Search results for: mathematical and computational methods

Authors: Anda-veronica Gherman, Dimitrios Varthalitis

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Neurosurgery, like many surgical specialties, undoubtedly exhibits a significant gender gap, particularly in leadership positions. While increasing women representation in neurosurgery is important, it is crucial to increase their presence in leadership positions. Across the globe and Europe there are concerning trends of only 4% of all neurosurgical departments being chaired by women. This study aims to explore the situation regarding gender disparities in leadership in the United Kingdom and to identify possible contributing factors as well as discussing future strategies to bridge this gap. Methods: A literature review was conducted utilising PubMed as main database with search keywords including ‘female neurosurgeon’, ‘women neurosurgeon’, ‘gender disparity’, ‘leadership’ and ‘UK’. Additionally, a manual search of all neurosurgical departments in the UK was performed to identify the current female department leads and training director leads. Results: The literature search identified a paucity of literature addressing specifically leadership in female neurosurgeons within the UK, with very few published papers specifically on this topic. Despite more than half of medical students in the UK being female, only a small proportion pursue a surgical career, with neurosurgery being one of the least represented specialties. Only 27% of trainee neurosurgeons are female, and numbers are even lower at a consultant level, where women represent just 8%.Findings from published studies indicated that only 6.6% of leadership positions in neurosurgery are occupied by women in the UK. Furthermore, our manual searches across UK neurosurgical departments revealed that around 5% of department lead positions are currently held by women. While this figure is slightly higher than the European average of 4%, it remains lower compared to figures of 10% in other North-West European countries. The situation is slightly more positive looking at the training directors, with 15% being female. Discussion: The findings of this study highlight a significant gender disparity in leadership positions within neurosurgery in the UK, which may have important implications, perpetuating the lack of diversity on the decision-making process, limiting the career advancement opportunities of women and depriving the neurosurgical field from the voices, opinions and talents of women. With women representing half of the population, there is an undeniable need for more female leaders at the policy-making level. There are many barriers that can contribute to these numbers, including bias, stereotypes, lack of mentorship and work-like balance. A few solutions to overcome these barriers can be training programs addressing bias and impostor syndrome, leadership workshops tailored for female needs, better workplace policies, increased in formal mentorship and increasing the visibility of women in neurosurgery leadership positions through media, speaking opportunities, conferences, awards etc. And lastly, more research efforts should focus on the leadership and mentorship of women in neurosurgery, with an increased number of published papers discussing these issues.

Keywords: female neurosurgeons, female leadership, female mentorship, gender disparities

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Authors: Vijaya Kumar, Vidayasagar Pagilla, Abraham Joshua, Rakshith Kedambadi, Prasanna Mithra

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Background: Post stroke rehabilitation are aimed to accelerate for optimal sensorimotor recovery, functional gain and to reduce long-term dependency. Intensive physical therapy interventions can enhance this recovery as experience-dependent neural plastic changes either directly act at cortical neural networks or at distal peripheral level (muscular components). Neuromuscular Electrical Stimulation (NMES), a traditional bottom-up approach, mirror therapy (MT), a relatively new top down approach have found to be an effective adjuvant treatment methods for lower extremity motor and functional recovery in stroke rehabilitation. However there is a scarcity of evidence to compare their therapeutic gain in stroke recovery.Aim: To compare the efficacy of neuromuscular electrical stimulation (NMES) and mirror therapy (MT) in very early phase of post stroke rehabilitation addressed to lower extremity motor recovery and balance. Design: observer blinded Randomized Clinical Trial. Setting: Neurorehabilitation Unit, Department of Physical Therapy, Tertiary Care Hospitals. Subjects: 32 acute stroke subjects with first episode of unilateral stroke with hemiparesis, referred for rehabilitation (onset < 3 weeks), Brunnstorm lower extremity recovery stages ≥3 and MMSE score more than 24 were randomized into two group [Group A-NMES and Group B-MT]. Interventions: Both the groups received eclectic approach to remediate lower extremity recovery which includes treatment components of Roods, Bobath and Motor learning approaches for 30 minutes a day for 6 days. Following which Group A (N=16) received 30 minutes of surface NMES training for six major paretic muscle groups (gluteus maximus and medius,quadriceps, hamstrings, tibialis anterior and gastrocnemius). Group B (N=16) was administered with 30 minutes of mirror therapy sessions to facilitate lower extremity motor recovery. Outcome measures: Lower extremity motor recovery, balance and activities of daily life (ADLs) were measured by Fugyl Meyer Assessment (FMA-LE), Berg Balance Scale (BBS), Barthel Index (BI) before and after intervention. Results: Pre Post analysis of either group across the time revealed statistically significant improvement (p < 0.001) for all the outcome variables for the either group. All parameters of NMES had greater change scores compared to MT group as follows: FMA-LE (25.12±3.01 vs. 23.31±2.38), BBS (35.12±4.61 vs. 34.68±5.42) and BI (40.00±10.32 vs. 37.18±7.73). Between the groups comparison of pre post values showed no significance with FMA-LE (p=0.09), BBS (p=0.80) and BI (p=0.39) respectively. Conclusion: Though either groups had significant improvement (pre to post intervention), none of them were superior to other in lower extremity motor recovery and balance among acute stroke subjects. We conclude that eclectic approach is an effective treatment irrespective of NMES or MT as an adjunct.

Keywords: balance, motor recovery, mirror therapy, neuromuscular electrical stimulation, stroke

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Authors: Andreas Hirseland, Lukas Kerschbaumer

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In Germany, during the past years there constantly are about one million long term unemployed who did not benefit from the prospering labor market while most short term unemployed did. Instead, they are continuously dependent on welfare and sometimes precarious short-term employment, experiencing work poverty. Long term unemployment thus turns into a main obstacle to regular employment, especially if accompanied by other impediments such as low level education (school/vocational), poor health (especially chronical illness), advanced age (older than fifty), immigrant status, motherhood or engagement in care for other relatives. Almost two thirds of all welfare recipients have multiple impediments which hinder a successful transition from welfare back to sustainable and sufficient employment. Hiring them is often considered as an investment too risky for employers. Therefore formal application schemes based on formal qualification certificates and vocational biographies might reduce employers’ risks but at the same time are not helpful for long-term unemployed and welfare recipients. The panel survey ‘Labor market and social security’ (PASS; ~15,000 respondents in ~10,000 households), carried out by the Institute of Employment Research (the research institute of the German Federal Labor Agency), shows that their chance to get back to work tends to fall to nil. Only 66 cases of such unlikely transitions could be observed. In a sequential explanatory mixed-method study, the very scarce ‘success stories’ of unlikely transitions from long term unemployment to work were explored by qualitative inquiry – in-depth interviews with a focus on biography accompanied by qualitative network techniques in order to get a more detailed insight of relevant actors involved in the processes which promote the transition from being a welfare recipient to work. There is strong evidence that sustainable transitions are influenced by biographical resources like habits of network use, a set of informal skills and particularly a resilient way of dealing with obstacles, combined with contextual factors rather than by job-placement procedures promoted by Job-Centers according to activation rules or by following formal paths of application. On the employer’s side small and medium-sized enterprises are often found to give job opportunities to a wider variety of applicants, often based on a slow but steadily increasing relationship leading to employment. According to these results it is possible to show and discuss some limitations of (German) activation policies targeting welfare dependency and long-term unemployment. Based on these findings, indications for more supportive small scale measures in the field of labor-market policies are suggested to help long-term unemployed with multiple impediments to overcome their situation.

