Search results for: gender impact assessment

Authors: Tomas Premoli, Sareh Rowlands

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In this study, we investigate the impact of various convolutional neural network (CNN) architectures on the accuracy of diagnosing Alzheimer’s disease (AD) using patient MRI scans. Alzheimer’s disease is a debilitating neurodegenerative disorder that affects millions worldwide. Early, accurate, and non-invasive diagnostic methods are required for providing optimal care and symptom management. Deep learning techniques, particularly CNNs, have shown great promise in enhancing this diagnostic process. We aim to contribute to the ongoing research in this field by comparing the effectiveness of different CNN architectures and providing insights for future studies. Our methodology involved preprocessing MRI data, implementing multiple CNN architectures, and evaluating the performance of each model. We employed intensity normalization, linear registration, and skull stripping for our preprocessing. The selected architectures included VGG, ResNet, and DenseNet models, all implemented using the Keras library. We employed transfer learning and trained models from scratch to compare their effectiveness. Our findings demonstrated significant differences in performance among the tested architectures, with DenseNet201 achieving the highest accuracy of 86.4%. Transfer learning proved to be helpful in improving model performance. We also identified potential areas for future research, such as experimenting with other architectures, optimizing hyperparameters, and employing fine-tuning strategies. By providing a comprehensive analysis of the selected CNN architectures, we offer a solid foundation for future research in Alzheimer’s disease diagnosis using deep learning techniques. Our study highlights the potential of CNNs as a valuable diagnostic tool and emphasizes the importance of ongoing research to develop more accurate and effective models.

Keywords: Alzheimer’s disease, convolutional neural networks, deep learning, medical imaging, MRI

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Authors: Arash Yousefi

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Experts suggest that relying exclusively on parameters to convey a situation or establish a condition may not be adequate. Assessing and appraising incidents in a system based on accident parameters, such as accident frequency, lost workdays, or fatalities, may not always be precise and occasionally erroneous. The frequency rate of accidents is a metric that assesses the correlation between the number of accidents causing work-time loss due to injuries and the total working hours of personnel over a year. Traditionally, this has been calculated based on one million working hours, but the American Occupational Safety and Health Organization has updated its standards. The new coefficient of 200/000 working hours is now used to compute the frequency rate of accidents. It's crucial to ensure that the total working hours of employees are equally represented when calculating individual event and incident numbers. The accident severity rate is a metric used to determine the amount of time lost or wasted during a given period, often a year, in relation to the total number of working hours. It measures the percentage of work hours lost or wasted compared to the total number of useful working hours, which provides valuable insight into the number of days lost or wasted due to work-related incidents for each working hour. Calculating the severity of an incident can be difficult if a worker suffers permanent disability or death. To determine lost days, coefficients specified in the "tables of days equivalent to OSHA or ANSI standards" for disabling injuries are used. The accident frequency coefficient denotes the rate at which accidents occur, while the accident severity coefficient specifies the extent of damage and injury caused by these accidents. These coefficients are crucial in accurately assessing the magnitude and impact of accidents.

Keywords: incidents, safety, analysis, frequency, severity, injuries, determine

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Authors: Zachary Bolo Awino

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The need to gain and sustain a competitive advantage is overwhelming for businesses, especially now with cut throat competition. Innovation has been suggested as one way of gaining the advantage sustainably. But innovation can only happen within certain enabling environment and cultures. This study had one hypothesis: that there is no relationship between innovation and performance. This research was a cross sectional survey in which variables of interest are not controlled or manipulated. The cross sectional survey design is also appropriate for this study as it improves accuracy in generalizing findings, since it involves detailed study of a unit. Also known as one shot study, this design enhances uniform data collection and comparison across respondents. The population of the study was the 55 publicly quoted corporations in the Nairobi Securities Exchange (NSE) as at October 2013.The number was initially envisaged to be 60 but 5 firms were delisted or suspended during the year, hence leaving 55 firms as the population of study. The rationale for the choice for these firms is because they cut across the key economic sectors in Kenyan economy which include agriculture, commercial and services, manufacturing, finance and investment. This was a census survey and targeted all the firms listed at the Nairobi Securities Exchange as of October 2013. The primary data for the study was collected through the use of a structured questionnaire. A five point type Likert scale ranging from 1 - denoting to a less event to 5 - denoting to a greater extent was used. Respondents were from senior management of NSE. From the analyses, the study established that there was a strong positive relationship between innovation and performance, and organization innovation significantly contributes to employee engagement. Also there was a moderate positive relationship between innovation and performance. The study drew expressions of interrelations between various variables, offered generalization of understanding and meaning of these relationships, thus expanding the frontiers of knowledge both theoretical and practical with respect to innovation and firm performance. Major conclusion in this study was that there is a positive strong relationship between innovation and major measures of firm performance.

Keywords: emperical, innovation, NSE, organizations, performance

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Authors: W. S. Barber, S. L. King

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This paper is a qualitative case study analysis of the development of a fully online learning community of graduate students through arts-based community building activities. With increasing numbers and types of online learning spaces, it is incumbent upon educators to continue to push the edge of what best practices look like in digital learning environments. In digital learning spaces, instructors can no longer be seen as purveyors of content knowledge to be examined at the end of a set course by a final test or exam. The rapid and fluid dissemination of information via Web 3.0 demands that we reshape our approach to teaching and learning, from one that is content-focused to one that is process-driven. Rather than having instructors as formal leaders, today’s digital learning environments require us to share expertise, as it is the collective experiences and knowledge of all students together with the instructors that help to create a very different kind of learning community. This paper focuses on innovations pursued in a 36 hour 12 week graduate course in higher education entitled “Critical and Reflective Practice”. The authors chronicle their journey to developing a fully online learning community (FOLC) by emphasizing the elements of social, cognitive, emotional and digital spaces that form a moving interplay through the community. In this way, students embrace anywhere anytime learning and often take the learning, as well as the relationships they build and skills they acquire, beyond the digital class into real world situations. We argue that in order to increase student online engagement, pedagogical approaches need to stem from two primary elements, both creativity and critical reflection, that are essential pillars upon which instructors can co-design learning environments with students. The theoretical framework for the paper is based on the interaction and interdependence of Creativity, Intuition, Critical Reflection, Social Constructivism and FOLCs. By leveraging students’ embedded familiarity with a wide variety of technologies, this case study of a graduate level course on critical reflection in education, examines how relationships, quality of work produced, and student engagement can improve by using creative and imaginative pedagogical strategies. The authors examine their professional pedagogical strategies through the lens that the teacher acts as facilitator, guide and co-designer. In a world where students can easily search for and organize information as self-directed processes, creativity and connection can at times be lost in the digitized course environment. The paper concludes by posing further questions as to how institutions of higher education may be challenged to restructure their credit granting courses into more flexible modules, and how students need to be considered an important part of assessment and evaluation strategies. By introducing creativity and critical reflection as central features of the digital learning spaces, notions of best practices in digital teaching and learning emerge.

