Search results for: building life cycle cost (ICC)

Authors: Nelomi Anandagoda, Leanne J. Eveson

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During the COVID-19 pandemic, the surge in in-patient admissions across the medical directorate of a district general hospital necessitated the implementation of an incident rota. Conscious of the impact on training and professional development, the idea of developing a virtual teaching programme was conceived. The programme initially aimed to provide junior doctors, specialist nurses, pharmacists, and allied healthcare professionals from medical specialties and those re-deployed from other specialties (e.g., ophthalmology, GP, surgery, psychiatry) the knowledge and skills to manage the deteriorating patient with COVID-19. The programme was later developed to incorporate the general internal medicine curriculum. To facilitate continuing medical education whilst maintaining social distancing during this period, a virtual platform was used to deliver teaching to junior doctors across two large district general hospitals and two community hospitals. Teaching sessions were recorded and uploaded to a common platform, providing a resource for participants to catch up on and re-watch teaching sessions, making strides towards reducing discrimination against the professional development of less than full-time trainees. Thus, creating a learning environment, which is inclusive and accessible to adult learners in a self-directed manner. The negative impact of the pandemic on the well-being of healthcare professionals is well documented. To support the multi-disciplinary team, the virtual teaching programme evolved to included sessions on well-being, resilience, and work-life balance. Providing teaching for learners across the multi-disciplinary team (MDT) has been an eye-opening experience. By challenging the concept that learners should only be taught within their own peer groups, the authors have fostered a greater appreciation of the strengths of the MDT and showcased the immense wealth of expertise available within the trust. The inclusive nature of the teaching and the ease of joining a virtual teaching session has facilitated the dissemination of knowledge across the MDT, thus improving patient care on the frontline. The weekly teaching programme has been running for over eight months, with ongoing engagement, interest, and participation. As described above, the teaching programme has evolved to accommodate the needs of its learners. It has received excellent feedback with an appreciation of its inclusive, multi-disciplinary, and holistic nature. The COVID-19 pandemic provided a catalyst to rapidly develop novel methods of working and training and widened access/exposure to the virtual technologies available to large organisations. By merging pedagogical expertise and technology, the authors have created an effective online learning environment. Although the authors do not propose to replace face-to-face teaching altogether, this model of virtual multidisciplinary team, cross-site teaching has proven to be a great leveler. It has made high-quality teaching accessible to learners of different confidence levels, grades, specialties, and working patterns.

Keywords: cross-site, cross-speciality, inter-disciplinary, multidisciplinary, virtual teaching

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Authors: Emma J. Dale, Christina D. Buesching, Kevin R. Theis, David W. Macdonald

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This study investigates the oral and intestinal microbiomes of wild-living European badgers (Meles meles) and will relate inter-individual differences to social contact networks, somatic and reproductive fitness, varying susceptibility to bovine tuberculous (bTB) and to the olfactory advertisement. Badgers are an interesting model for this research, as they have great variation in body condition, despite living in complex social networks and having access to the same resources. This variation in somatic fitness, in turn, affects breeding success, particularly in females. We postulate that microbiota have a central role to play in determining the successfulness of an individual. Our preliminary results, characterising the microbiota of individual badgers, indicate unique compositions of microbiota communities within social groups of badgers. This basal information will inform further questions related to the extent microbiota influence fitness. Hitherto, the potential role of microbiota has not been considered in determining host condition, but also other key fitness variables, namely; communication and resistance to disease. Badgers deposit their faeces in communal latrines, which play an important role in olfactory communication. Odour profiles of anal and subcaudal gland secretions are highly individual-specific and encode information about group-membership and fitness-relevant parameters, and their chemical composition is strongly dependent on symbiotic microbiota. As badgers sniff/ lick (using their Vomeronasal organ) and over-mark faecal deposits of conspecifics, these microbial communities can be expected to vary with social contact networks. However, this is particularly important in the context of bTB, where badgers are assumed to transmit bTB to cattle as well as conspecifics. Interestingly, we have found that some individuals are more susceptible to bTB than are others. As acquired immunity and thus potential susceptibility to infectious diseases are known to depend also on symbiotic microbiota in other members of the mustelids, a role of particularly oral microbiota can currently not be ruled out as a potential explanation for inter-individual differences in infection susceptibility of bTB in badgers. Tri annually badgers are caught in the context of a long-term population study that began in 1987. As all badgers receive an individual tattoo upon first capture, age, natal as well as previous and current social group-membership and other life history parameters are known for all animals. Swabs (subcaudal ‘scent gland’, anal, genital, nose, mouth and ear) and fecal samples will be taken from all individuals, stored at -80oC until processing. Microbial samples will be processed and identified at Wayne State University’s Theis (Host-Microbe Interactions) Lab, using High Throughput Sequencing (16S rRNA-encoding gene amplification and sequencing). Acknowledgments: Gas-Chromatography/ Mass-spectrometry (in the context of olfactory communication) analyses will be performed through an established collaboration with Dr. Veronica Tinnesand at Telemark University, Norway.

Keywords: communication, energetics, fitness, free-ranging animals, immunology

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Authors: Sabina Huč, Staffan Svensson, Tomaž Hozjan

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Timber structures may be exposed to various environmental conditions during their service life. Often, the structures have to resist extreme changes in the relative humidity of surrounding air, with simultaneously carrying the loads. Wood material response for this load case is seen as increasing deformation of the timber structure. Relative humidity variations cause moisture changes in timber and consequently shrinkage and swelling of the material. Moisture changes and loads acting together result in mechano-sorptive creep, while sustained load gives viscoelastic creep. In some cases, magnitude of the mechano-sorptive strain can be about five times the elastic strain already at low stress levels. Therefore, analyzing mechano-sorptive creep and its influence on timber structures’ long-term behavior is of high importance. Relatively many one-dimensional rheological models for rheological behavior of wood can be found in literature, while a number of models coupling creep response in each material direction is limited. In this study, mathematical formulation of a coupled two-dimensional mechano-sorptive model and its application to the experimental results are presented. The mechano-sorptive model constitutes of a moisture transport model and a mechanical model. Variation of the moisture content in wood is modelled by multi-Fickian moisture transport model. The model accounts for processes of the bound-water and water-vapor diffusion in wood, that are coupled through sorption hysteresis. Sorption defines a nonlinear relation between moisture content and relative humidity. Multi-Fickian moisture transport model is able to accurately predict unique, non-uniform moisture content field within the timber member over time. Calculated moisture content in timber members is used as an input to the mechanical analysis. In the mechanical analysis, the total strain is assumed to be a sum of the elastic strain, viscoelastic strain, mechano-sorptive strain, and strain due to shrinkage and swelling. Mechano-sorptive response is modelled by so-called spring-dashpot type of a model, that proved to be suitable for describing creep of wood. Mechano-sorptive strain is dependent on change of moisture content. The model includes mechano-sorptive material parameters that have to be calibrated to the experimental results. The calibration is made to the experiments carried out on wooden blocks subjected to uniaxial compressive loaded in tangential direction and varying humidity conditions. The moisture and the mechanical model are implemented in a finite element software. The calibration procedure gives the required, distinctive set of mechano-sorptive material parameters. The analysis shows that mechano-sorptive strain in transverse direction is present, though its magnitude and variation are substantially lower than the mechano-sorptive strain in the direction of loading. The presented mechano-sorptive model enables observing real temporal and spatial distribution of the moisture-induced strains and stresses in timber members. Since the model’s suitability for predicting mechano-sorptive strains is shown and the required material parameters are obtained, a comprehensive advanced analysis of the stress-strain state in timber structures, including connections subjected to constant load and varying humidity is possible.

Keywords: mechanical analysis, mechano-sorptive creep, moisture transport model, timber

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Authors: Teresa Rushe, Nicole Devlin, Tara O Neill

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In this study, we sought to examine associations between childhood experiences of community and collective violence and psychological functioning in young people who grew up in post-conflict Northern Ireland. We hypothesized that those who grew up with such experiences would demonstrate internalizing and externalizing difficulties in early adulthood and, furthermore, that these difficulties would be mediated by adverse childhood experiences occurring within the home environment. As part of the Northern Ireland Childhood Adversity Study, we recruited 213 young people aged 18-25 years (108 males) who grew up in the post-conflict society of Northern Ireland using purposive sampling. Participants completed a digital questionnaire to measure adverse childhood experiences as well as aspects of psychological functioning. We employed the Adverse Childhood Experience -International Questionnaire (ACE-IQ¬) adaptation of the original Adverse Childhood Experiences Questionnaire (ACE) as it additionally measured aspects of witnessing community violence (e.g., seeing someone being beaten/killed, fights) and experiences of collective violence (e.g., war, terrorism, police, or gangs’ battles exposure) during the first 18 years of life. 51% of our sample reported experiences of community and/or collective violence (N=108). Compared to young people with no such experiences (N=105), they also reported significantly more adverse experiences indicative of household dysfunction (e.g., family substance misuse, mental illness or domestic violence in the family, incarceration of a family member) but not more experiences of abuse or neglect. As expected, young people who grew up with the community and/or collective violence reported significantly higher anxiety and depression scores and were more likely to engage in acts of deliberate self-harm (internalizing symptoms). They also started drinking and taking drugs at a younger age and were significantly more likely to have been in trouble with the police (externalizing symptoms). When the type of violence exposure was separated by whether the violence was witnessed (community violence) or more directly experienced (collective violence), we found community and collective violence to have similar effects on externalizing symptoms, but for internalizing symptoms, we found evidence of a differential effect. Collective violence was associated with depressive symptoms, whereas witnessing community violence was associated with anxiety-type symptoms and deliberate self-harm. However, when experiences of household dysfunction were entered into the models predicting anxiety, depression, and deliberate self-harm, none of the main effects remained significant. This suggests internalizing type symptoms are mediated by immediate family-level experiences. By contrast, significant community and collective violence effects on externalizing behaviours: younger initiation of alcohol use, younger initiation of drug use, and getting into trouble with the police persisted after controlling for family-level factors and thus are directly associated with growing up with the community and collective violence. Given the cross-sectional nature of our study, we cannot comment on the direction of the effect. However, post-hoc correlational analyses revealed associations between externalising behaviours and personal factors, including greater risk-taking and young age at puberty. The implications of the findings will be discussed in relation to interventions for young people and families living with the community and collective violence.