Keywords: against-all-odds, economic sociology, long-term unemployment, mixed-methods

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Authors: Thomas Turner

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Due to the Covid-19 pandemic alternative ways of delivering dental education were required. As a result, many institutions moved teaching online. The impact of this is poorly understood. Is online problem-based learning (PBL) and case-based learning (CBL) effective and is it suitable in the post-pandemic era? PBL and CBL are both types of interactive, group-based learning which are growing in popularity within many dental schools. PBL was first introduced in the 1960’s and can be defined as learning which occurs from collaborative work to resolve a problem. Whereas CBL encourages learning from clinical cases, encourages application of knowledge and helps prepare learners for clinical practice. To evaluate the use of online PBL and CBL. A literature search was conducted using the CINAHL, Embase, PubMed and Web of Science databases. Literature was also identified from reference lists. Studies were only included from dental education. Seven suitable studies were identified. One of the studies found a high learner and facilitator satisfaction rate with online CBL. Interestingly one study found learners preferred CBL over PBL within an online format. A study also found, that within the context of distance learning, learners preferred a hybrid curriculum including PBL over a traditional approach. A further study pointed to the limitations of PBL within an online format, such as reduced interaction, potentially hindering the development of communication skills and the increased time and technology support required. An audience response system was also developed for use within CBL and had a high satisfaction rate. Interestingly one study found achievement of learning outcomes was correlated with the number of student and staff inputs within an online format. Whereas another study found the quantity of learner interactions were important to group performance, however the quantity of facilitator interactions was not. This review identified generally favourable evidence for the benefits of online PBL and CBL. However, there is limited high quality evidence evaluating these teaching methods within dental education and there appears to be limited evidence comparing online and faceto-face versions of these sessions. The importance of the quantity of learner interactions is evident, however the importance of the quantity of facilitator interactions appears to be questionable. An element to this may be down to the quality of interactions, rather than just quantity. Limitations of online learning regarding technological issues and time required for a session are also highlighted, however as learners and facilitators get familiar with online formats, these may become less of an issue. It is also important learners are encouraged to interact and communicate during these sessions, to allow for the development of communication skills. Interestingly CBL appeared to be preferred to PBL in an online format. This may reflect the simpler nature of CBL, however further research is required to explore this finding. Online CBL and PBL appear promising, however further research is required before online formats of these sessions are widely adopted in the post-pandemic era.

Keywords: case-based learning, online, problem-based learning, remote, virtual

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Authors: Hamda M. Al-Ali

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From addressing fundamental questions about the history of the solar system to exploring other planets for any signs of life have always been the core of human space exploration. This triggered humans to explore whether other planets such as Mars could support human life on them. Therefore, many planned space missions to other planets have been designed and conducted to examine the feasibility of human survival on them. However, space missions are expensive and consume a large number of various resources to be successful. To overcome these problems, material efficiency shall be maximized through the use of reusable launch vehicles (RLV) rather than disposable and expendable ones. Material efficiency is defined as a way to achieve service requirements using fewer materials to reduce CO2 emissions from industrial processes. Materials such as aluminum-lithium alloys, steel, Kevlar, and reinforced carbon-carbon composites used in the manufacturing of spacecrafts could be reused in closed-loop cycles directly or by adding a protective coat. Material efficiency is a fundamental principle of a circular economy. The circular economy aims to cutback waste and reduce pollution through maximizing material efficiency so that businesses can succeed and endure. Five strategies have been proposed to improve material efficiency in the space industry, which includes waste minimization, introduce Key Performance Indicators (KPIs) to measure material efficiency, and introduce policies and legislations to improve material efficiency in the space sector. Another strategy to boost material efficiency is through maximizing resource and energy efficiency through material reusability. Furthermore, the environmental effects associated with the rapid growth in the number of space missions include black carbon emissions that lead to climate change. The levels of emissions must be tracked and tackled to ensure the safe utilization of space in the future. The aim of this research paper is to examine and suggest effective methods used to improve material efficiency in space missions so that space and Earth become more environmentally and economically sustainable. The objectives used to fulfill this aim are to identify the materials used in space missions that are suitable to be reused in closed-loop cycles considering material efficiency indicators and circular economy concepts. An explanation of how spacecraft materials could be re-used as well as propose strategies to maximize material efficiency in order to make RLVs possible so that access to space becomes affordable and reliable is provided. Also, the economic viability of the RLVs is examined to show the extent to which the use of RLVs has on the reduction of space mission costs. The environmental and economic implications of the increase in the number of space missions as a result of the use of RLVs are also discussed. These research questions are studied through detailed critical analysis of the literature, such as published reports, books, scientific articles, and journals. A combination of keywords such as material efficiency, circular economy, RLVs, and spacecraft materials were used to search for appropriate literature.

Keywords: access to space, circular economy, material efficiency, reusable launch vehicles, spacecraft materials

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Authors: A. V. Samokhin, A. A. Fadeev, M. A. Sinaiskii, N. V. Alekseev, A. V. Kolesnikov

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Composite materials where metal matrix is reinforced by ceramic or metal particles are of great interest for use in the manufacturing of electrical contacts. Significant improvement of the composite physical and mechanical properties as well as increase of the performance parameters of composite-based products can be achieved if the nanoscale structure in the composite materials is obtained by using nanosized powders as starting components. The results of nanosized composite powders synthesis (Ag-SnO2, W-Cu and Cu-C) in the DC thermal plasma flows are presented in this paper. The investigations included the following processes: - Recondensation of micron powder mixture Ag + SnO2 in a nitrogen plasma; - The reduction of the oxide powders mixture (WO3 + CuO) in a hydrogen-nitrogen plasma; - Decomposition of the copper formate and copper acetate powders in nitrogen plasma. The calculations of equilibrium compositions of multicomponent systems Ag-Sn-O-N, W-Cu-O-H-N and Cu-O-C-H-N in the temperature range of 400-5000 K were carried to estimate basic process characteristics. Experimental studies of the processes were performed using a plasma reactor with a confined jet flow. The plasma jet net power was in the range of 2 - 13 kW, and the feedstock flow rate was up to 0.35 kg/h. The obtained powders were characterized by TEM, HR-TEM, SEM, EDS, ED-XRF, XRD, BET and QEA methods. Nanocomposite Ag-SnO2 (12 wt. %). Processing of the initial powder mixture (Ag-SnO2) in nitrogen thermal plasma stream allowed to produce nanopowders with a specific surface area up to 24 m2/g, consisting predominantly of particles with size less than 100 nm. According to XRD results, tin was present in the obtained products as SnO2 phase, and also as intermetallic phases AgxSn. Nanocomposite W-Cu (20 wt .%). Reduction of (WO3+CuO) mixture in the hydrogen-nitrogen plasma provides W-Cu nanopowder with particle sizes in the range of 10-150 nm. The particles have mainly spherical shape and structure tungsten core - copper shell. The thickness of the shell is about several nanometers, the shell is composed of copper and its oxides (Cu2O, CuO). The nanopowders had 1.5 wt. % oxygen impurity. Heat treatment in a hydrogen atmosphere allows to reduce the oxygen content to less than 0.1 wt. %. Nanocomposite Cu-C. Copper nanopowders were found as products of the starting copper compounds decomposition. The nanopowders primarily had a spherical shape with a particle size of less than 100 nm. The main phase was copper, with small amount of Cu2O and CuO oxides. Copper formate decomposition products had a specific surface area 2.5-7 m2/g and contained 0.15 - 4 wt. % carbon; and copper acetate decomposition products had the specific surface area 5-35 m2/g, and carbon content of 0.3 - 5 wt. %. Compacting of nanocomposites (sintering in hydrogen for Ag-SnO2 and electric spark sintering (SPS) for W-Cu) showed that the samples having a relative density of 97-98 % can be obtained with a submicron structure. The studies indicate the possibility of using high-intensity plasma processes to create new technologies to produce nanocomposite materials for electric contacts.

Keywords: electrical contact, material, nanocomposite, plasma, synthesis

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Authors: Alak Kumar Patra, Nilanjan Mitra

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Higher strength to weight ratio is the main advantage of sandwich composite structures. Interfacial delamination between the face sheet and core is a major problem in these structures. Many research works are devoted to improve the interfacial fracture toughness of composites majorities of which are on nano and laminated composites. Work on influence of multiwalled carbon nano-tubes (MWCNT) dispersed resin system on interface fracture of glass-epoxy PVC core sandwich composite is extremely limited. Finite element study is followed by experimental investigation on interface fracture toughness of glass-epoxy (G/E) PVC core sandwich composite with and without MWCNT. Results demonstrate an improvement in interface fracture toughness values (Gc) of samples with a certain percentages of MWCNT. In addition, dispersion of MWCNT in epoxy resin through sonication followed by mixing of hardener and vacuum resin infusion (VRI) technology used in this study is an easy and cost effective methodology in comparison to previously adopted other methods limited to laminated composites. The study also identifies the optimum weight percentage of MWCNT addition in the resin system for maximum performance gain in interfacial fracture toughness. The results agree with finite element study, high-resolution transmission electron microscope (HRTEM) analysis and fracture micrograph of field emission scanning electron microscope (FESEM) investigation. Interface fracture toughness (GC) of the DCB sandwich samples is calculated using the compliance calibration (CC) method considering the modification due to shear. Compliance (C) vs. crack length (a) data of modified sandwich DCB specimen is fitted to a power function of crack length. The calculated mean value of the exponent n from the plots of experimental results is 2.22 and is different from the value (n=3) prescribed in ASTM D5528-01for mode 1 fracture toughness of laminate composites (which is the basis for modified compliance calibration method). Differentiating C with respect to crack length (a) and substituting it in the expression GC provides its value. The research demonstrates improvement of 14.4% in peak load carrying capacity and 34.34% in interface fracture toughness GC for samples with 1.5 wt% MWCNT (weight % being taken with respect to weight of resin) in comparison to samples without MWCNT. The paper focuses on significant improvement in experimentally determined interface fracture toughness of sandwich samples with MWCNT over the samples without MWCNT using much simpler method of sonication. Good dispersion of MWCNT was observed in HRTEM with 1.5 wt% MWCNT addition in comparison to other percentages of MWCNT. FESEM studies have also demonstrated good dispersion and fiber bridging of MWCNT in resin system. Ductility is also observed to be higher for samples with MWCNT in comparison to samples without.

