Search results for: practical approach to reducing insecurity

Authors: J. J. Rickard, A. Belli, P. Goldberg Oppenheimer

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Medical diagnostics, environmental monitoring, homeland security and forensics increasingly demand specific and field-deployable analytical technologies for quick point-of-care diagnostics. Although technological advancements have made optical methods well-suited for miniaturization, a highly-sensitive detection technique for minute sample volumes is required. Raman spectroscopy is a well-known analytical tool, but has very weak signals and hence is unsuitable for trace level analysis. Enhancement via localized optical fields (surface plasmons resonances) on nanoscale metallic materials generates huge signals in surface-enhanced Raman scattering (SERS), enabling single molecule detection. This enhancement can be tuned by manipulation of the surface roughness and architecture at the sub-micron level. Nevertheless, the development and application of SERS has been inhibited by the irreproducibility and complexity of fabrication routes. The ability to generate straightforward, cost-effective, multiplex-able and addressable SERS substrates with high enhancements is of profound interest for SERS-based sensing devices. While most SERS substrates are manufactured by conventional lithographic methods, the development of a cost-effective approach to create nanostructured surfaces is a much sought-after goal in the SERS community. Here, a method is established to create controlled, self-organized, hierarchical nanostructures using electrohydrodynamic (HEHD) instabilities. The created structures are readily fine-tuned, which is an important requirement for optimizing SERS to obtain the highest enhancements. HEHD pattern formation enables the fabrication of multiscale 3D structured arrays as SERS-active platforms. Importantly, each of the HEHD-patterned individual structural units yield a considerable SERS enhancement. This enables each single unit to function as an isolated sensor. Each of the formed structures can be effectively tuned and tailored to provide high SERS enhancement, while arising from different HEHD morphologies. The HEHD fabrication of sub-micrometer architectures is straightforward and robust, providing an elegant route for high-throughput biological and chemical sensing. The superior detection properties and the ability to fabricate SERS substrates on the miniaturized scale, will facilitate the development of advanced and novel opto-fluidic devices, such as portable detection systems, and will offer numerous applications in biomedical diagnostics, forensics, ecological warfare and homeland security.

Keywords: hierarchical electrohydrodynamic patterning, medical diagnostics, point-of care devices, SERS

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Authors: Jennifer De Paola

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Objectives: The literature is saturated with figures and hard data on happiness and its rates, causes and effects at a large scale, whereas very little is known about the way specific groups of people within societies understand and talk about happiness in their everyday life. The present study contributes to fill this gap in the happiness research by analyzing social representations of happiness among young women through the theoretical frame provided by Moscovici’s Social Representation Theory. Methods: Participants were (N= 351) female students (16-18 year olds) from Finnish, Swedish and English speaking high schools in the Helsinki region, Finland. Main source of data collection were word associations using the stimulus word ‘happiness’ and word associations using as stimulus the term that in the participants’ opinion represents the opposite of happiness. The allowed number of associations was five per stimulus word (10 associations per participant). In total, the 351 participants produced 6973 associations with the two stimulus words given: 3500 (50,19%) associations with ‘happiness’ and 3473 (49,81%) associations with ‘opposite of happiness’. The associations produced were analyzed qualitatively to identify associations with similar meaning and then coded combining similar associations in larger categories. Results: In total, 33 categories were identified respectively for the stimulus word ‘happiness’ and for the stimulus word ‘opposite of happiness’. In general terms, the 33 categories identified for ‘happiness’ included associations regarding relationships with key people considered important, such as ‘family’, abstract concepts such as meaningful life, success and moral values as well as more mundane and hedonic elements like food, pleasure and fun. Similarly, the 33 categories emerged for ‘opposite of happiness’ included relationship problems and arguments, negative feelings such as sadness, depression, stress as well as more concrete issues such as financial problems. Participants were also asked to rate their own level of happiness on a scale from 1 to 10. Results indicated the mean of the self-rated level of happiness was 7,93 (the range varied from 1 to 10; SD = 1, 50). Participants’ responses were further divided into three different groups according to the self-rated level of happiness: group 1 (level 10-9), group 2 (level 8-6), and group 3 (level 5 and lower) in order to investigate the way the categories mentioned above were distributed among the different groups. Preliminary results show that the category ‘family’ is associated with higher level of happiness, whereas its presence gradually decreases among the participants with a lower level of happiness. Moreover, the category ‘depression’ seems to be mainly present among participants in group 3, whereas the category ‘sadness’ is mainly present among participants with higher level of happiness. Conclusion: In conclusion, this study indicates the prevalent ways of thinking about happiness and its opposite among young female students, suggesting that representations varied to some extent depending on the happiness level of the participants. This study contributes to bringing new knowledge as it considers happiness as a holistic state, thus going beyond the literature that so far has too often viewed happiness as a mere unidimensional spectrum.

Keywords: female, happiness, social representations, unhappiness

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Authors: Fei Chen, Wei Lu, Jun Cai

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During the Twelve Five period, China promulgated industrial policies promoting the relocation of energy-intensive industries to coastal areas in order to utilize marine shipping resources. Consequently, some major state-owned steel and gas enterprises have relocated and resulted in a large-scale coastal area development. However, some land may have been over-exploited with seamless coastline projects. To balance between employment and housing, new industrial coastal towns were constructed to support the industrial-led development. In this paper, we adopt a case-study approach to closely examine the development of several new industrial coastal towns of Liaoning Province situated in the Bohai Bay area, which is currently under rapid economic growth. Our investigations reflect the common phenomenon of long distance commuting and a massive amount of vacant residences. More specifically, large plant relocation caused hundreds of kilometers of daily commute and enterprises had to provide housing subsidies and education incentives to motivate employees to relocate to coastal areas. Nonetheless, many employees still refuse to relocate due to job stability, diverse needs of family members and access to convenient services. These employees averaged 4 hours of commute daily and some who lived further had to reside in temporary industrial housing units and subject to long-term family separation. As a result, only a small portion of employees purchase new coastal residences but mostly for investment and retirement purposes, leading to massive vacancy and ghost-town phenomenon. In contrast to the low demand, coastal areas tend to develop large amount of residences prior to industrial relocation, which may be directly related to local government finances. Some local governments have sold residential land to developers to general revenue to support the subsequent industrial development. Subject to the strong preference of ocean-view, residential housing developers tend to select coast-line land to construct new residential towns, which further reduces the access of marine resources for major industrial enterprises. This violates the original intent of developing industrial coastal towns and drastically limits the availability of marine resources. Lastly, we analyze the co-existence of over-exploiting residential areas and massive vacancies in reference to the demand and supply of land, as well as the demand of residential housing units with the choice criteria of enterprise employees.

