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Authors: Sally Abu Sabaa, Lindsey Gutt

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In an attempt to use education as a way of raising a socially responsible and engaged global citizen, the YU-Bridge program, the largest and fastest pathway program of its kind in North America, has embarked on the journey of integrating general themes from the UN’s sustainable developmental goals (SDGs) in its English for Academic Purposes (EAP) curriculum. The purpose of this initiative was to redefine the general philosophy of education in the middle of a pandemic and align with York University’s University Academic Plan that was released in summer 2020 framed around the SDGs. The YUB program attracts international students from all over the world but mainly from China, and its goal is to enable students to achieve the minimum language requirement to join their undergraduate courses at York University. However, along with measuring outcomes, objectives, and the students’ GPA, instructors and academics are always seeking innovation of the YUB curriculum to adapt to the ever growing challenges of academics in the university context, in order to focus more on subject matter that students will be exposed to in their undergraduate studies. However, with the sudden change that has happened globally with the advance of the COVID-19 pandemic, and other natural disasters like the increase in forest fires and floods, rethinking the philosophy and goal of education was a must. Accordingly, the SDGs became the solid pillars upon which we, academics and administrators of the program, could build a new curriculum and shift our perspective from simply ESL education to education with moral and ethical goals. The preliminary implementation of this initiative was supported by an institutional-wide consultation with EAP instructors who have diverse experiences, disciplines, and interests. Along with brainstorming sessions and mini-pilot projects preceding the integration of the SDGs in the YUB-EAP curriculum, those meetings led to creating a general outline of a curriculum and an assessment framework that has the SDGs at its core with the medium of ESL used for language instruction. Accordingly, a community of knowledge exchange was spontaneously created and facilitated by instructors. This has led to knowledge, resources, and teaching pedagogies being shared and examined further. In addition, experiences and reactions of students are being shared, leading to constructive discussions about opportunities and challenges with the integration of the SDGs. The discussions have branched out to discussions about cultural and political barriers along with a thirst for knowledge and engagement, which has resulted in increased engagement not only on the part of the students but the instructors as well. Later in the program, two surveys will be conducted: one for the students and one for the instructors to measure the level of engagement of each in this initiative as well as to elicit suggestions for further development. This paper will describe this fundamental step into using ESL methodology as a mode of disseminating essential ethical and socially correct knowledge for all learners in the 21st Century, the students’ reactions, and the teachers’ involvement and reflections.

Keywords: EAP, curriculum, education, global citizen

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Authors: Amita Rana

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From the ancient to modern times, the nature of fitness activities has varied. We can choose any form of exercise that is suitable for our particular need. Watchers of fitness trends say that the road to better health is paved with new possibilities along with some old ones that are poised to make a comeback. Educated, certified and experienced fitness professionals; strength training; fitness programmes for older adults; exercise and weight loss; children and obesity; personal training; core training; group personal training; Zumba and other dance workouts; functional fitness; yoga; comprehensive health promotion programmes at worksite; boot-camp; outdoor activities; reaching new markets; spinning; sport-specific training; worker incentive programmes; wellness coaching; and physician referrals are among the fitness trends included in worldwide surveys. However, trends related to fitness in India could be the same or different. Hence, the present paper makes an attempt to analyze the latest fitness trends in India. A total of eighteen (18) surveys were shortlisted on the basis of their relevance to the present topic of study and were arranged in descending order of their chronology. Content analysis was done after the preliminary set of data collection, which formed the basis of a group of data. Further, frequency and percentage were used to statistically represent the data. It can be concluded from the analysis of data regarding recent fitness trends in India that yoga dominates the fitness activity list, followed by numerous other activities including running, Zumba and sh’bam, boot camp, boxing, kickboxing, cycling, swimming, TRX, ass-pocalypse, ballet, biking, bokwa fitness, dance-iso-bic, masala bhangra, outdoor activities, pilates, planks, push-ups, sofa workouts, stairs Workouts, tabata training, and twerking. The body weight/ gym-specified/ strength training as well as high intensity interval training dominate the preferred workouts; followed by mixed work-outs, cross training work-outs, express work-outs, functional fitness, natural body movements, personalized training, and stay-at-home workouts. General areas that featured in the latest fitness trends in India demonstrates that the fitness is making an impact on all sections of the society be it children, women, older adults, senior citizens, worksite fitness. Fitness is becoming the lifestyle of the masses. People are doing exercise for weight-loss, combining diet with exercising; prefer sweating, making groups participate in fitness activities and wellness programmes. Technology is another area which has a high impact on the lives of people. They are using wearable technology for workout tracking and following numerous mobile friendly apps.

Keywords: fitness, India, survey, trend

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Authors: R. Christopher, C. Brandt, N. Damons

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Background: The sequence of prevention model states that by constant assessment of injury, injury mechanisms and risk factors are identified, highlighting that collecting and recording of data is a core approach for preventing injuries. Several screening tools are available for use in the clinical setting. These screening techniques only recently received research attention, hence there is a dearth of inconsistent and controversial data regarding their applicability, validity, and reliability. Several systematic reviews related to common soccer injuries have been conducted; however, none of them addressed the screening tools for common soccer injuries. Objectives: The purpose of this study was to conduct a review of screening tools and their accuracy for common injuries in soccer. Methods: A systematic scoping review was performed based on the Joanna Briggs Institute procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed, and grey literature were used to access suitable studies. Some of the key search terms included: injury screening, screening, screening tool accuracy, injury prevalence, injury prediction, accuracy, validity, specificity, reliability, sensitivity. All types of English studies dating back to the year 2000 were included. Two blind independent reviewers selected and appraised articles on a 9-point scale for inclusion as well as for the risk of bias with the ACROBAT-NRSI tool. Data were extracted and summarized in tables. Plot data analysis was done, and sensitivity and specificity were analyzed with their respective 95% confidence intervals. I² statistic was used to determine the proportion of variation across studies. Results: The initial search yielded 95 studies, of which 21 were duplicates, and 54 excluded. A total of 10 observational studies were included for the analysis: 3 studies were analysed quantitatively while the remaining 7 were analysed qualitatively. Seven studies were graded low and three studies high risk of bias. Only high methodological studies (score > 9) were included for analysis. The pooled studies investigated tools such as the Functional Movement Screening (FMS™), the Landing Error Scoring System (LESS), the Tuck Jump Assessment, the Soccer Injury Movement Screening (SIMS), and the conventional hamstrings to quadriceps ratio. The accuracy of screening tools was of high reliability, sensitivity and specificity (calculated as ICC 0.68, 95% CI: 52-0.84; and 0.64, 95% CI: 0.61-0.66 respectively; I² = 13.2%, P=0.316). Conclusion: Based on the pooled results from the included studies, the FMS™ has a good inter-rater and intra-rater reliability. FMS™ is a screening tool capable of screening for common soccer injuries, and individual FMS™ scores are a better determinant of performance in comparison with the overall FMS™ score. Although meta-analysis could not be done for all the included screening tools, qualitative analysis also indicated good sensitivity and specificity of the individual tools. Higher levels of evidence are, however, needed for implication in evidence-based practice.