Keywords: carbon nanotube, epoxy resin, foam, glass fibers, interfacial fracture, sandwich composite

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Authors: Jochen Nelles, Susanne Kohns, Julia Spies, Friederike Schmitz-Buhl, Roland Thietje, Christopher Brandl, Alexander Mertens, Christopher M. Schlick

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Industrial robots as part of highly automated manufacturing are recently developed to cooperative (light-weight) robots. This offers the opportunity of using them as assistance robots and to improve the participation in professional life of disabled or handicapped people such as tetraplegics. Robots under development are located within a cooperation area together with the working person at the same workplace. This cooperation area is an area where the robot and the working person can perform tasks at the same time. Thus, working people and robots are operating in the immediate proximity. Considering the physical restrictions and the limited mobility of tetraplegics, a hands-free robot control could be an appropriate approach for a cooperative assistance robot. To meet these requirements, the research project MeRoSy (human-robot synergy) develops methods for cooperative assistance robots based on the measurement of head movements of the working person. One research objective is to improve the participation in professional life of people with disabilities and, in particular, mobility impaired persons (e.g. wheelchair users or tetraplegics), whose participation in a self-determined working life is denied. This raises the research question, how a human-robot cooperation workplace can be designed for hands-free robot control. Here, the example of a library scenario is demonstrated. In this paper, an empirical study that focuses on the impact of head movement related stress is presented. 12 test subjects with tetraplegia participated in the study. Tetraplegia also known as quadriplegia is the worst type of spinal cord injury. In the experiment, three various basic head movements were examined. Data of the head posture were collected by a motion capture system; muscle activity was measured via surface electromyography and the subjective mental stress was assessed via a mental effort questionnaire. The muscle activity was measured for the sternocleidomastoid (SCM), the upper trapezius (UT) or trapezius pars descendens, and the splenius capitis (SPL) muscle. For this purpose, six non-invasive surface electromyography sensors were mounted on the head and neck area. An analysis of variance shows differentiated muscular strains depending on the type of head movement. Systematically investigating the influence of different basic head movements on the resulting strain is an important issue to relate the research results to other scenarios. At the end of this paper, a conclusion will be drawn and an outlook of future work will be presented.

Keywords: assistance robot, human-robot interaction, motion capture, stress-strain-concept, surface electromyography, tetraplegia

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Authors: Sudha Arlikatti, Laura Siebeneck, Simon A. Andrew

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The objective of this research is to measure organizational resiliency through five attributes namely, rapidity, redundancy, resourcefulness, and robustness and to provide recommendations for resiliency building in flood risk communities. The research was conducted in Thailand following the severe floods of 2011 triggered by Tropical Storm Nock-ten. The floods lasted over eight months starting in June 2011 affecting 65 of the country’s 76 provinces and over 12 million people. Funding from a US National Science Foundation grant was used to collect ephemeral data in rural (Ayutthaya), suburban (Pathum Thani), and urban (Bangkok) provinces of Thailand. Semi-structured face-to-face interviews were conducted in Thai with 44 contacts from public, private, and non-profit organizations including universities, schools, automobile companies, vendors, tourist agencies, monks from temples, faith based organizations, and government agencies. Multiple triangulations were used to analyze the data by identifying selective themes from the qualitative data, validated with quantitative data and news media reports. This helped to obtain a more comprehensive view of how organizations in different geographic settings varied in their understanding of what enhanced or hindered their resilience and consequently their speed and capacities to respond. The findings suggest that the urban province of Bangkok scored highest in resourcefulness, rapidity of response, robustness, and ability to rebound. This is not surprising considering that it is the country’s capital and the seat of government, economic, military and tourism sectors. However, contrary to expectations all 44 respondents noted that the rural province of Ayutthaya was the fastest to recover amongst the three. Its organizations scored high on redundancy and rapidity of response due to the strength of social networks, a flood disaster sub-culture due to annual flooding, and the help provided by monks from and faith based organizations. Organizations in the suburban community of Pathum Thani scored lowest on rapidity of response and resourcefulness due to limited and ambiguous warnings, lack of prior flood experience and controversies that government flood protection works like sandbagging favored the capital city of Bangkok over them. Such a micro-level examination of organizational resilience in rural, suburban and urban areas in a country through mixed methods studies has its merits in getting a nuanced understanding of the importance of disaster subcultures and religious norms for resilience. This can help refocus attention on the strengths of social networks and social capital, for flood mitigation.

Keywords: disaster subculture, flood response, organizational resilience, Thailand floods, religious beliefs and response, social capital and disasters

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Authors: Julia Córdoba

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People are not completely autonomous, as we live in society; therefore, people could be defined as relationally dependent. The lack, decrease or loss of physical, psychological and/or social interdependence due to a disability situation is known as dependence. This is related to the need for help from another person in order to carry out activities of daily living. This population group lives with major social limitations that significantly reduce their participation and autonomy. They have high levels of stigma and invisibility from private environments (family and close networks), as well as from the public order (environment, community). The importance of this study lies in the fact that the lack of support and adjustments leads to what authors call the circle of exclusion. This circle describes how not accessing services - due to the difficulties caused by the disability situation impacts biological, social and psychological levels. This situation produces higher levels of exclusion and vulnerability. This study will focus on the process of autonomy and dependence of adults with disability from the model of disability proposed by the International Classification of Functioning, Health and Disability (ICF). The objectives are: i) to write down the relationship between autonomy and dependence based on socio-health variables and ii) to determine the relationship between the situation of autonomy and dependence and the expectations and interests of the participants. We propose a study that will use a survey technique through a previously validated virtual questionnaire. The data obtained will be analyzed using quantitative and qualitative methods for the details of the profiles obtained. No less than 200 questionnaires will be administered to people between 18 and 64 years of age who self-identify as having some degree of dependency due to disability. For the analysis of the results, the two main variables of autonomy and dependence will be considered. Socio-demographic variables such as age, gender identity, area of residence and family composition will be used. In relation to the biological dimension of the situation, the diagnosis, if any, and the type of disability will be asked. For the description of these profiles of autonomy and dependence, the following variables will be used: self-perception, decision-making, interests, expectations and life project, care of their health condition, support and social network, and labor and educational inclusion. The relationship between the target population and the variables collected provides several guidelines that could form the basis for the analysis of other research of interest in terms of self-perception, autonomy and dependence. The areas and situations where people state that they have greater possibilities to decide and have a say will be obtained. It will identify social (networks and support, educational background), demographic (age, gender identity and residence) and health-related variables (diagnosis and type of disability, quality of care) that may have a greater relationship with situations of dependency or autonomy. It will be studied whether the level of autonomy and/or dependence has an impact on the type of expectations and interests of the people surveyed.