Keywords: coastal industry town, commuter traffic, employment-housing space, outer suburb industrial area

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Authors: Rituparna Pal, Faiz Ahmed

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Neighbourhood energy efficiency is a newly emerged term to address the quality of urban strata of built environment in terms of various covariates of sustainability. The concept of sustainability paradigm in developed nations has encouraged the policymakers for developing urban scale cities to envision plans under the aegis of urban scale sustainability. The concept of neighbourhood energy efficiency is realized a lot lately just when the cities, towns and other areas comprising this massive global urban strata have started facing a strong blow from climate change, energy crisis, cost hike and an alarming shortfall in the justice which the urban areas required. So this step of urban sustainability can be easily referred more as a ‘Retrofit Action’ which is to cover up the already affected urban structure. So even if we start energy efficiency for existing cities and urban areas the initial layer remains, for which a complete model of urban sustainability still lacks definition. Urban sustainability is a broadly spoken off word with end number of parameters and policies through which the loop can be met. Out of which neighbourhood energy efficiency can be an integral part where the concept and index of neighbourhood scale indicators, block level indicators and building physics parameters can be understood, analyzed and concluded to help emerge guidelines for urban scale sustainability. The future of neighbourhood energy efficiency not only lies in energy efficiency but also important parameters like quality of life, access to green, access to daylight, outdoor comfort, natural ventilation etc. So apart from designing less energy-hungry buildings, it is required to create a built environment which will create less stress on buildings to consume more energy. A lot of literary analysis has been done in the Western countries prominently in Spain, Paris and also Hong Kong, leaving a distinct gap in the Indian scenario in exploring the sustainability at the urban strata. The site for the study has been selected in the upcoming capital city of Amaravati which can be replicated with similar neighbourhood typologies in the area. The paper suggests a methodical intent to quantify energy and sustainability indices in detail taking by involving several macro, meso and micro level covariates and parameters. Several iterations have been made both at macro and micro level and have been subjected to simulation, computation and mathematical models and finally to comparative analysis. Parameters at all levels are analyzed to suggest the best case scenarios which in turn is extrapolated to the macro level finally coming out with a proposal model for energy efficient neighbourhood and worked out guidelines with significance and correlations derived.

Keywords: energy quantification, macro scale parameters, meso scale parameters, micro scale parameters

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Authors: Liliana Gomez Cardona, Echo Parent-Racine, Joy Outerbridge, Arlene Laliberté, Outi Linnaranta

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

Keywords: cultural adaptation, cultural safety, empowerment, Inuit, mental health, Nunavik, resiliency

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Authors: Felicite Ann Fairer-Wessels

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There has always been a disparity between mining and tourism mainly due to the socio-economic and environmental impacts of mines on both the adjacent resident communities and the areas taken up by the mining operation. Although heritage mining tourism has been actively and successfully pursued and developed in the UK, largely Wales, and Scandinavian countries, the debate whether active mining and tourism can have a mutually beneficial relationship remains imminent. This pilot study explores the relationship between the ‘to be developed’ future Nokeng Mine and its adjacent community, the rural community of Moloto, will be investigated in terms of whether sustainable tourism and livelihood activities can potentially be developed with the support of the mine. Concepts such as social entrepreneur, corporate social responsibility, sustainable development and triple bottom line are discussed. Within the South African context as a mineral rich developing country, the government has a statutory obligation to empower disenfranchised communities through social and labour plans and policies. All South African mines must preside over a Social and Labour Plan according to the Mineral and Petroleum Resources Development Act, No 28 of 2002. The ‘social’ component refers to the ‘social upliftment’ of communities within or adjacent to any mine; whereas the ‘labour’ component refers to the mine workers sourced from the specific community. A qualitative methodology is followed using the case study as research instrument for the Nokeng Mine and Moloto community with interviews and focus group discussions. The target population comprised of the Moloto Tribal Council members (8 in-depth interviews), the Moloto community members (17: focus groups); and the Nokeng Mine representatives (4 in-depth interviews). In this pilot study two disparate ‘worlds’ are potentially linked: on the one hand, the mine as social entrepreneur that is searching for feasible and sustainable ideas; and on the other hand, the community adjacent to the mine, with potentially sustainable tourism entrepreneurs that can tap into the resources of the mine should their ideas be feasible to build their businesses. Being an exploratory study the findings are limited but indicate that the possible success of tourism and sustainable livelihood activities lies in the fact that both the Mine and Community are keen to work together – the mine in terms of obtaining labour and profit; and the community in terms of improved and sustainable social and economic conditions; with both parties realizing the importance to mitigate negative environmental impacts. In conclusion, a relationship of trust is imperative between a mine and a community before a long term liaison is possible. However whether tourism is a viable solution for the community to engage in is debatable. The community could initially rather pursue the sustainable livelihoods approach and focus on life-supporting activities such as building, gardening, etc. that once established could feed into possible sustainable tourism activities.

Keywords: community development, mining tourism, sustainability, South Africa

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Authors: Olivia Garcia, Sandra Tullio-Pow

