27.5% required short-term tube feeding, 17.8% required long-term enteral tube nutrition, and 45.3% of patients did not have a feeding tube at any point. Relapse was more common in patients who required tube feeding, with relapses in 42.1% of the patients requiring long-term tube feeding, 31.8% in those requiring a short-term tube, versus 18.9% in the ‘no tube’ group. Survival outcomes for patients who required a long-term tube were also significantly poorer when compared to patients who only required a short-term tube, or not at all. Long-term tube-requiring patients were half as likely to survive (29.8%) compared to patients requiring a short-term tube (62.5%) or no tube at all (63.5%). Patients requiring a long-term tube were twice as likely to die with active disease (59.6%) as patients with no tube (28%), or a short term tube (33%). This may suggest an increased relapse risk in patients who require long-term feeding, due to consequences of malnutrition on cancer and treatment outcomes, although may simply reflect that patients with recurrent disease were more likely to have longer-term swallowing dysfunction due to recurrent disease and salvage treatments. Interestingly long-term tube patients were also more likely to die with no active disease (10.5%) (compared with short-term tube requiring patients (4.6%), or patients with no tube (8%)), which is likely reflective of the increased mortality associated with long-term aspiration and malnutrition issues. Conclusions: Requirement for tube feeding was associated with a higher rate of cancer relapse, and in particular, long-term tube feeding was associated with a higher likelihood of dying from head and neck cancer, but also a higher risk of dying from other causes without cancer relapse. This data reflects the complex effect of head and neck cancer and its treatments on swallowing and nutrition, and ultimately, the effects of malnutrition, swallowing dysfunction, and aspiration on overall cancer and survival outcomes. Tube feeding was seen at similar rates in Aboriginal and non-Aboriginal patient, however failure to return to oral intake with a requirement for a long-term feeding tube was seen far more commonly in the Aboriginal population.Keywords: head and neck cancer, enteral tube feeding, malnutrition, survival, relapse, aboriginal patients
Procedia PDF Downloads 10319 Swedish Police Officers' Experiences of Meeting with Women Who Were Raped
Authors: Lisa Rudolfsson
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Socio-cognitive factors, such as social support and attribution of blame, influence the victim’s psychological adjustment after the abuse. Furthermore, the response from the person that the victim first confides to effect adjustment following the abuse. In Sweden, although police are investigating most of the reported cases of rape, very few rape-cases leads to trial and sentence. For many women who have been raped, contact with the police officer when reporting the crime will, therefore, be the most notable experience of how representatives for the Swedish society regard and handle what has happened. Hence, it seems urgent to gather information about these initial meetings. This study is part of a three-year research project, titled 'Female rape victims: Quality of initial police and medical care contact', funded by the Swedish Crime Victim and Support Authority. The focus of this study was on police officers in Sweden: their thoughts and experiences of meeting with raped women. Forthcoming are interviews with raped women about their experiences of meeting with police. Sixteen police officers participated in three focus groups and one interview. The participants consisted of five men and eleven women. Focus groups and interview were audio recorded and transcribed verbatim. The material was analyzed using thematic analysis. Participants described how violence against women was not a priority in Swedish society or within the Police Authority. They talked about rape cases as a Sisyphean work-task that put high demands on them, while they also lacked training and support. They expressed a wish to offer the woman some kind of restoration, and they talked about their work as potentially making a difference for the woman – even if she did not get juridical justice. However, participants also described that they did not feel validated in their hard work. They talked about working rape cases as causing them a great deal of frustration - directed towards the Police Authority, the juridical system, colleagues, and sometimes towards the woman. Participants also described how meeting with raped women was a work that affected them in a personal manner. Listening to stories about sexual violence made the participants sad, and they described it as a struggle to understand. They described wondering how the woman’s life turned out and how they sometimes questioned if they had done enough. Some of the conclusions concern the lack of prerequisites needed for police officers to be able to offer a good-enough treatment of raped women, as well as the lack of tools needed for police officers to care for themselves. In lack of training, validation, and support, the knowledge of how to offer a good- enough treatment of raped women becomes a task learned by doing. Attempts to offer, if not legal justice, then at least some kind of restoration becomes a personal task, dependent on individual police officers. It seems urgent that we address the risk of police officers’ frustration building up to be detrimental for both the crime victim and the officer her/himself.Keywords: focus groups, police, raped women, restoration
Procedia PDF Downloads 12318 Teachers’ Instructional Decisions When Teaching Geometric Transformations
Authors: Lisa Kasmer
