Search results for: long term services and supports

Authors: Jaci Mastrandrea

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening is directly correlated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project is to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline from March 15th, 2022, to April 29th, 2022. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated and evidence-based PC referral criteria. The tool was initially implemented using paper forms and later was integrated into the Epic-Beacon EHR system. Patients were screened by registered nurses on the SLCTC treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher were considered to be a positive screen. Scores of five or higher triggered a PC referral order in the patient’s EHR for the oncologist to review and approve. All patients with a positive screen received an educational handout on the topic of PC, and the EHR was flagged for follow-up. Results: Prior to implementation of the PSCNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the first 100 patient screenings completed within the eight-week data collection period. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting the criteria were flagged in the EHR for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative care, symptom management, symptom screening, ambulatory oncology, cancer, supportive care

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Authors: Tony Ikponmwosa Obaseki

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The paper studied Colleges of education environments with specific insight at available technologies in college libraries with the objective of ascertaining the services rendered and the impact of information services on teacher trainings in the overall development and benefit of the educational ecosystem. Problems were situated and assumptions formulated made to guide the study proper. Twelve (12) Colleges of education environment from the six geopolitical zones in Nigeria were comparatively studied, using twelve (12) librarians and six hundred (600) randomly selected training teachers. Analysis and presentation of findings will be done using well stated scientific procedures.

Keywords: library, technologies, digital library, colleges of education, teacher training, education ecosystem

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Authors: Yared Yitagesu Tilahun

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Every nation, developed or developing, relies on transportation, but Addis Abeba City's transportation service is impacted by a number of variables. The current study's objectives are to determine the factors that influence transportation and gauge consumer satisfaction with such services in Addis Abeba. Customers and employees of Addis Ababa's transportation service authority would be the study's target group. 40 workers of the authority would be counted as part of the 310 000 clients that make up the population of the searcher service. Using a straightforward random selection technique, the researcher only chose 99 customers and 28 staff from this enormous group due to the considerable cost and time involved. Data gathering and analysis options included both quantitative and qualitative approaches. The results of this poll show that young people between the ages of 18 and 25 make up the majority of respondents (51.6%). The majority of employees and customers indicated that they are not satisfied with Addis Ababa's overall transportation system. The Addis Abeba Transportation Authority prioritizes client happiness by providing fair service. The company should have a system in place for managing time, resources, and people effectively. It should also provide employees the opportunity to contribute to client handling policies.

Keywords: transportation, customer satisfaction, services, determinants

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Authors: Megan E. Davies

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With the intention of identifying cognitive processes uniquely involved in the dark triad personality traits of psychopathy, Machiavellianism, and narcissism, this study aimed to determine further potential differences and parameters of individual traits by explaining a statistically significant amount of variance between the constructs of manipulativeness, impulsiveness, grit, and need for cognition within the dark triad. Applying a cross-sectional design, N = 96 participants self-reported using the MACH-IV, SRP-III, NFC-S, and Grit Scale for Perseverance and Passion for Long-Term Goals. Hierarchical regression analyses showed that only manipulativeness predicted Machiavellianism, whereas manipulativeness and impulsiveness were found to have predictive qualities for psychopathy. Overall, these results found areas of discrepancy and overlap between manipulation and impulsivity regarding psychopathy and Machiavellianism. Additionally, this study serves to preliminarily eliminate the Need for Cognition and grit as predictive variables for Machiavellianism and psychopathy.

Keywords: Machiavellianism, psychopathy, manipulation, impulsiveness, need for cognition, grit, dark triad

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Authors: Stephanie Zuba-Bates

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Purpose: This qualitative research study explored the lived experience of people with functional movement disorder (FMD) including how it impacts their quality of life and participation in life activities. It aims to educate health care professionals about FMD from the perspective of those living with the disorder. Background: Functional movement disorder is characterized by abnormal motor movements including tremors, abnormal gait, paresis, and dystonia with no known underlying pathophysiological cause. Current research estimates that FMD may account for 2-20% of clients seen by neurologists. Getting a diagnosis of FMD is typically long and difficult. In addition, many healthcare professionals are unfamiliar with the disorder which may delay treatment. People living with FMD face great disruption in major areas of life including activities of daily living (ADLs), work, leisure, and community participation. OT practitioners have expertise in working with people with both physical disabilities as well as mental illness and this expertise has the potential to guide treatment and become part of the standard of care. In order for occupational therapists to provide these services, they must be aware of the disorder and must advocate for clients to be referred to OT services. In addition, referring physicians and other health professionals need to understand how having FMD impacts the daily functioning of people living with the disorder and how OT services can intervene to improve their quality of life. This study aimed to answer the following research questions: 1) What is the lived experience of individuals with FMD?; 2) How has FMD impacted their participation in major areas of life?; and, 3) What treatment have they found to be effective in improving their quality of life? Method: A naturalistic approach was used to collect qualitative data through semi-structured telephone interviews of five individuals living with FMD. Subjects were recruited from social media websites and resources for people with FMD. Data was analyzed for common themes among participants. Results: Common themes including the variability of symptoms of the disorder; challenges to receiving a diagnosis; frustrations with and distrust of health care professionals; the impact of FMD on the participant’s ability to perform daily activities; and, strategies for living with the symptoms of FMD. Conclusion: All of the participants in the study had to modify their daily activities, roles and routines as a result of the disorder. This is an area where occupational therapists may intervene to improve the quality of life of these individuals. Additionally, participants reported frustration with the medical community regarding the awareness of the disorder and how they were treated by medical professionals. Much more research and awareness of the disorder is in order.