Keywords: online, pedagogy, learning, communities

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Authors: Asrat M.Belachew, Tiago Pereira, Institute of Mathematics, Computer Sciences, Avenida Trabalhador São Carlense, 400, São Carlos, 13566-590, Brazil

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Infectious diseases are among the most prominent threats to human beings. They cause morbidity and mortality to an individual and collapse the social, economic, and political systems of the whole world collectively. Mathematical models are fundamental tools and provide a comprehensive understanding of how infectious diseases spread and designing the control strategy to mitigate infectious diseases from the host population. Modeling the spread of infectious diseases using a compartmental model of inhomogeneous populations is good in terms of complexity. However, in the real world, there is a situation that accounts for heterogeneity, such as ages, locations, and contact patterns of the population which are ignored in a homogeneous setting. In this work, we study how classical an SEIR infectious disease spreading of the compartmental model can be extended by incorporating the mobility of population between heterogeneous cities during an outbreak of infectious disease. We have formulated an SEIR multi-cities epidemic spreading model using a system of 4k ordinary differential equations to describe the disease transmission dynamics in k-cities during the day and night. We have shownthat the model is epidemiologically (i.e., variables have biological interpretation) and mathematically (i.e., a unique bounded solution exists all the time) well-posed. We constructed the next-generation matrix (NGM) for the model and calculated the basic reproduction number R0for SEIR-epidemic spreading model with cities mobility. R0of the disease depends on the spectral radius mobility operator, and it is a threshold between asymptotic stability of the disease-free equilibrium and disease persistence. Using the eigenvalue perturbation theorem, we showed that sending a fraction of the population between cities decreases the reproduction number of diseases in interconnected cities. As a result, disease transmissiondecreases in the population.

Keywords: SEIR-model, mathematical model, city mobility, epidemic spreading

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Authors: Hassan Beigi Rizi, Harold Auradou, Lamine Hattali

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Various industries, including civil engineering, automotive, aerospace, and biomedical fields, are currently seeking novel and innovative high-performance lightweight materials to reduce energy consumption. Inspired by the structure of Euplectella Aspergillum Glass Sponges (EA-sponge), 2D unit cells were created and fabricated using a Fused Filament Fabrication (FFF) process with Polylactic acid (PLA) filaments. The stiffness and strength of bio-inspired EA-sponge lattices were investigated both experimentally and numerically under uniaxial tensile loading and are compared to three standard square lattices with diagonal struts (Designs B and C) and non-diagonal struts (Design D) reinforcements. The aim is to establish predictive scaling laws models and examine the deformation mechanisms involved. The results indicated that for the EA-sponge structure, the relative moduli and yield strength scaled linearly with relative density, suggesting that the deformation mechanism is stretching-dominated. The Finite element analysis (FEA), with periodic boundary conditions for volumetric homogenization, confirms these trends and goes beyond the experimental limits imposed by the FFF printing process. Therefore, the stretching-dominated behavior, investigated from 0.1 to 0.5 relative density, demonstrate that the study of EA-sponge structure can be exploited for the realization of square lattice topologies that are stiff and strong and have attractive potential for lightweight structural applications. However, the FFF process introduces an accuracy limitation, with approximately 10% error, making it challenging to print structures with a relative density below 0.2. Future work could focus on exploring the impact of different printing materials on the performance of EA-sponge structures.

Keywords: bio-inspiration, lattice structures, fused filament fabrication, scaling laws

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Authors: Anna Strakowska, Marian Zaborski

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This abstract focuses an overview of the methods used to create self-healing silicone composites. It has been shown how incorporating of polyhedral oligomeric silsesquioxanes (POSS) molecules with acid and basic groups to silicone rubber affects the barrier properties, mechanical properties in room and reduced temperature or the influence on relaxation rates of the methylvinylsilicone rubber vulcanizates. Moreover, the presence of silsesquioxanes, their content and the way of composites preparing affect the amount of ionic bonds, as indicated by dynamic - mechanical thermal analysis (DMTA) as well as measurements of equilibrium swelling in toluene. The aim of this work was to study the influence of concentration and different functional groups types selected silsesquioxanes compounds on self-healing effect of silicone rubber and obtain elastomers with good barrier and mechanical properties. Composites based on the methylvinylsilicone rubber with fumed silica as the fillers were manufactured and studied. To obtain self-healing effect various silsesquioxanes with amino and acid groups were used. Every tested sample demonstrated the ability to the self-treatment. The most significant effect was observed for system containing amic-acid isobytyl POSS/ aminopropylisobutyl POSS. Composite with this silsesquioxanes was exhibited the best improvement of gas permeability after heal. Moreover, the addition of POSS with acid and basic groups clearly affects the mechanical properties of the vulcanizates. The most significant effect was observed for the composite material consisting of amic-acid isobytyl POSS / aminoethylaminopropylisobutyl POSS, which tensile strength was even greater than the reference vulcanizate with fumed silica. The development of autonomous self-healing materials could have an enormous influence on all industry branches from motorization to power industry. Self-repairing materials would have a massive impact on lengthening product lifetimes, increasing safety, and lowering product costs by reducing maintenance requirements.

Keywords: barrier properties, mechanical properties, POSS, self-healing composites

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Authors: Mohammed Ahmed Alghamdi, Hazem Mahmoud Ali Darwish, Mostafa Mohamed Abdelraheem

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Transparent conducting oxides (TCOs) possess low resistivity, exhibit good adherence to many substrates, and have good transmission characteristics from the visible to near-infrared wavelengths, which make it useful for various applications. Thin films of transparent conducting oxide (TCO’s) have received much attention because of their wide applications in the field of optoelectronic devices. Advancement of transparent conducting oxides TCO’s may not only lie within the improvement of existing materials in use, but also the development of novel materials. Solar cells are devices, which convert solar energy into electricity, either directly via the photovoltaic effect, or indirectly by first converting the solar energy to heat or chemical energy. Solar power has attracted attention of late as the most advanced of the alternative energy resources. The project aims to access the solar energy in Al-Baha region by search for materials (transparent-conductive oxides (TCO's)) to use in solar cells with highly transparent to the solar spectrum, have low electrical resistivity, be stable under H-plasma, and have a suitable structure in particular for a-Si solar cells. As the PV surface is exposed to the sunlight, the module temperature increases. High ambient temperatures along with long sunlight exposure time increases the temperature impact on PV cells efficiency. Since Al-Baha area is characterized by an atmosphere and pressure different from their counterparts in Saudi Arabia due to the height above sea level, hence it is appropriate to do studies to improve the efficiency of solar cells under these conditions. In this work, some ion change materials will be deposited using either sputtering/ or electron beam evaporation techniques. The optical properties of the synthesized materials will be studied in details for solar cell application. As we will study the effect of some dyes on the optical properties of the prepared films. The efficiency and other parameters of solar cell will be determined.

Keywords: thin films, solar cell, optical properties, electrical properties

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Authors: Bikis Muhammed, Sehra Sedigh Sarvestani, Ali R. Hurson, Lasanthi Gamage

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Vehicular traffic events have overly complex spatial correlations and temporal interdependencies and are also influenced by environmental events such as weather conditions. To capture these spatial and temporal interdependencies and make more realistic vehicular traffic predictions, graph neural networks (GNN) based traffic prediction models have been extensively utilized due to their capability of capturing non-Euclidean spatial correlation very effectively. However, most of the already existing GNN-based traffic prediction models have some limitations during learning complex and dynamic spatial and temporal patterns due to the following missing factors. First, most GNN-based traffic prediction models have used static distance or sometimes haversine distance mechanisms between spatially separated traffic observations to estimate spatial correlation. Secondly, most GNN-based traffic prediction models have not incorporated environmental events that have a major impact on the normal traffic states. Finally, most of the GNN-based models did not use an attention mechanism to focus on only important traffic observations. The objective of this paper is to study and make real-time vehicular traffic predictions while incorporating the effect of weather conditions. To fill the previously mentioned gaps, our prediction model uses a real-time driving distance between sensors to build a distance matrix or spatial adjacency matrix and capture spatial correlation. In addition, our prediction model considers the effect of six types of weather conditions and has an attention mechanism in both spatial and temporal data aggregation. Our prediction model efficiently captures the spatial and temporal correlation between traffic events, and it relies on the graph attention network (GAT) and Bidirectional bidirectional long short-term memory (Bi-LSTM) plus attention layers and is called GAT-BILSTMA.