Keywords: accuracy, screening tools, sensitivity, soccer injuries, specificity

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Authors: Sinead Morrison, Ann Swillen, Therese Van Amelsvoort, Samuel Chawner, Elfi Vergaelen, Michael Owen, Marianne Van Den Bree

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22q11.2 Deletion Syndrome (22q11.2DS) is caused by the deletion of approximately 60 genes on chromosome 22 and is associated with high rates of neurodevelopmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD). The presentation of these disorders in 22q11.2DS is reported to be comparable to idiopathic forms and therefore presents a valuable model for understanding mechanisms of neurodevelopmental disorders. Cognitive deficits are thought to be a core feature of neurodevelopmental disorders, and possibly manifest in behavioural and emotional problems. There have been mixed findings in 22q11.2DS on whether the presence of ADHD or ASD is associated with greater cognitive deficits. Furthermore, the influence of developmental stage has never been taken into account. The aim was therefore to examine whether the presence of ADHD or ASD was associated with cognitive deficits in childhood and/or adolescence in 22q11.2DS. We conducted the largest study to date of this kind in 22q11.2DS. The same battery of tasks measuring processing speed, attention and spatial working memory were completed by 135 participants with 22q11.2DS. Wechsler IQ tests were completed, yielding Full Scale (FSIQ), Verbal (VIQ) and Performance IQ (PIQ). Age-standardised difference scores were produced for each participant. Developmental stages were defined as children (6-10 years) and adolescents (10-18 years). ADHD diagnosis was ascertained from a semi-structured interview with a parent. ASD status was ascertained from a questionnaire completed by a parent. Interaction and main effects of cognitive performance of those with or without a diagnosis of ADHD or ASD in childhood or adolescence were conducted with 2x2 ANOVA. Significant interactions were followed up with t-tests of simple effects. Adolescents with ASD displayed greater deficits in all measures (processing speed, p = 0.022; sustained attention, p = 0.016; working memory, p = 0.006) than adolescents without ASD; there was no difference between children with and without ASD. There were no significant differences on IQ measures. Both children and adolescents with ADHD displayed greater deficits on sustained attention (p = 0.002) than those without ADHD. There were no significant differences on any other measures for ADHD. Magnitude of cognitive deficit in individuals with 22q11.2DS varied by cognitive domain, developmental stage and presence of neurodevelopmental disorder. Adolescents with 22q11.2DS and ASD showed greater deficits on all measures, which suggests there may be a sensitive period in childhood to acquire these domains, or reflect increasing social and academic demands in adolescence. The finding of poorer sustained attention in children and adolescents with ADHD supports previous research and suggests a specific deficit which can be separated from processing speed and working memory. This research provides unique insights into the association of ASD and ADHD with cognitive deficits in a group at high genomic risk of neurodevelopmental disorders.

Keywords: 22q11.2 deletion syndrome, attention deficit hyperactivity disorder, autism spectrum disorder, cognitive development

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Authors: Lik Hang Gary Wong

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Background: Practice learning is crucial for preparing the healthcare profession to meet the real challenge upon graduation. Students are required to demonstrate their competence in managing interpersonal challenges, such as teamwork with other professionals and communicating well with the service users, during the placement. Such competence precedes clinical practice, and it may eventually affect students' actual performance in a clinical context. Unfortunately, there were limited studies investigating how such competence affects students' performance in practice learning. Objectives: The aim of this study is to investigate how self-rated interpersonal competence affects students' actual performance during clinical placement. Methods: 40 occupational therapy students from Hong Kong were recruited in this study. Prior to the clinical placement (level two or above), they completed an online survey that included the Interpersonal Communication Competence Scale (ICCS) measuring self-perceived competence in interpersonal communication. Near the end of their placement, the clinical educator rated students’ performance with the Student Practice Evaluation Form - Revised edition (SPEF-R). The SPEF-R measures the eight core competency domains required for an entry-level occupational therapist. This study adopted the cross-sectional observational design. Pearson correlation and multiple regression are conducted to examine the relationship between students' interpersonal communication competence and their actual performance in clinical placement. Results: The ICCS total scores were significantly correlated with all the SPEF-R domains, with correlation coefficient r ranging from 0.39 to 0.51. The strongest association was found with the co-worker communication domain (r = 0.51, p < 0.01), followed by the information gathering domain (r = 0.50, p < 0.01). Regarding the ICCS total scores as the independent variable and the rating in various SPEF-R domains as the dependent variables in the multiple regression analyses, the interpersonal competence measures were identified as a significant predictor of the co-worker communication (R² = 0.33, β = 0.014, SE = 0.006, p = 0.026), information gathering (R² = 0.27, β = 0.018, SE = 0.007, p = 0.011), and service provision (R² = 0.17, β = 0.017, SE = 0.007, p = 0.020). Moreover, some specific communication skills appeared to be especially important to clinical practice. For example, immediacy, which means whether the students were readily approachable on all social occasions, correlated with all the SPEF-R domains, with r-values ranging from 0.45 to 0.33. Other sub-skills, such as empathy, interaction management, and supportiveness, were also found to be significantly correlated to most of the SPEF-R domains. Meanwhile, the ICCS scores correlated differently with the co-worker communication domain (r = 0.51, p < 0.01) and the communication with the service user domain (r = 0.39, p < 0.05). It suggested that different communication skill sets would be required for different interpersonal contexts within the workplace. Conclusion: Students' self-perceived interpersonal communication competence could predict their actual performance during clinical placement. Moreover, some specific communication skills were more important to the co-worker communication but not to the daily interaction with the service users. There were implications on how to better prepare the students to meet the future challenge upon graduation.

Keywords: interpersonal competence, clinical education, healthcare professional education, occupational therapy, occupational therapy students

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Authors: Thais O. de Paula, Marjorie R. A. Sarmiento, Francis M. Borges, Alessandra B. Ferreira-Machado, Juliana A. Resende, Dioneia E. Cesar, Vania L. Silva, Claudio G. Diniz

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Obesity is currently a worldwide public health threat, being considered a pandemic multifactorial disease related to the human gut microbiota (GM). Add to that GM is considered an important reservoir of antimicrobial resistance genes (ARG) and little is known on GM and ARG in obesity, considering the altered physiology and xenobiotics intake. As regional and social behavior may play important roles in GM modulation, and most of the studies are based on small sample size and various methodological approaches resulting in difficulties for data comparisons, this study was focused on the investigation of GM bacterial diversity in obese (OB), overweight (OW) and eutrophic individuals (ET) considering their nutritional, clinical and social characteristics; and comparative screening of AGR related to their physiology and xenobiotics intake. Microbial community was accessed by FISH considering phyla as a taxonomic level, and PCR-DGGE followed by dendrograms evaluation (UPGMA method) from fecal metagenome of 72 volunteers classified according to their body mass index (BMI). Nutritional, clinical, social parameters and xenobiotics intake were recorded for correlation analysis. The fecal metagenome was also used as template for PCR targeting 59 different ARG. Overall, 62% of OB were hypertensive, and 12% or 4% were, regarding the OW and ET individuals. Most of the OB were rated as low income (80%). Lower relative bacterial densities were observed in the OB compared to ET for almost all studied taxa (p < 0.05) with Firmicutes/Bacteroidetes ratio increased in the OB group. OW individuals showed a bacterial density representative of GM more likely to the OB. All the participants were clustered in 3 different groups based on the PCR-DGGE fingerprint patterns (C1, C2, C3), being OB mostly grouped in C1 (83.3%) and ET mostly grouped in C3 (50%). The cluster C2 showed to be transitional. Among 27 ARG detected, a cluster of 17 was observed in all groups suggesting a common core. In general, ARG were observed mostly within OB individuals followed by OW and ET. The ratio between ARG and bacterial groups may suggest that AGR were more related to enterobacteria. Positive correlations were observed between ARG and BMI, calories and xenobiotics intake (especially use of sweeteners). As with nutritional and clinical characteristics, our data may suggest that GM of OW individuals behave in a heterogeneous pattern, occasionally more likely to the OB or to the ET. Regardless the regional and social behaviors of our population, the methodological approaches in this study were complementary and confirmatory. The imbalance of GM over the health-disease interface in obesity is a matter of fact, but its influence in host's physiology is still to be clearly elucidated to help understanding the multifactorial etiology of obesity. Although the results are in agreement with observations that GM is altered in obesity, the altered physiology in OB individuals seems to be also associated to the increased xenobiotics intake and may interfere with GM towards antimicrobial resistance, as observed by the fecal metagenome and ARG screening. Support: FAPEMIG, CNPQ, CAPES, PPGCBIO/UFJF.