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The purpose of this study was to understand what design attributes make the most ideal (wearable and memorable) national soccer jersey. The research probed Canadian soccer enthusiasts to better understand their jersey-purchasing rationale. The research questions framing this study were: how do consumers feel about their jerseys? How do these feelings influence their choices? There has been limited research on soccer jerseys from a material culture perspective, and it is not inclusive of national soccer jerseys. The results of this study may be used for product developers and advertisers who are looking to better understand the consumer base for national soccer jersey design. A mixed methods approach informed the research. To begin, a content analysis of all the home jerseys from the 2018 World Cup was done. Information such as size range, main colour, fibre content, brand, collar details, availability, sleeve length, place of manufacturing, pattern, price, fabric as per company, neckline, availability on company website, jersey inspiration, and badge/crest details were noted. Following the content analysis, wardrobe interviews were conducted with six consumers/fans. Participants brought two or more jerseys to the interviews, where the jerseys acted as clothing probes to recount information. Interview questions were semi-structured and focused on the participants’ relationship with the sport, their personal background, who they cheered for, why they bought the jerseys, and fit preferences. The goal of the inquiry was to pull out information on how participants feel about their jerseys and why. Finally, an interview with an industry professional was done. This interview was semi-structured, focusing on basic questions regarding sportswear design, sales, the popularity of soccer, and the manufacturing and marketing process. The findings proved that national soccer jerseys are an integral part of material culture. Women liked more fitted jerseys, and men liked more comfortable jerseys. Jerseys should be made with a cooling, comfortable fabric and should always prevent peeling. The symbols on jerseys are there to convey a team’s history and are most typically placed on the left chest. Jerseys should always represent the flag and/or the country’s colours and should use designs that are both fashionable and innovative. Jersey design should always consider the opinions of the consumers to help influence the design process. Jerseys should always use concepts surrounding culture, as consumers feel connected to the jerseys that represent the culture and/or family they have grown up with. Jerseys should use a team’s history, as well as the nostalgia associated with the team, as consumers prefer jerseys that reflect important moments in soccer. Jerseys must also sit at a reasonable price point for consumers, with an experience to go along with the jersey purchase. In conclusion, national soccer jerseys are considered sites of attachment and memories and play an integral part in the study of material culture.

Keywords: Design, Fashion, Material Culture, Sport

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Authors: Mohammad Idrees Yusofzai, Hirobata Yasuhiro, Matsuo Kojiro

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Kabul is the capital of Afghanistan. It is the focal point of educational, industrial, etc. of Afghanistan. Additionally, the population of Kabul has grown recently and will increase because of return of refugees and shifting of people from other province to Kabul city. However, this increase in population, the issues of urban congestion and other related problems of urban transportation in Kabul city arises. One of the problems is public transport (large buses) service and needs to be modified and enhanced especially large bus routes that are operating in each zone of the 22 zone of Kabul City. To achieve the above mentioned goal of improving public transport, Spatial Accessibility Analysis is one of the important attributes to assess the effectiveness of transportation system and urban transport policy of a city, because accessibility indicator as an alternative tool to support public policy that aims the reinforcement of sustainable urban space. The case study of this research compares the present model (present bus route) and the modified model of public transport. Furthermore, present model, the bus routes in most of the zones are active, however, with having low frequency and unpublished schedule, and accessibility result is analyzed in four cases, based on the variables of accessibility. Whereas in modified model all zones in Kabul is taken into consideration with having specified origin and high frequency. Indeed the number of frequencies is kept high; however, this number is based on the number of buses Millie Bus Enterprise Authority (MBEA) owns. The same approach of cases is applied in modified model to figure out the best accessibility for the modified model. Indeed, the modified model is having a positive impact in congestion level in Kabul city. Besides, analyses of person trip and trip distribution have been also analyzed because how people move in the study area by each mode of transportation. So, the general aims of this research are to assess the present movement of people, identify zones in need of public transport and assess equity level of accessibility in Kabul city. The framework of methodology used in this research is based on gravity analysis model of accessibility; besides, generalized cost (time) of travel and travel mode is calculated. The main data come from person trip survey, socio-economic characteristics, demographic data by Japan International Cooperation Agency, 2008, study of Kabul city and also from the previous researches on travel pattern and the remaining data regarding present bus line and routes have been from MBEA. In conclusion, this research explores zones where public transport accessibility level is high and where it is low. It was found that both models the downtown area or central zones of Kabul city is having high level accessibility. Besides, the present model is the most unfavorable compared with the modified model based on the accessibility analysis.

Keywords: accessibility, bus generalized cost, gravity model, public transportation network

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Authors: Alida Sandison, Louise A. Stroud

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Narcissism is a personality configuration which has both normal and pathological personality expressions. Narcissism is highly complex, and is linked to a broad field of research. There are both dimensional and categorical conceptualisations of narcissism, and a variety of theoretical formulations that have been put forward to understand the narcissistic personality configuration. Currently, Kernberg’s Object Relations theory is well supported for this purpose. The complexity and particular defense mechanisms at play in the narcissistic personality make it a difficult personality configuration worth further research. Psychobiography as a methodology allows for the exploration of the lived life, and is thus a useful methodology to surmount these inherent challenges. Narcissism has been a focus of academic interest for a long time, and although there is a lot of research done in this area, to the researchers' knowledge, narcissistic dynamics have never been explored within a psychobiographical format. Thus, the primary aim of the research was to explore and describe narcissism in the life of Howard Hughes, with the objective of gaining further insight into narcissism through the use of this unconventional research approach. Hughes was chosen as subject for the study as he is renowned as an eccentric billionaire who had his revolutionary effect on the world, but was concurrently disturbed within his personal pathologies. Hughes was dynamic in three different sectors, namely motion pictures, aviation and gambling. He became more and more reclusive as he entered into middle age. From his early fifties he was agoraphobic, and the social network of connectivity that could reasonably be expected from someone in the top of their field was notably distorted. Due to his strong narcissistic personality configuration, and the interpersonal difficulties he experienced, Hughes represents an ideal figure to explore narcissism. The study used a single case study design, and purposive sampling to select Hughes. Qualitative data was sampled, using secondary data sources. Given that Hughes was a famous figure, there is a plethora of information on his life, which is primarily autobiographical. This includes books written about his life, and archival material in the form of newspaper articles, interviews and movies. Gathered data were triangulated to avoid the effect of author bias, and increase the credibility of the data used. It was collected using Yin’s guidelines for data collection. Data was analysed using Miles and Huberman strategy of data analysis, which consists of three steps, namely, data reduction, data display, and conclusion drawing and verification. Patterns which emerged in the data highlighted the defense mechanisms used by Hughes, in particular that of splitting and projection, in defending his sense of self. These defense mechanisms help us to understand the high levels of entitlement and paranoia experienced by Hughes. Findings provide further insight into his sense of isolation and difference, and the consequent difficulty he experienced in maintaining connections with others. Findings furthermore confirm the effectiveness of Kernberg’s theory in understanding narcissism observing an individual life.