Keywords: deep learning, real time prediction, GAT, Bi-LSTM, attention

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Authors: Christos E. Lampropoulos, Maria Konsta, Vicky Dradaki, Irini Dri, Tamta Sirbilatze, Ifigenia Apostolou, Christina Kordali, Konstantina Panouria, Kostas Argyros, Georgios Mavras

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Malnutrition in hospitalized patients is related to increased morbidity and mortality. Purpose of our study was to assess nutritional status of hospitalized, elderly patients with various nutritional scores and to detect unfavorable prognostic factors, related to increased mortality and extended duration of admission. Methods: 150 patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. Nutritional status was assessed by Mini Nutritional Assessment (MNA full, short-form), Malnutrition Universal Screening Tool (MUST) and short Nutritional Appetite Questionnaire (sNAQ). The following data were incorporated in analysis: Anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits and mediterranean diet (assessed by MedDiet score), cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were the mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Mann-Whitney two-sample statistics or t-test was used for group comparisons and Spearman or Pearson coefficients for testing correlation between variables. Results: Normal nutrition was assessed in 54/150 (36%), 92/150 (61.3%) and in 106/150 (70.7%) of patients, according to full MNA, MUST and sNAQ questionnaires respectively. Mortality rate was 20.7% (31/150 patients). The patients who died until 6 months after admission had lower BMI (24±4.4 vs 26±4.8, p=0.04) and albumin levels (2.9±0.7 vs 3.4±0.7, p=0.002), significantly lower full MNA (14.5±7.3 vs 20.7±6, p<0.0001) and short-form MNA scores (7.3±4.2 vs 10.5±3.4, p=0.0002) compared to non-dead one. In contrast, the aforementioned patients had higher MUST (2.5±1.8 vs 0.5±1.02, p=<0.0001) and sNAQ scores (2.9±2.4 vs 1.1±1.3, p<0.0001). Additionally, they showed significantly lower MedDiet (23.5±4.3 vs 31.1±5.6, p<0.0001) and IPAQ scores (37.2±156.2 vs 516.5±1241.7, p<0.0001) compared to remaining one. These patients had extended hospitalization [5 (0-13) days vs 0 (-1-3) days, p=0.001]. Patients who admitted due to cancer depicted higher mortality rate (10/13, 77%), compared to those who admitted due to infections (12/73, 18%), stroke (4/15, 27%) or other causes (4/49, 8%) (p<0.0001). Extension of hospitalization was negatively correlated to both full (Spearman r=-0.35, p<0.0001) and short-form MNA (Spearman r=-0.33, p<0.0001) and positively correlated to MUST (Spearman r=0.34, p<0.0001) and sNAQ (Spearman r=0.3, p=0.0002). Additionally, the extension was inversely related to MedDiet score (Spearman r=-0.35, p<0.0001), IPAQ score (Spearman r=-0.34, p<0.0001), albumin levels (Pearson r=-0.36, p<0.0001), Ht (Pearson r=-0.2, p=0.02) and Hb (Pearson r=-0.18, p=0.02). Conclusion: A great proportion of elderly, hospitalized patients are malnourished or at risk of malnutrition. All nutritional scores, physical activity and albumin are significantly related to mortality and increased hospitalization.

Keywords: dietary habits, duration of admission, malnutrition, prognostic factors for mortality

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Authors: Gramza-Michalowska Anna, Skrety Joanna, Anna Zywica, Kobus-Cisowska Joanna, Kmiecik Dominik, Korczak Jozef

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Background: Modern consumer highly appreciates the positive influence of consumed products on well-being and overall health. High acceptance of new food is a result of intensified research showing many proofs confirming that food offers significant prophylactic and therapeutic potential, next to its basic nutritional function. Objective: Proposition of the technology of unsweetened oat drinks enriched with plant extracts for pro-health oriented individuals. We investigated the effects of selected plant extracts addition on antioxidative capacity and consumer’s acceptance of drinks as representative of all day diet product. Methods: The analysis of the basic composition and antioxidant properties of the drinking product was conducted. Basic composition included protein, lipids and fiber content. Antioxidant capacity of drink was evaluated with use radical scavenging methods (DPPH, ABTS), ORAC value and FRAP. Proposed drink as new product was also characterized with sensory analysis, which included color, aroma, taste, consistency and overall acceptance. Results: Results showed that addition of plant extracts into a oat drink allowed to enhance its antioxidant potential and influenced significantly its sensory values. The preferred composition and properties of designed beverage permit claim that it can have a positive impact on the health of the consumers. Conclusion: Designed oat drink would be an answer for pro-healthy life style of the consumers. Results showed that product with plant extracts addition would be accepted by the consumers and because of its antioxidative potential could be an important factor in prevention of free radicals influence on human organism.

Keywords: phytonutrients, pro-health, well-being, antioxidant potential, sensory value

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Authors: Nirman Kumar Ojha

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Bamboo plantation can be integrated for natural embankment against flood and live fencing against wild animals, at the same time provide economic opportunity for the poor farmers as a sustainable solution and adaptation alternative. 2010 flood in the Rui River completely inundated fields of four VDCs in Madi, Chitwan National Park with extensive bank erosion. The main aim of this action research was to identify an economically sustainable natural embankment against flood and also providing wildlife friendly fencing to reduce human-wildlife conflict. Community people especially poor farmers were trained for soil testing, land identification, plantation, and the harvesting regime, nursery set up and intercropping along with bamboo plantation on the edge of the river bank in order to reduce or minimize soil erosion. Results show that farmers are able to establish cost efficient and economically sustainable river embankment with bamboo plantation also creating a fence for wildlife which has also promoted bamboo cultivation and conservation. This action research has amalgamated flood control and wildlife control with the livelihood of the farmers which otherwise would cost huge resource. Another major impact of the bamboo plantation is its role in climate change and its adaptation process reducing degradation and improving vegetation cover contributing to landscape management. Based on this study, we conclude that bamboo plantation in Madi, Chitwan promoted the livelihood of the poor farmers providing a sustainable economic solution to reduce bank erosion, human-wildlife conflict and contributes to landscape management.