Keywords: functional movement disorder, occupational therapy, participation, quality of life

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Authors: Meral Huri, Sedef Şahin

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Post-traumatic stress disorder (PTSD) is characterized by psychiatric symptoms and triggered by a terrifying experience which may immediately effect cognitive, affective, behavioral and social skills of the individual. One of the most common noncutaneous cancer among men is prostate cancer. The incidence of psychological stress is quite common in men with prostate cancer. The aim of the study was to explore the PTSD frequency among prostate cancer and define the relationship between occupational participation, coping skills and level of perceived social support among patients with prostate cancer. Forty patients diagnosed with prostate cancer were included in the study. After dividing the patients into two groups ( study/ control) according to type of tumor, we recorded their characteristics and evaluations differences. We evaluated the demographic information form, Structured Clinical Interview for DSM-IV (SCID- I)- Clinical Version for PTSD, Multidimensional Scale of Perceived Social Support, Styles of Coping Inventory and Canadian Occupational Performance Measure (COPM) before and after 1 month from surgery. The mean age of the study group (n:18) was 65.85.6 years (range: 61-79 years). The mean age of the control group (n: 22) was a little bit higher than the study group with mean age 71.3±6.9 years (range: 60-85 years). There was no statistically significant difference between the groups for age and the other characteristics. According to the results of the study, statistically significant difference was found between the level of PTSD of study and the control group. 22% of study group showed PTSD while 13% of the control group showed PTSD (r: 0.02, p<0.001). The scores of study group and control group showed statistically significant difference in five sub-categories of Styles of Coping Inventory. Patients with prostate cancer showed decreased scores in optimistic, seeking social supports and self-confident approach, while increased scores in helpless and submissive sub-categories than the control group (p<0.001). The scores of Multidimensional Scale of Perceived Social Supports of study group and control group showed statistically significant difference. The total perceived social supports score of the study group was 71.34 ± 0.75 while it was 75.34 ± 0.64 for the control group. Total and the sub-category scores of study group were statistically significant lower than the control group. According to COPM, mean scores of occupational participation of study group for occupational performance were 4.32±2.24 and 7.01±1.52 for the control group, respectively). Mean Satisfaction scores were 3,22±2.31 and 7.45±1.74 for the study and control group, respectively. The patients with prostate cancer and benign prostate hyperplasia (BPH) did not show any statistically difference in activity performance (r:0.87) while patients with prostate cancer showed statistically lower scores than the patients with BPH in activity satisfaction (r:0.02, p<0.001).Psycho-social occupational therapy interventions might help to decrease the prevalence of PTSD by increasing associated factors such as the social support perception, using coping skills and activity participation of patients with prostate cancer.

Keywords: activity performance, occupational therapy, posttraumatic stress disorder, prostate cancer

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Authors: Jiyeon Kim

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This conceptual paper examines the psychological drivers of green consumerism and sustainable consumption by integrating the Value-Belief-Norm (VBN) Theory and the Theory of Reasoned Action (TRA). With growing environmental concerns, green consumerism promotes eco-friendly choices such as purchasing sustainable products and supporting environmentally responsible companies. However, there remains a need for research that effectively guides strategies to encourage sustainable behaviors. This paper evaluates VBN Theory’s role in driving pro-environmental behaviors. By incorporating TRA, the paper proposes an enhanced model that improves understanding of the factors driving sustained pro-environmental actions. Focusing on values, beliefs, and norms, this integrated model provides a deeper understanding of the cognitive and motivational factors that influence sustainable consumption. The findings offer valuable theoretical and practical insights for developing strategies to support long-term responsible consumer behavior.

Keywords: green consumerism, sustainable behavior, TRA, VBN

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Authors: Maham Leeza Adil, Mahrukh Alvi, Muhammad Osman

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Introduction: Sheehan's syndrome (SS) is a rare cause of hypopituitarism resulting from postpartum hemorrhage and pituitary necrosis. It remains an underdiagnosed condition, especially in developing countries, due to poor obstetric care and home deliveries. This case report highlights the significance of recognizing atypical presentations of SS, such as pancytopenia, to aid in early diagnosis and management. Case Presentation: A 40-year-old female presented with acute abdomen symptoms and was initially diagnosed with acalculous cholecystitis. However, a detailed history revealed a history of postpartum hemorrhage 18 years prior, leading to a provisional diagnosis of SS. Further investigations confirmed panhypopituitarism, including hypothyroidism, hypocortisolism, and hypogonadism. Notably, the patient also exhibited pancytopenia, a rarely reported hematological manifestation of SS. Discussion: SS often presents with nonspecific symptoms, leading to delayed or missed diagnoses. In this case, the patient's initial presentation of acute abdomen symptoms was attributed to secondary adrenal insufficiency due to panhypopituitarism. The presence of pancytopenia, along with hyponatremia, further complicated the clinical picture. Hormone replacement therapy led to a remarkable improvement in the patient's condition, emphasizing the importance of early diagnosis and intervention. Conclusion: SS is a common cause of panhypopituitarism in developing countries, but its atypical presentations, such as pancytopenia, are rare and often overlooked. This case highlights the need for increased awareness among clinicians to consider SS in patients with unexplained hematological abnormalities, particularly in regions with high rates of postpartum hemorrhage. Early recognition and appropriate hormone replacement therapy can significantly improve patients' outcomes and prevent long-term complications associated with this underdiagnosed syndrome.