Keywords: life project, disability, inclusion, autonomy

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Authors: Meifang Chen

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Background: As China increased its engagement in global health affairs and research, global Health (GH) emerged as a new discipline in China after 2010. Duke Kunshan University (DKU), as a member of the Chinese Consortium of Universities for Global Health, is the first university that experiments “Western-style” liberal arts and sciences (LAS) education pedagogy in GH undergraduate and postgraduate programs in China since 2014. The COVID-19 pandemic has brought significant disruption to education across the world. At the peak of the pandemic, 45 countries in the Europe and Central Asia regions closed their schools, affecting 185 million students. DKU, as many other universities and schools, was unprepared for this sudden abruptness and were forced to build emergency remote learning systems almost immediately. This qualitative study aims to gain a deeper understanding of 1) how Chinese students and parents embrace GH training in the liberal arts and sciences education context, and 2) how the COVID pandemic influences the students’ learning experience as well as affects students and parents’ perceptions of GH-related study and career development in China. Methods: students and parents at DKU were invited and recruited for open-ended, semi-structured interviews during Sept 2021-Mar 2022. Open coding procedures and thematic content analysis were conducted using Nvivo 12 software. Results: A total of 18 students and 36 parents were interviewed. Both students and parents were fond of delivering GH education using the liberal arts and sciences pedagogy. Strengths of LAS included focusing on whole person development, allowing personal enrichment, tailoring curriculum to individual’s interest, providing well-rounded knowledge through interdisciplinary learning, and increasing self-study capacity and adaptability. Limitations of LAS included less time to dive deep into disciplines. There was a significant improvement in independence, creativity, problem solving, and team coordinating capabilities among the students. The impact of the COVID pandemic on GH learning experience included less domestic and abroad fieldwork opportunities, less in-person interactions (especially with foreign students and faculty), less timely support, less lab experience, and coordination challenges due to time-zone difference. The COVID pandemic increased the public’s awareness of the importance of GH and acceptance of GH as a career path. More job and postgraduate program opportunities were expected in near future. However, some parents expressed concerns about GH-related employment opportunities in China. Conclusion: The application of the liberal arts and science education pedagogy in GH training were well-received by the Chinese students and parents. Although global pandemic like COVID disrupted GH learning in many ways, most Chinese students and parents held optimistic attitudes toward GH study and career development.

Keywords: COVID, global health, liberal arts and sciences pedagogy, China

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Authors: Michel Soto Chalhoub

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Building code-related literature provides recommendations on normalizing approaches to the calculation of the dynamic properties of structures. Most building codes make a distinction among types of structural systems, construction material, and configuration through a numerical coefficient in the expression for the fundamental period. The period is then used in normalized response spectra to compute base shear. The typical parameter used in simplified code formulas for the fundamental period is overall building height raised to a power determined from analytical and experimental results. However, reinforced concrete buildings which constitute the majority of built space in less developed countries pose additional challenges to the ones built with homogeneous material such as steel, or with concrete under stricter quality control. In the present paper, the particularities of reinforced concrete buildings are explored and related to current methods of equivalent static analysis. A comparative study is presented between the Uniform Building Code, commonly used for buildings within and outside the USA, and data from the Middle East used to model 151 reinforced concrete buildings of varying number of bays, number of floors, overall building height, and individual story height. The fundamental period was calculated using eigenvalue matrix computation. The results were also used in a separate regression analysis where the computed period serves as dependent variable, while five building properties serve as independent variables. The statistical analysis shed light on important parameters that simplified code formulas need to account for including individual story height, overall building height, floor plan, number of bays, and concrete properties. Such inclusions are important for reinforced concrete buildings of special conditions due to the level of concrete damage, aging, or materials quality control during construction. Overall results of the present analysis show that simplified code formulas for fundamental period and base shear may be applied but they require revisions to account for multiple parameters. The conclusion above is confirmed by the analytical model where fundamental periods were computed using numerical techniques and eigenvalue solutions. This recommendation is particularly relevant to code upgrades in less developed countries where it is customary to adopt, and mildly adapt international codes. We also note the necessity of further research using empirical data from buildings in Lebanon that were subjected to severe damage due to impulse loading or accelerated aging. However, we excluded this study from the present paper and left it for future research as it has its own peculiarities and requires a different type of analysis.

Keywords: seismic behaviour, reinforced concrete, simplified code formulas, equivalent static analysis, base shear, response spectra

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Authors: Shin Woo Kim, Eui Ju Lee

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The recent development of biofuel production technology facilitates the use of bioethanol and biodiesel on automobile. Bioethanol, especially, can be used as a fuel for gasoline vehicles because the addition of ethanol has been known to increase octane number and reduce soot emissions. However, the wide application of biofuel has been still limited because of lack of detailed combustion properties such as auto-ignition temperature and pollutant emissions such as NOx and soot, which has been concerned mainly on the vehicle fire safety and environmental safety. In this study, the combustion characteristics of gasoline/ethanol fuel were investigated both numerically and experimentally. For auto-ignition temperature and NOx emission, the numerical simulation was performed on the well-stirred reactor (WSR) to simulate the homogeneous gasoline engine and to clarify the effect of ethanol addition in the gasoline fuel. Also, the response surface method (RSM) was introduced as a design of experiment (DOE), which enables the various combustion properties to be predicted and optimized systematically with respect to three independent variables, i.e., ethanol mole fraction, equivalence ratio and residence time. The results of stoichiometric gasoline surrogate show that the auto-ignition temperature increases but NOx yields decrease with increasing ethanol mole fraction. This implies that the bioethanol added gasoline is an eco-friendly fuel on engine running condition. However, unburned hydrocarbon is increased dramatically with increasing ethanol content, which results from the incomplete combustion and hence needs to adjust combustion itself rather than an after-treatment system. RSM results analyzed with three independent variables predict the auto-ignition temperature accurately. However, NOx emission had a big difference between the calculated values and the predicted values using conventional RSM because NOx emission varies very steeply and hence the obtained second order polynomial cannot follow the rates. To relax the increasing rate of dependent variable, NOx emission is taken as common logarithms and worked again with RSM. NOx emission predicted through logarithm transformation is in a fairly good agreement with the experimental results. For more tangible understanding of gasoline/ethanol fuel on pollutant emissions, experimental measurements of combustion products were performed in gasoline/ethanol pool fires, which is widely used as a fire source of laboratory scale experiments. Three measurement methods were introduced to clarify the pollutant emissions, i.e., various gas concentrations including NOx, gravimetric soot filter sampling for elements analysis and pyrolysis, thermophoretic soot sampling with transmission electron microscopy (TEM). Soot yield by gravimetric sampling was decreased dramatically as ethanol was added, but NOx emission was almost comparable regardless of ethanol mole fraction. The morphology of the soot particle was investigated to address the degree of soot maturing. The incipient soot such as a liquid like PAHs was observed clearly on the soot of higher ethanol containing gasoline, and the soot might be matured under the undiluted gasoline fuel.

Keywords: gasoline/ethanol fuel, NOx, pool fire, soot, well-stirred reactor (WSR)

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Authors: Michael Amankwaa Adu

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Effective communication in the classroom plays a vital role in ensuring successful teaching and learning. In particular, the types of language and speech acts teachers use shape classroom interactions and influence student engagement. This study aims to analyze the speech acts employed by a Career Technology teacher in a junior high school. While much research has focused on speech acts in language classrooms, less attention has been given to how these acts operate in non-language subject areas like technical education. The study explores how different types of speech acts—directives, assertives, expressives, and commissives—are used during three classroom encounters: lesson introduction, content delivery, and classroom management. This research seeks to fill the gap in understanding how teachers of non-language subjects use speech acts to manage classroom dynamics and facilitate learning. The study employs a mixed-methods design, combining qualitative and quantitative approaches. Data was collected through direct classroom observation and audio recordings of a one-hour Career Technology lesson. The transcriptions of the lesson were analyzed using John Searle’s taxonomy of speech acts, classifying the teacher’s utterances into directives, assertives, expressives, and commissives. Results show that directives were the most frequently used speech act, accounting for 59.3% of the teacher's utterances. These speech acts were essential in guiding student behavior, giving instructions, and maintaining classroom control. Assertives made up 20.4% of the speech acts, primarily used for stating facts and reinforcing content. Expressives, at 14.2%, expressed emotions such as approval or frustration, helping to manage the emotional atmosphere of the classroom. Commissives were the least used, representing 6.2% of the speech acts, often used to set expectations or outline future actions. No declarations were observed during the lesson. The findings of this study reveal the critical role that speech acts play in managing classroom behavior and delivering content in technical subjects. Directives were crucial for ensuring students followed instructions and completed tasks, while assertives helped in reinforcing lesson objectives. Expressives contributed to motivating or disciplining students, and commissives, though less frequent, helped set clear expectations for students’ future actions. The absence of declarations suggests that the teacher prioritized guiding students over making formal pronouncements. These insights can inform teaching strategies across various subject areas, demonstrating that a diverse use of speech acts can create a balanced and interactive learning environment. This study contributes to the growing field of pragmatics in education and offers practical recommendations for educators, particularly in non-language classrooms, on how to utilize speech acts to enhance both classroom management and student engagement.