Keywords: climate change and conservation, economic opportunity, flood control, national park

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Authors: Joan Esper Kuhnly, Jess Holden, Lynn Shelley, Nicole Kuhnly

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Empathy serves as a foundational nursing principle inherent in the nurse’s ability to form those relationships from which to care for patients. Evidence supports, including empathy in nursing and healthcare education, but there is limited data on what methods are effective to do so. Building evidence supports experiential and interactive learning methods to be effective for students to gain insight and perspective from a personalized experience. The purpose of this project is to evaluate learning activities designed to promote the attainment of empathic behaviors across 5 levels of the nursing curriculum. Quantitative analysis will be conducted on data from pre and post-learning activities using the Toronto Empathy Questionnaire. The main hypothesis, that simulation learning activities will increase empathy, will be examined using a repeated measures Analysis of Variance (ANOVA) on Pre and Post Toronto Empathy Questionnaire scores for three simulation activities (Stroke, Poverty, Dementia). Pearson product-moment correlations will be conducted to examine the relationships between continuous demographic variables, such as age, credits earned, and years practicing, with the dependent variable of interest, Post Test Toronto Empathy Scores. Krippendorff’s method of content analysis will be conducted to identify the quantitative incidence of empathic responses. The researchers will use Colaizzi’s descriptive phenomenological method to describe the students’ simulation experience and understand its impact on caring and empathy behaviors employing bracketing to maintain objectivity. The results will be presented, answering multiple research questions. The discussion will be relevant to results and educational pedagogy in the nursing curriculum as they relate to the attainment of empathic behaviors.

Keywords: curriculum, empathy, nursing, simulation

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Authors: Shahira El Shafie, Hanaa Eldash, Engy Ghabbour, Mohamed Eid

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Several immunologic defects can be found in patients with beta-thalassemia, among which the impairment of neutrophil phagocytic function is of utmost importance. Attention has been directed to the role of proinflammatory cytokines in neutrophil chemotaxis and phagocytosis. Interleukin-8 (IL-8) is an important chemotactic and activation peptide for neutrophils; changes in IL-8 level and potential correlation with neutrophil function can be relevant to immunomodulation pathophysiology in beta-thalassemia patients. This case-control study aimed to evaluate IL-8 level and to assess granulocyte recruitment, as markers of immunomodulation, in poly-transfused thalassemia patients attending Fayoum University Hospitals. The study was conducted on 50 patients with ß thalassemia and 32 age-matched controls. 21/50 patients were transfused more than ten times, and 29/50 were transfused in a lower frequency. Patients and controls were subjected to thorough history taking and clinical examination, measurement of IL-8 level using human IL-8 ELISA kit, and Rebuck skin window technique (RSWT) to assess granulocyte recruitment. Our data showed statistically significant higher levels of IL-8 in ß thalassemia patients compared to control with a much higher difference in patients transfused more than ten times. Neutrophil recruitment was significantly lower in ß thalassemia patients compared to control at 4 hours and 24 hours test time. Although IL-8, the main chemotactic pro-inflammatory cytokine showed a higher level in thalassemia patients, neutrophils recruitment was significantly lower, especially in those receiving more than ten transfusion times. Our findings suggest a possible role of other neutrophil chemotactic factors, defective neutrophil response, or increased IL-8 as compensation of abnormal function. We recommend the use of IL-8 and Rebuck skin window technique as useful markers of immunomodulation in thalassemia and further study for these biomarkers to assess their clinical implications and impact on the management of thalassemia patients.

Keywords: beta-thalassemia, Interleukin-8, Rebuck skin window technique, immunomodulation

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Authors: Mustafa Taskin, Ozgur Demir, M. Mert Serveren

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The precise study of the impact of underwater explosions on structures is of great importance in the design and engineering calculations of floating structures, especially those used for military purposes, as well as power generation facilities such as offshore platforms that can become a target in case of war. Considering that ship and submarine structures are mostly curved surfaces, it is extremely important and interesting to examine the destructive effects of underwater explosions on curvilinear surfaces. In this study, geometric nonlinear dynamic analysis of cylindrical composite sandwich shells subjected to instantaneous pressure load is performed. The instantaneous pressure load is defined as an underwater explosion and the effects of the liquid medium are taken into account. There are equations in the literature for pressure due to underwater explosions, but these equations have been obtained for flat plates. For this reason, the instantaneous pressure load equations are arranged to be suitable for curvilinear structures before proceeding with the analyses. Fluid-solid interaction is defined by using Taylor's Plate Theory. The lower and upper layers of the cylindrical composite sandwich shell are modeled as composite laminate and the middle layer consists of soft core. The geometric nonlinear dynamic equations of the shell are obtained by Hamilton's principle, taken into account the von Kàrmàn theory of large displacements. Then, time dependent geometric nonlinear equations of motion are solved with the help of generalized differential quadrature method (GDQM) and dynamic behavior of cylindrical composite sandwich shells exposed to underwater explosion is investigated. An algorithm that can work parametrically for the solution has been developed within the scope of the study.

Keywords: cylindrical composite sandwich shells, generalized differential quadrature method, geometric nonlinear dynamic analysis, underwater explosion

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Authors: Maher Z. Mohammed, Barry G. Clarke

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As an alternative to stone column in fine grained soils, it is possible to create stiffened columns of soils using electroosmosis (electroosmotic piles). This program of this research is to establish the effectiveness and efficiency of the process in different soils. The aim of this study is to assess the capability of electroosmosis treatment in a range of composite soils. The combined electroosmotic and preloading equipment developed by Nizar and Clarke (2013) was used with an octagonal array of anodes surrounding a single cathode in a nominal 250mm diameter 300mm deep cylinder of soil and 80mm anode to cathode distance. Copper coiled springs were used as electrodes to allow the soil to consolidate either due to an external vertical applied load or electroosmosis. The equipment was modified to allow the temperature to be monitored during the test. Electroosmotic tests were performed on China Clay Grade E kaolin and calcium bentonite (Bentonex CB) mixed with sand fraction C (BS 1881 part 131) at different ratios by weight; (0, 23, 33, 50 and 67%) subjected to applied voltages (5, 10, 15 and 20). The soil slurry was prepared by mixing the dry soil with water to 1.5 times the liquid limit of the soil mixture. The mineralogical and geotechnical properties of the tested soils were measured before the electroosmosis treatment began. In the electroosmosis cell tests, the settlement, expelled water, variation of electrical current and applied voltage, and the generated heat was monitored during the test time for 24 osmotic tests. Water content was measured at the end of each test. The electroosmotic tests are divided into three phases. In Phase 1, 15 kPa was applied to simulate a working platform and produce a uniform soil which had been deposited as a slurry. 50 kPa was used in Phase 3 to simulate a surcharge load. The electroosmotic treatment was only performed during Phase 2 where a constant voltage was applied through the electrodes in addition to the 15 kPa pressure. This phase was stopped when no further water was expelled from the cell, indicating the electroosmotic process had stopped due to either the degradation of the anode or the flow due to the hydraulic gradient exactly balanced the electroosmotic flow resulting in no flow. Control tests for each soil mixture were carried out to assess the behaviour of the soil samples subjected to only an increase of vertical pressure, which is 15kPa in Phase 1 and 50kPa in Phase 3. Analysis of the experimental results from this study showed a significant dewatering effect on the soil slurries. The water discharged by the electroosmotic treatment process decreased as the sand content increased. Soil temperature increased significantly when electrical power was applied and drops when applied DC power turned off or when the electrode degraded. The highest increase in temperature was found in pure clays at higher applied voltage after about 8 hours of electroosmosis test.