Keywords: Howard Hughes, narcissism, narcissistic defenses, object relations

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Authors: Waseem Makai

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The term ‘political Islam’ now seem to have gained the centre stage in every discourse pertaining to Islamic legitimacy and compatibility in modern civilisations. A never ceasing tradition of the philosophy of caliphate that has kept overriding the options of any alternate political institution in the Muslim world still permeates a huge faction of believers. Fully accustomed with the proliferation of changes and developments in individual, social and natural dispositions of the world, Islamic theologians retaliated to this flux through both conventional and modernist approaches. The so-called conventional approach was quintessential of the interpretations put forth by Syed Maududi, with new comprehensive, academic and powerful vigour, as never seen before. He generated the avant-garde scholarship which would bear testimony to his statements, made to uphold the political institution of Islam as supreme and noble. However, it was not his trait to challenge the established views but to codify them in such a bracket which a man of the 20th century would find captivating to his heart and satisfactory to his rationale. The delicate microcosms like selection of a caliph, implementation of Islamic commandments (Sharia), interest free banking sectors, imposing tax (Jazyah) on non-believers, waging the holy crusade (Jihad) for the expansion of Islamic boundaries, stoning for committing adulteration and capital punishment for apostates were all there in his scholarship which he spent whole of his life defending in the best possible manner. What and where did he went wrong with all this, was supposedly to be notified later, by his once been disciple, Javed Ahmad Ghamidi. Ghamidi is being accused of struggling between Scylla and Charybdis as he tries to remain steadfast to his basic Islamic tenets while modernising their interpretations to bring them in harmony with the Western ideals of democracy and liberty. His blatant acknowledgement of putting democracy at a high pedestal, calling the implementation of Sharia a non-mandatory task and denial to bracket people in the categories of Zimmi and Kaafir fully vindicates his stance against conventional narratives like that of Syed Maududi. Ghamidi goes to the extent of attributing current forms of radicalism and extremism, as exemplified in the operations of organisations like ISIS in Iraq and Syria and Tehreek-e-Taliban in Pakistan, to such a version of political Islam as upheld not only by Syed Maududi but by other prominent theologians like Ibn-Timyah, Syed Qutub and Dr. Israr Ahmad also. Ghamidi is wretched, in a way that his allegedly insubstantial claims gained him enough hostilities to leave his homeland when two of his close allies were brutally murdered. Syed Maududi and Javed Ghamidi, both stand poles apart in their understanding of Islam and its political domain. Who has the appropriate methodology, scholarship and execution in his mode of comprehension, is an intriguing task, worth carrying out in detail.

Keywords: caliphate, democracy, ghamidi, maududi

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Authors: Tshephang Bright Molale

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Much is written on the importance of participatory communication and its role in uplifting indigent communities. As the closest government sphere to communities, local government is charged with directly improving the lives of the poor and is required by legislation to conduct Integrated Development Planning (IDP). This requires a municipality to utilise participatory communication aspects including dialogue, empowerment, and planning. These are most important pillars of community development. However, many studies have warned that elements such as modernisation, dependency and bureaucracy need to be observed with caution since they have the potential to impede and limit the extent of participatory communication in community development. These concepts serve as the basic points of departure and theoretical background underpinning this study, which is tasked with exploring the extent of participatory communication in the IDP context of Jouberton Township in the Matlosana Local Municipality, South Africa. In her public address on challenges facing South Africa’s local municipalities in January 2014, former premier, Thandi Modise, emphasised the need for communities to attend municipal IDP meetings, approve earmarked IDP projects, and learn about municipal budget spending. It is evident from theory and higher echelon of government that participatory communication is seen as cardinal to the existence of municipal government. From this background, this study was carried out under the assumption that the practice of participatory communication in contemporary local government only exists on paper; while in reality the public does not enjoy active participation in municipal IDP consultative frameworks. This is despite much discourse being available in government and in academia around the importance of participatory communication in community development. The study espoused a qualitative research approach to gather data and purposive sampling was used to select respondents linked to two IDP projects in Jouberton Township from the 2012/13 financial year. Its purpose was to explore perceptions among municipal representatives and community members in Jouberton Township on the extent of participatory communication in the IDP context. The empirical part of the study comprised of focus group, unstructured interviews, and participant observation. The study revealed that Jouberton communities are passive participators in municipal IDP consultative frameworks where they participate by just being informed about what is going to happen or has already happened and feedback is minimal. This is opposed to a desired form of empowered participation which is recommended by scholars in development communication where stakeholders granted space to participate in joint analysis and joint decision-making about what should be achieved and how. It has been discovered that there is a lack of active participation in community development in the IDP context of Matlosana Municipality and the study makes recommendations on how transformative participatory communication can be applied to improve current norms and standards in local government.

Keywords: development communication, government communication, integrated development plan, participatory communication

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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A preliminary systematic review shows that health professionals experience a tension when communicating with the parents and family members of children with life-threatening and life-limiting conditions. On the one hand, they want to promote open and honest communication, while on the other, they are apprehensive about fostering an unrealistic sense of hope. Defining the boundaries between information that might offer reasonable hope versus that which results in false reassurance is challenging. Some healthcare providers worry that instilling a false sense of hope could motivate parents to seek continued aggressive treatment for their child, which in turn might cause the patient further unnecessary suffering. To date, there has been a lack of research in the Middle East regarding how healthcare providers do or should communicate bad news; in particular, the issue of hope in the field of paediatric palliative care has not been researched thoroughly. This study aims to explore, from the perspective of patients’ mothers, physicians, and nurses, the experience of communicating and receiving bad news in the care of children with palliative care needs. Data were collected using a collective qualitative case study approach across three paediatric units in a Jordanian hospital. Two data collection methods were employed: participant observation and semi-structured interviews. The overall number of cases was 15, with a total of 56 interviews with mothers (n=24), physicians (n=12), and nurses (n=20) completed, as well as 197 observational hours logged. The findings demonstrate that mothers wanted their doctors to provide them with hopeful information about the future progression of their child’s illness. Although some mothers asked their doctors to provide them with honest information regarding the condition of their child, they still considered a sense of hope to be essential for coping with caring for their child. According to mothers, hope was critical to treatment as it helped them to stay committed to the treatment and protected them to some extent from the extreme emotional suffering that would occur if they lost hope. The health professionals agreed with the mothers on the importance of hope, so long as it was congruent with the stage and severity of each patient’s disease. The findings of this study conclude that while parents typically insist on knowing all relevant information when their child is diagnosed with a severe illness, they considered hope to be an essential part of life, and they found it very difficult to handle suffering without any glimmer of it. This study finds that using negative terms has extremely adverse effects on the parents’ emotions. Hence, although the mothers asked the doctors to be as honest as they could, they still wanted the physicians to provide them with a positive message by communicating this information in a sensitive manner including hope.