Keywords: community and collective violence, adverse childhood experiences, youth, psychological wellbeing

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Authors: Ernest Moles, Patricia Urbán, María Belén Jiménez-Díaz, Sara Viera-Morilla, Iñigo Angulo-Barturen, Maria Antònia Busquets, Xavier Fernàndez-Busquets

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Bearing in mind the absence of an effective vaccine against malaria and its severe clinical manifestations causing nearly half a million deaths every year, this disease represents nowadays a major threat to life. Besides, the basic rationale followed by currently marketed antimalarial approaches is based on the administration of drugs on their own, promoting the emergence of drug-resistant parasites owing to the limitation in delivering drug payloads into the parasitized erythrocyte high enough to kill the intracellular pathogen while minimizing the risk of causing toxic side effects to the patient. Such dichotomy has been successfully addressed through the specific delivery of immunoliposome (iLP)-encapsulated antimalarials to Plasmodium falciparum-infected red blood cells (pRBCs). Unfortunately, this strategy has not progressed towards clinical applications, whereas in vitro assays rarely reach drug efficacy improvements above 10-fold. Here, we show that encapsulation efficiencies reaching >96% can be achieved for the weakly basic drugs chloroquine (CQ) and primaquine using the pH gradient active loading method in liposomes composed of neutrally charged, saturated phospholipids. Targeting antibodies are best conjugated through their primary amino groups, adjusting chemical crosslinker concentration to retain significant antigen recognition. Antigens from non-parasitized RBCs have also been considered as targets for the intracellular delivery of drugs not affecting the erythrocytic metabolism. Using this strategy, we have obtained unprecedented nanocarrier targeting to early intraerythrocytic stages of the malaria parasite for which there is a lack of specific extracellular molecular tags. Polyethylene glycol-coated liposomes conjugated with monoclonal antibodies specific for the erythrocyte surface protein glycophorin A (anti-GPA iLP) were capable of targeting 100% RBCs and pRBCs at the low concentration of 0.5 μM total lipid in the culture, with >95% of added iLPs retained into the cells. When exposed for only 15 min to P. falciparum in vitro cultures synchronized at early stages, free CQ had no significant effect over parasite viability up to 200 nM drug, whereas iLP-encapsulated 50 nM CQ completely arrested its growth. Furthermore, when assayed in vivo in P. falciparum-infected humanized mice, anti-GPA iLPs cleared the pathogen below detectable levels at a CQ dose of 0.5 mg/kg. In comparison, free CQ administered at 1.75 mg/kg was, at most, 40-fold less efficient. Our data suggest that this significant improvement in drug antimalarial efficacy is in part due to a prophylactic effect of CQ found by the pathogen in its host cell right at the very moment of invasion.

Keywords: immunoliposomal nanoparticles, malaria, prophylactic-therapeutic polyvalent activity, targeted drug delivery

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Authors: Matthew Arnaouti, Michael Baird, Gabrielle Cahill, Tamara Worlton, Michelle Joseph

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Introduction: Over ten years after the 7.0 magnitude Earthquake struck the capital of Haiti, impacting over three million people and leading to the deaths of over two hundred thousand, the multinational humanitarian response remains the largest disaster relief effort to date. This study critically evaluates the multi-sector and multinational disaster response to the Earthquake, looking at how the lessons learned from this analysis can be applied to future disaster response efforts. We put particular emphasis on assessing the interaction between civilian and military sectors during this humanitarian relief effort, with the hopes of highlighting how concrete guidelines are essential to improve future responses. Methods: An extensive scoping review of the relevant literature was conducted - where library scientists conducted reproducible, verified systematic searches of multiple databases. Grey literature and hand searches were utilised to identify additional unclassified military documents, for inclusion in the study. More than 100 documents were included for data extraction and analysis. Key domains were identified, these included: Humanitarian and Military Response, Communication, Coordination, Resources, Needs Assessment and Pre-Existing Policy. Corresponding information and lessons-learned pertaining to these domains was then extracted - detailing the barriers and facilitators to an effective response. Results: Multiple themes were noted which stratified all identified domains - including the lack of adequate pre-existing policy, as well as extensive ambiguity of actors’ roles. This ambiguity was continually influenced by the complex role the United States military played in the disaster response. At a deeper level, the effects of neo-colonialism and concern about infringements on Haitian sovereignty played a substantial role at all levels: setting the pre-existing conditions and determining the redevelopment efforts that followed. Furthermore, external factors significantly impacted the response, particularly the loss of life within the political and security sectors. This was compounded by the destruction of important infrastructure systems - particularly electricity supplies and telecommunication networks, as well as air and seaport capabilities. Conclusions: This study stands as one of the first and most comprehensive evaluations, systematically analysing the civilian and military response - including their collaborative efforts. This study offers vital information for improving future combined responses and provides a significant opportunity for advancing knowledge in disaster relief efforts - which remains a more pressing issue than ever. The categories and domains formulated serve to highlight interdependent factors that should be applied in future disaster responses, with significant potential to aid the effective performance of humanitarian actors. Further studies will be grounded in these findings, particularly the need for greater inclusion of the Haitian perspective in the literature, through additional qualitative research studies.

Keywords: civilian and military collaboration, combined response, disaster, disaster response, earthquake, Haiti, humanitarian response

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Authors: Vusala Amirbayova

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The science of modern musicology, based on the achievements of a number of neighboring science fields, has more deeply penetrated into the sphere of artistic content of the art of music and developed a new scientific methodology, methods and approaches for a comprehensive study of the problem. In this regard, a new theory developed by the famous Russian musician-scientist, professor V. Kholopova – the specific and non – specific content of music – draws the attention with its different philosophical foundation and covering historical periods of the art of composing. The scientist related her theory to the art of European composer’s creativity, and did not include musical professionalism and especially, folklore creativity existing in other continent in her circle of interest. The researcher made an effort to explain triad (the world of ideas, emotions and subjects) which is included in the general content of music in the example of composers’ works belonging to different periods and cultures. In this respect, the artistic content of works has been deeply and comprehensively analyzed new philosophical basis. The theme ‘Leyli and Majnun’ was developed by many poets as one of the ancient legends of the East, and each artist was able to give a unique artistic interpretation of the work. This literary source was successfully developed in cognominal opera of great U. Hajibeyli in Azerbaijani music and its embodiment with symphonic means required great skill and courage from Gara Garayev. Unlike opera, as there is the opportunity to show the plot of ‘Leyli and Majnun’ in the symphonic poem, the composer achieved to reflect the main purpose of its idea convincingly with pure musical means, and created a great work with tragic spirit having a great emotional impact. Though the artistic content and form of ‘Leyli and Majnun’ symphonic poem have been sufficiently analyzed by music theorists until now, in our opinion, it is for the first time that the work is considered from the point of specific music content. Therefore, we will make an effort to penetrate into a specific layer of its artistic content after firstly reviewing the poem with traditional methods in the general plan. The use of both national fret – intonations and the system of major – minor by G. Garayev is based on well-tempered root. The composer, widely using national fret – intonations and model harmonic means on this ground, achieved to express the spirit and content of the poem. It perfectly embodies the grandeur and immortality of divine love, and the struggle of powerful human personality with the forces of despotism. Gara Garayev said about this work: “My most sublime goal and desire is to explain the literary issue that love endures to all obstacles and overcomes even death”. The music of ‘Leyli and Majnun’ symphonic poem is rich with deep desires and sharp contradictions. G.Garayev reflected these wonderful ideas about the power of music in his book ‘Articles, schools and sayings’: “Music is the decoration of life and a powerful source of inspiration”.

Keywords: content, music, symphonic, theory

Procedia PDF Downloads 267

Authors: Lizinis Cassendra Frederick Dony, Jirom Jeremy Frederick Dony, Cyril Supain Christopher