Keywords: Sheehan syndrome, panhypopituitarism, pancytopenia, delayed diagnosis

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Authors: Ilona Ivova Anachkova

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The analogy between the artist and the shaman as both being practitioners that more easily recognize and explore spiritual matters, and thus contribute to the society in a unique way has been implied in both Modernity and Postmodernity. The Romantic conception of the shaman as a great artist who helps common men see and understand messages of a higher consciousness has been employed throughout Modernity and is active even now. This paper deconstructs the term ‘shaman’ in the metaphorical analogy ‘artist – shaman’ that was developed more fully in Modernity in different artistic and scientific discourses. The shaman is a figure that to a certain extent adequately reflects the late modern and postmodern holistic views on the world. Such views aim at distancing from traditional religious and overly rationalistic discourses. However, the term ‘shaman’ can be well substituted by other concepts such as the priest, for example. The concept ‘shaman’ is based on modern ethnographic and historical investigations. Its later philosophical, psychological and artistic appropriations designate the role of the artist as a spiritual and cultural leader. However, the artist and the shaman are not fully interchangeable terms. The figure of the shaman in ‘primitive’ societies has performed many social functions that are now delegated to different institutions and positions. The shaman incorporates the functions of a judge, a healer. He is a link to divine entities. He is the creative, aspiring human being that has heightened sensitivity to the world in both its spiritual and material aspects. Building the metaphorical analogy between the shaman and the artist comes in many ways. Both are seen as healers of the society, having propensity towards connection to spiritual entities, or being more inclined to creativity than others. The ‘shaman’ however is a fashionable word for a spiritual person used perhaps because of the anti-traditionalist religious modern and postmodern views. The figure of the priest is associated with a too rational, theoretical and detached attitude towards spiritual matters, while the practices of the shaman and the artist are considered engaged with spirituality on a deeper existential level. The term ‘shaman’ however does not have priority of other words/figures that can explore and deploy spiritual aspects of reality. Having substituted the term ‘shaman’ in the pair ‘artist as a shaman’ with ‘the priest’ or literally ‘anybody,' we witness destruction of spiritual hierarchies and come to the view that everybody is responsible for their own spiritual and creative evolution.

Keywords: artist as a shaman, creativity, extended theory of art, functions of art, priest as an artist

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Authors: Marco Naegele, Klaus Stoppel, Thomas Dekorsy

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Passively Q-switched microchip lasers enable the great potential for sophisticated LiDAR systems due to their compact overall system design, excellent beam quality, and scalable pulse energies. However, many near-infrared solid-state lasers show emitting wavelengths > 1000 nm, which are not compatible with state-of-the-art silicon detectors. Here we demonstrate a passively Q-switched microchip laser operating at 914 nm. The microchip laser consists of a 3 mm long Nd:YVO₄ crystal as a gain medium, while Cr⁴⁺:YAG with an initial transmission of 98% is used as a saturable absorber. Quasi-continuous pumping enables single pulse operation, and low duty cycles ensure low overall heat generation and power consumption. Thus, thermally induced instabilities are minimized, and operation without active cooling is possible while ambient temperature changes are compensated by adjustment of the pump laser current only. Single-emitter diode pumping at 808 nm leads to a compact overall system design and robust setup. Utilization of a microchip cavity approach ensures single-longitudinal mode operation with spectral bandwidths in the picometer regime and results in short laser pulses with pulse durations below 10 ns. Beam quality measurements reveal an almost diffraction-limited beam and enable conclusions concerning the thermal lens, which is essential to stabilize the plane-plane resonator. A 7% output coupler transmissivity is used to generate pulses with energies in the microjoule regime and peak powers of more than 600 W. Long-term pulse duration, pulse energy, central wavelength, and spectral bandwidth measurements emphasize the excellent system stability and facilitate the utilization of this laser in the context of a LiDAR system.

Keywords: diode-pumping, LiDAR system, microchip laser, Nd:YVO4 laser, passively Q-switched

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Authors: Daniele Lerede, Gianvito Colucci, Matteo Nicoli, Laura Savoldi