Keywords: antimicrobial resistance, bacterial diversity, gut microbiota, obesity

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Authors: Louise Reyntjens

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Where criminal law used to be the traditional response to cope with the terrorist threat, European governments are increasingly relying on administrative paths. The reliance on immigration law fits into this trend. Terrorism is seen as a civilization menace emanating from abroad. In this context, the expulsion of dangerous aliens, immigration law’s core task, is put forward as a key security tool. Governments all over Europe are focusing on removing dangerous individuals from their territory rather than bringing them to justice. This research reflects on the consequences for the expelled individuals’ fundamental rights. For this, the author selected four European countries for a comparative study: Belgium, France, the United Kingdom and Sweden. All these countries face similar social and security issues, igniting the recourse to immigration law as a counterterrorism tool. Yet, they adopt a very different approach on this: the United Kingdom positions itself on the repressive side of the spectrum. Sweden on the other hand, also 'securitized' its immigration policy after the recent terrorist hit in Stockholm, but remains on the tolerant side of the spectrum. Belgium and France are situated in between. This paper addresses the situation in Belgium. In 2017, the Belgian parliament introduced several legislative changes by which it considerably expanded and facilitated the possibility to expel unwanted aliens. First, the expulsion measure was subjected to new and questionably definitions: a serious attack on the nation’s safety used to be required to expel certain categories of aliens. Presently, mere suspicions suffice to fulfil the new definition of a 'serious threat to national security'. A definition which fails to respond to the principle of legality; the law, nor the prepatory works clarify what is meant by 'a threat to national security'. This creates the risk of submitting this concept’s interpretation almost entirely to the discretion of the immigration authorities. Secondly, in name of intervening more quickly and efficiently, the automatic suspensive appeal for expulsions was abolished. The European Court of Human Rights nonetheless requires such an automatic suspensive appeal under Article 13 and 3 of the Convention. Whether this procedural reform will stand to endure, is thus questionable. This contribution also raises questions regarding expulsion’s efficacy as a key security tool. In a globalized and mobilized world, particularly in a European Union with no internal boundaries, questions can be raised about the usefulness of this measure. Even more so, by simply expelling a dangerous individual, States avoid their responsibility and shift the risk to another State. Criminal law might in these instances be more capable of providing a conclusive and long term response. This contribution explores the human rights consequences of expulsion as a security tool in Belgium. It also offers a critical view on its efficacy for protecting national security.

Keywords: Belgium, counter-terrorism and human rights, expulsion, immigration law

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Authors: Aleksander Ejsmont, Stefan Wuttke, Joanna Goscianska

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Gaining control over particle shape, size and crystallinity is an ongoing challenge for many materials. Especially metalorganic frameworks (MOFs) are recently widely studied. Besides their remarkable porosity and interesting topologies, morphology has proven to be a significant feature. It can affect the further material application. Thus seeking new approaches that enable MOF morphology modulation is important. MOFs are reticular structures, where building blocks are made up of organic linkers and metallic nodes. The most common strategy of ensuring metal source is using salts, which usually exhibit high solubility and hinder morphology control. However, there has been a growing interest in using metal oxides as structure-directing agents towards MOFs due to their very low solubility and shape preservation. Metal oxides can be treated as a metal reservoir during MOF synthesis. Up to now, reports in which receiving MOFs from metal oxides mostly present ZnO conversion to ZIF-8. However, there are other oxides, for instance, Co₃O₄, which often is overlooked due to their structural stability and insolubility in aqueous solutions. Cobalt-based materials are famed for catalytic activity. Therefore the development of their efficient synthesis is worth attention. In the presented work, an optimized Co₃O₄transition to Co-MOFviaa solvothermal approach was proposed. The starting point of the research was the synthesis of Co₃O₄ flower petals and needles under hydrothermal conditions using different cobalt salts (e.g., cobalt(II) chloride and cobalt(II) nitrate), in the presence of urea, and hexadecyltrimethylammonium bromide (CTAB) surfactant as a capping agent. After receiving cobalt hydroxide, the calcination process was performed at various temperatures (300–500 °C). Then cobalt oxides as a source of cobalt cations were subjected to reaction with trimesic acid in solvothermal environment and temperature of 120 °C leading to Co-MOF fabrication. The solution maintained in the system was a mixture of water, dimethylformamide, and ethanol, with the addition of strong acids (HF and HNO₃). To establish how solvents affect metal oxide conversion, several different solvent ratios were also applied. The materials received were characterized with analytical techniques, including X-ray powder diffraction, energy dispersive spectroscopy,low-temperature nitrogen adsorption/desorption, scanning, and transmission electron microscopy. It was confirmed that the synthetic routes have led to the formation of Co₃O₄ and Co-based MOF varied in shape and size of particles. The diffractograms showed receiving crystalline phase for Co₃O₄, and also for Co-MOF. The Co₃O₄ obtained from nitrates and with using low-temperature calcination resulted in smaller particles. The study indicated that cobalt oxide particles of different size influence the efficiency of conversion and morphology of Co-MOF. The highest conversion was achieved using metal oxides with small crystallites.

Keywords: Co-MOF, solvothermal synthesis, morphology control, core-shell

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Authors: Ahlem Dhahri, Audrey Becuwe

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This study examines the adoption of sustainable purchasing practices among Tunisian SMEs, with a focus on assessing how environmental and social sustainability maturity affects the implementation of sustainable supplier selection (SSS) criteria. Using institutional theory to classify coercive, normative, and mimetic pressures, as well as emerging drivers and barriers, this study explores the institutional factors influencing sustainable purchasing practices and the specific barriers faced by Tunisian SMEs in this area. An exploratory, abductive qualitative research design was adopted for this multiple case study, which involved 19 semi-structured interviews with owners and managers of 17 Tunisian manufacturing SMEs. The Gioia method was used to analyze the data, thus enabling the identification of key themes and relationships directly from the raw data. This approach facilitated a structured interpretation of the institutional factors influencing sustainable purchasing practices, with insights drawn from the participants' perspectives. The study reveals that Tunisian SMEs are at different levels of sustainability maturity, with a significant impact on their procurement practices. SMEs with advanced sustainability maturity integrate both environmental and social criteria into their supplier selection processes, while those with lower maturity levels rely on mostly traditional criteria such as cost, quality, and delivery. Key institutional drivers identified include regulatory pressure, market expectations, and stakeholder influence. Additional emerging drivers—such as certifications and standards, economic incentives, environmental commitment as a core value, and group-wide strategic alignment—also play a critical role in driving sustainable procurement. Conversely, the study reveals significant barriers, including economic constraints, limited awareness, and resource limitations. It also identifies three main categories of emerging barriers: (1) logistical and supply chain constraints, including retailer/intermediary dependency, tariff regulations, and a perceived lack of direct responsibility in B2B supply chains; (2) economic and financial constraints; and (3) operational barriers, such as unilateral environmental responsibility, a product-centric focus and the influence of personal relationships. Providing valuable insights into the role of sustainability maturity in supplier selection, this study is the first to explore sustainable procurement practices in the Tunisian SME context. Integrating an analysis of institutional drivers, including emerging incentives and barriers, provides practical implications for SMEs seeking to improve sustainability in procurement. The results highlight the need for stronger regulatory frameworks and support mechanisms to facilitate the adoption of sustainable practices among SMEs in Tunisia.