Keywords: health professionals, children, communication, hope, information, mothers, palliative care

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Authors: Frederique A. Demeijer

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This article addresses the religious beliefs of members of the Apostolic Society –a Dutch religious community wherein the oldest living members were raised with very different beliefs than those upheld today. Currently, the Apostolic Society is the largest liberal religious community of the Netherlands, consisting of roughly 15,000 members. It is characterized by its close-knit community life and the importance of its apostle: the spiritual leader who writes a weekly letter around which the Sunday morning service is centered. The society sees itself as ‘religious-humanistic’, inspired by its Judeo-Christian roots without being dogmatic. Only a century earlier, the beliefs of the religious community revolved more strongly around the Bible, the apostle is a link to Christ. Also, the community believed in the return of the Lord, resonating with the millenarian roots of community in 1830. Thus, the oldest living members have experienced fundamental changes in beliefs and rituals, yet remained members. This article reveals how members experience(d) their religious beliefs and feelings of belonging to the community, how these may or may not have changed over time, and what role the Apostolic Society played in their lives. The article presents a qualitative research approach based on two main pillars. First, life narrative interviews were conducted, to work inductively and allow different interview topics to emerge. Second, it uses generational theory, in three ways: 1) to select respondents; 2) to guide the interview methodology –by being sensitive to differences in socio-historical context and events experienced during formative years of interviewees of different social generations, and 3) to analyze and contextualize the qualitative interview data. The data were gathered from 27 respondents, belonging to six social generations. All interviews were recorded, transcribed, coded, and analyzed, using the Atlas.ti software program. First, the elder generations talk about growing up with the Apostolic Society being absolutely central in their daily and spiritual lives. They spent most of their time with fellow members and dedicated their free time to Apostolic activities. The central beliefs of the Apostolic Society were clear and strongly upheld, and they experienced strong belonging. Although they now see the set of central beliefs to be more individually interpretable and are relieved to not have to spend all that time to Apostolic activities anymore, they still regularly attend services and speak longingly of the past with its strong belief and belonging. Second, the younger generations speak of growing up in a non-dogmatic, religious-humanist set of beliefs, but still with a very strong belonging to the religious community. They now go irregularly to services, and talk about belonging, but not as strong as the elderly generations do. Third, across the generations, members spend more time outside of the Apostolic Society than within. The way they speak about their religious beliefs is fluid and differs as much within generations as between: for example, there is no central view on what God is. It seems the experience of members of the Apostolic Society across different generations can now be characterized as belonging without believing.

Keywords: generational theory, individual religious experiences, life narrative history interviews, qualitative research design

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Authors: Iris Xiaohong Quan

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The global digital health market reached 175 billion U.S. dollars in 2019, and is expected to grow at about 25% CAGR to over 650 billion USD by 2025. Different terms such as digital health, e-health, mHealth, telehealth have been used in the field, which can sometimes cause confusion. The term digital health was originally introduced to refer specifically to the use of interactive media, tools, platforms, applications, and solutions that are connected to the Internet to address health concerns of providers as well as consumers. While mHealth emphasizes the use of mobile phones in healthcare, telehealth means using technology to remotely deliver clinical health services to patients. According to FDA, “the broad scope of digital health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, telehealth and telemedicine, and personalized medicine.” Some researchers believe that digital health is nothing else but the cultural transformation healthcare has been going through in the 21st century because of digital health technologies that provide data to both patients and medical professionals. As digital health is burgeoning, but research in the area is still inadequate, our paper aims to clear the definition confusion and provide an overall picture of digital health companies. We further investigate how business models are designed and differentiated in the emerging digital health sector. Both quantitative and qualitative methods are adopted in the research. For the quantitative analysis, our research data came from two databases Crunchbase and CBInsights, which are well-recognized information sources for researchers, entrepreneurs, managers, and investors. We searched a few keywords in the Crunchbase database based on companies’ self-description: digital health, e-health, and telehealth. A search of “digital health” returned 941 unique results, “e-health” returned 167 companies, while “telehealth” 427. We also searched the CBInsights database for similar information. After merging and removing duplicate ones and cleaning up the database, we came up with a list of 1464 companies as digital health companies. A qualitative method will be used to complement the quantitative analysis. We will do an in-depth case analysis of three successful unicorn digital health companies to understand how business models evolve and discuss the challenges faced in this sector. Our research returned some interesting findings. For instance, we found that 86% of the digital health startups were founded in the recent decade since 2010. 75% of the digital health companies have less than 50 employees, and almost 50% with less than 10 employees. This shows that digital health companies are relatively young and small in scale. On the business model analysis, while traditional healthcare businesses emphasize the so-called “3P”—patient, physicians, and payer, digital health companies extend to “5p” by adding patents, which is the result of technology requirements (such as the development of artificial intelligence models), and platform, which is an effective value creation approach to bring the stakeholders together. Our case analysis will detail the 5p framework and contribute to the extant knowledge on business models in the healthcare industry.

Keywords: digital health, business models, entrepreneurship opportunities, healthcare