Keywords: classroom interaction, pragmatics, speech acts, teacher communication, career technology

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Authors: Richard Okyere Boadu, Godwin Adzakpah, Nathan Kumasenu Mensah, Kwame Adu Okyere Boadu, Jonathan Kissi, Christiana Dziyaba, Rosemary Bermaa Abrefa

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Information and communication technology (ICT) has significantly advanced global healthcare, with electronic health (e-Health) applications improving health records and delivery. These innovations, including electronic health records, strengthen healthcare systems. The study investigates healthcare professionals' perceptions of health information applications and their associated factors in the Cape Coast Metropolis of Ghana's health facilities. Methods: We used a descriptive cross-sectional study design to collect data from 632 healthcare professionals (HCPs), in the three purposively selected health facilities in the Cape Coast municipality of Ghana in July 2022. Shapiro-Wilk test was used to check the normality of dependent variables. Descriptive statistics were used to report means with corresponding standard deviations for continuous variables. Proportions were also reported for categorical variables. Bivariate regression analysis was conducted to determine the factors influencing the Benefits of Information Technology (BoIT); Barriers to Information Technology Use (BITU); and Motives of Information Technology Use (MoITU) in healthcare delivery. Stata SE version 15 was used for the analysis. A p-value of less than 0.05 served as the basis for considering a statistically significant accepting hypothesis. Results: Healthcare professionals (HCPs) generally perceived moderate benefits (Mean score (M)=5.67) from information technology (IT) in healthcare. However, they slightly agreed that barriers like insufficient computers (M=5.11), frequent system downtime (M=5.09), low system performance (M=5.04), and inadequate staff training (M=4.88) hindered IT utilization. Respondents slightly agreed that training (M=5.56), technical support (M=5.46), and changes in work procedures (M=5.10) motivated their IT use. Bivariate regression analysis revealed significant influences of education, working experience, healthcare profession, and IT training on attitudes towards IT utilization in healthcare delivery (BoIT, BITU, and MoITU). Additionally, the age of healthcare providers, education, and working experience significantly influenced BITU. Ultimately, age, education, working experience, healthcare profession, and IT training significantly influenced MoITU in healthcare delivery. Conclusions: Healthcare professionals acknowledge moderate benefits of IT in healthcare but encounter barriers like inadequate resources and training. Motives for IT use include staff training and support. Bivariate regression analysis shows education, working experience, profession, and IT training significantly influence attitudes toward IT adoption. Targeted interventions and policies can enhance IT utilization in the Cape Coast Metropolis, Ghana.

Keywords: health information application, utilization of information application, information technology use, healthcare

Procedia PDF Downloads 64

Authors: A. S. Ibrahim Mamane, S. Giljean, M.-J. Pac, G. L’Hostis

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Fiber reinforced composite laminates are particularly subject to residual stresses due to their heterogeneity and the complex chemical, mechanical and thermal mechanisms that occur during their processing. Residual stresses are now well known to cause damage accumulation, shape instability, and behavior disturbance in composite parts. Many works exist in the literature on techniques for minimizing residual stresses in thermosetting and thermoplastic composites mainly. To study in-depth the influence of processing mechanisms on the formation of residual stresses and to minimize them by establishing a reliable correlation, it is essential to be able to measure very precisely the profile of residual stresses in the composite. Residual stresses are important data to consider when sizing composite parts and predicting their behavior. The incremental hole drilling is very effective in measuring the gradient of residual stresses in composite laminates. This method is semi-destructive and consists of drilling incrementally a hole through the thickness of the material and measuring relaxation strains around the hole for each increment using three strain gauges. These strains are then converted into residual stresses using a matrix of coefficients. These coefficients, called calibration coefficients, depending on the diameter of the hole and the dimensions of the gauges used. The reliability of the incremental hole drilling depends on the accuracy with which the calibration coefficients are determined. These coefficients are calculated using a finite element model. The samples’ features and the experimental conditions must be considered in the simulation. Any mismatch can lead to inadequate calibration coefficients, thus introducing errors on residual stresses. Several calibration coefficient correction methods exist for isotropic material, but there is a lack of information on this subject concerning composite laminates. In this work, a Python program was developed to automatically generate the adequate finite element model. This model allowed us to perform a parametric study to assess the influence of experimental errors on the calibration coefficients. The results highlighted the sensitivity of the calibration coefficients to the considered errors and gave an order of magnitude of the precisions required on the experimental device to have reliable measurements. On the basis of these results, improvements were proposed on the experimental device. Furthermore, a numerical method was proposed to correct the calibration coefficients for different types of materials, including thick composite parts for which the analytical approach is too complex. This method consists of taking into account the experimental errors in the simulation. Accurate measurement of the experimental errors (such as eccentricity of the hole, angular deviation of the gauges from their theoretical position, or errors on increment depth) is therefore necessary. The aim is to determine more precisely the residual stresses and to expand the validity domain of the incremental hole drilling technique.

Keywords: fiber reinforced composites, finite element simulation, incremental hole drilling method, numerical correction of the calibration coefficients, residual stresses

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Authors: László L. Lippai

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In addition to the fact that mental health bears great significance to a particular individual, it can also be regarded as an organizational, community and societal resource. Within the Szeged Health Promotion Research Group, we conducted mental health surveys on two levels: The inhabitants of a medium-sized Hungarian town and students of a Hungarian university with a relatively big headcount were requested to participate in surveys whose goals were to define local government priorities and organization-level health promotion programmes, respectively. To facilitate professional decision-making, we defined three, pragmatically relevant, groups of the target population: the mentally healthy, the vulnerable and the endangered. In order to determine which group a person actually belongs to, we designed a simple and quick measurement tool, which could even be utilised as a smoothing method, the Mental State Questionnaire validity of the above three categories was verified by analysis of variance against psychological quality of life variables. We demonstrate the pragmatic significance of our method via the analyses of the scores of our two mental health surveys. On town level, during our representative survey in Hódmezővásárhely (N=1839), we found that 38.7% of the participants was mentally healthy, 35.3% was vulnerable, while 16.3% was considered as endangered. We were able to identify groups that were in a dramatic state in terms of mental health. For example, such a group consisted of men aged 45 to 64 with only primary education qualification and the ratios of the mentally healthy, vulnerable and endangered were 4.5, 45.5 and 50%, respectively. It was also astonishing to see to what a little extent qualification prevailed as a protective factor in the case of women. Based on our data, the female group aged 18 to 44 with primary education—of whom 20.3% was mentally healthy, 42.4% vulnerable and 37.3% was endangered—as well as the female group aged 45 to 64 with university or college degree—of whom 25% was mentally healthy, 51.3 vulnerable and 23.8% endangered—are to be handled as priority intervention target groups in a similarly difficult position. On organizational level, our survey involving the students of the University of Szeged, N=1565, provided data to prepare a strategy of mental health promotion for a university with a headcount exceeding 20,000. When developing an organizational strategy, it was important to gather information to estimate the proportions of target groups in which mental health promotion methods; for example, life management skills development, detection, psychological consultancy, psychotherapy, would be applied. Our scores show that 46.8% of the student participants were mentally healthy, 42.1% were vulnerable and 11.1% were endangered. These data convey relevant information as to the allocation of organizational resources within a university with a considerable headcount. In conclusion, The Mental State Questionnaire, as a valid smoothing method, is adequate to describe a community in a plain and informative way in the terms of mental health. The application of the method can promote the preparation, design and implementation of mental health promotion interventions. 

Keywords: health promotion, mental health promotion, mental state questionnaire, psychological well-being

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Authors: A. J. Olatunji, Adebolu Temitope Johnson

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Groundwater samples were collected randomly from hand-dug wells and boreholes in parts of the Ado Ekiti metropolis and were subjected to quality assessment and characterization. Physicochemical analyses, which include the in-situ parameters (pH units, Turbidity, and Electrical Conductivity) and laboratory analysis of selected ionic concentrations, were carried out following standard methods. Hydrochemistry of the present study revealed relative mean concentrations of cations in the order Ca2+ > Na+ > Mg2+ > Cu2+> Fe > Mn2+ and that of anions: Cl- > NO3- > SO42- > F - respectively considering World Health Organisation Standard (WHO) range of values for potable water. The result shows that values of certain parameters (Total Dissolved Solid (TDS), Manganese, Calcium, Magnesium, Fluoride, and Sulphate) were below the Highest Desirable Level of the Standards, while values of some other parameters (pH Units, Electrical Conductivity, Turbidity, Alkalinity, Sodium, Copper, Chloride, and Total Hardness) were within the range of figures between Highest Desirable Level (HDL) and Maximum Permissible Level (MPL) of World Health Organization (WHO) drinking water Standards. The reduction in the mean concentration value of Total Dissolved Solids (TDS) of most borehole samples follows the fact that water had been allowed to settle in the overhead tanks before usage; we discussed and brainstormed in the course of sampling and agreed to take a sample that way because that represents what the people consume, it also shows an indication while there was slightly concentration increase of these soluble ions in hand-dug wells samples than borehole samples only with the exception of borehole sample seven BH7 because BH7 uses the mono-pumping system. These in-situ parameters and ionic concentrations were further displayed and or represented on bar charts along with the WHO standards for better pictorial clarifications. Deductions from field observation indices revealed the imprints of natural weathering, ion-exchange processes, and anthropogenic activities influencing groundwater quality. A strong degree of association was found to exist between sodium and chlorine ions in both hand-dug well and borehole groundwater samples through the use of Pearson’s correlation coefficient; this association can further be supported by the chemistry of the parent bedrock associated with the study area because the chemistry of groundwater is a replica of its host rock. The correlation of those two ions must have begun from the period of mountain building, indicating an identical source from which they were released to the groundwater. Moreover, considering the comparison of ionic species concentrations of all samples with the (WHO) standards, there were no anomalous increases or decreases in the laboratory analysis results; this simply reveals an insignificant state of pollution of the groundwater. The study and its sampling techniques were not set to target the likely area and extent of groundwater pollution but its portability. It could be said that the samples were safe for human consumption.