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The purpose of this paper is to improve the devotion to leadership through HR practices implementation at the PETRONAS stations. This emphasize the importance of personal grooming and Customer Care hospitality training for their front line working individuals and teams’ at PETRONAS stations in Sabah. Based on Thomas Edison, International Leadership Journal, theory, research, education and development practice and application to all organizational phenomena may affect or be affected by leadership. FINDINGS – PETRONAS in short called Petroliam Nasional Berhad is a Malaysian oil and gas company that was founded on August 17, 1974. Wholly owned by the Government of Malaysia, the corporation is vested with the entire oil and gas resources in Malaysia and is entrusted with the responsibility of developing and adding value to these resources. Fortune ranks PETRONAS as the 68th largest company in the world in 2012. It also ranks PETRONAS as the 12th most profitable company in the world and the most profitable in Asia. As of the end of March 2005, the PETRONAS Group comprised 103 wholly owned subsidiaries, 19 partly owned outfits and 57 associated companies. The group is engaged in a wide spectrum of petroleum activities, including upstream exploration and production of oil and gas to downstream oil refining, marketing and distribution of petroleum products, trading, gas processing and liquefaction, gas transmission pipeline network operations, marketing of liquefied natural gas; petrochemical manufacturing and marketing; shipping; automotive engineering and property investment. PETRONAS has growing their marketing channel in a competitive market. They have combined their resources to pursue common goals. PETRONAS provides opportunity to carry out Industrial Training Job Placement to the University students in Malaysia for 6-8 months. The effects of the Industrial Training have exposed them to the real working environment experience acting representing on behalf of General Manager for almost one year. Thus, the management education and reward incentives schemes have aspire the working teams transformed to gain their good leadership. Furthermore, knowledge and experiences are very important in the human capital development transformation. SPSS extends the accurate analysis PETRONAS achievement through 280 questionnaires and 81 questionnaires through excel calculation distributed to interview face to face with the customers, PETRONAS dealers and front desk staffs stations in the 17 stations in Kota Kinabalu, Sabah. Hence, this research study will improve its service quality innovation and business sustainability performance optimization. ORIGINALITY / VALUE – The impact of Transformational Leadership practices have influenced the working team’s behaviour as a Brand Ambassadors of PETRONAS. Finally, the findings correlation indicated that PETRONAS stations needs more HR resources practices to deploy more customer care retention resources in mitigating the business challenges in oil and gas industry. Therefore, as the business established at stiff competition globally (Cooper, 2006; Marques and Simon, 2006), it is crucial for the team management should be capable to minimize noises risk, financial risk and mitigating any other risks as a whole at the optimum level. CONCLUSION- As to conclude this research found that both transformational and transactional contingent reward leadership4 were positively correlated with ratings of platoon potency and ratings of leadership for the platoon leader and sergeant were moderately inter correlated. Due to this identification, we recommended that PETRONAS management should offers quality team management in PETRONAS stations in a broader variety of leadership training specialization in the operation efficiency at the front desk Customer Care hospitality. By having the reliability and validity of job experiences, it leverages diversity teamwork and cross collaboration. Other than leveraging factor, PETRONAS also will strengthen the interpersonal front liners effectiveness and enhance quality of interaction through effective communication. Finally, through numerous CSR correlation studies regression PETRONAS performance on Corporate Social Performance and several control variables.1 CSR model activities can be mis-specified if it is not controllable under R & D which evident in various feedbacks collected from the local communities and younger generation is inclined to higher financial expectation from PETRONAS. But, however, it created a huge impact on the nation building as part of its social adaptability overreaching their business stakeholders’ satisfaction in Sabah.

Keywords: human resources practices implementation (hrpi), source of competitive advantage in people’s development (socaipd), corporate social responsibility (csr), service quality at front desk stations (sqafd), impacts of petronas leadership (iopl)

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Authors: Sheikh Mohammed Rafiul Huque

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Bangladesh since its inception has been an economy that is fuelled by agriculture and agriculture has significant contribution to the GDP of Bangladesh. The agriculture of Bangladesh predominantly and historically dependent on organic sources of raw material though the place has taken in decades by inorganic sources of raw materials due to the high demand of food for rapidly growing of population. Meanwhile, a new market segment, which is niche market, has been evolving in the urban area in favor of organic products, though 71.1% population living in rural areas is dependent mainly on conventional products. The new market segment is search of healthy and safer source of food and they could believe that organic products are the solution of that. In Bangladesh, food adulteration is very common practices among the shop-keepers to extend the shelf life of raw vegetables and fruits. The niche group of city dwellers is aware about the fact and gradually shifting their buying behavior to organic products. A recent survey on organic farming revealed that 16,200 hectares under organic farming in recent time, which was only 2,500 hectares in 2008. This study is focused on consumer awareness of organic products and tried to explore the factors affecting organic food consumption among high income group of people. The hypothesis is developed to explore the effect of gender (GENDER), ability to purchase (ABILITY) and health awareness (HEALTH) on purchase intention (INTENTION). A snowball sampling was administered among the high income group of people in Dhaka city among 150 respondents. In this sampling process the study could identify only those samples who has consume organic products. A Partial Least Square (PLS) method was used to analyze data using path analysis. It was revealed from the analysis that coefficient determination R2 is 0.829 for INTENTION endogenous latent variable. This means that three latent variables (GENDER, ABILITY, and HEALTH) significantly explain 82.9% of the variance in INTENTION of purchasing organic products. Moreover, GENDER solely explains 6.3% and 8.6% variability of ABILITY and HEALTH respectively. The inner model suggests that HEALTH has strongest negative effect on INTENTION (-0.647) followed by ABILITY (0.344) and GENDER (0.246). The hypothesized path relationship between ABILITY->INTENTION, HEALTH->INTENTION and GENDER->INTENTION are statistically significant. Furthermore, the hypothesized path relationship between GENDER->ABILITY (0.262) and GENDER->HEALTH (-0.292) also statistically significant. The purpose of the study is to demonstrate how an organic product producer can improve his participatory guarantee system (PGS) while marketing the products. The study focuses on understanding gender (GENDER), ability (ABILITY) and health (HEALTH) factors while positioning the products (INTENTION) in the mind of the consumer. In this study, the respondents are found to care about high price and ability to purchase variables with loading -0.920 and 0.898. They are good indicators of ability to purchase (ABILITY). The marketers should consider about price of organic comparing to conventional products while marketing, otherwise, that will create negative intention to buy with a loading of -0.939. Meanwhile, it is also revealed that believability of chemical free component in organic products and health awareness affects health (HEALTH) components with high loading -0.941 and 0.682. The study analyzes that low believability of chemical free component and high price of organic products affects intension to buy. The marketers should not overlook this point while targeting the consumers in Bangladesh.

Keywords: health awareness, organic products, purchase ability, purchase intention

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Authors: Ashik Sarder

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Bangladesh is a disaster-prone and one of the most vulnerable countries to climate change. The country has a long coastal area which is frequently being affected by several types of natural disasters due to climate change. The disasters have impacts on the life and livelihood of different natural resources depending on communities living in the coastal areas. The Malo is a Hindu religious traditional fishing community living at Sarafpur Union of Dumuria Upazila of Khulna district of south-west coastal Bangladesh. Fishing is the only means of their livelihood and the community has been engaged in fishing practices inherently in rivers, estuaries, and sea for more than 300 years. and they are totally dependent on this traditional occupation. But, in recent year’s climate change has negative impacts on their only livelihood option. The study aims to examine the impacts of climate change on the livelihood of Malo fishing community in south-west coastal Bangladesh, identify the adaptation strategies undertaken and practiced by Malo fishing community to cope with climate change and sustain their livelihood and explore the changing adaptation strategies undertaken by Malo fishing community and others. The study has been conducted from both qualitative and quantitative perspectives. Data has been collected from both primary and secondary sources. The primary data has been collected in the participatory observation approach following both qualitative and quantitative method. The primary source of data includes village census, face-to-face interview and in-depth case studies using structured questionnaire. The secondary source of the literature includes different national and international documents, policy papers, books and articles; related websites and peer-viewed documents on climate change, vulnerability, adaptation, livelihood, and fisheries. The study has identified different practices of adaption to climate change by Malo fishing community and others in the selected area. Three types of adaption practices have been identified. Firstly, the indigenous adaptation practices by Malo fishing community to cope with climate change have been identified. These identified adaptation practices by Malo fishing community include; ensuring drinking water and sanitation facilities, planting trees to tackle impacts of cyclone, excavating dumps to preserve the valuable assets, growing vegetables and rearing domestic livestock to earn surplus money, taking loans for ensuring continuation of present livelihood and migrating to near city or towns for better livelihood options. Secondly, adaptation initiatives undertaken by the government have provided limited facility to this vulnerable fishing community and made them benefited. And thirdly, some adaptation initiatives commenced by few non-government and community-based organizations have also made the Malo fishing community as beneficiaries. The study has suggested recommendations for Malo fishing community to overcome the challenges and impacts of climate change for retaining their traditional fishing livelihood. The accumulated recommendations would be very useful for the researchers, academicians, policy-makers of Government and non-government organizations to conduct more researches and take initiatives for Malo fishing community to make them more capable to sustain their fishing livelihood.

Keywords: climate change, livelihood, adaptation, anthropology, vulnerability

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Authors: Akiko Ohta, Masahiro Minami, Yusra Qadir, Jennifer York

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The Home Instruction for Parents of Preschool Youngsters (HIPPY) is a home instruction program for mothers of children 3 to 5 years old. Using role-play as a method of teaching, the participating mothers work with their home visitors and learn how to deliver the HIPPY curriculum to their children. Applying HIPPY, Reviving Hope and Home for High-risk Refugee Mothers Program (RHH) was created to provide more personalized peer support and to respond to ongoing settlement challenges for isolated and vulnerable Government Assisted Refugee (GAR) mothers. GARs often have greater needs and vulnerabilities than other refugee groups. While the support is available, they often face various challenges and barriers in starting their new lives in Canada, such as inadequate housing, low first-language literacy levels, low competency in English or French, and social isolation. The pilot project was operated by Mothers Matter Centre (MMC) from January 2019 to March 2021 in partnership with the Immigrant Services Society of BC (ISSofBC). The formative evaluation was conducted by a research team at Simon Fraser University. In order to provide more suitable support for GAR mothers, RHH intended to offer more flexibility in HIPPY delivery, supported by a home visitor, to meet the need of refugee mothers facing various conditions and challenges; to have a pool of financial resources to be used for the RHH families when necessitated during the program period; to have another designated staff member, called a community navigator, assigned to facilitate the support system for the RHH families in their settlement; to have a portable device available for each RHH mother to navigate settlement support resources; and to provide other variations of the HIPPY curriculum as an option for the RHH mothers, including a curriculum targeting pre-HIPPY age children. Reflections on each program component was collected from RHH mothers and staff members of MMC and ISSofBC, including frontline workers and management staff, through individual interviews and focus group discussions. Each of the RHH program components was analyzed and evaluated by applying Moore’s four domains framework to identify key information and generate new knowledge (data). To capture RHH mothers’ program experience more in depth based on their own reflections, the photovoice method was used. Some photos taken by the mothers will be shared to illustrate their RHH experience as part of their life stories. Over the period of the program, this evaluation observed how RHH mothers became more confident in various domains, such as communicating with others, taking public transportations alone, and teaching their own child(ren). One of the major factors behind the success was their home visitors’ flexibility and creativity to create a more meaningful and tailored approach for each mother, depending on her background and personal situation. The role of the community navigator was tested out and improved during the program period. The community navigators took the key role to assess the needs of the RHH families and connect them with community resources. Both the home visitors and community navigators were immigrant mothers themselves and owing to their dedicated care for the RHH mothers; they were able to gain trust and work closely and efficiently with RHH mothers.