Keywords: electrokinetic treatment, electrical conductivity, electroosmotic consolidation, electroosmosis permeability ratio

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Authors: Mustafa Mutahari, Nao Sugiki, Kojiro Matsuo

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The four decades of war, lack of job opportunities, poverty, lack of services, and natural disasters in different provinces of Afghanistan have contributed to a rapid increase in the population of Kabul, the capital city of Afghanistan. Population census has not been conducted since 1979, the first and last population census in Afghanistan. However, according to population estimations by Afghan authorities, the population of Kabul has been estimated at more than 4 million people, whereas the city was designed for two million people. Although the major transport mode of Kabul residents is public transport, responsible authorities within the country failed to supply the required means of transportation systems for the city. Besides, informal resettlement, lack of intersection control devices, presence of illegal vendors on streets, presence of illegal and unstandardized on-street parking and bus stops, driver`s unprofessional behavior, weak traffic law enforcement, and blocked roads and sidewalks have contributed to the extreme traffic congestion of Kabul. In 2018, the government of Afghanistan approved the Kabul city Urban Design Framework (KUDF), a vision towards the future of Kabul, which provides strategies and design guidance at different scales to direct urban development. Considering traffic congestion of the city and its budget limitations, the KUDF proposes a BRT route network with seven lines to reduce the traffic congestion, and it is said to facilitate more than 50% of Kabul population to benefit from this service. Based on the KUDF, it is planned to increase the BRT mode share from 0% to 17% and later to 30% in medium and long-term planning scenarios, respectively. Therefore, a detailed research study is needed to evaluate the proposed system before the implementation stage starts. The integrated land-use transport model is an effective tool to evaluate the Kabul BRT because of its future assessment capabilities that take into account the interaction between land use and transportation. This research aims to analyze and evaluate the proposed BRT route network with the application of an integrated land-use and transportation model. The research estimates the population distribution and travel behavior of Kabul within small boundary scales. The actual road network and land-use detailed data of the city are used to perform the analysis. The BRT corridors are evaluated not only considering its impacts on the spatial interactions in the city`s transportation system but also on the spatial developments. Therefore, the BRT are evaluated with the scenarios of improving the Kabul transportation system based on the distribution of land-use or spatial developments, planned development typology and population distribution of the city. The impacts of the new improved transport system on the BRT network are analyzed and the BRT network is evaluated accordingly. In addition, the research also focuses on the spatial accessibility of BRT stops, corridors, and BRT line beneficiaries, and each BRT stop and corridor are evaluated in terms of both access and geographic coverage, as well.

Keywords: accessibility, BRT, integrated land-use and transport model, travel behavior, spatial development

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Authors: Marlen Acosta Alamo, Lisa Manne, Richard Veit

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Habitat loss due to land use change is one of the leading causes of biodiversity loss worldwide. This form of habitat loss is a non-random phenomenon since the same environmental factors that make an area suitable for supporting high local biodiversity overlap with those that make it attractive for urban development. We aimed to compare the effect of two non-random habitat loss predictors on the richness, abundance, and rarity of nature-affiliated and human-affiliated North American breeding birds. For each group of birds, we simulated the non-random habitat loss using two predictors: the House Price Index as a measure of the attractiveness of an area for humans and the Normalized Difference Vegetation Index as a proxy for primary productivity. We compared the results of the two non-random simulation sets and one set of random habitat loss simulations using an analysis of variance and followed up with a Tukey-Kramer test when appropriate. The attractiveness of an area for humans predicted estimates of richness loss and increase of rarity higher than primary productivity and random habitat loss for nature-affiliated and human-affiliated birds. For example, at 50% of habitat loss, the attractiveness of an area for humans produced estimates of richness at least 5% lower and of a rarity at least 40% higher than primary productivity and random habitat loss for both groups of birds. Only for the species abundance of nature-affiliated birds, the attractiveness of an area for humans did not outperform primary productivity as a predictor of biodiversity following habitat loss. We demonstrated the value of the House Price Index, which can be used in conservation assessments as an index of the risks of habitat loss for natural communities. Thus, our results have relevant implications for sustainable urban land-use planning practices and can guide stakeholders and developers in their efforts to conserve local biodiversity.

Keywords: biodiversity loss, bird biodiversity, house price index, non-random habitat loss

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Authors: Ndeye Tiguida Sarr, Onur Akpinar

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The tourism industry, being the sector that includes all the activities related to the organization and satisfaction of tourists during their trip, also has a very important role in the national economy of the host country. In order to measure the stakes of tourism on the economy, microeconomic and macroeconomic factors are elements of analysis. While microeconomics is limited to an individual perspective, macroeconomics extends to a global perspective and treats the economy as a whole by focusing on social and economic actors in general. It is in this context that this study focuses on macroeconomic variables in order to determine the factors that influence the financial performance of tourism firms in Turkey, which is one of the world's major destinations. The aim of the study is to demonstrate the relationship between macroeconomic variables and the financial performance of tourism firms. Data from 2011 to 2020 are collected, from a sample of 16 companies that represent the tourism sector in Borsa Istanbul. Tobin’s Q ratio, Market to Book ratio, Return on Invested Capital, and Return on Assets as the financial performance indicators were dependent variables of the study. Gross Domestic Products, Inflation, Interest Rates, and Unemployment as macroeconomic indicators were independent variables. Again, Size, Liquidity, Leverage, and Age were control variables of the study. According to the results, value indicators, which are Tobin’s Q ratio and Market to Book ratio, have a statistically significant relationship with Inflation, Interest Rates, and Unemployment. A negative relationship is found between value indicators and Interest rates and a positive relationship between value indicators and Unemployment and Inflation. On the other hand, there is no significant relationship between profit indicators (Return on Invested Capital and Return on Assets) and macroeconomic variables. Accordingly, Interest rates negatively affect the financial performance of tourism firms and stand out as a factor that decreases the value.

Keywords: financial performance, macroeconomic variables, panel data, Tobin Q

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Authors: Ariungerel Jargal

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: Cave mining is a bulk underground mining method, which allows large low-grade deposits to be mined underground. This method involves undermining the orebody to make it collapse under its own weight into a series of chambers from which the ore extracted. It is a useful technique to extend the life of large deposits previously mined by open pits, and it is a method increasingly proposed for new mines around the world. We plan to conduct a feasibility study using Electrical impedance tomography (EIT) technology to show how much subsidence there is at the intersection with the cave mining surface. EIT is an imaging technique which uses electrical measurements at electrodes attached on the body surface to yield a cross-sectional image of conductivity changes within the object. EIT has been developed in several different applications areas as a simpler, cheaper alternative to many other imaging methods. A low frequency current is injected between pairs of electrodes while voltage measurements are collected at all other electrode pairs. In the difference EIT, images are reconstructed of the change in conductivity distribution (σ) between the acquisition of the two sets of measurements. Image reconstruction in EIT requires the solution of an ill-conditioned nonlinear inverse problem on noisy data, typically requiring make simpler assumptions or regularization. It is noted that the ratio of current to voltage represents a complex value according to Ohm’s law, and that it is theoretically possible to re-express EIT. The results of the experiment were presented on the simulation, and it was concluded that it is possible to conduct further real experiments. Drill a certain number of holes in the top wall of the cave to attach the electrodes, flow a current through them, and measure and acquire the potential through these electrodes. Appropriate values should be selected depending on the distance between the holes, the frequency and duration of the measurements, the surface characteristics and the size of the study area using an EIT device.