Procedia PDF Downloads 183

Authors: Robby Y. Tallar, Nikodemus L., Yuri S., Jian P. Suen

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Research in the subject of ecological water resources management is full of trivial questions addressed and it seems, today to be one branch of science that can strongly contribute to the study of complexity (physical, biological, ecological, socio-economic, environmental, and other aspects). Existing literature available on different facets of these studies, much of it is technical and targeted for specific users. This study offered the combination all aspects in evaluation methodology for aquaculture lakes with its paradigm refer to hierarchical theory and to the effects of spatial specific arrangement of an object into a space or local area. Therefore, the process in developing a conceptual framework represents the more integrated and related applicable concept from the grounded theory. A design of integrated evaluation methodology for aquaculture lakes is presented. The method is based on the identification of a series of attributes which can be used to describe status of aquaculture lakes using certain indicators from aquaculture water quality index (AWQI), aesthetic aquaculture lake index (AALI) and rapid appraisal for fisheries index (RAPFISH). The preliminary preparation could be accomplished as follows: first, the characterization of study area was undertaken at different spatial scales. Second, an inventory data as a core resource such as city master plan, water quality reports from environmental agency, and related government regulations. Third, ground-checking survey should be completed to validate the on-site condition of study area. In order to design an integrated evaluation methodology for aquaculture lakes, finally we integrated and developed rating scores system which called Integrated Aquaculture Lake Index (IALI).The development of IALI are reflecting a compromise all aspects and it responds the needs of concise information about the current status of aquaculture lakes by the comprehensive approach. IALI was elaborated as a decision aid tool for stakeholders to evaluate the impact and contribution of anthropogenic activities on the aquaculture lake’s environment. The conclusion was while there is no denying the fact that the aquaculture lakes are under great threat from the pressure of the increasing human activities, one must realize that no evaluation methodology for aquaculture lakes can succeed by keeping the pristine condition. The IALI developed in this work can be used as an effective, low-cost evaluation methodology of aquaculture lakes for developing countries. Because IALI emphasizes the simplicity and understandability as it must communicate to decision makers and the experts. Moreover, stakeholders need to be helped to perceive their lakes so that sites can be accepted and valued by local people. For this site of lake development, accessibility and planning designation of the site is of decisive importance: the local people want to know whether the lake condition is safe or whether it can be used.

Keywords: aesthetic value, AHP, aquaculture lakes, integrated lakes, RAPFISH

Procedia PDF Downloads 237

Authors: Sergey Nikitenko, Vladimir Klishin, Yury Malakhov, Elena Goosen

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Transition to renewable energy sources (solar, wind, bioenergy, etc.) and launching of alternative energy generation has weakened the role of coal as a source of energy. The Paris Agreement and assumption of obligations by many nations to orderly reduce CO₂ emissions by means of technological modernization and climate change adaptation has abridged coal demand yet more. This paper aims to assess current resilience of the coal industry to stress and to define prospects for coal production optimization using high technologies pursuant to global challenges and requirements of energy transition. Our research is based on the resilience concept adapted to the coal industry. It is proposed to divide the coal sector into segments depending on the prevailing value chains (VC). Four representative models of VC are identified in the coal sector. The most promising lines of upgrading VC in the coal industry include: •Elongation of VC owing to introduction of clean technologies of coal conversion and utilization; •Creation of parallel VC by means of waste management; •Branching of VC (conversion of a company’s VC into a production network). The upgrade effectiveness is governed in many ways by applicability of advanced coal processing technologies, usability of waste, expandability of production, entrance to non-rival markets and localization of new segments of VC in receiving regions. It is also important that upgrade of VC by means of formation of agile high-tech inter-industry production networks within the framework of operating surface and underground mines can reduce social, economic and ecological risks associated with closure of coal mines. Such promising route of VC upgrade is application of methanotrophic bacteria to produce protein to be used as feed-stuff in fish, poultry and cattle breeding, or in production of ferments, lipoids, sterols, antioxidants, pigments and polysaccharides. Closed mines can use recovered methane as a clean energy source. There exist methods of methane utilization from uncontrollable sources, including preliminary treatment and recovery of methane from air-and-methane mixture, or decomposition of methane to hydrogen and acetylene. Separated hydrogen is used in hydrogen fuel cells to generate power to feed the process of methane utilization and to supply external consumers. Despite the recent paradigm of carbon-free energy generation, it is possible to preserve the coal mining industry using the differentiated approach to upgrade of value chains based on flexible technologies with regard to specificity of mining companies.

Keywords: resilience, resilience concept, resilience indicator, resilience in the Russian coal industry, value chains

Procedia PDF Downloads 107

Authors: Jian Wu

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Since a few years, some French companies have integrated CRS (corporate social responsibility) criteria in their variable remuneration plans to ‘restore a good working atmosphere’ and ‘preserve the natural environment’. These CSR criteria are based on concerns on environment protection, social aspects, and corporate governance. In June 2012, a report on this practice has been made jointly by ORSE (which means Observatory on CSR in French) and PricewaterhouseCoopers. Facing this initiative from the business world, we need to examine whether it has a real economic utility. We adopt a theoretical approach for our study. First, we examine the debate between the ‘orthodox’ point of view in economics and the CSR school of thought. The classical economic model asserts that in a capitalist economy, exists a certain ‘invisible hand’ which helps to resolve all problems. When companies seek to maximize their profits, they are also fulfilling, de facto, their duties towards society. As a result, the only social responsibility that firms should have is profit-searching while respecting the minimum legal requirement. However, the CSR school considers that, as long as the economy system is not perfect, there is no ‘invisible hand’ which can arrange all in a good order. This means that we cannot count on any ‘divine force’ which makes corporations responsible regarding to society. Something more needs to be done in addition to firms’ economic and legal obligations. Then, we reply on some financial theories and empirical evident to examine the sound foundation of CSR. Three theories developed in corporate governance can be used. Stakeholder theory tells us that corporations owe a duty to all of their stakeholders including stockholders, employees, clients, suppliers, government, environment, and society. Social contract theory tells us that there are some tacit ‘social contracts’ between a company and society itself. A firm has to respect these contracts if it does not want to be punished in the form of fine, resource constraints, or bad reputation. Legitime theory tells us that corporations have to ‘legitimize’ their actions toward society if they want to continue to operate in good conditions. As regards empirical results, we present a literature review on the relationship between the CSR performance and the financial performance of a firm. We note that, due to difficulties in defining these performances, this relationship remains still ambiguous despite numerous research works realized in the field. Finally, we are curious to know whether the integration of CSR criteria in variable remuneration plans – which is practiced so far in big companies – should be extended to other ones. After investigation, we note that two groups of firms have the greatest need. The first one involves industrial sectors whose activities have a direct impact on the environment, such as petroleum and transport companies. The second one involves companies which are under pressures in terms of return to deal with international competition.