Keywords: refugee mothers, settlement support, program evaluation, Canada

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Authors: E. O. Okan, A. Kepic, P. Williams

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Iron oxide copper gold (IOCG) deposits constitute important sources of copper and gold in Australia especially since the discovery of the supergiant Olympic Dam deposits in 1975. They are considered to be metasomatic expressions of large crustal-scale alteration events occasioned by intrusive actions and are associated with felsic igneous rocks in most cases, commonly potassic igneous magmatism, with the deposits ranging from ~2.2 –1.5 Ga in age. For the past two decades, geological, geochemical and potential methods have been used to identify the structures hosting these deposits follow up by drilling. Though these methods have largely been successful for shallow targets, at deeper depth due to low resolution they are limited to mapping only very large to gigantic deposits with sufficient contrast. As the search for ore-bodies under regolith cover continues due to depletion of the near surface deposits, there is a compelling need to develop new exploration technology to explore these deep seated ore-bodies within 1-4km which is the current mining depth range. Seismic reflection method represents this new technology as it offers a distinct advantage over all other geophysical techniques because of its great depth of penetration and superior spatial resolution maintained with depth. Further, in many different geological scenarios, it offers a greater ‘3D mapability’ of units within the stratigraphic boundary. Despite these superior attributes, no arguments for crustal scale seismic surveys have been proposed because there has not been a compelling argument of economic benefit to proceed with such work. For the seismic reflection method to be used at these scales (100’s to 1000’s of square km covered) the technical risks or the survey costs have to be reduced. In addition, as most IOCG deposits have large footprint due to its association with intrusions and large fault zones; we hypothesized that these deposits can be found by mainly looking for the seismic signatures of intrusions along prospective structures. In this study, we present two of such cases: - Olympic Dam and Vulcan iron-oxide copper-gold (IOCG) deposits all located in the Gawler craton, South Australia. Results from our 2D modelling experiments revealed that seismic reflection surveys using 20m geophones and 40m shot spacing as an exploration tool for locating IOCG deposit is possible even when hosted in very complex structures. The migrated sections were not only able to identify and trace various layers plus the complex structures but also show reflections around the edges of intrusive packages. The presences of such intrusions were clearly detected from 100m to 1000m depth range without losing its resolution. The modelled seismic images match the available real seismic data and have the hypothesized characteristics; thus, the seismic method seems to be a valid exploration tool to find IOCG deposits. We therefore propose that 2D seismic survey is viable for IOCG exploration as it can detect mineralised intrusive structures along known favourable corridors. This would help in reducing the exploration risk associated with locating undiscovered resources as well as conducting a life-of-mine study which will enable better development decisions at the very beginning.

Keywords: crustal scale, exploration, IOCG deposit, modelling, seismic surveys

Procedia PDF Downloads 324

Authors: Natalia C. E. S. Nascimento, Mercia L. Oliveira, Fernando R. A. Lima, Leonardo T. C. do Nascimento, Marina B. Silveira, Brigida G. A. Schirmer, Andrea V. Ferreira, Carlos Malamut, Juliana B. da Silva

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Tissue hypoxia is a common characteristic of solid tumors leading to decreased sensitivity to radiotherapy and chemotherapy. In the clinical context, tumor hypoxia assessment employing the positron emission tomography (PET) tracer ¹⁸F-fluoromisonidazole ([¹⁸F]FMISO) is helpful for physicians for planning and therapy adjusting. The aim of this work was to implement the synthesis of 18F-FMISO in a TRACERlab® MXFDG module and also to establish the quality control procedure. [¹⁸F]FMISO was synthesized at Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN/Brazil) using an automated synthesizer (TRACERlab® MXFDG, GE) adapted for the production of [¹⁸F]FMISO. The FMISO chemical standard was purchased from ABX. 18O- enriched water was acquired from Center of Molecular Research. Reagent kits containing eluent solution, acetonitrile, ethanol, 2.0 M HCl solution, buffer solution, water for injections and [¹⁸F]FMISO precursor (dissolved in 2 ml acetonitrile) were purchased from ABX. The [¹⁸F]FMISO samples were purified by Solid Phase Extraction method. The quality requirements of [¹⁸F]FMISO are established in the European Pharmacopeia. According to that reference, quality control of [¹⁸F]FMISO should include appearance, pH, radionuclidic identity and purity, radiochemical identity and purity, chemical purity, residual solvents, bacterial endotoxins, and sterility. The duration of the synthesis process was 53 min, with radiochemical yield of (37.00 ± 0.01) % and the specific activity was more than 70 GBq/µmol. The syntheses were reproducible and showed satisfactory results. In relation to the quality control analysis, the samples were clear and colorless at pH 6.0. The spectrum emission, measured by using a High-Purity Germanium Detector (HPGe), presented a single peak at 511 keV and the half-life, determined by the decay method in an activimeter, was (111.0 ± 0.5) min, indicating no presence of radioactive contaminants, besides the desirable radionuclide (¹⁸F). The samples showed concentration of tetrabutylammonium (TBA) < 50μg/mL, assessed by visual comparison to TBA standard applied in the same thin layer chromatographic plate. Radiochemical purity was determined by high performance liquid chromatography (HPLC) and the results were 100%. Regarding the residual solvents tested, ethanol and acetonitrile presented concentration lower than 10% and 0.04%, respectively. Healthy female mice were injected via lateral tail vein with [¹⁸F]FMISO, microPET imaging studies (15 min) were performed after 2 h post injection (p.i), and the biodistribution was analyzed in five-time points (30, 60, 90, 120 and 180 min) after injection. Subsequently, organs/tissues were assayed for radioactivity with a gamma counter. All parameters of quality control test were in agreement to quality criteria confirming that [¹⁸F]FMISO was suitable for use in non-clinical and clinical trials, following the legal requirements for the production of new radiopharmaceuticals in Brazil.

Keywords: automatic radiosynthesis, hypoxic tumors, pharmacopeia, positron emitters, quality requirements

Procedia PDF Downloads 193

Authors: C. Sancho Salvatierra, J. M. Martinez Nieto, R. García Gonzalez-Gordon, M. I. Martinez Bellido

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Introduction: Nature could act as an asset for human health protecting against possible diseases and promoting the state of both physical and mental health. Goals: This paper aims to determine which natural elements present evidence that show positive influence on human health, on which particular aspects and how. It also aims to determine the best biomarkers to measure such influence. Method: A systematic literature review was carried out. First, a general free text search was performed in databases, such as Scopus, PubMed or PsychInfo. Secondly, a specific search was performed combining keywords in order of increasing complexity. Also the Snowballing technique was used and it was consulted in the CSIC’s (The Spanish National Research Council). Databases: Of the 130 articles obtained and reviewed, 80 referred to natural elements that influenced health. These 80 articles were classified and tabulated according to the nature elements found, the health aspects studied, the health measurement parameters used and the measurement techniques used. In this classification the results of the studies were codified according to whether they were positive, negative or neutral both for the elements of nature and for the aspects of health studied. Finally, the results of the 80 selected studies were summarized and categorized according to the elements of nature that showed the greatest positive influence on health and the biomarkers that had shown greater reliability to measure said influence. Results: Of the 80 articles studied, 24 (30.0%) were reviews and 56 (70.0%) were original research articles. Among the 24 reviews, 18 (75%) found positive results of natural elements on health, and 6 (25%) both positive and negative effects. Of the 56 original articles, 47 (83.9%) showed positive results, 3 (5.4%) both positive and negative, 4 (7.1%) negative effects, and 2 (3.6%) found no effects. The results reflect positive effects of different elements of nature on the following pathologies: diabetes, high blood pressure, stress, attention deficit hyperactivity disorder, psychotic, anxiety and affective disorders. They also show positive effects on the following areas: immune system, social interaction, recovery after illness, mood, decreased aggressiveness, concentrated attention, cognitive performance, restful sleep, vitality and sense of well-being. Among the elements of nature studied, those that show the greatest positive influence on health are forest immersion, natural views, daylight, outdoor physical activity, active transport, vegetation biodiversity, natural sounds and the green residences. As for the biomarkers used that show greater reliability to measure the effects of natural elements are the levels of cortisol (both in blood and saliva), vitamin D levels, serotonin and melatonin, blood pressure, heart rate, muscle tension and skin conductance. Conclusions: Nature is an asset for health, well-being and quality of life. Awareness programs, education and health promotion are needed based on the elements that nature brings us, which in turn generate proactive attitudes in the population towards the protection and conservation of nature. The studies related to this subject in Spain are very scarce. Aknowledgements. This study has been promoted and partially financed by the Environmental Foundation Jaime González-Gordon.