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The European Green Deal is the first internationally agreed set of measures to contrast climate change and environmental degradation. Besides the main target of reducing emissions by at least 55% by 2030, it sets the target of accompanying European countries through an energy transition to make the European Union into a modern, resource-efficient, and competitive net-zero emissions economy by 2050, decoupling growth from the use of resources and ensuring a fair adaptation of all social categories to the transformation process. While the general purpose to allow the realization of the purposes of the Green Deal already dates back to 2019, strategies and policies keep being developed coping with recent circumstances and achievements. However, general long-term measures like the Circular Economy Action Plan, the proposals to shift from fossil natural gas to renewable and low-carbon gases, in particular biomethane and hydrogen, and to end the sale of gasoline and diesel cars by 2035, will all have significant effects on energy supply and demand evolution across the next decades. The interactions between energy supply and demand over long-term time frames are usually assessed via energy system models to derive useful insights for policymaking and to address technological choices and research and development. TEMOA-Europe is a newly developed energy system optimization model instance based on the minimization of the total cost of the system under analysis, adopting a technologically integrated, detailed, and explicit formulation and considering the evolution of the system in partial equilibrium in competitive markets with perfect foresight. TEMOA-Europe is developed on the TEMOA platform, an open-source modeling framework totally implemented in Python, therefore ensuring third-party verification even on large and complex models. TEMOA-Europe is based on a single-region representation of the European Union and EFTA countries on a time scale between 2005 and 2100, relying on a set of assumptions for socio-economic developments based on projections by the International Energy Outlook and a large technological dataset including 7 sectors: the upstream and power sectors for the production of all energy commodities and the end-use sectors, including industry, transport, residential, commercial and agriculture. TEMOA-Europe also includes an updated hydrogen module considering its production, storage, transportation, and utilization. Besides, it can rely on a wide set of innovative technologies, ranging from nuclear fusion and electricity plants equipped with CCS in the power sector to electrolysis-based steel production processes and steel in the industrial sector – with a techno-economic characterization based on public literature – to produce insightful energy scenarios and especially to cope with the very long analyzed time scale. The aim of this work is to examine in detail the scheme of measures and policies for the realization of the purposes of the Green Deal and to transform them into a set of constraints and new socio-economic development pathways. Based on them, TEMOA-Europe will be used to produce and comparatively analyze scenarios to assess the consequences of Green Deal-related measures on the future evolution of the energy mix over the whole energy system in an economic optimization environment.

Keywords: European Green Deal, energy system optimization modeling, scenario analysis, TEMOA-Europe

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Authors: Diwei Lin, Amanda Jh. Tan

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We present a very rare case of de novo large cell neuroendocrine carcinoma of the prostate (LCNEC) in an 84-year-old male on a background of high-grade, muscle-invasive transitional cell carcinoma of the bladder. While NE tumours account for 1% to 5% of all cases of prostate cancer and scattered NE cells can be found in 10% to 100% of prostate adenocarcinomas, pure LCNEC of the prostate is extremely rare. Most LCNEC of the prostate is thought to originate by clonal progression under the selection pressure of therapy and refractory to long-term hormonal treatment for adenocarcinoma of the prostate. De novo LCNEC is only described in case reports and is thought to develop via direct malignant transformation. Limited data in the English literature makes it difficult to accurately predict the prognosis of LCNEC of the prostate. However, current evidence suggesting that increasing NE differentiation in prostate adenocarcinoma is associated with a higher stage, high-grade disease, and a worse prognosis.

Keywords: large cell neuroendocrine cancer, prostate cancer, refractory cancer, medical and health sciences

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Authors: Harvey Hyman, Thomas Hull

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As one of the largest cancer treatment centers in the United States, we continuously confront the challenge of how to leverage the best possible technological solutions, in order to provide the highest quality of service to our customers – the doctors, nurses and patients at Moffitt who are fighting every day for the prevention and cure of cancer. This paper reports on the transition from a vertical to a horizontal IT infrastructure. We discuss how the new frameworks and methods such as public, private and hybrid cloud, brokering cloud services are replacing the traditional vertical paradigm for computing. We also report on the impact of containers, micro services, and the shift to continuous integration/continuous delivery. These impacts and changes in delivery methodology for computing are driving how we accomplish our strategic IT goals across the enterprise.

Keywords: cloud computing, IT infrastructure, IT architecture, healthcare

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Authors: Nabin Prasad Joshi, Samiksha Neupane

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Since its emergence in December 2019, Corona Virus disease has impacted several countries, affecting many people. The first cases were recorded in Wuhan, China, between December 2019 and January 2020. Italy is one of the affected countries in Europe. The relations between India and Nepal have reverted to the pre-pandemic period as both countries have open borders. The study focused on the overall psychosocial impact among covid-19 survivors in their life what are the changes they are facing after covid also how are their relations with friends and relatives after they have covid in different municipalities of Kathmandu valley, where people from different regions are living in rent and have their own houses. Support from friends and family during a pandemic can prevent it if it is strong enough. Nonetheless, there were risk factors for psychosocial damage, including a lack of or insufficient family and social support, psychiatric assistance, and inadequate insurance or compensation. Poorer mental health outcomes were inversely correlated with social rejection or isolation.