Keywords: impedance tomography, cave mining, soil, EIT device

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Authors: Olufunke Ayilara Aje-Famuyide

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The centrality of the Petroleum Industry in the world energy is undoubted. The world economy almost runs and depends on petroleum. Petroleum industry is a multi-trillion industry; it turns otherwise poor and underdeveloped countries into wealthy nations and thrusts them at the center of international diplomacy. Although these developing nations lack the necessary technology to explore and exploit petroleum resources they are not without help as developed nations, represented by their multinational corporations are ready and willing to provide both the technical and managerial expertise necessary for the development of this natural resource. However, the exploration of these petroleum resources comes with, sometimes, grave, concomitant consequences. These consequences are especially pronounced with respect to the environment. From the British Petroleum Oil rig explosion and the resultant oil spillage and pollution in New Mexico, United States to the Mobil Oil spillage along Nigerian coast, the story and consequence is virtually the same. Nigeria’s Niger Delta Region produces Nigeria’s petroleum which accounts for more than ninety-five percent of Nigeria’s foreign exchange earnings. Between 1999 and 2007, Nigeria earned more than $400 billion from petroleum exports. Nevertheless, petroleum exploration and exploitation has devastated the Niger Delta environment. From oil spillage which pollutes the rivers, farms and wetlands to gas flaring by the multi-national corporations; the consequences is similar-a region that has been devastated by petroleum exploitation. This paper thus seeks to examine the consequences and impact of petroleum pollution in the Niger Delta of Nigeria with particular reference on the right of the people of Niger Delta to a healthy environment. The paper further seeks to examine the relevant international, regional instrument and Nigeria’s municipal laws that are meant to protect the result of the people of the Niger Delta and their enforcement by the Nigerian State. It is quite worrisome that the Niger Delta Region and its people have suffered and are still suffering grave violations of their right to a healthy environment as a result of petroleum exploitation in their region. The Nigerian effort at best is half-hearted in its protection of the people’s right.

Keywords: environment, exploration, petroleum, pollution

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Authors: Kadri-Ann Kertsmik, Martin Talvik, Kimmo Lylykangas, Simo Ilomets, Targo Kalamees

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This study compares the building carbon footprint (CF) values for a case study of a private house located in a cold climate, using the Level(s) methodology. It provides a framework for measuring the environmental performance of buildings throughout their life cycle, taking into account various factors. The study presents the results of the three scenarios, comparing their carbon emissions and highlighting the benefits of circular material usage. The construction process was thoroughly documented, and all materials and components (including minuscule mechanical fasteners, each meter of cable, a kilogram of mortar, and the component of HVAC systems, among other things) delivered to the construction site were noted. Transportation distances of each delivery, the fuel consumption of construction machines, and electricity consumption for temporary heating and electrical tools were also monitored. Using the detailed data on material and energy resources, the CF was calculated for two scenarios: one where circular material usage was applied and another where virgin materials were used instead of reused ones. The results were compared with the CF calculated based on the building permit design model using the Level(s) methodology. To study the range of possible results in the early stage of CF assessment, the same building permit design was given to several experts. Results showed that embodied carbon values for a built scenario were significantly lower than the values predicted by the building permit stage as a result of more precise material quantities, as the calculation methodology is designed to overestimate the CF. Moreover, designers made an effort to reduce the building's CF by reusing certain materials such as ceramic tiles, lightweight concrete blocks, and timber during the construction process. However, in a cold climate context where operational energy (B6) continues to dominate, the total building CF value changes between the three scenarios were less significant. The calculation for the building permit project was performed by several experts, and CF results were in the same range. It alludes that, for the first estimation of preliminary building CF, using average values proves to be an appropriate method for the Estonian national carbon footprint estimation phase during building permit application. The study also identified several opportunities for reducing the carbon footprint of the building, such as reusing materials from other construction sites, preferring local material producers, and reducing wastage on site. The findings suggest that using circular materials can significantly reduce the carbon footprint of buildings. Overall, the study highlights the importance of using a comprehensive approach to measure the environmental performance of buildings, taking into account both the project and the actually built house. It also emphasises the need for ongoing monitoring for designing the building and construction site waste. The study also gives some examples of how to enable future circularity of building components and materials, e.g., building in layers, using wood as untreated, etc.

Keywords: carbon footprint, circular economy, sustainable construction, level(s) methodology

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Authors: Marisa Rio, Sharanya Bola, Richard H. W. Funk, Gerald Gerlach

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Cell migration, wound healing and regeneration are some of the physiological phenomena in which electric fields (EFs) have proven to have an important function. Physiologically, cells experience electrical signals in the form of transmembrane potentials, ion fluxes through protein channels as well as electric fields at their surface. As soon as a wound is created, the disruption of the epithelial layers generates an electric field of ca. 40-200 mV/mm, directing cell migration towards the wound site, starting the healing process. In vitro electrotaxis, experiments have shown cells respond to DC EFs polarizing and migrating towards one of the poles (cathode or anode). A standard electrotaxis experiment consists of an electrotaxis chamber where cells are cultured, a DC power source and agar salt bridges that help delaying toxic products from the electrodes to attain the cell surface. The electric field strengths used in such an experiment are uniform and homogeneous. In contrast, the endogenous electric field strength around a wound tend to be multi-field and non-homogeneous. In this study, we present a custom device that enables electrotaxis experiments in non-homogeneous DC electric fields. Its main feature involves the replacement of conventional metallic electrodes, separated from the electrotaxis channel by agarose gel bridges, through electrolyte-filled microchannels. The connection to the DC source is made by Ag/AgCl electrodes, incased in agarose gel and placed at the end of each microfluidic channel. An SU-8 membrane closes the fluidic channels and simultaneously serves as the single connection from each of them to the central electrotaxis chamber. The electric field distribution and current density were numerically simulated with the steady-state electric conduction module from ANSYS 16.0. Simulation data confirms the application of nonhomogeneous EF of physiological strength. To validate the biocompatibility of the device cellular viability of the photoreceptor-derived 661W cell line was accessed. The cells have not shown any signs of apoptosis, damage or detachment during stimulation. Furthermore, immunofluorescence staining, namely by vinculin and actin labelling, allowed the assessment of adhesion efficiency and orientation of the cytoskeleton, respectively. Cellular motility in the presence and absence of applied DC EFs was verified. The movement of individual cells was tracked for the duration of the experiments, confirming the EF-induced, cathodal-directed motility of the studied cell line. The in vitro monolayer wound assay, or “scratch assay” is a standard protocol to quantitatively access cell migration in vitro. It encompasses the growth of a confluent cell monolayer followed by the mechanic creation of a scratch, representing a wound. Hence, wound dynamics was monitored over time and compared for control and applied the electric field to quantify cellular population motility.

Keywords: DC non-homogeneous electric fields, electrotaxis, microfluidic biochip, wound healing

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Authors: Vibha Venkataramu, B. V. Venkatarama Reddy

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Natural river sand is the most preferred choice as fine aggregate in masonry mortars. Uncontrolled mining of sand from riverbeds for several decades has had detrimental effects on the environment. Several countries across the world have put strict restrictions on sand mining from riverbeds. However, in countries like India, the huge infrastructural boom has made the local construction industry to look for alternative materials to sand. This study aims at understanding the suitability of granulated blast furnace slag (GBS) as fine aggregates in masonry mortars. Apart from characterising the material properties of GBS, such as particle size distribution, pH, chemical composition, etc., of GBS, tests were performed on the mortars with GBS as fine aggregate. Additionally, the properties of five brick tall, stack bonded masonry prisms with various types of GBS mortars were studied. The mortars with mix proportions 1: 0: 6 (cement: lime: fine aggregate), 1: 1: 6, and 1: 0: 3 were considered for the study. Fresh and hardened properties of mortar, such as flow and compressive strength, were studied. To understand the behaviour of GBS mortars on masonry, tests such as compressive strength and flexure bond strength were performed on masonry prisms made with a different type of GBS mortars. Furthermore, the elastic properties of masonry with GBS mortars were also studied under compression. For comparison purposes, the properties of corresponding control mortars with natural sand as fine aggregate and masonry prisms with sand mortars were also studied under similar testing conditions. From the study, it was observed the addition of GBS negatively influenced the flow of mortars and positively influenced the compressive strength. The GBS mortars showed 20 to 25 % higher compressive strength at 28 days of age, compared to corresponding control mortars. Furthermore, masonry made with GBS mortars showed nearly 10 % higher compressive strengths compared to control specimens. But, the impact of GBS on the flexural strength of masonry was marginal.