Keywords: health, green areas, nature, well-being

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Authors: Demet Devrimsel Dogan, Ecem Deniz Kirkpantur, Muharrem Dogan, Ahmet Aykut, Ebru Unal Akoglu, Ozge Ecmel Onur

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Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain due to external compression of the celiac trunk by a fibrous arch that unites diaphragmatic crura on each side of the aortic hiatus. While 10-24% of the population may suffer from compression of celiac trunk, it rarely causes patients to develop symptoms. The typical clinical triad of symptoms includes postprandial epigastric pain, weight loss and vomiting. The diagnosis can be made using thin section multi-detector computed tomography (CT) scans which delineate the ligament and the compressed vessel. The treatment of MALS is aimed at relieving the compression of the celiac artery to restore adequate blood flow through the vessel and neurolysis to address chronic pain. Case: A 68-year-old male presented to our clinic with acute postprandial epigastric pain. This was patients’ first attack, and the pain was the worst pain of his life. The patient did not have any other symptoms like nausea, vomiting, chest pain or dyspnea. In his medical history, the patient has had an ischemic cerebrovascular stroke 5 years ago which he recovered with no sequel, and he was using 75 mg clopidogrel and 100 mg acetylsalicylic acid. He was not using any other medication and did not have a story of cardiovascular disease. His vital signs were stable (BP:113/72 mmHg, Spo2:97, temperature:36.3°C, HR:90/bpm). In his electrocardiogram, there was ST depression in leads II, III and AVF. In his physical examination, there was only epigastric tenderness, other system examinations were normal. Physical examination through his upper gastrointestinal system showed no bleeding. His laboratory results were as follows: creatinine:1.26 mg/dL, AST:42 U/L, ALT:17 U/L, amylase:78 U/L, lipase:26 U/L, troponin:10.3 pg/ml, WBC:28.9 K/uL, Hgb:12.7 gr/dL, Plt:335 K/uL. His serial high-sensitive troponin levels were also within normal limits, his echocardiography showed no segmental wall motion abnormalities, an acute myocardial infarction was excluded. In his abdominal ultrasound, no pathology was founded. Contrast-enhanced abdominal CT and CT angiography reported ‘thickened diaphragmatic cruras are compressing and stenosing truncus celiacus superior, this is likely compatible with MALS’. The patient was consulted to general surgery, and they admitted the patient for laparoscopic ligament release. Results: MALS is a syndrome that causes postprandial pain, nausea and vomiting as its most common symptoms. Affected patients are normally young, slim women between the ages of 30 and 50 who have undergone extensive examinations to find the source of their symptoms. To diagnose MALS, other underlying pathologies should initially be excluded. The gold standard is aortic angiography. Although diagnosis and treatment of MALS are unclear, symptom resolution has been achieved with multiple surgical modalities, including open, laparoscopic or robotic ligament release as well as celiac ganglionectomy, which often requires celiac artery revascularisation.

Keywords: differential diagnosis, epigastric pain, median arcuate ligament syndrome, celiac trunk

Procedia PDF Downloads 260

Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

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Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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Authors: Cristina Maria Mendoza Sanchez, Maria Angeles Navarro Perán

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Introduction: Nursing as a profession, from its initial formation and after its development in practice, has been built and identified mainly from its technical competence and professionalization within the positivist approach of the XIX century that provides a conception of the disease built on the basis of to the biomedical paradigm, where the care provided is more focused on the physiological processes and the disease than on the suffering person understood as a whole. The main issue that is in need of study here is a review of the nursing profession's history to get to know how the nursing profession was before the XIX century. It is unclear if there were organizations or people with knowledge about looking after others or if many people survived by chance. The holistic care, in which the appearance of the disease directly affects all its dimensions: physical, emotional, cognitive, social and spiritual. It is not a concept from the 21st century. It is common practice, most probably since established life in this world, with the final purpose of covering all these perspectives through quality care. Objective: In this paper, we describe and analyze the history of education in nursing learning in terms of reviewing and analysing theoretical foundations of clinical teaching and learning in nursing, with the final purpose of determining and describing the development of the nursing profession along the history. Method: We have done a descriptive systematic review study, doing a systematically searched of manuscripts and articles in the following health science databases: Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL. The selection of articles has been made according to PRISMA criteria, doing a critical reading of the full text using the CASPe method. A compliment to this, we have read a range of historical and contemporary sources to support the review, such as manuals of Florence Nightingale and John of God as primary manuscripts to establish the origin of modern nursing and her professionalization. We have considered and applied ethical considerations of data processing. Results: After applying inclusion and exclusion criteria in our search, in Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL, we have obtained 51 research articles. We have analyzed them in such a way that we have distinguished them by year of publication and the type of study. With the articles obtained, we can see the importance of our background as a profession before modern times in public health and as a review of our past to face challenges in the near future. Discussion: The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management and development of the professional body has a longer and more complex history than is generally accepted. Conclusions: There is a paucity of studies on the subject of the review to be able to extract very precise evidence and recommendations about nursing before modern times. But even so, as more representative data, an increase in research about nursing history has been observed. In light of the aspects analyzed, the need for new research in the history of nursing emerges from this perspective; in order to germinate studies of the historical construction of care before the XIX century and theories created then. We can assure that pieces of knowledge and ways of care were taught before the XIX century, but they were not called theories, as these concepts were created in modern times.

Keywords: nursing history, nursing theory, Saint John of God, Florence Nightingale, learning, nursing education

Procedia PDF Downloads 111

Authors: Sultana Afrin Nipa

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Life on Earth cannot thrive or survive without water. Water is intimately tied with community, culture, spirituality, identity, socio-economic progress, security, self-determination, and livelihood. Thus, access to water is a United Nations recognized human right due to its significance in these realms. However, there is often conflict between those who consider water as the spiritual and cultural value and those who consider it an economic value thus being threatened by economic development, corporate exploitation, government regulation, and increased privatization, highlighting the complex relationship between water and culture. The Colorado River basin is home to over 29 federally recognized tribal nations. To these tribes, it holds cultural, economic, and spiritual significance and often extends to deep human-to-non-human connections frequently precluded by the Westphalian regulations and settler laws. Despite the recognition of access to rivers as a fundamental human right by the United Nations, tribal communities and their water rights have been historically disregarded through inter alia, colonization, and dispossession of their resources. Law of the River such as ‘Winter’s Doctrine’, ‘Bureau of Reclamation (BOR)’ and ‘Colorado River Compact’ have shaped the water governance among the shareholders. However, tribal communities have been systematically excluded from these key agreements. While the Winter’s Doctrine acknowledged that tribes have the right to withdraw water from the rivers that pass through their reservations for self-sufficiency, the establishment of the BOR led to the construction of dams without tribal consultation, denying the ‘Winters’ regulation and violating these rights. The Colorado River Compact, which granted only 20% of the water to the tribes, diminishes the significance of international legal frameworks that prioritize indigenous self-determination and free pursuit of socio-economic and cultural development. Denial of this basic water right is the denial of the ‘recognition’ of their sovereignty and self-determination that questions the effectiveness of the international law. This review assesses the international legal frameworks concerning indigenous rights and water justice and aims to pinpoint gaps hindering the effective recognition and protection of Indigenous water rights in Colorado River Basin. This study draws on a combination of historical and qualitative data sets. The historical data encompasses the case settlements provided by the Bureau of Reclamation (BOR) respectively the notable cases of Native American water rights settlements on lower Colorado basin related to Arizona from 1979-2008. This material serves to substantiate the context of promises made to the Indigenous people and establishes connections between existing entities. The qualitative data consists of the observation of recorded meetings of the Central Arizona Project (CAP) to evaluate how the previously made promises are reflected now. The study finds a significant inconsistency in participation in the decision-making process and the lack of representation of Native American tribes in water resource management discussions. It highlights the ongoing challenges faced by the indigenous people to achieve their self-determination goal despite the legal arrangements.

Keywords: colorado river, indigenous rights, law of the river, water governance, water justice

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Authors: Iris Alkaher, Nurit Carmi

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It is widely agreed among scientists that population growth (PG) is a major factor that drives the global environmental crisis. Many researchers recognize that explicitly addressing the impact of PG on the environment and human quality of life through education systems worldwide could play a significant role in improving understanding regarding the links between rapid PG and environmental degradation and changing perceptions, attitudes, and behaviors concerning the necessity to reduce the fertility rate. However, the issue of PG is still rarely included in schools' curricula, mainly because of its complexity and controversiality. This study aims to explore the perspectives of teachers with an academic background in environmental and sustainability education (ESEteachers) and teachers with no such background (non-ESE teachers) regarding PG as an environmental risk. The study also explores the teachers’ willingness to include PG in their teaching and identifies what predicts their inclusion of it. In this mixed-methods research study, data were collected using questionnaires and interviews. The findings portray a complex picture concerning the debate aboutPG as a major factor that drives the global environmental crisis in the Israeli context. Consistent with other countries, we found that the deep-rooted pronatalist culture in the Israeli society, as well as a robust national pronatalist agenda and policies, have a tremendous impact on the education system. Therefore, we found that an academic background in ESE had a limited impact on teachers' perceptions concerning PG as a problem and on their willingness to include it in their teaching and discuss its controversiality. Teachers' attitudes related to PG demonstrated social, cultural, and politically oriented disavowal justification regarding the negative impacts of rapid PG, identified in the literature as population-skepticism and population-fatalism. Specifically, factors such as the ongoing Israeli-Palestinian conflict, the Jewish anxiety of destruction, and the religious command to“be fruitful and multiply”influenced the perceptions of both ESE and non-ESE teachers. While these arguments are unique to the Israeli context, pronatalist policies are international. In accordance with the pronatalist policy, we also found that the absence of PG from both school curricula and the Israeli public discourse was reported by ESE and non-ESE teachers as major reasons for their disregarding PG in their teaching. Under these circumstances, the role of the education system to bring the population question to the front stage in Israel and elsewhere is more challenging. To encourage science and social studies teachers to incorporate the controversial issue of PG in their teaching and successfully confront dominant pronatalist cultures, they need strong and ongoing scaffolding and support. In accordance with scientists' agreement regarding the role of PG as a major factor that drives the global environmental crisis, we call on stakeholders and policymakers in the education system to bring the population debate into schools' curricula, the sooner, the better. And not only as part of human efforts to mitigate environmental degradation but also to use this controversial topic as a platform for shaping critical learners and responsible and active citizens who are tolerant of different people’s opinions.