Keywords: groundwater, physicochemical, parameters ionic, concentrations, WHO standards

Procedia PDF Downloads 39

Authors: Hanan Algarni

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Background: Impairment of walking and balance skills has negative impact on functional independence and community participation after stroke. Gait recovery is considered a primary goal in rehabilitation by both patients and physiotherapists. Treadmill training coupled with virtual reality technology is a new emerging approach that offers patients with feedback, open and random skills practice while walking and interacting with virtual environmental scenes. Objectives: To synthesize the evidence around the effects of the VR treadmill training on gait speed and balance primarily, functional independence and community participation secondarily in stroke patients. Methods: Systematic review was conducted; search strategy included electronic data bases: MEDLINE, AMED, Cochrane, CINAHL, EMBASE, PEDro, Web of Science, and unpublished literature. Inclusion criteria: Participant: adult >18 years, stroke, ambulatory, without severe visual or cognitive impartments. Intervention: VR treadmill training alone or with physiotherapy. Comparator: any other interventions. Outcomes: gait speed, balance, function, community participation. Characteristics of included studies were extracted for analysis. Risk of bias assessment was performed using Cochrane's ROB tool. Narrative synthesis of findings was undertaken and summary of findings in each outcome was reported using GRADEpro. Results: Four studies were included involving 84 stroke participants with chronic hemiparesis. Interventions intensity ranged (6-12 sessions, 20 minutes-1 hour/session). Three studies investigated the effects on gait speed and balance. 2 studies investigated functional outcomes and one study assessed community participation. ROB assessment showed 50% unclear risk of selection bias and 25% of unclear risk of detection bias across the studies. Heterogeneity was identified in the intervention effects at post training and follow up. Outcome measures, training intensity and durations also varied across the studies, grade of evidence was low for balance, moderate for speed and function outcomes, and high for community participation. However, it is important to note that grading was done on few numbers of studies in each outcome. Conclusions: The summary of findings suggests positive and statistically significant effects (p<0.05) of VR treadmill training compared to other interventions on gait speed, dynamic balance skills, function and participation directly after training. However, the effects were not sustained at follow up in two studies (2 weeks-1 month) and other studies did not perform follow up measurements. More RCTs with larger sample sizes and higher methodological quality are required to examine the long term effects of VR treadmill effects on function independence and community participation after stroke, in order to draw conclusions and produce stronger robust evidence.

Keywords: virtual reality, treadmill, stroke, gait rehabilitation

Procedia PDF Downloads 272

Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

Procedia PDF Downloads 59

Authors: Sami Alanazi

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Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

Procedia PDF Downloads 139

Authors: John Zanetich

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Due to their positive associations with student learning and retention, certain undergraduate opportunities are designated ‘high-impact.’ High-Impact Practices (HIPs) such as, learning communities, community based projects, research, internships, study abroad and culminating senior experience, share several traits bin common: they demand considerable time and effort, learning occurs outside of the classroom, and they require meaningful interactions between faculty and students, they encourage collaboration with diverse others, and they provide frequent and substantive feedback. As a result of experiential learning in these practices, participation in these practices can be life changing. High impact learning helps individuals locate tacit knowledge, and build mental models that support the accumulation of knowledge. On-going learning from experience and knowledge conversion provides the individual with a way to implicitly organize knowledge and share knowledge over a lifetime. Knowledge conversion is a knowledge management component which focuses on the explication of the tacit knowledge that exists in the minds of students and that knowledge which is embedded in the process and relationships of the classroom educational experience. Knowledge conversion is required when working with tacit knowledge and the demand for a learner to align deeply held beliefs with the cognitive dissonance created by new information. Knowledge conversion and tacit knowledge result from the fact that an individual's way of knowing, that is, their core belief structure, is considered generalized and tacit instead of explicit and specific. As a phenomenon, tacit knowledge is not readily available to the learner for explicit description unless evoked by an external source. The development of knowledge–related capabilities such as Aggressive Development of Tacit Knowledge (ADTK) can be used in experiential educational programs to enhance knowledge, foster behavioral change, improve decision making, and overall performance. ADTK allows the student in HIPs to use their existing knowledge in a way that allows them to evaluate and make any necessary modifications to their core construct of reality in order to amalgamate new information. Based on the Lewin/Schein Change Theory, the learner will reach for tacit knowledge as a stabilizing mechanism when they are challenged by new information that puts them slightly off balance. As in word association drills, the important concept is the first thought. The reactionary outpouring to an experience is the programmed or tacit memory and knowledge of their core belief structure. ADTK is a way to help teachers design their own methods and activities to unfreeze, create new learning, and then refreeze the core constructs upon which future learning in a subject area is built. This paper will explore the use of ADTK as a technique for knowledge conversion in the classroom in general and in HIP programs specifically. It will focus on knowledge conversion in curriculum development and propose the use of one-time educational experiences, multi-session experiences and sequential program experiences focusing on tacit knowledge in educational programs.

Keywords: tacit knowledge, knowledge management, college programs, experiential learning

Procedia PDF Downloads 262

Authors: Hakimullah Hakim, Chiharu Toyofuku, Mari Ota, Mayuko Suzuki, Miyuki Komura, Masashi Yamada, Md. Shahin Alam, Natthanan Sangsriratanakul, Dany Shoham, Kazuaki Takehara

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Disinfectants and their application are essential part of infection control strategies and enhancement of biosecurity at farms, worldwide. Alkaline agents are well known for their strong and long term antimicrobial capacities and most frequently are applied at farms for control and prevention of biological hazards. However, inadequate information regarding such materials’ capacities to inactivate pathogens and their improper applications fail farmers to achieve the mentioned goal. Thus, this requires attention to further evaluate their efficacies, under different conditions and in different ways. Here in this study we evaluated bactericidal efficacies of food additive grade of calcium hydroxide (FdCa(OH)2) powder derived from natural calcium carbonates obtained from limestone (Fine Co., Ltd., Tokyo, Japan), and bioceramic powder (BCX) derived from chicken feces at pH 13 (NMG environmental development Co., Ltd., Tokyo, Japan), for their efficacies to inactivate bacteria in feces. [Materials & Methods] Chicken feces were inoculated by 100 µl Escherichia coli and Salmonella Infantis in falcon tubes, individually, then FdCa(OH)2 or BCX powders were individually added to make final concentration of 0, 5, 10, 20 and 30% (w/w) in total weight of 0.5g, followed by properly mixing and incubating at room temperature for certain periods of time, in a dark place. Afterwards, 10 ml 1M Tris-HCl (pH 7.2) was added onto them to reduce their pH, in order to stop powders’ activities and to harvest the remained viable bacteria, whereas using normal medium or dW2 to recover bacteria increases the mixture pH, and as a result bacteria would be inactivated soon; therefore, the latter practice brings about incorrect and misleading results. Samples were then inoculated on DHL agar plates in order to calculate colony forming units (CFU)/ml of viable bacteria. [Results and Discussion] FdCa(OH)2 powder at 10% and 5% required 3 hr and 6 hr exposure times, respectively, while BCX powder at 20% concentrations required 6 hr exposure time to kill the mentioned bacteria in feces down to lower than detectable level (≤ 3.6 log10 CFU/ml). This study confirmed capacities of FdCa(OH)2 and BCX powders to inactivate bacteria in feces, and both materials are environment friendly materials, with no risk to human or animal’s health. This finding helps farmers to properly apply alkaline agents in appropriate concentrations and exposure times in their farms, in order to prevent and control infectious diseases outbreaks and to enhance biosecurity. Finally, this finding may help farmers to implement better strategies for infections control in their livestock farms.