Keywords: building materials, fine aggregate, granulated blast furnace slag in mortars, masonry properties

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Authors: Jean-Philippe Amat, Timothée Vergne, Aymeric Hans, Bénédicte Ferry, Pascal Hendrikx, Jackie Tapprest, Barbara Dufour, Agnès Leblond

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The surveillance of infectious diseases is necessary to describe their occurrence and help the planning, implementation and evaluation of risk mitigation activities. However, the exact number of detected cases may remain unknown whether surveillance is based on serological tests because identifying seroconversion may be difficult. Moreover, incomplete detection of cases or outbreaks is a recurrent issue in the field of disease surveillance. This study addresses these two issues. Using a viral animal disease as an example (equine viral arteritis), the goals were to establish suitable rules for identifying seroconversion in order to estimate the number of cases and outbreaks detected by a surveillance system in France between 2006 and 2013, and to assess the sensitivity of this system by estimating the total number of outbreaks that occurred during this period (including unreported outbreaks) using a capture-recapture model. Data from horses which exhibited at least one positive result in serology using viral neutralization test between 2006 and 2013 were used for analysis (n=1,645). Data consisted of the annual antibody titers and the location of the subjects (towns). A consensus among multidisciplinary experts (specialists in the disease and its laboratory diagnosis, epidemiologists) was reached to consider seroconversion as a change in antibody titer from negative to at least 32 or as a three-fold or greater increase. The number of seroconversions was counted for each town and modeled using a unilist zero-truncated binomial (ZTB) capture-recapture model with R software. The binomial denominator was the number of horses tested in each infected town. Using the defined rules, 239 cases located in 177 towns (outbreaks) were identified from 2006 to 2013. Subsequently, the sensitivity of the surveillance system was estimated as the ratio of the number of detected outbreaks to the total number of outbreaks that occurred (including unreported outbreaks) estimated using the ZTB model. The total number of outbreaks was estimated at 215 (95% credible interval CrI95%: 195-249) and the surveillance sensitivity at 82% (CrI95%: 71-91). The rules proposed for identifying seroconversion may serve future research. Such rules, adjusted to the local environment, could conceivably be applied in other countries with surveillance programs dedicated to this disease. More generally, defining ad hoc algorithms for interpreting the antibody titer could be useful regarding other human and animal diseases and zoonosis when there is a lack of accurate information in the literature about the serological response in naturally infected subjects. This study shows how capture-recapture methods may help to estimate the sensitivity of an imperfect surveillance system and to valorize surveillance data. The sensitivity of the surveillance system of equine viral arteritis is relatively high and supports its relevance to prevent the disease spreading.

Keywords: Bayesian inference, capture-recapture, epidemiology, equine viral arteritis, infectious disease, seroconversion, surveillance

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Authors: Mohamed Abdel-Hamid, Olfat Gamil Shaker, Doha El-Sayed Ellakwa, Eman Fathy Abdel-Maksoud

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Introduction: Despite advances in the knowledge of the molecular virology of hepatitis C virus (HCV), the mechanisms of hepatocellular injury in HCV infection are not completely understood. Hepatitis C viral infection (HCV) influences the susceptibility to apoptosis. This could lead to insufficient antiviral immune response and persistent viral infection. Aim of this study: was to examine whether BCL-2 gene polymorphism at codon 43 (+127G/A or Ala43Thr) has an impact on development of hepatocellular carcinoma caused by chronic hepatitis C Egyptian patients. Subjects and Methods: The study included three groups; group 1: composing of 30 patients with hepatocellular carcinoma (HCC), group 2 composing of 30 patients with HCV, group 3 composing of 30 healthy subjects matching the same age and socioeconomic status were taken as a control group. Gene polymorphism of BCL2 (Ala43Thr) were evaluated by PCR-RFLP technique and measured for all patients and controls. Results: The summed 43Thr genotype was more frequent and statistically significant in HCC patients as compared to control group. This genotype of BCL2 gene may inhibit the programmed cell death which leads to disturbance in tissue and cells homeostasis and reduction in immune regulation. This result leads to viral replication and HCV persistence. Moreover, virus produces variety of mechanisms to block genes participated in apoptosis. This mechanism proves that HCV patients who have 43Thr genotype are more susceptible to HCC. Conclusion: The data suggest for the first time that the BCL2 polymorphism is associated with the susceptibility to HCC in Egyptian populations and might be used as molecular markers for evaluating HCC risk. This study clearly demonstrated that Chronic HCV exhibit a deregulation of apoptosis with the disease progression. This provides an insight into the pathogenesis of chronic HCV infection, and may contribute to the therapy.

Keywords: BCL2 gene, Hepatitis C Virus, Hepatocellular carcinoma, sensitivity, specificity, apoptosis

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Authors: Yuet Wah Echo Yeung

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Practice learning is an important component of social work education. Practice educators are charged with the responsibility to support and enable learning while students are on placement. They also play a key role in teaching students to integrate theory and practice, as well as assessing their performance. Current literature highlights the structural factors that make it difficult for practice educators to create a positive learning environment for students. Practice educators find it difficult to give sufficient attention to their students because of the lack of workload relief, the increasing emphasis on managerialism and bureaucratisation, and a range of competing organisational and professional demands. This paper reports the challenges practice educators face and how they manage these challenges in this context. Semi-structured face-to-face interviews were conducted with thirteen practice educators who support students in statutory and voluntary social care settings in the Northwest of England. Interviews were conducted between April and July 2017 and each interview lasted about 40 minutes. All interviews were recorded and transcribed. All practice educators are experienced social work practitioners with practice experience ranging from 6 to 42 years. On average they have acted as practice educators for 13 years and all together have supported 386 students. Our findings reveal that apart from the structural factors that impact how practice educators perform their roles, they also faced other challenges when supporting students on placement. They include difficulty in engaging resistant students, complexity in managing power dynamics in the context of practice learning, and managing the dilemmas of fostering a positive relationship with students whilst giving critical feedback. Suggestions to enhance the practice educators’ role include support from organisations and social work teams; effective communication with university tutors, and a forum for practice educators to share good practice and discuss placement issues.