Keywords: stress, anxiety, depression, Kathmandu

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Authors: Megan L. Srinivas

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Individuals with underlying rheumatologic diseases such as dermatomyositis may not adequately respond to tuberculin (PPD) skin tests, creating false negative results. These illnesses are frequently treated with immunosuppressive therapy making proper identification of TB infection imperative. A 59-year-old Filipino man was diagnosed with dermatomyositis on the basis of rash, electromyography, and muscle biopsy. He was initially treated with IVIG infusions and transitioned to oral prednisone and mycophenolate. The patient’s symptoms improved on this regimen. Six months after starting mycophenolate, the patient began having fevers, night sweats, and productive cough without hemoptysis. He moved from the Philippines 5 years prior to dermatomyositis diagnosis, denied sick contacts, and was PPD negative both at immigration and immediately prior to starting mycophenolate treatment. A third PPD was negative following the onset of these new symptoms. He was treated for community-acquired pneumonia, but symptoms worsened over 10 days and he developed watery diarrhea and a growing non-tender, non-mobile mass on the left side of his neck. A chest x-ray demonstrated a cavitary lesion in right upper lobe suspicious for TB that had not been present one month earlier. Chest CT corroborated this finding also exhibiting necrotic hilar and paratracheal lymphadenopathy. Neck CT demonstrated the left-sided mass as cervical chain lymphadenopathy. Expectorated sputum and stool samples contained acid-fast bacilli (AFB), cultures showing TB bacteria. Fine-needle biopsy of the neck mass (scrofula) also exhibited AFB. An MRI brain showed nodular enhancement suspected to be a tuberculoma. Mycophenolate was discontinued and dermatomyositis treatment was switched to oral prednisone with a 3-day course of IVIG. The patient’s infection showed sensitivity to standard RIPE (rifampin, isoniazid, pyrazinamide, and ethambutol) treatment. Within a week of starting RIPE, the patient’s diarrhea subsided, scrofula diminished, and symptoms significantly improved. By the end of treatment week 3, the patient’s sputum no longer contained AFB; he was removed from isolation, and was discharged to continue RIPE at home. He was discharged on oral prednisone, which effectively addressed his dermatomyositis. This case illustrates the unreliability of PPD tests in patients with long-term inflammatory diseases such as dermatomyositis. Other immunosuppressive therapies (adalimumab, etanercept, and infliximab) have been affiliated with conversion of latent TB to disseminated TB. Mycophenolate is another immunosuppressive agent with similar mechanistic properties. Thus, it is imperative that patients with long-term inflammatory diseases and high-risk TB factors initiating immunosuppressive therapy receive a TB blood test (such as a quantiferon gold assay) prior to the initiation of therapy to ensure that latent TB is unmasked before it can evolve into a disseminated form of the disease.

Keywords: dermatomyositis, immunosuppressant medications, mycophenolate, disseminated tuberculosis

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Authors: Haezreena Begum Abdul Hamid

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This article will explore the conflation between voluntary sex work and trafficked sex work. In doing so, the article will analyse the meaning of trafficking according to the United Nations ‘Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children’ and the Malaysian Anti-Trafficking in Persons and Anti-Migrant Smuggling Act, 2007 (ATIP), and discuss the ambiguities that may arise in understanding the term. While the law on human trafficking has long been understood by scholars, key stakeholders, and enforcement officers, identifying a victim of trafficking is far from being straight forward. This is because of the diverse understanding on sex trafficking and sex work, and the fact that ‘consent’ by trafficked persons remains irrelevant in cases of trafficking. As a result, women who voluntarily engage in sex work are sometimes categorised as ‘trafficked’ and are ‘rescued’ by the authorities in the name of ‘protection’, while those who insist of having agency can be charged for violating the immigration laws. In light of such circumstances, this article aims to explore the conflation between voluntary sex work and trafficked sex work and how such conflation have succeeded in fostering distrust between sex workers and authorities.

Keywords: voluntary sex work, trafficked sex work, sex work, coercion, protection

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Authors: Melanie Macgregor-Ramiasa, Isabel Hopp, Patricia Murray, Krasimir Vasilev

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Stem cells based therapies are one of the greatest promises of new-age medicine due to their potential to help curing most dreaded conditions such as cancer, diabetes and even auto-immune disease. However, establishing suitable in vitro culture materials allowing to control the fate of stem cells remain a challenge. Amongst the factor influencing stem cell behavior, substrate chemistry and nanotopogaphy are particularly critical. In this work, we used plasma assisted surface modification methods to produce model substrates with tailored nanotopography and controlled chemistry. Three different sizes of gold nanoparticles were bound to amine rich plasma polymer layers to produce homogeneous and gradient surface nanotopographies. The outer chemistry of the substrate was kept constant for all substrates by depositing a thin layer of our patented biocompatible polyoxazoline plasma polymer on top of the nanofeatures. For the first time, protein adsorption and stem cell behaviour (mouse kidney stem cells and mesenchymal stem cells) were evaluated on nanorough plasma deposited polyoxazoline thin films. Compared to other nitrogen rich coatings, polyoxazoline plasma polymer supports the covalent binding of proteins. Moderate surface nanoroughness, in both size and density, triggers cell proliferation. In association with polyoxazoline coating, cell proliferation is further enhanced on nanorough substrates. Results are discussed in term of substrates wetting properties. These findings provide valuable insights on the mechanisms governing the interactions between stem cells and their growth support.

Keywords: nanotopography, stem cells, differentiation, plasma polymer, oxazoline, gold nanoparticles

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Authors: Yali Liu, Maria Avello Iturriagagoitia

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Background: Fitness applications (apps) are one of the most popular mobile health (mHealth) apps. These apps can help prevent/control health issues such as obesity, which is one of the most serious public health challenges in the developed world in recent decades. Compared with the traditional intervention like face-to-face treatment, it is cheaper and more convenient to use fitness apps to interfere with physical activities and healthy behaviors. Nevertheless, fitness applications apps tend to have high abandonment rates and low levels of user engagement. Therefore, maintaining the endurance of users' usage is challenging. In fact, previous research shows a variety of strategies -goal-setting, self-monitoring, coaching, etc.- for promoting fitness and health behavior change. These strategies can influence the users’ perseverance and self-monitoring of the program as well as favoring their adherence to routines that involve a long-term behavioral change. However, commercial fitness apps rarely incorporate these strategies into their design, thus leading to a lack of engagement with the apps. Most of today’s mobile services and brands engage their users proactively via push notifications. Push notifications. These notifications are visual or auditory alerts to inform mobile users about a wide range of topics that entails an effective and personal mean of communication between the app and the user. One of the research purposes of this article is to implement the application of behavior change strategies through push notifications. Proposes: This study aims to better understand the influence that effective use of push notifications combined with the behavioral change strategies will have on users’ engagement with the fitness app. And the secondary objectives are 1) to discuss the sociodemographic differences in utilization of push notifications of fitness apps; 2) to determine the impact of each strategy in customer engagement. Methods: The study uses a combination of the Consumer Engagement Theory and UTAUT2 based model to conduct an online survey among current users of fitness apps. The questionnaire assessed attitudes to each behavioral change strategy, and sociodemographic variables. Findings: Results show the positive effect of push notifications in the generation of consumer engagement and the different impacts of each strategy among different groups of population in customer engagement. Conclusions: Fitness apps with behavior change strategies have a positive impact on increasing users’ usage time and customer engagement. Theoretical experts can participate in designing fitness applications, along with technical designers.