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Teachers’ instructional decisions shape the structure and content of mathematics lessons and influence the mathematics that students are given the opportunity to learn. Therefore, it is important to better understand how teachers make instructional decisions and thus find new ways to help practicing and future teachers give their students a more effective and robust learning experience. Understanding the relationship between teachers’ instructional decisions and their goals, resources, and orientations (beliefs) is important given the heightened focus on geometric transformations in the middle school mathematics curriculum. This work is significant as the development and support of current and future teachers need more effective ways to teach geometry to their students. The following research questions frame this study: (1) As middle school mathematics teachers plan and enact instruction related to teaching transformations, what thinking processes do they engage in to make decisions about teaching transformations with or without a coordinate system and (2) How do the goals, resources and orientations of these teachers impact their instructional decisions and reveal about their understanding of teaching transformations? Teachers and students alike struggle with understanding transformations; many teachers skip or hurriedly teach transformations at the end of the school year. However, transformations are an important mathematical topic as this topic supports students’ understanding of geometric and spatial reasoning. Geometric transformations are a foundational concept in mathematics, not only for understanding congruence and similarity but for proofs, algebraic functions, and calculus etc. Geometric transformations also underpin the secondary mathematics curriculum, as features of transformations transfer to other areas of mathematics. Teachers’ instructional decisions in terms of goals, orientations, and resources that support these instructional decisions were analyzed using open-coding. Open-coding is recognized as an initial first step in qualitative analysis, where comparisons are made, and preliminary categories are considered. Initial codes and categories from current research on teachers’ thinking processes that are related to the decisions they make while planning and reflecting on the lessons were also noted. Surfacing ideas and additional themes common across teachers while seeking patterns, were compared and analyzed. Finally, attributes of teachers’ goals, orientations and resources were identified in order to begin to build a picture of the reasoning behind their instructional decisions. These categories became the basis for the organization and conceptualization of the data. Preliminary results suggest that teachers often rely on their own orientations about teaching geometric transformations. These beliefs are underpinned by the teachers’ own mathematical knowledge related to teaching transformations. When a teacher does not have a robust understanding of transformations, they are limited by this lack of knowledge. These shortcomings impact students’ opportunities to learn, and thus disadvantage their own understanding of transformations. Teachers’ goals are also limited by their paucity of knowledge regarding transformations, as these goals do not fully represent the range of comprehension a teacher needs to teach this topic well.Keywords: coordinate plane, geometric transformations, instructional decisions, middle school mathematics
Procedia PDF Downloads 8917 Evaluating Energy Transition of a complex of buildings in a historic site of Rome toward Zero-Emissions for a Sustainable Future
Authors: Silvia Di Turi, Nicolandrea Calabrese, Francesca Caffari, Giulia Centi, Francesca Margiotta, Giovanni Murano, Laura Ronchetti, Paolo Signoretti, Lisa Volpe, Domenico Palladino
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Recent European policies have been set ambitious targets aimed at significantly reducing CO2 emissions by 2030, with a long-term vision of transforming existing buildings into Zero-Emissions Buildings (ZEmB) by 2050. This vision represents a key point for the energy transition as the whole building stock currently accounts for 36% of total energy consumption across the Europe, mainly due to their poor energy performance. The challenge towards Zero-Emissions Buildings is particularly felt in Italy, where a significant number of buildings with historical significance or situated within protected/constrained areas can be found. Furthermore, an estimated 70% of the national building stock are built before 1976, indicating a widespread issue of poor energy performance. Addressing the energy ineƯiciency of these buildings is crucial to refining a comprehensive energy renovation approach aimed at facilitating their energy transition. In this framework the current study focuses on analysing a challenging complex of buildings to be totally restored through significant energy renovation interventions. The goal is to recover these disused buildings situated in a significant archaeological zone of Rome, contributing to the restoration and reintegration of this historically valuable site, while also oƯering insights useful for achieving zeroemission requirements for buildings within such contexts. In pursuit of meeting the stringent zero-emission requirements, a comprehensive study was carried out to assess the complex of buildings, envisioning substantial renovation measures on building envelope and plant systems and incorporating renewable energy system solutions, always respecting and preserving the historic site. An energy audit of the complex of buildings was performed to define the actual energy consumption for each energy service by adopting the hourly calculation methods. Subsequently, significant energy renovation interventions on both building envelope and mechanical systems have been examined respecting the historical value and preservation of site. These retrofit strategies have been investigated with threefold aims: 1) to recover the existing buildings ensuring the energy eƯiciency of the whole complex of buildings, 2) to explore which solutions have allowed achieving and facilitating the ZEmB status, 3) to balance the energy transition requirements with the sustainable aspect in order to preserve the historic value of the buildings and site. This study has pointed out the potentiality and the technical challenges associated with implementing renovation solutions for such buildings, representing one of the first attempt towards realizing this ambitious target for this type of building.Keywords: energy conservation and transition, complex of buildings in historic site, zero-emission buildings, energy efficiency recovery