Keywords: social work education, placement challenges, practice educator, practice learning

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Authors: Neeraj Vij, Amber Brennan, Jenni Winters, Hadi Salehi, Hamy Temkit, Emily Andrisevic, Mohan V. Belthur

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Idiopathic clubfoot is a common lower extremity deformity with an incidence of 1:500. The Ponseti Method is well known as the gold standard of treatment. However, there is limited functional data demonstrating correction of the clubfoot after treatment with the Ponseti method. The purpose of this study was to study the clinical and functional outcomes after the Ponseti method with the Clubfoot Disease-Specific Instrument (CDS) and pedobarography. This IRB-approved prospective study included patients aged 3-18 who were treated for idiopathic clubfoot with the Ponseti method between January 2008 and December 2018. Age-matched controls were identified through siblings of clubfoot patients and other community members. Treatment details were collected through a chart review of the included patients. Laboratory assessment included a physical exam, gait analysis, and pedobarography. The Pediatric Outcomes Data Collection Instrument and the Clubfoot Disease-Specific Instrument were also obtained on clubfoot patients (CF). The Wilcoxson rank-sum test was used to study differences between the CF patients and the typically developing (TD) patients. Statistical significance was set at p < 0.05. There were a total of 37 enrolled patients in our study. 21 were priorly treated for CF and 16 were TD. 94% of the CF patients had bilateral involvement. The age at the start of treatment was 29 days, the average total number of casts was seven to eight, and the average total number of casts after Achilles tenotomy was one. The reoccurrence rate was 25%, tenotomy was required in 94% of patients, and ≥1 tenotomy was required in 25% of patients. There were no significant differences between step length, step width, stride length, force-time integral, maximum peak pressure, foot progression angles, stance phase time, single-limb support time, double limb support time, and gait cycle time between children treated with the Ponseti method and typically developing children. The average post-treatment Pirani and Dimeglio scores were 5.50±0.58 and 15.29±1.58, respectively. The average post-treatment PODCI subscores were: Upper Extremity: 90.28, Transfers: 94.6, Sports: 86.81, Pain: 86.20, Happiness: 89.52, Global: 88.6. The average post-treatment Clubfoot Disease-Specific Instrument scores subscores were: Satisfaction: 73.93, Function: 80.32, Overall: 78.41. The Ponseti Method has a very high success rate and remains to be the gold standard in the treatment of idiopathic clubfoot. Timely management leads to good outcomes and a low need for repeated Achilles tenotomy. Children treated with the Ponseti method demonstrate good functional outcomes as measured through pedobarography. Pedobarography may have clinical utility in studying congenital foot deformities. Objective measures for hours of brace wear could represent an improvement in clubfoot care.

Keywords: functional outcomes, pediatric deformity, patient-reported outcomes, talipes equinovarus

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Authors: P. H. G. J. Pushpakumara, A. M. P. Adikari, S. U. B. Tennakoon, Ranil Abeysinghe, Andrew Dawson

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Introduction: Deliberate Self-harm (DSH) is a global public health problem. Since 1950, suicide rates in Sri Lanka are among the highest national rates in the world. It has become an increasingly common response to emotional distress in young adults. However, it remains unclear the reason for this occurrence. Objectives: The descriptive component of this study was conducted to identify of epidemiological pattern of DSH and suicide in Kurunegala District (KD). Assessment of association between DSH socio-cultural, economical and psychological factors were the objectives of the case control component. Methods: Prospective data collection of DSH and suicide was conducted at all (46) hospitals and all (28) police stations in the KD for thirty six months, from 1st January 2011, as the descriptive component. Case control component was conducted at T.H. Kurunegala (THK) for eighteen months duration, from 1st July 2011. Cases (n=439) were randomly selected from a block of 7 consecutively admitted consenting DSP patients using a computer program. Age, sex and residential divisional secretariat division one to one matched, individuals were randomly selected as controls from patients presented to Out Patient Department. Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders was used to diagnose psychiatric disorders. Validated tools were used to measure other constructs. Results: Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011- 2013 (Male:female ratio 5.7, 4.4 and 6.4). 60% of suicides were due to poisoning. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population in 2011- 2013. Highest age standardized male DSP incidence reported in 20-24 years (769.6/100,000) and female in 15-19 years (1304.0/100,000). Bing married (age >25 years), monthly family income less than Rs.30,000, not achieving G.C.E (O/L) qualifications, a school drop-out, not in a permanent position in occupation, being a manual and an own account worker, were significantly associated with DSP. Perceiving the quality of relationship as bad or very bad with parents, spouse/ girlfriend/ boyfriend and sibling as associated with 8, 40 and 10.5 times higher risk respectively. Feeling and experiences of neglect, other emotional abuses, feeling of insecurity with the family, in child hood, and having a contact history carried an excess risk for DSP. Cases were less likely to seek help. Further, they had significantly lower scores for life skills and life skills application ability. 25.6% DSH patients had DSM TR axis-I and/or TR axis-II disorder. The presence of psychiatric disorder carried 7.7 (95% CI 4.3 – 13.8) times higher risk for DSP. Conclusion: In general, pattern of DSH and suicide is, unique, different from developed, upper and middle income and lower and middle income countries. It is a learned way of expressing emotions in difficult situations of vulnerable people.

Keywords: deliberate self-harm, help-seeking, life-skills, mental- health, psychological, social, suicide

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Authors: Ting-I Lin

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Objective: This article explores the nursing care experience of a 51-year-old terminal lung cancer patient admitted to the intensive care unit (ICU) following an upper right lobectomy. The patient initially sought emergency treatment due to worsening cough and dyspnea, which led to the placement of an endotracheal tube following sudden deterioration. Subsequent CT scans and chest X-rays revealed a tumor in the upper right lung with metastases to the lungs, liver, bones, and adrenal glands. The patient underwent a right upper lobectomy and a wedge resection of the right middle lobe. Pathology staging: T4N3M1c and the patient was diagnosed with advanced cancer postoperatively. Method: During the care period, nursing staff continuously monitored the patient’s physiological data through observations, direct care, interviews, physical assessments, and review of the patient’s medical records. The nursing team collaborated with the critical care team and the palliative care team, using Gordon's Eleven Functional Health Patterns to conduct a comprehensive assessment. The key health problems identified included pain related to postoperative cancer resection and invasive devices, fear of death due to rapid disease progression, and altered tissue perfusion associated with hemodynamic instability. Results: Postoperatively, the patient experienced pain from the surgical wound and dyspnea due to extensive metastasis, often leading to confusion. Through the adjustment of pain medication, the patient’s discomfort was alleviated, using Morphine 8 mg in 0.9% normal saline 60 ml IV drip q6h prn, and Ultracet 37.5 mg/325 mg 1# PO q6h. Additionally, lavender essential oil inhalation and limb massage were provided for 15 minutes four times a day. The patient’s FLACC pain score decreased from 7 to below 3. After respiratory training, the endotracheal tube was successfully removed, and the patient was weaned off the ventilator. Triflow exercises were used to promote alveolar expansion, with the goal of achieving 2 balls for 10 seconds, 5 repetitions per session, 6-8 times a day. The patient’s breathing stabilized at 16-18 breaths per minute, body temperature remained between 35.8°C and 36.1°C, and the mean arterial pressure was maintained between 60-80 mmHg. Conclusion: The critical care team and the palliative care team held a family meeting to discuss not only the patient’s care but also the emotional well-being of the family. Visiting hours were increased to two times per day, one hour each time, allowing the patient and family to express love and gratitude, which strengthened their emotional connection and reduced the patient’s anxiety from severe to mild. The family expressed that they had no regrets. After the patient was transferred to the general ward, the nursing team continued to provide end-of-life care with genuine empathy, compassion, and religious support, helping both the patient and family through the final stage of life.

Keywords: multiple metastases, lung cancer, palliative care, nursing experience

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