Keywords: behavioral change, customer engagement, fitness app, push notification, UTAUT2

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Authors: Abdelbasit Gadour

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This study explores the function of schools’ psychosocial services within Libyan mainstream schools in relation to children’s special educational needs (SEN). This is with the aim to examine the role of school social workers and psychologists in the assessment procedure of children with special educational needs. A semi-structured interview was used in this study, with 21 professionals working in the schools’ psychosocial services, of whom thirteen were school social workers (SSWs) and eight were school psychologists (SPs). The results of the interviews with SSWs and SPs provided insights into how SEN children are identified, assessed, and dealt with by school professionals. It appears from the results that what constitutes a problem has not changed significantly, and the link between learning difficulties and behavioral difficulties is also evident from this study. Children with behavior difficulties are more likely to be referred to school psychosocial services than children with learning difficulties. Yet, it is not clear from the interviews with SSWs and SPs whether children are excluded merely because of their behavior problems. Instead, they would surely be expelled from the school if they failed academically. Furthermore, the interviews with SSWs and SPs yield a rather unusual source accountable for children’s SEN; school-related difficulties were a major factor in which almost all participants attributed children’s learning and behavior problems to teachers’ deficiencies, followed by school lack of resources.

Keywords: psychologist, school, social workers, special education

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Authors: Lakshmi N. Reddi, Akanksha Varma Sagi

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Studies on biomimetics are largely developed, deriving inspiration from natural processes in our objective world to develop novel technologies. Recent studies are diverse in nature, making their categorization quite challenging. Based on an exhaustive survey, we developed categorizations based on either the essential elements of nature - air, water, land, fire, and space, or on form/shape, functionality, and process. Such diverse studies as aircraft wings inspired by bird wings, a self-cleaning coating inspired by a lotus petal, wetsuits inspired by beaver fur, and search algorithms inspired by arboreal ant path networks lend themselves to these categorizations. Our categorizations of biomimetic studies allowed us to define a different dimension of biomimetics. This new dimension is not restricted to inspiration from the objective world. It is based on the premise that the biological processes observed in the objective world find their reflections in our human bodies in a variety of ways. For example, the lungs provide the most efficient example for liquid-gas phase exchange, the heart exemplifies a very efficient pumping and circulatory system, and the kidneys epitomize the most effective cleaning system. The main focus of this paper is to bring out the magnificence of the cerebro-spinal system (CSS) insofar as it relates to our current computer architecture. In particular, the paper uses four key measures to analyze the differences between CSS and human- engineered computational systems. These are adaptability, sustainability, energy efficiency, and resilience. We found that the cerebrospinal system reveals some important challenges in the development and evolution of our current computer architectures. In particular, the myriad ways in which the CSS is integrated with other systems/processes (circulatory, respiration, etc) offer useful insights on how the human-engineered computational systems could be made more sustainable, energy-efficient, resilient, and adaptable. In our paper, we highlight the energy consumption differences between CSS and our current computational designs. Apart from the obvious differences in materials used between the two, the systemic nature of how CSS functions provides clues to enhance life-cycles of our current computational systems. The rapid formation and changes in the physiology of dendritic spines and their synaptic plasticity causing memory changes (ex., long-term potentiation and long-term depression) allowed us to formulate differences in the adaptability and resilience of CSS. In addition, the CSS is sustained by integrative functions of various organs, and its robustness comes from its interdependence with the circulatory system. The paper documents and analyzes quantifiable differences between the two in terms of the four measures. Our analyses point out the possibilities in the development of computational systems that are more adaptable, sustainable, energy efficient, and resilient. It concludes with the potential approaches for technological advancement through creation of more interconnected and interdependent systems to replicate the effective operation of cerebro-spinal system.

Keywords: cerebrospinal system, computer architecture, adaptability, sustainability, resilience, energy efficiency

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Authors: Brenden M. Shutt, Lubjana Beshaj, Paul L. Goethals, Ambrose Kam

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Communication security is of particular interest to military data networks. A relatively novel approach to network security is blockchain, a cryptographically secured distribution ledger with a decentralized consensus mechanism for data transaction processing. Recent advances in blockchain technology have proposed new techniques for both data validation and trust management, as well as different frameworks for managing dataflow. The purpose of this work is to test the feasibility of different blockchain architectures as applied to military command and control networks. Various architectures are tested through discrete-event simulation and the feasibility is determined based upon a blockchain design’s ability to maintain long-term stable performance at industry standards of throughput, network latency, and security. This work proposes a consortium blockchain architecture with a computationally inexpensive consensus mechanism, one that leverages a Proof-of-Identity (PoI) concept and a reputation management mechanism.