Keywords: Tunisian SME, sustainable supplier selection, institutional theory, determinant, qualitative study

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Authors: Nurgul A. Abenova, Gaukhar S. Dilmagambetova, Lazzat M. Zhamaliyeva

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Professionalism is a core competency that all medical students must achieve throughout their studies. Clinical knowledge, good communication skills and an understanding of ethics form the basis of professionalism. Patients, medical societies and accrediting organizations expect future specialists to be professionals in their field, which in turn leads to the best clinical results. Currently, there are no studies devoted to the study of medical professionalism in the Republic of Kazakhstan. As a result, medical education in the Kazakhstani system has a limited perception of the concept of professionalism compared to many Western medical schools. Thus, the primary purpose of this study is to analyze the perception of medical professionalism among residents and teachers of family medicine at the West Kazakhstan Marat Ospanov Medical University. А qualitative research method was used based on the content analysis methodology. A focus group discussion was held with 60 residents and 12 family medicine teachers to gather participants' views and experiences in the field of medical professionalism. The received information was processed using the MAXQDA-2020 software package. Respondents were selected for the study based on their age, gender, and educational level. The results of the conducted survey confirmed the respondents’ acknowledgment of the basic attributes of professionalism, such as medical knowledge and skills (more than 40% of the answers), personal and moral qualities of the doctor (more than 25% of the answers), respect for the interests of the patient (15% of the answers), the relationship between the doctor and the patient and among professionals themselves (15% of responses). Another important discovery of the survey was that residents are five times more likely to define the relationship between a doctor and a patient in a model “respect for the interests of the patient” in comparison with teachers of family medicine, who primarily reported responsibility and collegiality to be the basis for the development of professionalism and traditionally view doctor-patient relationship to be formed on the basis of paternalism defined by a high degree of control over patients. This significant difference demonstrates a rift among specialists in the field of family medicine, which causes a lot of problems. For example, nowadays, professional family doctors regularly face burnout problem due to many reasons and factors that force them to abandon their jobs. In addition to that, elements of professionalism such as reflective skills, time management and feedback collection were presented to the least extent (less than 1%) by both groups, which differs from the perception of the Western medical school and is a significant issue that needs to be solved. The qualitative nature of our study provides a detailed understanding of medical professionalism in the context of the Central Asian healthcare system, revealing many aspects that are inferior to the Western medical school counterparts and provides a solution, which is to teach the attributes and skills required for medical professionalism at all stages of medical education of family doctors.

Keywords: family medicine, family doctors, medical professionalism, medical education

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Authors: Qi Peng

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The Chinese sport sector is currently undergoing a dramatic institutional change. A sport system that was heavily dominated by the government is starting to shift towards one that is driven by the market. During the past sixty years, the Chinese Football Association (CFA), although ostensibly a ‘non-governmental organization’, has been in fact operated under the close supervision and control of the government. The double-identity of CFA has taken most of the blame for the poor performance of the Chinese football team, especially the men’s team. In 2015, a policy initiated by the Chinese government introduced a potentially radical change to the institutional structure of CFA by delegating the power of government agency – the General Administration of Sport of China - to the organization (CFA) itself. Against such background, an overarching research question was brought up- will an organization remained institutionalized within the system change in response to the external (policy) jolt? To answer this question, three principal data collection methods were employed: document review, participant observation and semi-structured interviews. Document review provides the mapping of the structural and cultural framework in which the CFA functions during the change process. The author have had the chance to interact closely with the organization as participant observer in the organization for a period of time, long enough to collect the data, but never too long to get biased view of the situation. This stage enables the author to gain an in-depth understanding of how CFA managed to restructure the governance and legitimacy. Conducting semi-structured interviews with staff within the CFA and from staff within selected stakeholders of CFA also provided a crucial step to gain an insight into the factors for change as well as the implications of the change. A wide range of interviewees that have been and to be interviewed include: CFA members (senior officials and staff); local football associations members; senior Chinese Super League football club managers; CFA Super League Co., LTD (senior officials and staff); CSL broadcasters; Chinese Olympic Committee members. The preliminary research data shows that the CFA is currently undergoing two levels of change: although the settings of CFA has been gradually restructured (organizational framework), the organizational values and beliefs remain almost the same as the CFA before the reform. This means that the plan of shifting from a governmental agency to an autonomous association is an going process, and that organizational core beliefs and values are more difficult to change than its structural framework. This is due to the inertia of the organizational history and the effect of institutionalization. The change of Chinese Football Association is looked at as a pioneering sport organization in China to undertake the “decoupling” road. It is believed that many other sport organizations, especially sport governing bodies will follow the step of CFA in the near future. Therefore, the experience of CFA change is worthy of studying.

Keywords: Chinese Football Association, Organizational Change, Organizational Culture, Structural Framework

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Authors: Aparna Datey

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This paper explores the theoretical frameworks underpinning professional learning, professional development, and academic identity. The focus is on sessional teachers (also called tutors or adjuncts) in architectural design studios, who may be practitioners, masters or doctoral students and academics hired ‘as needed’. Drawing from Schön’s work on reflective practice, learning and developmental theories of Vygotsky (social constructionism and zones of proximal development), informal and workplace learning, this research proposes that sessional teachers not only develop their teaching skills but also shape their identities through their 'everyday' work. Continuing academic staff develop their teaching through a combination of active teaching, self-reflection on teaching, as well as learning to teach from others via formalised programs and informally in the workplace. They are provided professional development and recognised for their teaching efforts through promotion, student citations, and awards for teaching excellence. The teaching experiences of sessional staff, by comparison, may be discontinuous and they generally have fewer opportunities and incentives for teaching development. In the absence of access to formalised programs, sessional teachers develop their teaching informally in workplace settings that may be supportive or unhelpful. Their learning as teachers is embedded in everyday practice applying problem-solving skills in ambiguous and uncertain settings. Depending on their level of expertise, they understand how to teach a subject such that students are stimulated to learn. Adult learning theories posit that adults have different motivations for learning and fall into a matrix of readiness, that an adult’s ability to make sense of their learning is shaped by their values, expectations, beliefs, feelings, attitudes, and judgements, and they are self-directed. The level of expertise of sessional teachers depends on their individual attributes and motivations, as well as on their work environment, the good practices they acquire and enhance through their practice, career training and development, the clarity of their role in the delivery of teaching, and other factors. The architectural design studio is ideal for study due to the historical persistence of the vocational learning or apprenticeship model (learning under the guidance of experts) and a pedagogical format using two key approaches: project-based problem solving and collaborative learning. Hence, investigating the theoretical frameworks underlying academic roles and informal professional learning in the workplace would deepen understanding of their professional development and how they shape their academic identities. This qualitative research is ongoing at a major university in Australia, but the growing trend towards hiring sessional staff to teach core courses in many disciplines is a global one. This research will contribute to including transient sessional teachers in the discourse on institutional quality, effectiveness, and student learning.

Keywords: academic identity, architectural design learning, pedagogy, teaching and learning, sessional teachers

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Authors: Mary A. Lindell

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Adults with intellectual disabilities (ID) are increasingly attending postsecondary institutions, including inclusive residential programs at four-year universities. The legislation, national organizations, and researchers support developing postsecondary education (PSE) options for this historically underserved population. Simultaneously, researchers are assessing the quality of life indicators (QOL) for people with ID. This study explores the quality of life characteristics for individuals with ID entering a two-year PSE program. A survey aligned with the PSE program was developed and administered to participants before they began their college program (in future studies, the same survey will be administered 6 months and 1 year after graduating). Employment, income, and housing are frequently cited QOL measures. People with disabilities, and especially people with ID, are more likely to experience unemployment and low wages than people without disabilities. PSE improves adult outcomes (e.g., employment, income, housing) for people with and without disabilities. Similarly, adults with ID who attend PSE are more likely to be employed than their peers who do not attend PSE; however, adults with ID are least likely among their typical peers and other students with disabilities to attend PSE. There is increased attention to providing individuals with ID access to PSE and more research is needed regarding the characteristics of students attending PSE. This study focuses on the participants of a fully residential two-year program for individuals with ID. Students earn an Applied Skills Certificate while focusing on five benchmarks: self-care, home care, relationships, academics, and employment. To create a QOL measure, the goals of the PSE program were identified, and possible assessment items were initially selected from the National Core Indicators (NCI) and the National Transition Longitudinal Survey 2 (NTLS2) that aligned with the five program goals. Program staff and advisory committee members offered input on potential item alignment with program goals and expected value to students with ID in the program. National experts in researching QOL outcomes of people with ID were consulted and concurred that the items selected would be useful in measuring the outcomes of postsecondary students with ID. The measure was piloted, modified, and administered to incoming students with ID. Research questions: (1) In what ways are students with ID entering a two-year PSE program similar to individuals with ID who complete the NCI and NTLS2 surveys? (2) In what ways are students with ID entering a two-year PSE program different than individuals with ID who completed the NCI and NTLS2 surveys? The process of developing a QOL measure specific to a PSE program for individuals with ID revealed that many of the items in comprehensive national QOL measures are not relevant to stake-holders of this two-year residential inclusive PSE program. Specific responses of students with ID entering an inclusive PSE program will be presented as well as a comparison to similar items on national QOL measures. This study explores the characteristics of students with ID entering a residential, inclusive PSE program. This information is valuable for, researchers, educators, and policy makers as PSE programs become more accessible for individuals with ID.