Keywords: corporate social responsibility, corporate governance, variable remuneration, stakeholder theory

Procedia PDF Downloads 186

Authors: Frank Dorrian, Aniket Adhikari

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The placenta accreta spectrum (PAS), which includes placenta accreta, increta, and percreta, is characterized by the abnormal implantation of placental chorionic villi beyond the decidua basalis. Key risk factors include placenta previa, prior cesarean sections, advanced maternal age, uterine surgeries, multiparity, pelvic radiation, and in vitro fertilization (IVF). The incidence of PAS has increased tenfold over the past 50 years, largely due to rising cesarean rates. PAS is associated with significant peripartum and postpartum hemorrhage. Magnetic resonance imaging (MRI) and ultrasound assist in the evaluation of PAS, enabling a multidisciplinary approach to mitigate morbidity and mortality. This study retrospectively analyzed PAS cases at Royal Prince Alfred Hospital, Sydney, Australia. Using the SAR-ESUR joint consensus statement, seven imaging signs were reassessed for their sensitivity and specificity in predicting PAS, with histopathological correlation. The standardized MRI protocols for PAS at the institution were also reviewed. Data were collected from the picture archiving and communication system (PACS) records from 2010 to July 2024, focusing on cases where MR imaging and confirmed histopathology or operative notes were available. This single-center, observational study provides insights into the reliability of MRI for PAS detection and the optimization of imaging protocols for accurate diagnosis. The findings demonstrate that intraplacental dark bands serve as highly sensitive markers for diagnosing PAS, achieving sensitivities of 88.9%, 85.7%, and 100% for placenta accreta, increta, and percreta, respectively, with a combined specificity of 42.9%. Sensitivity for abnormal vascularization was lower (33.3%, 28.6%, and 50%), with a specificity of 57.1%. The placenta bulge exhibited sensitivities of 55.5%, 57.1%, and 100%, with a specificity of 57.1%. Loss of the T2 hypointense interface had sensitivities of 66.6%, 85.7%, and 100%, with 42.9% specificity. Myometrial thinning showed high sensitivity across PAS conditions (88.9%, 71.4%, and 100%) and a specificity of 57.1%. Bladder wall thinning was sensitive only for placenta percreta (50%) but had a specificity of 100%. Focal exophytic mass displayed variable sensitivity (22.9%, 42.9%, and 100%) with a specificity of 85.7%. These results highlight the diagnostic variability among markers, with intraplacental dark bands and myometrial thinning being useful in detecting abnormal placentation, though they lack high specificity. The literature and the results of our study highlight that while no single feature can definitively diagnose PAS, the presence of multiple features -especially when combined with elevated clinical risk- significantly increases the likelihood of an underlying PAS. A thorough understanding of the range of MRI findings associated with PAS, along with awareness of the clinical significance of each sign, helps the radiologist more accurately diagnose the condition and assist in surgical planning, ultimately improving patient care.

Keywords: placenta, accreta, spectrum, MRI

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Authors: David A. Ullisch, Yantree D. Sankar-Thomas, Stefan Wilke, Thomas Selge, Matthias Pump, Thomas Leibold, Kai Schütte, Gilbert Gorr

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Plants have been considered as a source of natural substances for ages. Secondary metabolites from plants are utilized especially in medical applications but are more and more interesting as cosmetical ingredients and in the field of nutraceuticals. However, supply of compounds from natural harvest can be limited by numerous factors i.e. endangered species, low product content, climate impacts and cost intensive extraction. Especially in the pharmaceutical industry the ability to provide sufficient amounts of product and high quality are additional requirements which in some cases are difficult to fulfill by plant harvest. Whereas in many cases the complexity of secondary metabolites precludes chemical synthesis on a reasonable commercial basis, plant cells contain the biosynthetic pathway – a natural chemical factory – for a given compound. A promising approach for the sustainable production of natural products can be plant cell fermentation (PCF®). A thoroughly accomplished development process comprises the identification of a high producing cell line, optimization of growth and production conditions, the development of a robust and reliable production process and its scale-up. In order to address persistent, long lasting production, development of cryopreservation protocols and generation of working cell banks is another important requirement to be considered. So far the most prominent example using a PCF® process is the production of the anticancer compound paclitaxel. To demonstrate the power of plant suspension cultures here we present three case studies: 1) For more than 17 years Phyton produces paclitaxel at industrial scale i.e. up to 75,000 L in scale. With 60 g/kg dw this fully controlled process which is applied according to GMP results in outstanding high yields. 2) Thapsigargin is another anticancer compound which is currently isolated from seeds of Thapsia garganica. Thapsigargin is a powerful cytotoxin – a SERCA inhibitor – and the precursor for the derivative ADT, the key ingredient of the investigational prodrug Mipsagargin (G-202) which is in several clinical trials. Phyton successfully generated plant cell lines capable to express this compound. Here we present data about the screening for high producing cell lines. 3) The third case study covers ingenol-3-mebutate. This compound is found in the milky sap of the intact plants of the Euphorbiacae family at very low concentrations. Ingenol-3-mebutate is used in Picato® which is approved against actinic keratosis. Generation of cell lines expressing significant amounts of ingenol-3-mebutate is another example underlining the strength of plant cell culture. The authors gratefully acknowledge Inspyr Therapeutics for funding.

Keywords: Ingenol-3-mebutate, plant cell culture, sustainability, thapsigargin

Procedia PDF Downloads 250

Authors: Shaurya Chauhan, Sagar Gupta

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Prominent urbanizing centres across the globe like Delhi, Dhaka, or Manila have exhibited that development often faces a challenge in bridging the gap among the top-down collective requirements of the city and the bottom-up individual aspirations of the ever-diversifying population. When this exclusion is intertwined with rapid urbanization and diversifying urban demography: unplanned sprawl, poor planning, and low-density development emerge as automated responses. In parallel, new ideas and methods of densification and public participation are being widely adopted as sustainable alternatives for the future of urban development. This research advocates a collaborative design method for future development: one that allows rapid application with its prototypical nature and an inclusive approach with mediation between the 'user' and the 'urban', purely with the use of empirical tools. Building upon the concepts and principles of 'open-sourcing' in design, the research establishes a design framework that serves the current user requirements while allowing for future citizen-driven modifications. This is synthesized as a 3-tiered model: user needs – design ideology – adaptive details. The research culminates into a context-responsive 'open source project development framework' (hereinafter, referred to as OSPDF) that can be used for on-ground field applications. To bring forward specifics, the research looks at a 300-acre redevelopment in the core of a rapidly urbanizing city as a case encompassing extreme physical, demographic, and economic diversity. The suggestive measures also integrate the region’s cultural identity and social character with the diverse citizen aspirations, using architecture and urban design tools, and references from recognized literature. This framework, based on a vision – feedback – execution loop, is used for hypothetical development at the five prevalent scales in design: master planning, urban design, architecture, tectonics, and modularity, in a chronological manner. At each of these scales, the possible approaches and avenues for open- sourcing are identified and validated, through hit-and-trial, and subsequently recorded. The research attempts to re-calibrate the architectural design process and make it more responsive and people-centric. Analytical tools such as Space, Event, and Movement by Bernard Tschumi and Five-Point Mental Map by Kevin Lynch, among others, are deep rooted in the research process. Over the five-part OSPDF, a two-part subsidiary process is also suggested after each cycle of application, for a continued appraisal and refinement of the framework and urban fabric with time. The research is an exploration – of the possibilities for an architect – to adopt the new role of a 'mediator' in development of the contemporary urbanity.