Keywords: population growth, environmental and sustainability education, controversial environmental sustainability issues, pronatalism

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Authors: Marina Gold, Yves Jackson, David Parrat

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The high predominance of Latin American migrants in Geneva from countries where Chagas disease is endemic (Bolivia, Brazil, Argentina, Colombia) is increasing the incidence of chronic Chagas-related problems, especially cardiovascular complications. The precarious migratory status of what are mostly undocumented migrants complicates access to health and affects patients’ and doctors’ health perceptions regarding screening, treatment and monitoring of Chagas-related health concerns. This project results from a 3 year collaboration between the Geneva University Hospital and the NGO Mundo Sano to understand the following questions: 1) how do Latin American migrants perceive their health? 2) What do they understand from Chagas disease? 3) Are patients’ and doctors’ health perceptions similar or do they have competing agendas? This paper aims to present the results of a long-term study that interrogates health perceptions among Latin American migrants in Geneva. The first phase consisted in completing surveys at three community screening events (2016, 2017. 2018), and the results of these surveys reveal the subordination of the importance of health to that of having met economic family obligation. That is, health is important only when it becomes an impediment to economic gain. The contradictory result emerged that people are aware of the importance of health prevention in order to ensure long-term health, but they do not always have agency over their life-style habits (healthy food, regular exercise, emotional stability). The second phase of the research collected open-ended interviews with selected participants, in order to explore in more detail how Latin American migrants deal with Chagas in a different socio-political and economic context to that of endemic countries. These interviews (5 in total) reveal mixed methods of managing health: social networks, access to health care transnationally (in Geneva, Spain and back in their home country), and different valuations of health problems in each situation. The third phase consisted in observations of doctor-patient consultations and further extended interviews with patients to determine doctor/patient health perceptions around Chagas disease. This phase is ongoing, but it has yielded preliminarily observations regarding the expectations that patients’ have of doctors, and the understanding of doctors’ to patients’ complex situations. Positive and complementary health perceptions include patients’ feeling that doctors in Geneva are more understanding, more knowledgeable and less racist than those in their home country, who do not provide detailed information about Chagas or its treatment and discriminate against them for being indigenous or from poor rural areas, enabling a better communication between doctors and patients. Possible conflicting health perceptions include patients addressing their health concerns more holistically and encountering the specialist’s limitations to only treating one health concern, given time limitations and lack of competition with their colleagues (the general practitioner that referred the patient, for example). The implications of this study extend the case of Chagas disease in Geneva and is relevant for all chronic concerns and migratory contexts of precarity.

Keywords: chagas disease, health perceptions, Latin American Migrants, non-endemic countries

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Authors: Fstemeh Rais Esmaili, Ehsan Ranjbar

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Pedestrian streets as one type of urban public spaces have an important role in improving the quality of urban life. In Iran, planning and designing of pedestrian streets is in its primary steps. In spite of starting this approach in Iran, and designing several pedestrian streets, there are still not organized studies about quality assessment of pedestrian streets. As a result, the strength and weakness points of the initial experiences have not been utilized. This inattention to quality assessment have caused designing pedestrian streets to be limited to just vehicles traffic control and preliminary actions like paving; so that, special potentials of pedestrian streets for creating social, livable and dynamic public spaces have not been used. This article, as an organized study about quality assessment of pedestrian streets in Iran, tries to reach two main goals: first, introducing a framework for quality assessment of pedestrian streets in Iran, and second, creating a context for improving the quality of pedestrian streets especially for further experiences. The main research methods are description and context analyzing. With respect to comparative analysis of ideas about quality, considering international and local case studies and analyzing existing condition of Saf Pedestrian Street, a particular model for quality assessment has been introduced. In this model, main components and assessment criteria have been presented. On the basis of this model, questionnaire and checklist for assessment have been prepared. The questionnaire and interview have been used to assess qualities which are in direct contact with people and the checklist has been used for analyzing visual qualities by authors through observation. Some results of questionnaire and checklist show that 7 of 11 primary components, diversity, flexibility, cleanness, legibility and imaginably, identity, livability, form and physical setting are rated low and very low in quality degree. Three components, efficiency, comfort and distinctiveness, have medium and low quality degree and one component, access, linkage and permeability has high quality degree. Therefore, based on implemented analyzing process, Saf Pedestrian Street needs to be improved and these quality improvement priorities are determined based on presented criteria. Adaption of final results with existing condition illustrates the shortage of services for satisfying user’s needs, inflexibility and impossibility of using spaces in various times, lack of facilities for different climatic conditions, lack of facilities such as drinking fountain, inappropriate designing of existing urban furniture like garbage cans, and creating pollution and unsuitable view, lack of visual attractions, neglecting disabled persons in designing entrances, shortage of benches and their undesirable designing, lack of vegetation, absence of special characters making it different from other streets, preventing people taking part in the space causing lack of affiliation, lack of appropriate elements for leisure time and lack of exhilaration in the space. On the other hand, these results present high access and permeability, high safety, less sound pollution and more relief, comfortable movement along the way due to suitable pavement and economic efficiency, as the strength points of Saf pedestrian street.

Keywords: pedestrian streets, quality assessment, quality criteria, Saf Pedestrian Street

Procedia PDF Downloads 255

Authors: Jean Felix Tuyisingize

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Speeding or inappropriate speed is a major problem worldwide, contributing to 10-15% of road crashes and 30% of fatal injury crashes. The consequences of speeding put the driver's life at risk and the lives of other road users like motorists, cyclists, and pedestrians. To control vehicle speeds, governments, and traffic authorities enforced speed regulations through speed cameras and speed section control, which monitor all vehicle speeds and detect plate numbers to levy penalties. However, speed limit violations are prevalent, even on motorways with speed cameras. The problem with speed cameras is that they alter driver behaviors, and their effect declines with increasing distance from the speed camera location. Drivers decelerate short distances before the camera and vigorously accelerate above the speed limit just after passing by the camera. The sudden decelerating near cameras causes the drivers to try to make up for lost time after passing it, and they do this by speeding up, resulting in a phenomenon known as the "Kangaroo jump" or "V-profile" around camera/ASSC areas. This study investigated the impact of speed enforcement devices, specifically Average Speed Section Control (ASSCs) and fixed cameras, on acceleration and deceleration events within their vicinity. The research employed advanced statistical and Geographic Information System (GIS) analysis on naturalistic driving data, to uncover speeding patterns near the speed enforcement systems. The study revealed a notable concentration of events within a 600-meter radius of enforcement devices, suggesting their influence on driver behaviors within a specific range. However, most of these events are of low severity, suggesting that drivers may not significantly alter their speed upon encountering these devices. This behavior could be attributed to several reasons, such as consistently maintaining safe speeds or using real-time in-vehicle intervention systems. The complexity of driver behavior is also highlighted, indicating the potential influence of factors like traffic density, road conditions, weather, time of day, and driver characteristics. Further, the study highlighted that high-severity events often occurred outside speed enforcement zones, particularly around intersections, indicating these as potential hotspots for drastic speed changes. These findings call for a broader perspective on traffic safety interventions beyond reliance on speed enforcement devices. However, the study acknowledges certain limitations, such as its reliance on a specific geographical focus, which may impact the broad applicability of the findings. Additionally, the severity of speed modification events was categorized into low, medium, and high, which could oversimplify the continuum of speed changes and potentially mask trends within each category. This research contributes valuable insights to traffic safety and driver behavior literature, illuminating the complexity of driver behavior and the potential influence of factors beyond the presence of speed enforcement devices. Future research directions may employ various categories of event severity. They may also explore the role of in-vehicle technologies, driver characteristics, and a broader set of environmental variables in driving behavior and traffic safety.

Keywords: acceleration, deceleration, speeding, inappropriate speed, speed enforcement cameras

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Authors: Alaa Fezai, Anuj Sharma, Wolfgang Mueller-Hirsch, André Zimmermann

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Viscoelastic materials have been widely used in the automotive industry over the last few decades with different functionalities. Besides their main application as a simple and efficient surface damping treatment, they may ensure optimal operating conditions for on-board electronics as thermal interface or sealing layers. The dynamic behavior of viscoelastic materials is generally dependent on many environmental factors, the most important being temperature and strain rate or frequency. Prior to the reliability analysis of systems including viscoelastic layers, it is, therefore, crucial to accurately predict the dynamic and lifetime behavior of these materials. This includes the identification of the dynamic material parameters under critical temperature and frequency conditions along with a precise damage localization and identification methodology. The goal of this work is twofold. The first part aims at applying an inverse viscoelastic material-characterization approach for a wide frequency range and under different temperature conditions. For this sake, dynamic measurements are carried on a single lap joint specimen using an electrodynamic shaker and an environmental chamber. The specimen consists of aluminum beams assembled to adapter plates through a viscoelastic adhesive layer. The experimental setup is reproduced in finite element (FE) simulations, and frequency response functions (FRF) are calculated. The parameters of both the generalized Maxwell model and the fractional derivatives model are identified through an optimization algorithm minimizing the difference between the simulated and the measured FRFs. The second goal of the current work is to guarantee an on-line detection of the damage, i.e., delamination in the viscoelastic bonding of the described specimen during frequency monitored end-of-life testing. For this purpose, an inverse technique, which determines the damage location and size based on the modal frequency shift and on the change of the mode shapes, is presented. This includes a preliminary FE model-based study correlating the delamination location and size to the change in the modal parameters and a subsequent experimental validation achieved through dynamic measurements of specimen with different, pre-generated crack scenarios and comparing it to the virgin specimen. The main advantage of the inverse characterization approach presented in the first part resides in the ability of adequately identifying the material damping and stiffness behavior of soft viscoelastic materials over a wide frequency range and under critical temperature conditions. Classic forward characterization techniques such as dynamic mechanical analysis are usually linked to limitations under critical temperature and frequency conditions due to the material behavior of soft viscoelastic materials. Furthermore, the inverse damage detection described in the second part guarantees an accurate prediction of not only the damage size but also its location using a simple test setup and outlines; therefore, the significance of inverse numerical-experimental approaches in predicting the dynamic behavior of soft bonding layers applied in automotive electronics.