Keywords: blockchain, consensus mechanism, discrete-event simulation, fog computing

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Authors: Sultan Alotaibi, Dmitri Roussinov

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Many governments recently started to change the ways of providing their services by allowing their citizens to access services from anywhere without the need of visiting the location of the service provider. Mobile government (M-government) is one of the techniques that fulfill that goal. It has been adopted by many governments. M-government can be defined as an implementation of Electronic Government (E-Government) by using mobile technology with the aim of improving service delivery to citizens, businesses and all government agencies. There have been several research projects developing models to understand the behavior of individuals towards the adoption of m-government. This paper proposes a model for adoption of m-government services in Saudi Arabia by extending Technology Acceptance Model (TAM) by introducing external factors. This paper also reports on the development of a survey instrument designed to measure user perception of mobile government acceptance. A survey instrument has been developed by using existing scales from prior instruments and a pilot study has been conducted by distributing the survey to 33 participants. As a result, a survey instrument has been refined to retain 43 items. The results also showed that the reliabilities of all the scales in the survey instrument are above the levels acceptable in current academic research, thus the instruments developed by us are capable of analyzing the factors in M-government adoption.

Keywords: TAM, m-government, e-government, model, acceptance, mobile government

Procedia PDF Downloads 249

Authors: D. M. S. Bandara, Yunqi Lei, Ye Luo

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Fingerprints are suitable as long-term markers of human identity since they provide detailed and unique individual features which are difficult to alter and durable over life time. In this paper, we propose an algorithm to encrypt and decrypt fingerprint images by using a specially designed Elliptic Curve Cryptography (ECC) procedure based on block ciphers. In addition, to increase the confusing effect of fingerprint encryption, we also utilize a chaotic-behaved method called Arnold Cat Map (ACM) for a 2D scrambling of pixel locations in our method. Experimental results are carried out with various types of efficiency and security analyses. As a result, we demonstrate that the proposed fingerprint encryption/decryption algorithm is advantageous in several different aspects including efficiency, security and flexibility. In particular, using this algorithm, we achieve a margin of about 0.1% in the test of Number of Pixel Changing Rate (NPCR) values comparing to the-state-of-the-art performances.

Keywords: arnold cat map, biometric encryption, block cipher, elliptic curve cryptography, fingerprint encryption, Koblitz’s encoding

Procedia PDF Downloads 204

Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

Procedia PDF Downloads 123

Authors: Bisemiire Anthony,

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PESH Poultry is a business project proposed specifically to solve unemployment and income-related problems affecting the youths in the Busia district. The project is intended to transform the life of the youth in terms of economic, social and behavioral, as well as the domestic well-being of the community at large. PESH Poultry is a start-up poultry farm that will be engaged in the keeping of poultry birds, broilers and layers for the production of quality and affordable poultry meat and eggs respectively and other poultry derivatives targeting consumers in eastern Uganda, for example, hotels, restaurants, households and bakeries. We intend to use a semi-intensive system of farming, where water and some food are provided in a separate nighttime shelter for the birds; our location will be in Lumino, Busia district. The poultry project will be established and owned by Bisemiire Anthony, Nandera Patience, Naula Justine, Bwire Benjamin and other investors. The farm will be managed and directed by Nandera Patience, who has five years of work experience and business administration knowledge. We will sell poultry products, including poultry eggs, chicken meat, feathers and poultry manure. We also offer consultancy services for poultry farming. Our eggs and chicken meat are hygienic, rich in protein and high quality. We produce processes and packages to meet the standard organization of Uganda and international standards. The business project shall comprise five (5) workers on the key management team who will share various roles and responsibilities in the identified business functions such as marketing, finance and other related poultry farming activities. PESH Poultry seeks 30 million Ugandan shillings in long-term financing to cover start-up costs, equipment, building expenses and working capital. Funding for the launch of the business will be provided primarily by equity from the investors. The business will reach positive cash flow in its first year of operation, allowing for the expected repayment of its loan obligations. Revenue will top UGX 11,750,000, and net income will reach about UGX115 950,000 in the 1st year of operation. The payback period for our project is 2 years and 3 months. The farm plans on starting with 1000 layer birds and 1000 broiler birds, 20 workers in the first year of operation.

Keywords: chicken, pullets, turkey, ducks

Procedia PDF Downloads 95

Authors: Togzhan D. Mukasheva, Anel A. Omirbekova, Raikhan S. Sydykbekova, Ramza Zh. Berzhanova, Lyudmila V. Ignatova

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Following plants-barley (Hordeum sativum), alfalfa (Medicago sativa), grass mixture (red fescue-75%, long-term ryegrass - 20% Kentucky bluegrass - 10%), oilseed rape (Brassica napus biennis), resistant to growth in the contaminated soil with oil content of 15.8 g / kg 25.9 g / kg soil were used. Analysis of the population showed that the oil pollution reduces the number of bacteria in the rhizosphere and rhizoplane of plants and enhances the amount of spore-forming bacteria and saprotrophic micromycetes. It was shown that regardless of the plant, dominance of Pseudomonas and Bacillus genera bacteria was typical for the rhizosphere and rhizoplane of plants. The frequency of bacteria of these genera was more than 60%. Oil pollution changes the ratio of occurrence of various types of bacteria in the rhizosphere and rhizoplane of plants. Besides the Pseudomonas and Bacillus genera, in the presence of hydrocarbons in the root zone of plants dominant and most typical were the representatives of the Mycobacterium and Rhodococcus genera. Together the number was between 62% to 72%.