Keywords: bacterial inactivation, bioceramic, biosecurity at livestock farms, chicken feces

Procedia PDF Downloads 439

Authors: Thi Thi Zin, Pyke Tin, Ikuo Kobayashi, Yoichiro Horii

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Today dairy farm experts and farmers have well recognized the importance of dairy cow Body Condition Score (BCS) since these scores can be used to optimize milk production, managing feeding system and as an indicator for abnormality in health even can be utilized to manage for having healthy calving times and process. In tradition, BCS measures are done by animal experts or trained technicians based on visual observations focusing on pin bones, pin, thurl and hook area, tail heads shapes, hook angles and short and long ribs. Since the traditional technique is very manual and subjective, the results can lead to different scores as well as not cost effective. Thus this paper proposes an algebraic geometric imaging approach for an automatic dairy cow BCS system. The proposed system consists of three functional modules. In the first module, significant landmarks or anatomical points from the cow image region are automatically extracted by using image processing techniques. To be specific, there are 23 anatomical points in the regions of ribs, hook bones, pin bone, thurl and tail head. These points are extracted by using block region based vertical and horizontal histogram methods. According to animal experts, the body condition scores depend mainly on the shape structure these regions. Therefore the second module will investigate some algebraic and geometric properties of the extracted anatomical points. Specifically, the second order polynomial regression is employed to a subset of anatomical points to produce the regression coefficients which are to be utilized as a part of feature vector in scoring process. In addition, the angles at thurl, pin, tail head and hook bone area are computed to extend the feature vector. Finally, in the third module, the extracted feature vectors are trained by using Markov Classification process to assign BCS for individual cows. Then the assigned BCS are revised by using multiple regression method to produce the final BCS score for dairy cows. In order to confirm the validity of proposed method, a monitoring video camera is set up at the milk rotary parlor to take top view images of cows. The proposed method extracts the key anatomical points and the corresponding feature vectors for each individual cows. Then the multiple regression calculator and Markov Chain Classification process are utilized to produce the estimated body condition score for each cow. The experimental results tested on 100 dairy cows from self-collected dataset and public bench mark dataset show very promising with accuracy of 98%.

Keywords: algebraic geometric imaging approach, body condition score, Markov classification, polynomial regression

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Authors: W. Staiano, S. Marcora

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Introduction: It has been proposed that acute negative effect of mental fatigue (MF) could potentially become a training stimulus for the brain (Brain endurance training (BET)) to adapt and improve its ability to attenuate MF states during sport competitions. Purpose: The aim of this study was to test the efficacy of 6 weeks of BET on cognitive and cycling tests in a group of well-trained subjects. We hypothesised that combination of BET and standard physical training (SPT) would increase cognitive capacity and cycling performance by reducing rating of perceived exertion (RPE) and increase resilience to fatigue more than SPT alone. Methods: In a randomized controlled trial design, 26 well trained participants, after a familiarization session, cycled to exhaustion (TTE) at 80% peak power output (PPO) and, after 90 min rest, at 65% PPO, before and after random allocation to a 6 week BET or active placebo control. Cognitive performance was measured using 30 min of STROOP coloured task performed before cycling performance. During the training, BET group performed a series of cognitive tasks for a total of 30 sessions (5 sessions per week) with duration increasing from 30 to 60 min per session. Placebo engaged in a breathing relaxation training. Both groups were monitored for physical training and were naïve to the purpose of the study. Physiological and perceptual parameters of heart rate, lactate (LA) and RPE were recorded during cycling performances, while subjective workload (NASA TLX scale) was measured during the training. Results: Group (BET vs. Placebo) x Test (Pre-test vs. Post-test) mixed model ANOVA’s revealed significant interaction for performance at 80% PPO (p = .038) or 65% PPO (p = .011). In both tests, groups improved their TTE performance; however, BET group improved significantly more compared to placebo. No significant differences were found for heart rate during the TTE cycling tests. LA did not change significantly at rest in both groups. However, at completion of 65% TTE, it was significantly higher (p = 0.043) in the placebo condition compared to BET. RPE measured at ISO-time in BET was significantly lower (80% PPO, p = 0.041; 65% PPO p= 0.021) compared to placebo. Cognitive results in the STROOP task showed that reaction time in both groups decreased at post-test. However, BET decreased significantly (p = 0.01) more compared to placebo despite no differences accuracy. During training sessions, participants in the BET showed, through NASA TLX questionnaires, constantly significantly higher (p < 0.01) mental demand rates compared to placebo. No significant differences were found for physical demand. Conclusion: The results of this study provide evidences that combining BET and SPT seems to be more effective than SPT alone in increasing cognitive and cycling performance in well trained endurance participants. The cognitive overload produced during the 6-week training of BET can induce a reduction in perception of effort at a specific power, and thus improving cycling performance. Moreover, it provides evidence that including neurocognitive interventions will benefit athletes by increasing their mental resilience, without affecting their physical training load and routine.

Keywords: cognitive training, perception of effort, endurance performance, neuro-performance

Procedia PDF Downloads 118

Authors: Natalia V. Beloglazova, Pieterjan Lenain, Martin Hedstrom, Dietmar Knopp, Sarah De Saeger

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In recent years polycyclic aromatic hydrocarbons (PAHs), which represent a hazard to humans and entire ecosystem, have been receiving an increased interest due to their mutagenic, carcinogenic and endocrine disrupting properties. They are formed in all incomplete combustion processes of organic matter and, as a consequence, ubiquitous in the environment. Benzo(a)pyrene (BaP) is on the priority list published by the Environmental Agency (US EPA) as the first PAH to be identified as a carcinogen and has often been used as a marker for PAHs contamination in general. It can be found in different types of water samples, therefore, the European Commission set up a limit value of 10 ng L–1 (10 ppt) for BAP in water intended for human consumption. Generally, different chromatographic techniques are used for PAHs determination, but these assays require pre-concentration of analyte, create large amounts of solvent waste, and are relatively time consuming and difficult to perform on-site. An alternative robust, stand-alone, and preferably cheap solution is needed. For example, a sensing unit which can be submerged in a river to monitor and continuously sample BaP. An affinity sensor based on capacitive transduction was developed. Natural antibodies or their synthetic analogues can be used as ligands. Ideally the sensor should operate independently over a longer period of time, e.g. several weeks or months, therefore the use of molecularly imprinted polymers (MIPs) was discussed. MIPs are synthetic antibodies which are selective for a chosen target molecule. Their robustness allows application in environments for which biological recognition elements are unsuitable or denature. They can be reused multiple times, which is essential to meet the stand-alone requirement. BaP is a highly lipophilic compound and does not contain any functional groups in its structure, thus excluding non-covalent imprinting methods based on ionic interactions. Instead, the MIPs syntheses were based on non-covalent hydrophobic and π-π interactions. Different polymerization strategies were compared and the best results were demonstrated by the MIPs produced using electropolymerization. 4-vinylpyridin (VP) and divinylbenzene (DVB) were used as monomer and cross-linker in the polymerization reaction. The selectivity and recovery of the MIP were compared to a non-imprinted polymer (NIP). Electrodes were functionalized with natural receptor (monoclonal anti-BaP antibody) and with MIPs selective towards BaP. Different sets of electrodes were evaluated and their properties such as sensitivity, selectivity and linear range were determined and compared. It was found that both receptor can reach the cut-off level comparable to the established ML, and despite the fact that the antibody showed the better cross-reactivity and affinity, MIPs were more convenient receptor due to their ability to regenerate and stability in river till 7 days.