Keywords: intellectual disabilities, inclusion, post-secondary education, quality of life

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Authors: Karolina Wieczorek, Zofia Przypaśniak

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Climate change is a rapidly growing threat to global health, and part of the responsibility to combat it lies within the healthcare sector itself, including adequate education of future medical professionals. To mitigate the consequences, the General Medical Council (GMC) has equipped medical schools with a list of outcomes regarding sustainability teaching. Students are expected to analyze the impact of the healthcare sector’s emissions on climate change. The delivery of the related teaching content is, however, often inadequate and insufficient time is devoted for exploration of the topics. Teaching curricula lack in-depth exploration of the learning objectives. This study aims to assess the extent and characteristics of climate change and sustainability subjects teaching in the curriculum of a chosen UK medical school (Barts and The London School of Medicine and Dentistry). It compares the data to the national average scores from the Climate Change and Sustainability Teaching (C.A.S.T.) in Medical Education Audit to draw conclusions about teaching on a regional level. This is a single-center audit of the timetabled sessions of teaching in the medical course. The study looked at the academic year 2020/2021 which included a review of all non-elective, core curriculum teaching materials including tutorials, lectures, written resources, and assignments in all five years of the undergraduate and graduate degrees, focusing only on mandatory teaching attended by all students (excluding elective modules). The topics covered were crosschecked with GMC Outcomes for graduates: “Educating for Sustainable Healthcare – Priority Learning Outcomes” as gold standard to look for coverage of the outcomes and gaps in teaching. Quantitative data was collected in form of time allocated for teaching as proxy of time spent per individual outcomes. The data was collected independently by two students (KW and ZP) who have received prior training and assessed two separate data sets to increase interrater reliability. In terms of coverage of learning outcomes, 12 out of 13 were taught (with the national average being 9.7). The school ranked sixth in the UK for time spent per topic and second in terms of overall coverage, meaning the school has a broad range of topics taught with some being explored in more detail than others. For the first outcome 4 out of 4 objectives covered (average 3.5) with 47 minutes spent per outcome (average 84 min), for the second objective 5 out of 5 covered (average 3.5) with 46 minutes spent (average 20), for the third 3 out of 4 (average 2.5) with 10 mins pent (average 19 min). A disproportionately large amount of time is spent delivering teaching regarding air pollution (respiratory illnesses), which resulted in the topic of sustainability in other specialties being excluded from teaching (musculoskeletal, ophthalmology, pediatrics, renal). Conclusions: Currently, there is no coherent strategy on national teaching of climate change topics and as a result an unstandardized amount of time spent on teaching and coverage of objectives can be observed.

Keywords: audit, climate change, sustainability, education

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Authors: Isabel N. Sierra-Garcia, Maria J. Ferreira, Sandro Figuereido, Newton Gomes, Helena Silva, Angela Cunha

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Plant-associated microbial communities are considered crucial in the adaptation of halophytes to coastal environments. The plant microbiota can be horizontally acquired from the environment or vertically transmitted from generation to generation via seeds. Recruiting of the microbial communities by the plant is affected by geographical location, soil source, host genotype, and cultivation practice. There is limited knowledge reported on the microbial communities in halophytes the influence of biotic and abiotic factors. In this work, the microbiota associated with the halophyte Salicornia ramosissima was investigated to determine whether the structure of bacterial communities is influenced by host genotype or soil source. For this purpose, two contrasting sites where S. ramosissima is established in the estuarine system of the Ria de Aveiro were investigated. One site corresponds to a natural salt marsh where S. ramosissima plants are present (wild plants), and the other site is a former salt pan that nowadays are subjected to intensive crop production of S. ramosissima (crop plants). Bacterial communities from the rhizosphere, seeds and root endosphere of S. ramossisima from both sites were investigated by sequencing bacterial 16S rRNA gene using the Illumina MiSeq platform. The analysis of the sequences showed that the three plant-associated compartments, rhizosphere, root endosphere, and seed endosphere, harbor distinct microbiomes. However, bacterial richness and diversity were higher in seeds of wild plants, followed by rhizosphere in both sites, while seeds in the crop site had the lowest diversity. Beta diversity measures indicated that bacterial communities in root endosphere and seeds were more similar in both wild and crop plants in contrast to rhizospheres that differed by local, indicating that the recruitment of the similar bacterial communities by the plant genotype is active in regard to the site. Moreover, bacterial communities from the root endosphere and rhizosphere were phylogenetically more similar in both sites, but the phylogenetic composition of seeds in wild and crop sites was distinct. These results indicate that cultivation practices affect the seed microbiome. However, minimal vertical transmission of bacteria from seeds to adult plants is expected. Seeds from the crop site showed higher abundances of Kushneria and Zunongwangia genera. Bacterial members of the classes Alphaprotebacteria and Bacteroidia were the most ubiquitous across sites and compartments and might encompass members of the core microbiome. These findings indicate that bacterial communities associated with S. ramosissima are more influenced by host genotype rather than local abiotic factors or cultivation practices. This study provides a better understanding of the composition of the plant microbiota in S. ramosissima , which is essential to predict the interactions between plant and associated microbial communities and their effects on plant health. This knowledge is useful to the manipulations of these microbial communities to enhance the health and productivity of this commercially important plant.

Keywords: halophytes, plant microbiome, Salicornia ramosissima, agriculture

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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: Deborah Weidner, Melissa Morgera

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The model of care delivery in the Behavioral Health Network (BHN) is integrated across all five regions of Hartford Healthcare and thus spans the entirety of the state of Connecticut, with care provided in seven inpatient settings and over 30 ambulatory outpatient locations. While safety has been a core priority of the BHN in alignment with High Reliability practices, safety initiatives have historically been facilitated locally in each region or within each entity, with interventions implemented locally as opposed to throughout the network. To address this, the BHN introduced a network wide Safety Huddle during 2022. Launched in January, the BHN Safety Huddle brought together internal stakeholders, including medical and administrative leaders, along with executive institute leadership, quality, and risk management. By bringing leaders together and introducing a network-wide safety huddle into the way we work, the benefit has been an increase in awareness of safety events occurring in behavioral health areas as well as increased systemization of countermeasures to prevent future events. One significant discussion topic presented in huddles has pertained to environmental design and patient access to potentially dangerous items, addressing some of the most relevant factors resulting in harm to patients in inpatient and emergency settings for behavioral health patients. The safety huddle has improved visibility of potential environmental safety risks through the generation of over 15 safety alerts cascaded throughout the BHN and also spurred a rapid improvement project focused on standardization of patient belonging searches to reduce patient access to potentially dangerous items on inpatient units. Safety events pertaining to potentially dangerous items decreased by 31% as a result of standardized interventions implemented across the network and as a result of increased awareness. A second positive outcome originating from the BHN Safety Huddle was implementation of a recommendation to increase the emergency Narcan®(naloxone) supply on hand in ambulatory settings of the BHN after incidents involving accidental overdose resulted in higher doses of naloxone administration. By increasing the emergency supply of naloxone on hand in all ambulatory and residential settings, colleagues are better prepared to respond in an emergency situation should a patient experience an overdose while on site. Lastly, discussions in safety huddle spurred a new initiative within the BHN to improve responsiveness to assaultive incidents through a consultation service. This consult service, aligned with one of the network’s improvement priorities to reduce harm events related to assaultive incidents, was borne out of discussion in huddle in which it was identified that additional interventions may be needed in providing clinical care to patients who are experiencing multiple and/ or frequent safety events.