Procedia PDF Downloads 7716 Barriers to Business Model Innovation in the Agri-Food Industry
Authors: Pia Ulvenblad, Henrik Barth, Jennie Cederholm BjöRklund, Maya Hoveskog, Per-Ola Ulvenblad
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The importance of business model innovation (BMI) is widely recognized. This is also valid for firms in the agri-food industry, closely connected to global challenges. Worldwide food production will have to increase 70% by 2050 and the United Nations’ sustainable development goals prioritize research and innovation on food security and sustainable agriculture. The firms of the agri-food industry have opportunities to increase their competitive advantage through BMI. However, the process of BMI is complex and the implementation of new business models is associated with high degree of risk and failure. Thus, managers from all industries and scholars need to better understand how to address this complexity. Therefore, the research presented in this paper (i) explores different categories of barriers in research literature on business models in the agri-food industry, and (ii) illustrates categories of barriers with empirical cases. This study is addressing the rather limited understanding on barriers for BMI in the agri-food industry, through a systematic literature review (SLR) of 570 peer-reviewed journal articles that contained a combination of ‘BM’ or ‘BMI’ with agriculture-related and food-related terms (e.g. ‘agri-food sector’) published in the period 1990-2014. The study classifies the barriers in several categories and illustrates the identified barriers with ten empirical cases. Findings from the literature review show that barriers are mainly identified as outcomes. It can be assumed that a perceived barrier to growth can often be initially exaggerated or underestimated before being challenged by appropriate measures or courses of action. What may be considered by the public mind to be a barrier could in reality be very different from an actual barrier that needs to be challenged. One way of addressing barriers to growth is to define barriers according to their origin (internal/external) and nature (tangible/intangible). The framework encompasses barriers related to the firm (internal addressing in-house conditions) or to the industrial or national levels (external addressing environmental conditions). Tangible barriers can include asset shortages in the area of equipment or facilities, while human resources deficiencies or negative willingness towards growth are examples of intangible barriers. Our findings are consistent with previous research on barriers for BMI that has identified human factors barriers (individuals’ attitudes, histories, etc.); contextual barriers related to company and industry settings; and more abstract barriers (government regulations, value chain position, and weather). However, human factor barriers – and opportunities - related to family-owned businesses with idealistic values and attitudes and owning the real estate where the business is situated, are more frequent in the agri-food industry than other industries. This paper contributes by generating a classification of the barriers for BMI as well as illustrating them with empirical cases. We argue that internal barriers such as human factors barriers; values and attitudes are crucial to overcome in order to develop BMI. However, they can be as hard to overcome as for example institutional barriers such as governments’ regulations. Implications for research and practice are to focus on cognitive barriers and to develop the BMI capability of the owners and managers of agri-industry firms.Keywords: agri-food, barriers, business model, innovation
Procedia PDF Downloads 23615 Integrating Multiple Types of Value in Natural Capital Accounting Systems: Environmental Value Functions
Authors: Pirta Palola, Richard Bailey, Lisa Wedding
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Societies and economies worldwide fundamentally depend on natural capital. Alarmingly, natural capital assets are quickly depreciating, posing an existential challenge for humanity. The development of robust natural capital accounting systems is essential for transitioning towards sustainable economic systems and ensuring sound management of capital assets. However, the accurate, equitable and comprehensive estimation of natural capital asset stocks and their accounting values still faces multiple challenges. In particular, the representation of socio-cultural values held by groups or communities has arguably been limited, as to date, the valuation of natural capital assets has primarily been based on monetary valuation methods and assumptions of individual rationality. People relate to and value the natural environment in multiple ways, and no single valuation method can provide a sufficiently comprehensive image of the range of values associated with the environment. Indeed, calls have been made to improve the representation of multiple types of value (instrumental, intrinsic, and relational) and diverse ontological and epistemological perspectives in environmental valuation. This study addresses this need by establishing a novel valuation framework, Environmental Value Functions (EVF), that allows for the integration of multiple types of value in natural capital accounting systems. The EVF framework is based on the estimation and application of value functions, each of which describes the relationship between the value and quantity (or quality) of an ecosystem component of interest. In this