Keywords: damage detection, dynamic characterization, inverse approaches, vibration testing, viscoelastic layers

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Authors: Laverne Seales

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When most people think of Panama, they immediately think of the Canal; however, the construction and the people who made it possible are often omitted and seldom acknowledged. The reality is that the construction of this waterway was achieved through forced migration and discriminatory practices toward people of African descent, specifically black people from the Caribbean. From the colonial period to the opening and subsequent operation of the Panama Canal by the United States, this paper goes through the rich layers of Panamanian history to examine the life of Afro-Caribbeans and their descendants in Panama. It also considers the role of the United States in Panama; it explores how the United States in Panama forged a racially complex country that made the integration of Afro-Caribbeans and their descendants difficult. After laying a historical foundation, the exploration of Afro-Caribbean people and Panamanians of Afro-Caribbean descent are analyzed through Afro-Panamanian writer Carlos Guillermo ‘Cubena’ Wilson's novels, short stories, and poetry. This study focuses on how Cubena addresses racism, discrimination, inequality, and social justice issues towards Afro-Caribbeans and their descendants who traveled to Panama to construct the Canal. Content analysis methodology can yield several significant contributions, and analyzing Carlos Guillermo Wilson's literature under this framework allows us to consider social commentary and critique of Panamanian society. It identifies the social issues and concerns of Afro-Caribbeans and people of Afro-Caribbean descent, such as inequality, corruption, racism, political oppression, and cultural identity. Analysis methodology allows us to explore how Cubena's literature engages with questions of cultural identity and belonging in Panamanian society. By examining themes related to race, ethnicity, language, and heritage, this research uncovers the complexities of Panamanian cultural identity, allowing us to interrogate power dynamics and social hierarchies in Panamanian society. Analyzing the portrayal of different social groups, institutions, and power structures helps uncover how power is wielded, contested, and resisted; Cubena's fictional world allows us to see how it functions in Panama. Content analysis methodology also provides for critiquing political systems and governance in Panama. By examining the representation and presentation of political figures, institutions, and events in Cubena's literature, we uncover his commentary on corruption, authoritarianism, governance, and the role of the United States in Panama. Content analysis highlights how Wilson's literature amplifies the voices and experiences of marginalized individuals and communities in Panamanian society. By centering the narratives of Afro-Panamanians and other marginalized groups, this researcher uncovers Cubena's commitment to social justice and inclusion in his writing and helps the reader engage with historical narratives and collective memory in Panama. Overall, analyzing Carlos Guillermo ‘Cubena’ Wilson's literature as a platform for social commentary and critique of Panamanian society using content analysis methodology provides valuable insights into the cultural, social, and political dimensions of Afro-Panamanians during and after the construction of the Panama Canal.

Keywords: Afro-Caribbean, Panama Canal, race, Afro-Panamanian, identity, history

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Authors: David J. Foran, Nhan Do, Samuel Ajjarapu, Wenjin Chen, Tahsin Kurc, Joel H. Saltz

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The large-scale data and computational requirements of investigators throughout the clinical and research communities demand an informatics infrastructure that supports both existing and new investigative and translational projects in a robust, secure environment. In some subspecialties of medicine and research, the capacity to generate data has outpaced the methods and technology used to aggregate, organize, access, and reliably retrieve this information. Leading health care centers now recognize the utility of establishing an enterprise-wide, clinical data warehouse. The primary benefits that can be realized through such efforts include cost savings, efficient tracking of outcomes, advanced clinical decision support, improved prognostic accuracy, and more reliable clinical trials matching. The overarching objective of the work presented here is the development and implementation of a flexible Intelligent Retrieval and Interrogation System (IRIS) that exploits the combined use of computational imaging, genomics, and data-mining capabilities to facilitate clinical assessments and translational research in oncology. The proposed System includes a multi-modal, Clinical & Research Data Warehouse (CRDW) that is tightly integrated with a suite of computational and machine-learning tools to provide insight into the underlying tumor characteristics that are not be apparent by human inspection alone. A key distinguishing feature of the System is a configurable Extract, Transform and Load (ETL) interface that enables it to adapt to different clinical and research data environments. This project is motivated by the growing emphasis on establishing Learning Health Systems in which cyclical hypothesis generation and evidence evaluation become integral to improving the quality of patient care. To facilitate iterative prototyping and optimization of the algorithms and workflows for the System, the team has already implemented a fully functional Warehouse that can reliably aggregate information originating from multiple data sources including EHR’s, Clinical Trial Management Systems, Tumor Registries, Biospecimen Repositories, Radiology PAC systems, Digital Pathology archives, Unstructured Clinical Documents, and Next Generation Sequencing services. The System enables physicians to systematically mine and review the molecular, genomic, image-based, and correlated clinical information about patient tumors individually or as part of large cohorts to identify patterns that may influence treatment decisions and outcomes. The CRDW core system has facilitated peer-reviewed publications and funded projects, including an NIH-sponsored collaboration to enhance the cancer registries in Georgia, Kentucky, New Jersey, and New York, with machine-learning based classifications and quantitative pathomics, feature sets. The CRDW has also resulted in a collaboration with the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC) at the U.S. Department of Veterans Affairs to develop algorithms and workflows to automate the analysis of lung adenocarcinoma. Those studies showed that combining computational nuclear signatures with traditional WHO criteria through the use of deep convolutional neural networks (CNNs) led to improved discrimination among tumor growth patterns. The team has also leveraged the Warehouse to support studies to investigate the potential of utilizing a combination of genomic and computational imaging signatures to characterize prostate cancer. The results of those studies show that integrating image biomarkers with genomic pathway scores is more strongly correlated with disease recurrence than using standard clinical markers.

Keywords: clinical data warehouse, decision support, data-mining, intelligent databases, machine-learning.

Procedia PDF Downloads 126

Authors: Marie Boost

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Despite activation policies, forced personal initiative to step out of unemployment and a general prosper economic situation, poverty and financial hardship constitute a crucial role in the daily lives of many families in Germany. In 2015, ~16 million persons (20.2%) of the German population are at risk of poverty or social exclusion. This is illustrated by an unemployment rate of 13.3% in the research area, located in East Germany. Despite this high amount of persons living in vulnerable households, we know little about how they manage to stabilize their lives or even overcome poverty – apart from solely relying on welfare state benefits or entering in a stable, well-paid job. Most of them are struggling in precarious living circumstances, switching from one or several short-term, low-paid jobs into self-employment or unemployment, sometimes accompanied by welfare state benefits. Hence, insecurity and uncertain future expectation form a crucial part of their lives. Within the EU-funded project “RESCuE”, resilient practices of vulnerable households were investigated in nine European countries. Approximately, 15 expert interviews with policy makers, representatives from welfare state agencies, NGOs and charity organizations and 25 household interviews have been conducted within each country. It aims to find out more about the chances and conditions of social resilience. The research is based on the triangulation of biographical narrative interviews, followed by participatory photo interviews, asking the household members to portray their typical everyday life. The presentation is focusing on the explanatory strength of this mixed-methods approach in order to show the potential of household practices to overcome financial hardship. The methodological combination allows an in-depth analysis of the families and households everyday living circumstances, including their poverty and employment situation, whether formal and informal. Active household budgeting practices, such as saving and consumption practices are based on subsistence or Do-It-Yourself work. Especially due to the photo-interviews, the importance of inherent cultural and tacit knowledge becomes obvious as it pictures their typical practices, like cultivation and gathering fruits and vegetables or going fishing. One of the central findings is the multiple purposes of these practices. They contribute to ease financial burden through consumption reduction and strengthen social ties, as they are mostly conducted with close friends or family members. In general, non-commodified practices are found to be re-commodified and to contribute to ease financial hardship, e.g. by the use of commons, barter trade or simple mutual exchange (gift exchange). These practices can substitute external purchases and reduce expenses or even generate a small income. Mixing different income sources are found to be the most likely way out of poverty within the context of a precarious labor market. But these resilient household practices take its toll as they are highly preconditioned, and many persons put themselves into risk of overstressing themselves. Thus, the potentials and risks of resilient household practices are reflected in the presentation.