Keywords: quality, safety, behavioral health, risk management

Procedia PDF Downloads 83

Authors: Venus Torabi

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ISIS, the terrorist organization, modified two videogames, ARMA III and Grand Theft Auto 5 (2013) as means of online recruitment and ideological propaganda. The urge to study the mechanism at work, whether it has been successful or not, derives (Digital) Humanities experts to explore how codes of terror, Islamic ideology and recruitment strategies are incorporated into the ludic mechanics of videogames. Another aspect of the significance lies in the fact that this is a latent problem that has not been fully addressed in an interdisciplinary framework prior to this study, to the best of the researcher’s knowledge. Therefore, due to the complexity of the subject, the present paper entangles with game studies, philosophical and religious poles to form the methodology of conducting the research. As a contextualized epistemology of such exploitation of videogames, the core argument is building on the notion of “Culture Industry” proposed by Theodore W. Adorno and Max Horkheimer in Dialectic of Enlightenment (2002). This article posits that the ideological underpinnings of ISIS’s cause corroborated by the action-bound mechanics of the videogames are in line with adhering to the Islamic Eschatology as a furnishing ground and an excuse in exercising terrorism. It is an account of ISIS’s modification of the videogames, a tool of technological progression to practice online radicalization. Dialectically, this practice is packed up in rhetoric for recognizing a religious myth (the advent of a savior), as a hallmark of regression. The study puts forth that ISIS’s wreaking havoc on the world, both in reality and within action videogames, is negotiating the process of self-assertion in the players of such videogames (by assuming one’s self a member of terrorists) that leads to self-annihilation. It tries to unfold how ludic Mod videogames are misused as tools of mass deception towards ethnic cleansing in reality and line with the distorted Eschatological myth. To conclude, this study posits videogames to be a new avenue of mass deception in the framework of the Culture Industry. Yet, this emerges as a two-edged sword of mass deception in ISIS’s modification of videogames. It shows that ISIS is not only trying to hijack the minds through online/ludic recruitment, it potentially deceives the Muslim communities or those prone to radicalization into believing that it's terrorist practices are preparing the world for the advent of a religious savior based on Islamic Eschatology. This is to claim that the harsh actions of the videogames are potentially breeding minds by seeds of terrorist propaganda and numbing them to violence. The real world becomes an extension of that harsh virtual environment in a ludic/actual continuum, the extension that is contributing to the mass deception mechanism of the terrorists, in a clandestine trend.

Keywords: culture industry, dialectic, ISIS, islamic eschatology, mass deception, video games

Procedia PDF Downloads 137

Authors: Vangmayee V. Subban, Suzan Deelan. Pinto, Somashekara Haralakatta Shivananjappa, Shwetha Prabhu, Jayashree S. Bhat

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Introduction and Need: During early years of schooling, the instruction in the schools mainly focus on children’s word decoding abilities. However, the skilled readers should master all the components of reading such as word decoding, reading fluency and comprehension. Nevertheless, the relationship between each component during the process of learning to read is less clear. The studies conducted in alphabetical languages have mixed opinion on relative contribution of word decoding and reading fluency on reading comprehension. However, the scenarios in alphasyllabary languages are unexplored. Aim and Objectives: The aim of the study was to explore the role of word decoding, reading fluency on reading comprehension abilities in children learning to read Kannada between the age ranges of 5.6 to 8.6 years. Method: In this cross sectional study, a total of 60 typically developing children, 20 each from Grade I, Grade II, Grade III maintaining equal gender ratio between the age range of 5.6 to 6.6 years, 6.7 to 7.6 years and 7.7 to 8.6 years respectively were selected from Kannada medium schools. The reading fluency and reading comprehension abilities of the children were assessed using Grade level passages selected from the Kannada text book of children core curriculum. All the passages consist of five questions to assess reading comprehension. The pseudoword decoding skills were assessed using 40 pseudowords with varying syllable length and their Akshara composition. Pseudowords are formed by interchanging the syllables within the meaningful word while maintaining the phonotactic constraints of Kannada language. The assessment material was subjected to content validation and reliability measures before collecting the data on the study samples. The data were collected individually, and reading fluency was assessed for words correctly read per minute. Pseudoword decoding was scored for the accuracy of reading. Results: The descriptive statistics indicated that the mean pseudoword reading, reading comprehension, words accurately read per minute increased with the Grades. The performance of Grade III children found to be higher, Grade I lower and Grade II remained intermediate of Grade III and Grade I. The trend indicated that reading skills gradually improve with the Grades. Pearson’s correlation co-efficient showed moderate and highly significant (p=0.00) positive co-relation between the variables, indicating the interdependency of all the three components required for reading. The hierarchical regression analysis revealed 37% variance in reading comprehension was explained by pseudoword decoding and was highly significant. Subsequent entry of reading fluency measure, there was no significant change in R-square and was only change 3%. Therefore, pseudoword-decoding evolved as a single most significant predictor of reading comprehension during early Grades of reading acquisition. Conclusion: The present study concludes that the pseudoword decoding skills contribute significantly to reading comprehension than reading fluency during initial years of schooling in children learning to read Kannada language.

Keywords: alphasyllabary, pseudo-word decoding, reading comprehension, reading fluency

Procedia PDF Downloads 262

Authors: Ine Huybrechts, Anja Declercq, Emily Verté, Peter Raeymaeckers, Sibyl Anthierens

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Goal-oriented care is a concept gaining increased interest as an approach to go towards more coordinated and integrated primary care. It places patients’ personal life goals at the core of health care support, hereby shifting the focus from “what’s the matter with this patient” to “what matters to this patient.” In Flanders/Belgium, various primary care providers, health and social care organizations and governmental bodies have picked up this concept and have initiated actions to facilitate this approach. The implementation of goal-oriented care not only happens on the micro-level, but it also requires efforts on the meso- and macro-level. Within implementation research, there is a growing recognition that the context in which an intervention takes place strongly relates to its implementation outcomes. However, when investigating contextual variables, the external context and its impact on implementation processes is often overlooked. This study aims to explore how we can better identify and understand the external context and how it relates to the mechanism of change within the implementation process of goal-oriented care in Flanders/Belgium. Results can be used to support and guide initiatives to introduce innovative approaches such as goal-oriented care inside an organization or in the broader primary care landscape. We have conducted qualitative research, performing in-depth interviews with n=23 respondents who have affinity with the implementation of goal-oriented care within their professional function. This lead to in-depth insights from a wide range of actors, with meso-level and/or macro-level perspectives on the implementation of goal-oriented care. This means that we have interviewed actors that are not only involved with initiatives to implement goal-oriented care, but also actors that actively give form to the external context in which goal-oriented care is implemented. Data were collected using a semi-structured interview guide, audio recorded, and analyzed first inductively and then deductively using various theories and concepts that derive from organizational research. Our preliminary findings suggest t Our findings can contribute to further define actions needed for sustainable implementation of goal-oriented primary care. It gives insights in the dynamics between contextual variables and implementation efforts, hereby indicating towards those contextual variables that can be further shaped to facilitate the implementation of an innovation such as goal-oriented care. hat organizational theories can help understand the mechanism of change of implementation processes with a macro-level perspective. Institutional theories, contingency theories, resources dependency theories and others can expose the mechanism of change for an innovation such as goal-oriented care. Our findings can contribute to further define actions needed for sustainable implementation of goal-oriented primary care. It gives insights in the dynamics between contextual variables and implementation efforts, hereby indicating towards those contextual variables that can be further shaped to facilitate the implementation of an innovation such as goal-oriented care.