framework, values are estimated in terms of change relative to the current level instead of calculating absolute values. Furthermore, EVF was developed to also support non-marginalist conceptualizations of value: it is likely that some environmental values cannot be conceptualized in terms of marginal changes. For example, ecological resilience value may, in some cases, be best understood as a binary: it either exists (1) or is lost (0). In such cases, a logistic value function may be used as the discriminator. Uncertainty in the value function parameterization can be considered through, for example, Monte Carlo sampling analysis. The use of EVF is illustrated with two conceptual examples. For the first time, EVF offers a clear framework and concrete methodology for the representation of multiple types of value in natural capital accounting systems, simultaneously enabling 1) the complementary use and integration of multiple valuation methods (monetary and non-monetary); 2) the synthesis of information from diverse knowledge systems; 3) the recognition of value incommensurability; 4) marginalist and non-marginalist value analysis. Furthermore, with this advancement, the coupling of EVF and ecosystem modeling can offer novel insights to the study of spatial-temporal dynamics in natural capital asset values. For example, value time series can be produced, allowing for the prediction and analysis of volatility, long-term trends, and temporal trade-offs. This approach can provide essential information to help guide the transition to a sustainable economy.Keywords: economics of biodiversity, environmental valuation, natural capital, value function
Procedia PDF Downloads 19414 Integrating High-Performance Transport Modes into Transport Networks: A Multidimensional Impact Analysis
Authors: Sarah Pfoser, Lisa-Maria Putz, Thomas Berger
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In the EU, the transport sector accounts for roughly one fourth of the total greenhouse gas emissions. In fact, the transport sector is one of the main contributors of greenhouse gas emissions. Climate protection targets aim to reduce the negative effects of greenhouse gas emissions (e.g. climate change, global warming) worldwide. Achieving a modal shift to foster environmentally friendly modes of transport such as rail and inland waterways is an important strategy to fulfill the climate protection targets. The present paper goes beyond these conventional transport modes and reflects upon currently emerging high-performance transport modes that yield the potential of complementing future transport systems in an efficient way. It will be defined which properties describe high-performance transport modes, which types of technology are included and what is their potential to contribute to a sustainable future transport network. The first step of this paper is to compile state-of-the-art information about high-performance transport modes to find out which technologies are currently emerging. A multidimensional impact analysis will be conducted afterwards to evaluate which of the technologies is most promising. This analysis will be performed from a spatial, social, economic and environmental perspective. Frequently used instruments such as cost-benefit analysis and SWOT analysis will be applied for the multidimensional assessment. The estimations for the analysis will be derived based on desktop research and discussions in an interdisciplinary team of researchers. For the purpose of this work, high-performance transport modes are characterized as transport modes with very fast and very high throughput connections that could act as efficient extension to the existing transport network. The recently proposed hyperloop system represents a potential high-performance transport mode which might be an innovative supplement for the current transport networks. The idea of hyperloops is that persons and freight are shipped in a tube at more than airline speed. Another innovative technology consists in drones for freight transport. Amazon already tests drones for their parcel shipments, they aim for delivery times of 30 minutes. Drones can, therefore, be considered as high-performance transport modes as well. The Trans-European Transport Networks program (TEN-T) addresses the expansion of transport grids in Europe and also includes high speed rail connections to better connect important European cities. These services should increase competitiveness of rail and are intended to replace aviation, which is known to be a polluting transport mode. In this sense, the integration of high-performance transport modes as described above facilitates the objectives of the TEN-T program. The results of the multidimensional impact analysis will reveal potential future effects of the integration of high-performance modes into transport networks. Building on that, a recommendation on the following (research) steps can be given which are necessary to ensure the most efficient implementation and integration processes.Keywords: drones, future transport networks, high performance transport modes, hyperloops, impact analysis
Procedia PDF Downloads 33313 The Burmese Exodus of 1942: Towards Evolving Policy Protocols for a Refugee Archive
Authors: Vinod Balakrishnan, Chrisalice Ela Joseph