Keywords: consumption practices, labor market, qualitative research, resilience

Procedia PDF Downloads 219

Authors: Sandra Regina Cavalcante, Rodolfo A. G. Vilela

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Introduction: Work accidents and occupational diseases are a big problem for public health around the world and the main health problem of workers with high social and economic costs. Brazil has shown progress over the last years, with the development of the regulatory system to improve safety and quality of life in the workplace. However, the situation is far from acceptable, because the occurrences remain high and there is a great gap between legislation and reality, generated by the low level of voluntary compliance with the law. Brazilian laws provide procedural legal instruments for both, to compensate the damage caused to the worker's health and to prevent future injuries. In the Judiciary, the prevention idea is in the collective action, effected through Brazilian Class Actions. Inhibitory guardianships may impose both, improvements to the working environment, as well as determine the interruption of activity or a ban on the machine that put workers at risk. Both the Labor Prosecution and trade unions have to stand to promote this type of action, providing payment of compensation for collective moral damage. Objectives: To verify how class actions (known as ‘public civil actions’), regulated in Brazilian legal system to protect diffuse, collective and homogeneous rights, are being used to protect workers' health and safety. Methods: The author identified and evaluated decisions of Brazilian Superior Court of Labor involving collective actions and work accidents. The timeframe chosen was December 2015. The online jurisprudence database was consulted in page available for public consultation on the court website. The categorization of the data was made considering the result (court application was rejected or accepted), the request type, the amount of compensation and the author of the cause, besides knowing the reasoning used by the judges. Results: The High Court issued 21,948 decisions in December 2015, with 1448 judgments (6.6%) about work accidents and only 20 (0.09%) on collective action. After analyzing these 20 decisions, it was found that the judgments granted compensation for collective moral damage (85%) and/or obligation to make, that is, changes to improve prevention and safety (71%). The processes have been filed mainly by the Labor Prosecutor (83%), and also appeared lawsuits filed by unions (17%). The compensation for collective moral damage had average of 250,000 reais (about US$65,000), but it should be noted that there is a great range of values found, also are several situations repaired by this compensation. This is the last instance resource for this kind of lawsuit and all decisions were well founded and received partially the request made for working environment protection. Conclusions: When triggered, the labor court system provides the requested collective protection in class action. The values of convictions arbitrated in collective actions are significant and indicate that it creates social and economic repercussions, stimulating employers to improve the working environment conditions of their companies. It is necessary to intensify the use of collective actions, however, because they are more efficient for prevention than reparatory individual lawsuits, but it has been underutilized, mainly by Unions.

Keywords: Brazilian Class Action, collective action, work accident penalization, workplace accident prevention, workplace protection law

Procedia PDF Downloads 273

Authors: Clea Southall

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Many children leave primary school having formed preconceptions about their relationship with science. Thus, primary school represents a critical window for stimulating scientific interest in younger children. Engagement relies on the provision of hands-on activities coupled with an ability to capture a child’s innate curiosity. This requires children to perceive science topics as interesting and relevant to their everyday life. Teachers and pupils alike have suggested the school curriculum be tailored to help stimulate scientific interest. Young children are naturally inquisitive about the human body; the brain is one topic which frequently engages pupils, although it is not currently included in the UK primary curriculum. Teaching children about the brain could have wider societal impacts such as increasing knowledge of neurological disorders. However, many primary school teachers do not receive formal neuroscience training and may feel apprehensive about delivering lessons on the nervous system. This is exacerbated by a lack of educational neuroscience resources. One solution is for undergraduates to form partnerships with schools - delivering engaging lessons and supplementing teacher knowledge. The aim of this project was to evaluate the success of a short lesson on the brain delivered by an undergraduate neuroscientist to primary school pupils. Prior to entering schools, semi-structured online interviews were conducted with teachers to gain pedagogical advice and relevant websites were searched for neuroscience resources. Subsequently, a single lesson plan was created comprising of four hands-on activities. The activities were devised in a top-down manner, beginning with learning about the brain as an entity, before focusing on individual neurons. Students were asked to label a ‘brain map’ to assess prior knowledge of brain structure and function. They viewed animal brains and created ‘pipe-cleaner neurons’ which were later used to depict electrical transmission. The same session was delivered by an undergraduate student to 570 key stage 2 (KS2) pupils across five schools in Leeds, UK. Post-session surveys, designed for teachers and pupils respectively, were used to evaluate the session. Children in all year groups had relatively poor knowledge of brain structure and function at the beginning of the session. When asked to label four brain regions with their respective functions, older pupils labeled a mean of 1.5 (± 1.0) brain regions compared to 0.8 (± 0.96) for younger pupils (p=0.002). However, by the end of the session, 95% of pupils felt their knowledge of the brain had increased. Hands-on activities were rated most popular by pupils and were considered the most successful aspect of the session by teachers. Although only half the teachers were aware of neuroscience educational resources, nearly all (95%) felt they would have more confidence in teaching a similar session in the future. All teachers felt the session was engaging and that the content could be linked to the current curriculum. Thus, a short fifty-minute session can successfully enhance pupils’ knowledge of a new topic: the brain. Partnerships with an undergraduate student can provide an alternative method for supplementing teacher knowledge, increasing their confidence in delivering future lessons on the nervous system.

Keywords: education, neuroscience, primary school, undergraduate

Procedia PDF Downloads 209

Authors: K. A.Veselova, N. V.Gromova, I. N.Antonova, I. N. Kalakutskii

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There are many diseases and incidents that may result facial defects and deformities: cancer, trauma, burns, congenital anomalies, and autoimmune diseases. In some cases, patient may acquire atypically extensive facial defect, including more than one anatomical region or, by contrast, atypically small defect (e.g. partial auricular defect). The anaplastology gives us opportunity to help patient with facial disfigurement in cases when plastic surgery is contraindicated. Using of implant retention for facial prosthesis is strongly recommended because improves both aesthetic and functional results and makes using of the prosthesis more comfortable. Prostheticly oriented fixture position is extremely important for aesthetic and functional long-term result; however, the optimal site for fixture placement is not clear in cases with atypical configuration of facial defect. The objective of this report is to demonstrate challenges in fixture position determination we have faced with and offer the solution. In this report, four cases of implant-supported facial prosthesis are described. Extra-oral implants with four millimeter length were used in all cases. The decision regarding the quantity of surgical stages was based on anamnesis of disease. Facial prostheses were manufactured according to conventional technique. Clinical and technological difficulties and mistakes are described, and prostheticly oriented approach for determination of fixture position is demonstrated. The case with atypically large combined orbital and nasal defect resulting after arteriovenous malformation is described: the correct positioning of artificial eye was impossible due to wrong position of the fixture (with suprastructure) located in medial aspect of supraorbital rim. The suprastructure was unfixed and this fixture wasn`t used for retention in order to achieve appropriate artificial eye placement and better aesthetic result. In other case with small partial auricular defect (only helix and antihelix were absent) caused by squamoized cell carcinoma T1N0M0 surgical template was used to avoid the difficulties. To achieve the prostheticly oriented fixture position in case of extremely small defect the template was made on preliminary cast using vacuum thermoforming method. Two radiopaque markers were incorporated into template in preferable for fixture placement positions taking into account future prosthesis configuration. The template was put on remaining ear and cone-beam CT was performed to insure, that the amount of bone is enough for implant insertion in preferable position. Before the surgery radiopaque markers were extracted and template was holed for guide drill. Fabrication of implant-retained facial prostheses gives us opportunity to improve aesthetics, retention and patients’ quality of life. But every inaccuracy in planning leads to challenges on surgery and prosthetic stages. Moreover, in cases with atypically small or extended facial defects prostheticly oriented approach for determination of fixture position is strongly required. The approach including surgical template fabrication is effective, easy and cheap way to avoid mistakes and unpredictable result.

Keywords: anaplastology, facial prosthesis, implant-retained facial prosthesis., maxillofacil prosthese

Procedia PDF Downloads 112

Authors: Nancy A. Delich, Stephen D. Roberts

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This case study explores using self-efficacy theory in counseling deaf and hard of hearing students in one California school district. Self-efficacy is described as the confidence a student has for performing a set of skills required to succeed at a specific task. When students need to learn a skill, self-efficacy can be a major factor in influencing behavioral change. Self-efficacy is domain specific, meaning that students can have high confidence in their abilities to accomplish a task in one domain, while at the same time having low confidence in their abilities to accomplish another task in a different domain. The communication isolation experienced by deaf and hard of hearing children and adolescents can negatively impact their belief about their ability to navigate life challenges. There is a need to address issues that impact deaf and hard of hearing students’ social-emotional development. Failure to address these needs may result in depression, suicidal ideation, and anxiety among other mental health concerns. Self-efficacy training can be used to address these socio-emotional developmental issues with this population. Four sources of experiences are applied during an intervention: (a) enactive mastery experience, (b) vicarious experience, (c) verbal persuasion, and (d) physiological and affective states. This case study describes the use of self-efficacy training with a coed group of 12 deaf and hard of hearing high school students who experienced bullying at school. Beginning with enactive mastery experience, the counselor introduced the topic of bullying to the group. The counselor educated the students about the different types of bullying while teaching them the terminology, signs and their meanings. The most effective way to increase self-efficacy is through extensive practice. To better understand these concepts, the students practiced through role-playing with the goal of developing self-advocacy skills. Vicarious experience is the perception that students have about their capabilities. Viewing other students advocating for themselves, cognitively rehearsing what actions they will and will not take, and teaching each other how to stand up against bullying can strengthen their belief in successfully overcoming bullying. The third source of self-efficacy beliefs is verbal persuasion. It occurs when others express belief in the capabilities of the student. Didactic training and pedagogic materials on bullying were employed as part of the group counseling sessions. The fourth source of self-efficacy appraisals is physiological and affective states. Students expect positive emotions to be associated with successful skilled performance. When students practice new skills, the counselor can apply several strategies to enhance self-efficacy while reducing and controlling emotional and physical states. The intervention plan incorporated all four sources of self-efficacy training during several interactive group sessions regarding bullying. There was an increased understanding around the issues of bullying, resulting in the students’ belief of their ability to perform protective behaviors and deter future occurrences. The outcome of the intervention plan resulted in a reduction of reported bullying incidents. In conclusion, self-efficacy training can be an effective counseling and teaching strategy in addressing and enhancing the social-emotional functioning with deaf and hard of hearing adolescents.

Keywords: counseling, self-efficacy, bullying, social-emotional development, mental health, deaf and hard of hearing students

Procedia PDF Downloads 351