Keywords: goal-oriented care, implementation processes, organizational theories, person-centered care, implementation research

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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

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Authors: Jane-Francis A. Abongdia, Thandiswa Mpiti

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There is an international concern to develop children’s literacy skills. In many parts of the world, the need to become fluent in a second language is essential for gaining meaningful access to education, the labour market and broader social functioning. In spite of these efforts, the problem still continues. The level of English language proficiency is far from satisfactory and these goals are unattainable by others. The issue is more complex in South Africa as learners are immersed in a second language (L2) curriculum. South Africa is a prime example of a country facing the dilemma of how to effectively equip a majority of its population with English as a second language or first additional language (FAL). Given the multilingual nature of South Africa with eleven official languages, and the position and power of English, the study investigates teachers’ and learners’ experiences on isiXhosa and Afrikaans background learners’ writing in English First Additional Language (EFAL). Moreover, possible causes of writing difficulties and teacher’s practices for writing are explored. The theoretical and conceptual framework for the study is provided by studies on constructivist theories and sociocultural theories. In exploring these issues, a qualitative approach through semi-structured interviews, classroom observations, and document analysis were adopted. This data is analysed by critical discourse analysis (CDA). The study identified a weak correlation between teachers’ beliefs and their actual teaching practices. Although the teachers believe that writing is as important as listening, speaking, reading, grammar and vocabulary, and that it needs regular practice, the data reveal that they fail to put their beliefs into practice. Moreover, the data revealed that learners were disturbed by their home language because when they do not know a word they would write either the isiXhosa or the Afrikaans equivalent. Code-switching seems to have instilled a sense of “dependence on translations” where some learners would not even try to answer English questions but would wait for the teacher to translate the questions into isiXhosa or Afrikaans before they could attempt to give answers. The findings of the study show a marked improvement in the writing performance of learners who used the process approach in writing. These findings demonstrate the need for assisting teachers to shift away from focusing only on learners’ performance (testing and grading) towards a stronger emphasis on the process of writing. The study concludes that the process approach to writing could enable teachers to focus on the various parts of the writing process which can give more freedom to learners to experiment their language proficiency. It would require that teachers develop a deeper understanding of the process/genre approaches to teaching writing advocated by CAPS. All in all, the study shows that both learners and teachers face numerous challenges relating to writing. This means that more work still needs to be done in this area. The present study argues that teachers teaching EFAL learners should approach writing as a critical and core aspect of learners’ education. Learners should be exposed to intensive writing activities throughout their school years.

Keywords: constructivism, English second language, language of learning and teaching, writing

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Authors: Ahlad Neti, Elisa Arch, Martha Hall

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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: Aaron Derner

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Unlike the histories of France, the UK, or even Spain, the Russian colonial past often dissolves before the seemingly more salient Cold War figurations or Soviet dissolution. The obvious explanation behind Caucasian states’ roles—that of Russian-propped governments obeying the whims of their patron—is but the latest instance of such oversight. Where the results of colonial social and cultural interactions are indelibly stamped across France, Algeria, and every other former (and current) French holding, so to are the Muscovite and Russian colonial ambitions embedded within the modern politics and cultures of both Russia and the Caucasus. Russian colonial artefacts are enhanced and perhaps granted an additional social explanatory edge over those of the ‘typical’ colonizers, by the cyclical adoration for and noisy rejection of European cultural markers over the centuries, along with the somewhat unusual composition of the Cossacks: Russia’s main agents of colonialization within the Caucasian frontier. The story of Russia and Chechnya, of all the Caucasus, is of the manufacture of social and individual identity through “modes of subjectification” inherent within the region’s colonial history and driven by the triangular interactions between three main groups: the Cossacks, the Caucasian Mountain Tribes, and the Russian Metropol. Together, interactions between these social groups worked to shape and transform the lifestyles and institutional pathologies that constitute the Russian and Chechen states and the politics between them. At the core of this (Western) state-building is the simultaneous and seemingly contradictory desire to be more Western and emulate Western cultural and political practices while also desperately grasping for a uniquely Russian identity. This sits somewhat ironically against the backdrop that Russia hosted a frontier-based settler society and had established that distinctly European feature of settler colonialism early in its history—arguably establishing a claim to being the most “colonial” of the colonial powers. There is no doubt that these forces worked to shape contemporary Russian political and social identity—apparent in the mythic popularity of the Cossack in Russian literature, politics, and academic discourse. What needs to be expanded from the current narrative, however, is that beyond the Cossack identity’s attractiveness on the grounds of its tones of freedom and resistance to unjust authority, the identity is rooted in the imperial ambitions and colonial experiences of the Russian state, and is, therefore, a direct marker of domination and subjectification. Adding an unusual dimension to this not-uncommon cultural progression, the Russian state needed to colonize both the Caucases and the Russian Cossacks, appropriating them in much the same way they appropriated the Circassian mountain tribes. The focus of this paper is not to tell yet another story of how one culture entered an area to overpower another but how a ‘powerful,’ ‘modern,’ ‘Western(ish)’ culture was profoundly and continually changed through its contact with a group of tribal ‘savages’ and ‘braves.’

Keywords: Russia, chechnya, subjectification, caucasus, cossacks, Ukraine

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Authors: Aisha Alshdefat, Lina Shakman

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Objective: With environmental sustainability (ES) emerging as a critical concern due to its global impact, higher education institutions play a vital role in promoting ES through curricula and campus operations. This study examines the perceptions, attitudes, and behaviors related to ES among students at Sultan Qaboos University, aiming to identify areas for improved integration of sustainability practices in higher education. Design: A descriptive cross-sectional study, conducted via an online questionnaire, examines perceptions and attitudes toward environmental sustainability among students at Sultan Qaboos University, Muscat, Oman. The survey instrument employs a 5-point Likert scale to assess six key areas: awareness, concern, attitude, willingness to participate, current behaviors, and recommendations for enhancing campus sustainability initiatives. A convenience sample of 200 students was initially targeted, with 157 students ultimately responding between September and November 2024. Eligible participants included Undergraduate and graduate students who consented after being fully informed of the study objectives and design were included, while those who withdrew or refused participation were excluded. Following ethical approval, data collection was carried out through Google Forms. SPSS Version 23 was used for descriptive and inferential analyses, including Pearson’s correlation, chi-square, and Fisher's exact test, to explore associations among key variables. Findings: Preliminary analysis indicates that 68% of participants are familiar with core environmental sustainability (ES) concepts, including the Sustainable Development Goals (SDGs), and express high concern regarding environmental issues. However, only 47% report active involvement in campus-led ES initiatives, underscoring an engagement gap. Over 70% of respondents believe that sustainability should be prioritized as a university policy, and 62% expressed willingness to participate in additional ES-related programs. Despite this interest, 58% advocated for more sustainability-focused courses in their curriculum, suggesting current offerings are insufficient. Statistical analysis revealed a significant positive correlation between ES awareness and willingness to engage in sustainable practices (p < 0.05). These findings highlight the need for expanded institutional efforts, including targeted programs and curriculum integration, to cultivate a more sustainability-centered culture among students. Conclusion: The results emphasize that while students demonstrate a strong foundational awareness of ES, greater institutional support is essential to transform this awareness into active engagement. More comprehensive integration of sustainability within academic programs and campus life could substantially enhance students’ involvement and commitment to environmental stewardship.

Keywords: environmental sustainability, higher education, students, perceptions, Sultan Qaboos University.

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Authors: Jeni Stolow, Lina Moses, Carl Kendall

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Zika virus (ZIKV) reemerged as a global threat in 2015 with Brazil at its epicenter. Brazilians have a long history of combatting Aedes aegypti mosquitos as it is a common vector for dengue, chikungunya, and yellow fever. As a response to the epidemic, public health authorities promoted ZIKV prevention behaviors such as mosquito bite prevention, reproductive counseling for women who are pregnant or contemplating pregnancy, pregnancy avoidance, and condom use. Most prevention efforts from Brazil focused on the mosquito vector- utilizing recycled dengue approaches without acknowledging the context in which women were able to adhere to these prevention messages. This study used qualitative methods to explore how women in Fortaleza, Brazil perceive ZIKV, the Brazilian authorities’ ZIKV prevention recommendations, and the feasibility of adhering to these recommendations. A core study aim was to look at how women perceive their physical, social, and natural environment as it impacts women’s ability to adhere to ZIKV prevention behaviors. A Rapid Anthropological Assessment (RAA) containing observations, informational interviews, and semi-structured in-depth interviews were utilized for data collection. The study utilized Grounded Theory as the systematic inductive method of analyzing the data collected. Interviews were conducted with 35 women of reproductive age (15-39 years old), who primarily utilize the public health system. It was found that women’s self-identified economic class was associated with how strongly women felt they could prevent ZIKV. All women interviewed technically belong to the C-class, the middle economic class. Although all members of the same economic class, there was a divide amongst participants as to who perceived themselves as higher C-class versus lower C-class. How women saw their economic status was dictated by how they perceived their physical, social, and natural environment. Women further associated their environment and their economic class to their likelihood of contracting ZIKV, their options for preventing ZIKV, their ability to prevent ZIKV, and their willingness to attempt to prevent ZIKV. Women’s perceived economic status was found to relate to their structural environment (housing quality, sewage, and locations to supplies), social environment (family and peer norms), and natural environment (wetland areas, natural mosquito breeding sites, and cyclical nature of vectors). Findings from this study suggest that women’s perceived environment and economic status impact their perceived feasibility and desire to attempt behaviors to prevent ZIKV. Although ZIKV has depleted from epidemic to endemic status, it is suggested that the virus will return as cyclical outbreaks like that seen with similar arboviruses such as dengue and chikungunya. As the next ZIKV epidemic approaches it is essential to understand how women perceive themselves, their abilities, and their environments to best aid the prevention of ZIKV.