Keywords: antibody, benzo(a)pyrene, capacitive sensor, MIPs, river water

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Authors: Ahlad Neti, Elisa Arch, Martha Hall

Abstract:

Studies have shown that individuals who use Ankle-Foot-Orthoses (AFOs) have a high level of dissatisfaction regarding their current AFOs. Studies point to the focus on technical design with little attention given to the user perspective as a source of AFO designs that leave users dissatisfied. To design a new AFO that satisfies users and thereby improves their quality of life, the reasons for their dissatisfaction and their wants and needs for an improved AFO design must be identified. There has been little research into the user perspective on AFO use and desired improvements, so the relationship between AFO design and satisfaction in daily use must be assessed to develop appropriate metrics and constraints prior to designing a novel AFO. To assess the user perspective on AFO design, structured interviews were conducted with 7 individuals (average age of 64.29±8.81 years) who use AFOs. All interviews were transcribed and coded to identify common themes using Grounded Theory Method in NVivo 12. Qualitative analysis of these results identified sources of user dissatisfaction such as heaviness, bulk, and uncomfortable material and overall needs and wants for an AFO. Beyond the user perspective, certain objective factors must be considered in the construction of metrics and constraints to ensure that the AFO fulfills its medical purpose. These more objective metrics are rooted in a common medical device market and technical standards. Given the large body of research concerning these standards, these objective metrics and constraints were derived through a literature review. Through these two methods, a comprehensive list of metrics and constraints accounting for both the user perspective on AFO design and the AFO’s medical purpose was compiled. These metrics and constraints will establish the framework for designing a new AFO that carries out its medical purpose while also improving the user experience. The metrics can be categorized into several overarching areas for AFO improvement. Categories of user perspective related metrics include comfort, discreteness, aesthetics, ease of use, and compatibility with clothing. Categories of medical purpose related metrics include biomechanical functionality, durability, and affordability. These metrics were used to guide an iterative prototyping process. Six concepts were ideated and compared using system-level analysis. From these six concepts, two concepts – the piano wire model and the segmented model – were selected to move forward into prototyping. Evaluation of non-functional prototypes of the piano wire and segmented models determined that the piano wire model better fulfilled the metrics by offering increased stability, longer durability, fewer points for failure, and a strong enough core component to allow a sock to cover over the AFO while maintaining the overall structure. As such, the piano wire AFO has moved forward into the functional prototyping phase, and healthy subject testing is being designed and recruited to conduct design validation and verification.

Keywords: ankle-foot orthotic, assistive technology, human centered design, medical devices

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Authors: Aikaterini Tavoulari, Mike Richardson

Abstract:

Objective: This abstract presents a multisensory participatory design project, inspired by a deafblind PhD student's ambition to climb Mount Everest. The project aims to explore accessible routes for filmmaking and video content creation, catering to the needs of individuals with hearing and sight loss. By engaging participants from the Southwest area of England, recruited through multiple networks, the project seeks to gather qualitative data and insights to inform the development of inclusive media practices. Design: It will be a community-based participatory research design. The workshop will feature various stations that stimulate different senses, such as scent, touch, sight, hearing as well as movement. Participants will have the opportunity to engage with these multisensory experiences, providing valuable feedback on their effectiveness and potential for enhancing accessibility in filmmaking and video content. Methods: Brief semi-structured interviews will be conducted to collect qualitative data, allowing participants to share their perspectives, challenges, and suggestions for improvement. The participatory design approach emphasizes the importance of involving the target audience in the creative process. By actively engaging individuals with hearing and sight loss, the project aims to ensure that their needs and preferences are central to the development of accessible filmmaking techniques and video content. This collaborative effort seeks to bridge the gap between content creators and diverse audiences, fostering a more inclusive media landscape. Results: The findings from this study will contribute to the growing body of research on accessible filmmaking and video content creation. Via inductive thematic analysis of the qualitative data collected through interviews and observations, the researchers aim to identify key themes, challenges, and opportunities for creating engaging and inclusive media experiences for deafblind audiences. The insights will inform the development of best practices and guidelines for accessible filmmaking, empowering content creators to produce more inclusive and immersive video content. Conclusion: The abstract targets the hybrid International Conference for Disability and Diversity in Canada (January 2025), as this platform provides an excellent opportunity to share the outcomes of the project with a global audience of researchers, practitioners, and advocates working towards inclusivity and accessibility in various disability domains. By presenting this research at the conference in person, the authors aim to contribute to the ongoing discourse on disability and diversity, highlighting the importance of multisensory experiences and participatory design in creating accessible media content for the deafblind community and the community with sensory impairments more broadly.

Keywords: vision impairment, hearing impairment, deafblindness, accessibility, filmmaking

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Authors: Huang Wei-Yi

Abstract:

Objective: This article explores the intensive care nursing experience of a lung cancer patient with pulmonary embolism who was placed on ECMO. Following a sudden change in the patient’s condition and a consensus reached during a family meeting, the decision was made to withdraw life-sustaining equipment and collaborate with the palliative care team. Methods: The nursing period was from October 20 to October 27, 2023. The author monitored physiological data, observed, provided direct care, conducted interviews, performed physical assessments, and reviewed medical records. Together with the critical care team and bypass personnel, a comprehensive assessment was conducted using Gordon's Eleven Functional Health Patterns to identify the patient’s health issues, which included pain related to lung cancer and invasive devices, fear of death due to sudden deterioration, and altered tissue perfusion related to hemodynamic instability. Results: The patient was admitted with fever, back pain, and painful urination. During hospitalization, the patient experienced sudden discomfort followed by cardiac arrest, requiring multiple CPR attempts and ECMO placement. A subsequent CT angiogram revealed a pulmonary embolism. The patient's condition was further complicated by severe pain due to compression fractures, and a diagnosis of terminal lung cancer was unexpectedly confirmed, leading to emotional distress and uncertainty about future treatment. Throughout the critical care process, ECMO was removed on October 24, stabilizing the patient’s body temperature between 36.5-37°C and maintaining a mean arterial pressure of 60-80 mmHg. Pain management, including Morphine 8mg in 0.9% N/S 100ml IV drip q6h PRN and Ultracet 37.5 mg/325 mg 1# PO q6h, kept the pain level below 3. The patient was transferred to the ward on October 27 and discharged home on October 30. Conclusion: During the care period, collaboration with the medical team and palliative care professionals was crucial. Adjustments to pain medication, symptom management, and lung cancer-targeted therapy improved the patient’s physical discomfort and pain levels. By applying the unique functions of nursing and the four principles of palliative care, positive encouragement was provided. Family members, along with social workers, clergy, psychologists, and nutritionists, participated in cross-disciplinary care, alleviating anxiety and fear. The consensus to withdraw ECMO and life-sustaining equipment enabled the patient and family to receive high-quality care and maintain autonomy in decision-making. A follow-up call on November 1 confirmed that the patient was emotionally stable, pain-free, and continuing with targeted lung cancer therapy.

Keywords: intensive care, lung cancer, pulmonary embolism, ECMO

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Authors: Liliana Gomez Cardona, Mary McComber, Kristyn Brown, Arlene Laliberté, Outi Linnaranta

Abstract:

The history of colonialism and more contemporary political issues have resulted in the exposure of Kanien'kehá:ka: non (Kanien'kehá:ka of Kahnawake) to challenging and even traumatic experiences. Colonization, religious missions, residential schools as well as economic and political marginalization are the factors that have challenged the wellbeing and mental health of these populations. In psychiatry, screening for mental illness is often done using questionnaires with which the patient is expected to respond to how often he/she has certain symptoms. However, the Indigenous view of mental wellbeing may not fit well with this approach. Moreover, biomedical treatments do not always meet the needs of Indigenous people because they do not understand the culture and traditional healing methods that persist in many communities. Assess whether the questionnaires used to measure symptoms, commonly used in psychiatry are appropriate and culturally safe for the Mohawk in Quebec. Identify the most appropriate tool to assess and promote wellbeing and follow the process necessary to improve its cultural sensitivity and safety for the Mohawk population. Qualitative, collaborative, and participatory action research project which respects First Nations protocols and the principles of ownership, control, access, and possession (OCAP). Data collection based on five focus groups with stakeholders working with these populations and members of Indigenous communities. Thematic analysis of the data collected and emerging through an advisory group that led a revision of the content, use, and cultural and conceptual relevance of the instruments. The questionnaires measuring psychiatric symptoms face significant limitations in the local indigenous context. We present the factors that make these tools not relevant among Mohawks. Although the scale called Growth and Empowerment Measure (GEM) was originally developed among Indigenous in Australia, the Mohawk in Quebec found that this tool comprehends critical aspects of their mental health and wellbeing more respectfully and accurately than questionnaires focused on measuring symptoms. We document the process of cultural adaptation of this tool which was supported by community members to create a culturally safe tool that helps in growth and empowerment. The cultural adaptation of the GEM provides valuable information about the factors affecting wellbeing and contributes to mental health promotion. This process improves mental health services by giving health care providers useful information about the Mohawk population and their clients. We believe that integrating this tool in interventions can help create a bridge to improve communication between the Indigenous cultural perspective of the patient and the biomedical view of health care providers. Further work is needed to confirm the clinical utility of this tool in psychological and psychiatric intervention along with social and community services.

Keywords: cultural adaptation, cultural safety, empowerment, Mohawks, mental health, Quebec

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