Keywords: pollution, root system, micromycetes, identification

Procedia PDF Downloads 500

Authors: Oleg Shovkovyy

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This research conducted in response to one of the most pressing questions on the agenda of many public administration offices around the world: “What could be done for better integration and assimilation of immigrants into hosting communities?” In author’s view, the answer could be suggested by immigrants themselves. They, often ‘bogged down in the past,’ snared by own idols and demons, perceive things differently, which, in turn, may result in their inability to integrate smoothly into hosting communities. Brief literature review suggests that perceptions of immigrants are completely neglected or something unsought in the current research on migrants, which, often, based on opinion polls by members of hosting communities themselves or superficial research data by various research organizations. Even those specimens that include voices of immigrants, unlikely to shed any additional light onto the problem simply because certain things are not made to speak out loud, especially to those in whose hands immigrants’ fate is (authorities). In this regard, this qualitative study, conducted by an insider to a few Russian-speaking communities, represents a unique opportunity for all stakeholders to look at the question of integration through the eyes of immigrants, from a different perspective and thus, makes research findings especially valuable for better understanding of the problem. Case study research employed ethnographic methods of gathering data where, approximately 200 Russian-speaking immigrants of first and second generations were closely observed by the Russian-speaking researcher in their usual setting, for eight months, and at different venues. The number of informal interviews with 27 key informants, with whom the researcher managed to establish a good rapport and who were keen enough to share their experiences voluntarily, were conducted. The field notes were taken at 14 locations (study sites) within the Brisbane region of Queensland, Australia. Moreover, all this time, researcher lived in dwelling of one of the immigrants and was an active participant in the social life (worship, picnics, dinners, weekend schools, concerts, cultural events, social gathering, etc.) of observed communities, whose members, to a large extent, belong to various religious lines of the Russian and Protestant Church. It was found that the majority of immigrants had experienced some discrimination in matters of hiring, employment, recognition of educational qualifications from home countries, and simply felt a sort of dislike from society in various everyday situations. Many noted complete absences or very limited state assistance in terms of employment, training, education, and housing. For instance, the Australian Government Department of Human Services not only does not stimulate job search but, on the contrary, encourages to refuse short-term works and employment. On the other hand, offered free courses on adaptation, and the English language proved to be ineffective and unpopular amongst immigrants. Many interviewees have reported overstated requirements for English proficiency and local work experience, whereas it was not critical for the given task or job. Based on the result of long-term monitoring, the researcher also had the courage to assert the negative and decelerating roles of immigrants’ communities, particularly religious communities, on processes of integration and assimilation. The findings suggest that governments should either change current immigration policies in the direction of their toughening or to take more proactive and responsible role in dealing with immigrant-related issues; for instance, increasing assistance and support to all immigrants and probably, paying more attention to and taking stake in managing and organizing lives of immigrants’ communities rather, simply leaving it all to chance.

Keywords: Australia, immigration, integration, perceptions

Procedia PDF Downloads 220

Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

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Background: The COVID-19 pandemic exacerbated the already significant strain placed on family carers of people with profound and multiple intellectual disabilities (PMID), given the withdrawal of many services during lockdown. The aim of this study was to explore the experiences of family carers of people with PMID during the COVID-19 pandemic. Methods: Online focus groups were conducted with family carers (n=126) from across the UK and the Republic of Ireland. Participants were asked about their experiences of the COVID-19 pandemic, coping strategies, and challenges faced. Focus groups were audio recorded, transcribed verbatim and analyzed through thematic analysis. Findings: Three themes emerged from our analysis of the data: (i) COVID-19 as a double-edged sword, (ii) The struggle for support (iii) the Constant nature of caring. These included 11 subthemes: (i) ‘COVID-19 as a catalyst for change’, ‘Challenges during COVID-19: dealing with change’, ‘Challenges during COVID-19: fear of COVID-19’, ‘The online environment: the new normal’ (ii) ‘Invisibility of male carers’, ‘Carers supporting carers’, ‘The only service you get is lip service: non-existent services’, ‘Knowing your rights’ (iii) ‘Emotional response to the caring role: Feeling devalued’, ‘Emotional response to the caring role: Desperation of caring’, ‘Multiple demands of the caring role.’ Conclusions: Poor or inconsistent access to services and support has been an ongoing difficulty for many family carers. The COVID-19 pandemic has only further intensified these difficulties, increasing family carers' stress. There is an urgent need to design services, such as online support programs, in partnership with family carers that adequately address their needs.

Keywords: intellectual disabilities, family carer, COVID-19, disability

Procedia PDF Downloads 79

Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: bilingual, English, medicine, doctor

Procedia PDF Downloads 139

Authors: Ali Abdelsattar Elshabrawy

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The Egyptian government is struggling to build it's eGovernment project. They succeeded to build the Egyptian digital portal, which contain links for number of services provided by different ministries. For achieving such success, their are requirements necessary to build such a project such as: internet dissemination, IT literacy, Strategy, disqualification of paper based services. This paper is going to clarify the main obstacles to the Egyptian eGovernment project from both the supply and demand sides. Also will clarify the most critical requirements in this phase of the project lifecycle. This paper should be in great value for the project team and also for many other developing countries that share the same obstacles.

Keywords: the egyptian egovernment project lifecycle, supply side barriers, demand side barriers, egovernment project requirements

Procedia PDF Downloads 148