Keywords: Aedes aegypti, environment, prevention, qualitative, zika

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Authors: Audrey Ngambia, Ondrej Masek, Valentina Erastova

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Biochar is an amorphous carbon-rich material generated from the pyrolysis of biomass with multifarious properties and functionality. Biochar has shown proven applications in the treatment of flue gas and organic and inorganic pollutants in soil and water/wastewater as a result of its multiple surface functional groups and porous structures. These properties have also shown potential in energy storage and carbon capture. The availability of diverse sources of biomass to produce biochar has increased interest in it as a sustainable and environmentally friendly material. The properties and porous structures of biochar vary depending on the type of biomass and high heat treatment temperature (HHT). Biochars produced at HHT between 400°C – 800°C generally have lower H/C and O/C ratios, higher porosities, larger pore sizes and higher surface areas with temperature. While all is known experimentally, there is little knowledge on the porous role structure and functional groups play on processes occurring at the atomistic scale, which are extremely important for the optimization of biochar for application, especially in the adsorption of gases. Atomistic simulations methods have shown the potential to generate such amorphous materials; however, most of the models available are composed of only carbon atoms or graphitic sheets, which are very dense or with simple slit pores, all of which ignore the important role of heteroatoms such as O, N, S and pore morphologies. Hence, developing realistic models that integrate these parameters are important to understand their role in governing adsorption mechanisms that will aid in guiding the design and optimization of biochar materials for target applications. In this work, molecular dynamics simulations in the isobaric ensemble are used to generate realistic biochar models taking into account experimentally determined H/C, O/C, N/C, aromaticity, micropore size range, micropore volumes and true densities of biochars. A pore generation approach was developed using virtual atoms, which is a Lennard-Jones sphere of varying van der Waals radius and softness. Its interaction via a soft-core potential with the biochar matrix allows the creation of pores with rough surfaces while varying the van der Waals radius parameters gives control to the pore-size distribution. We focused on microporosity, creating average pore sizes of 0.5 - 2 nm in diameter and pore volumes in the range of 0.05 – 1 cm3/g, which corresponds to experimental gas adsorption micropore sizes of amorphous porous biochars. Realistic biochar models with surface functionalities, micropore size distribution and pore morphologies were developed, and they could aid in the study of adsorption processes in confined micropores.

Keywords: biochar, heteroatoms, micropore size, molecular dynamics simulations, surface functional groups, virtual atoms

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Authors: Zafar Iqbal, Eugene Chan, Fareed Ahmed, Mohamed Jama, Avez Rizvi

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Advancements in Ultrasound Technology have enabled machines to capture 3D and 4D images with intricate features of the growing fetus. Sonographers can now capture clear 3D images and 4D videos of the fetus, especially of the face. Fetal faces are often seen on the ultrasound scan of the third trimester where anatomical features become more defined. Parents often want 3D/4D images and videos of their ultrasounds, and particularly image that capture the child’s face. Sidra Medicine developed a patient education mobile app called 10 Moons to improve care and provide useful information during the length of their pregnancy. In addition to general information, we built the ability to send ultrasound images directly from the modality to the mobile application, allowing expectant mothers to easily store and share images of their baby. 10 Moons represent the length of the pregnancy on a lunar calendar, which has both cultural and religious significance in the Middle East. During the third trimester scan, sonographers can capture 3D pictures of the fetus. Ultrasound machines are connected with a local 10 Moons Server with a Digital Imaging and Communications in Medicine (DICOM) application running on it. Sonographers are able to send images directly to the DICOM server by a preprogrammed button on the ultrasound modality. Mothers can also request which pictures they would like to be available on the app. An internally built DICOM application receives the image and saves the patient information from DICOM header (for verification purpose). The application also anonymizes the image by removing all the DICOM header information and subsequently converts it into a lossless JPEG. Finally, and the application passes the image to the mobile application server. On the 10 Moons mobile app – patients enter their Medical Record Number (MRN) and Date of Birth (DOB) to receive a One Time Password (OTP) for security reasons to view the images. Patients can also share the images anonymized images with friends and family. Furthermore, patients can also request 3D printed mementos of their child through 10 Moons. 10 Moons is unique patient education and information application where expected mothers can also see 3D ultrasound images of their children. Sidra Medicine staff has the added benefit of a full content management administrative backend where updates to content can be made. The app is available on secure infrastructure with both local and public interfaces. The application is also available in both English and Arabic languages to facilitate most of the patients in the region. Innovation is at the heart of modern healthcare management. With Innovation being one of Sidra Medicine’s core values, our 10 Moons application provides expectant mothers with unique educational content as well as the ability to store and share images of their child and purchase 3D printed mementos.

Keywords: patient educational mobile application, ultrasound images, digital imaging and communications in medicine (DICOM), imaging informatics

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Authors: Anthony Nyamekeh-Armah Adjei, Toshiaki Aoki

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The unreliable and poor efficiency of electricity distribution leading to frequent power outages and high losses are the major challenge facing the power distribution sector in Ghana. Distribution system routes electricity from the power generating station at a higher voltage through the transmission grid and steps it down through the low voltage lines to end users. Approximately all electricity problems and disturbances that have increased the call for renewable and sustainable energy in recent years have their roots in the distribution system. Therefore, sustaining electricity distribution efficiency can potentially contribute to the reserve of natural energy resources use in power generation, reducing greenhouse gas emission (GHG), decreasing tariffs for consumers and effective human security. Human Security is a people-centered approach where individual human being is the principal object of concern, focuses on protecting the vital core of all human lives in ways for meeting basic needs that enhance the safety and protection of individuals and communities. The vulnerability is the diminished capacity of an individual or group to anticipate, resist and recover from the effect of natural, human-induced disaster. The research objectives are to explore the causes of frequent power outages to consumers, high losses in the distribution network and the effect of poor electricity distribution efficiency on the vulnerable (poor and ordinary) people that mostly depend on electricity for their daily activities or life to survive. The importance of the study is that in a developing country like Ghana where raising a capital for new infrastructure project is difficult, it would be beneficial to enhance the efficiency that will significantly minimize the high energy losses, reduce power outage, to ensure safe and reliable delivery of electric power to consumers to secure the security of people’s livelihood. The methodology used in this study is both interview and questionnaire survey to analyze the response from the respondents on causes of power outages and high losses facing the electricity company of Ghana (ECG) and its effect on the livelihood on the vulnerable people. Among the outcome of both administered questionnaire and the interview survey from the field were; poor maintenance of existing sub-stations, use of aging equipment, use of poor distribution infrastructure and poor metering and billing system. The main observation of this paper is that the poor network efficiency (high losses and power outages) affects the livelihood of the vulnerable people. Therefore, the paper recommends that policymakers should insist on all regulation guiding electricity distribution to improve system efficiency. In conclusion, there should be decentralization of off-grid solar PV technologies to provide a sustainable and cost-effective, which can increase daily productivity and improve the quality of life of the vulnerable people in the rural communities.

Keywords: electricity efficiency, high losses, human security, power outage

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