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The Burmese Exodus of 1942, which left more than 4 lakh as refugees and thousands dead, is one of the worst forced migrations in recorded history. Adding to the woes of the refugees is the lack of credible documentation of their lived experiences, trauma, and stories and their erasure from recorded history. Media reports, national records, and mainstream narratives that have registered the exodus provide sanitized versions which have reduced the refugees to a nameless, faceless mass of travelers and obliterated their lived experiences, trauma, and sufferings. This attitudinal problem compels the need to stem the insensitivity that accompanies institutional memory by making a case for a more humanistically evolved policy that puts in place protocols for the way the humanities would voice the concern for the refugee. A definite step in this direction and a far more relevant project in our times is the need to build a comprehensive refugee archive that can be a repository of the refugee experiences and perspectives. The paper draws on Hannah Arendt’s position on the Jewish refugee crisis, Agamben’s work on statelessness and citizenship, Foucault’s notion of governmentality and biopolitics, Edward Said’s concepts on Exile, Fanon’s work on the dispossessed, Derrida’s work on ‘the foreigner and hospitality’ in order to conceptualize the refugee condition which will form the theoretical framework for the paper. It also refers to the existing scholarship in the field of refugee studies such as Roger Zetter’s work on the ‘refugee label’, Philip Marfleet’s work on ‘refugees and history’, Lisa Malkki’s research on the anthropological discourse of the refugee and refugee studies. The paper is also informed by the work that has been done by the international organizations to address the refugee crisis. The emphasis is on building a strong argument for the establishment of the refugee archive that finds but a passing and a none too convincing reference in refugee studies in order to enable a multi-dimensional understanding of the refugee crisis. Some of the old questions cannot be dismissed as outdated as the continuing travails of the refugees in different parts of the world only remind us that they are still, largely, unanswered. The questions are -What is the nature of a Refugee Archive? How is it different from the existing historical and political archives? What are the implications of the refugee archive? What is its contribution to refugee studies? The paper draws on Diana Taylor’s concept of the archive and the repertoire to theorize the refugee archive as a repository that has the documentary function of the ‘archive’ and the ‘agency’ function of the repertoire. It then reads Ayya’s Accounts- a memoir by Anand Pandian -in the light of Hannah Arendt’s concepts of the ‘refugee as vanguard’ and ‘story telling as political action’- to illustrate how the memoir contributes to the refugee archive that provides the refugee a place and agency in history. The paper argues for a refugee archive that has implications for the formulation of inclusive refugee policies.Keywords: Ayya’s Accounts, Burmese Exodus, policy protocol, refugee archive
Procedia PDF Downloads 14112 Emphasizing Sumak Kawsay in Peace Ethics
Authors: Lisa Tragbar
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Since the Rio declaration, the agreement resulting from the Earth Summit in 1992, the UN member states acknowledge that peace and environmental protection are deeply linked to each other. It has also been made clear by Contemporary Peace research since the early 2000 that the lack of natural resources increases conflicts, as well as potential war conflicts (general environmental conflict thesis). I argue that peace ethics need to reconsider the role of the environment in peace ethics, from conflict prevention to peacebuilding. Sumak kawsay is a concept that offers a non-anthropocentric perspective on the subject. Several Contemporary Peace Ethicists don’t take environmental peace sufficiently into account. 1. The Peace theorist Johan Galtung famously argues that positive peace depends mostly on social, economic and political factors, as institutional structures establish peace. Galtung has a relational approach to peace, yet only between human interactors. 2. Michael Fox claims in his anti-war argument to consider nonhuman entities in conflicts. Because of their species interrelation, humans cannot decide on the fate of other species. 3. Although Mark Woods considers himself a peace ecologist, following Reichberg and Syse, and argues from a duty-based perspective towards nature, he mostly focuses on the protection of the environment during war conflicts. I want to focus on a non-anthropocentric view to argue that the environment is an entity of human concern in order to construct peace. Based on the premises that the lack of natural resources create tensions that play a significant part in international conflicts and these conflicts are potential war conflicts, I argue that a non-anthropocentric account to peace ethics is an indispensable perspective towards the recovery of these resources and therefore the reduction of war conflicts. Sumak kawsay is an approach contributing to a peaceful environment, which can play a crucial role in international peacekeeping operations. To emphasize sumak kawsay in peace ethics, it is necessary to explain what this principle includes and how it renews Contemporary Peace ethics. The indigenous philosophy of life of the Andean Quechua philosophy in Ecuador and varities from other countries from the Global South include a holistic real-world vision that contains concepts like the de-hierarchization of humans and nature as well as the reciprocity principle towards nature. Sumak kawsay represents the idea of the intrinsic value of nature and an egalitarian way of life and interconnectedness between human and nonhuman entities, which has been widely neglected in Traditional War and Peace Ethics. If sumak kawsay is transferred to peacekeeping practices, peacekeepers have restorative duties not only towards humans, but also towards nature. Resource conservation and environmental protection are the first step towards a positive peace. By recognising that healthy natural resources contribute to peacebuilding, by restoring balance through compensatory justice practices like recovery, by fostering dialogue between peacekeeping forces and by entitling ecosystems with rights natural resources and environmental conflicts are more unlikely to happen. This holistic approach pays nature sufficient attention and can contribute to a positive peace.Keywords: environment, natural resources, peace, Sumak Kawsay
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