Keywords: open source, public participation, urbanization, urban development

Procedia PDF Downloads 149

Authors: Lam Hong Lan

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The textile industry is said to be the second-largest polluter, responsible for 92 million tonnes of waste annually. There is an urgent need to practice the circular economy to increase the use and reuse around the world. By its nature, the pre-owned fashion business is considered part of the circular economy as it helps to eliminate waste and circulate products. Second-hand clothes and accessories used to be associated with a ‘cheap image’ that carried ‘old energy’ in Vietnam. This perception has been shifted, especially amongst the younger generation. Vietnamese consumer is spending more on products and services that increase self-esteem. The same consumer is moving away from a collectivist social identity towards a ‘me, not we’ outlook as they look for a way to express their individual identity. And pre-owned fashion is one of their solutions as it values money, can create a unique personal style for the wearer and links with sustainability. The design of this study is based on the second-hand shopping motivation theory. A semi-structured online survey with 100 consumers from one pre-owned clothing community and one pre-owned e-commerce site in Vietnam. The findings show that in contrast with Vietnamese older consumers (55+yo) who, in the previous study, generally associated pre-owned fashion with ‘low-cost’, ‘cheap image’ that carried ‘old energy’, young customers (20-30 yo) were actively promoted their pre-owned fashion items to the public via outlet’s social platforms and their social media. This cultural shift comes from the impact of global and local discourse around sustainable fashion and the growth of digital platforms in the pre-owned fashion business in the last five years, which has generally supported wider interest in pre-owned fashion in Vietnam. It can be summarised in three areas: (1) global and local celebrity influencers. A number of celebrities have been photographed wearing vintage items in music videos, photoshoots or at red carpet events. (2) E-commerce and intermediaries. International e-commerce sites – e.g., Vinted, TheRealReal – and/or local apps – e.g., Re.Loved – can influence attitudes and behaviors towards pre-owned consumption. (3) Eco-awareness. The increased online coverage of climate change and environmental pollution has encouraged customers to adopt a more eco-friendly approach to their wardrobes. While sustainable biomaterials and designs are still navigating their way into sustainability, sustainable consumerism via pre-owned fashion seems to be an immediate solution to lengthen the clothes lifecycle. This study has found that young consumers are primarily seeking value for money and/or a unique personal style from pre-owned/vintage fashion while using these purchases to promote their own “eco-awareness” via their social media networks. This is a good indication for fashion designers to keep in mind in their design process and for fashion enterprises in their business model’s choice to not overproduce fashion items.

Keywords: cultural shift, pre-owned fashion, sustainable consumption, sustainable fashion.

Procedia PDF Downloads 83

Authors: Huang Wei-Yi

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Objective: This article explores the intensive care nursing experience of a terminal lung cancer patient who received palliative care after tracheal intubation. The patient was nearing death, and the family experienced sadness and grief as they faced the patient’s deteriorating condition and impending death. Methods: The patient was diagnosed with lung cancer in 2018 and received chemotherapy and radiation therapy with regular outpatient follow-ups. Due to brain metastasis and recent poor pain control and treatment outcomes, the patient was admitted to the intensive care unit (ICU), where the tracheal tube was removed, and palliative care was initiated. During the care period, a holistic assessment was conducted, addressing the physical, psychological, social, and spiritual aspects of care. Medical records were reviewed, interviews and family meetings were held, and a comprehensive assessment was carried out by the critical care team in collaboration with the palliative care team. The primary nursing issues identified included pain, ineffective breathing patterns, fear of death, and altered tissue perfusion. Results: Throughout the care process, the palliative care nurse, along with the family, utilized listening, caring, companionship, pain management, essential oil massage, distraction, and comfortable positioning to alleviate the patient’s pain and breathing difficulties. The use of Morphine 6mg in 0.9% N/S 50ml IV drip q6h reduced the FLACC pain score from 6 to 3. The patient’s respiratory rate improved from 28 breaths/min to 18-22 breaths/min, and sleep duration increased from 4 to 7 uninterrupted hours. The holistic palliative care approach, coupled with the involvement of the palliative care team, facilitated expressions of gratitude, apologies, and love between the patient and family. Visiting hours were extended, and with the nurse’s assistance, these moments were recorded and shared with the patient’s consent, providing cherished memories for the family. The patient’s end-of-life experience was thus improved, and the family was able to find peace. This case also served to promote the concept of palliative care, ensuring that more patients and families receive high-quality nursing care. Conclusion: When caring for terminal patients, collaboration with the palliative care team, including social workers, clergy, psychologists, and nutritionists, is essential. Involving the family in decision-making and providing opportunities for closeness and expressions of gratitude improve personalized care and enhance the patient's quality of life. Upon transferring to the ward, the patient’s hemodynamic stability was maintained, including SBP 110-130 mmHg, respiratory rate 20-22 breaths/min, and pain score <3. The patient was later discharged and transitioned to home hospice care for ongoing support.

Keywords: intensive care, lung cancer, palliative care, ICU

Procedia PDF Downloads 23

Authors: Mandayachepa C. Nyando, Lauren Suchman, Innocencia Mtalimanja, Address Malata, Tamanda Jumbe, Martha Kamanga, Peter Waiswa

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Background: Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is a new innovation in contraceptive methods that allow users to inject themselves with a hormonal contraceptive in their own homes. Self-injection (SI) of DMPA-SC has the potential to improve the accessibility of family planning to women who want it and who are capable of injecting themselves. Malawi started implementing this new innovation in 2018. SI was incorporated into the DMPA-SC delivery strategy from its outset. Methodology: This study involved two districts in Malawi where DMPA-SC SI was rolled out: Mulanje and Ntchisi. We used a qualitative cross-sectional study design where 60 in-depth interviews were conducted with women of reproductive age group stratified as 15-45 age band. These included women who were SI users, non-users, and any woman who was on any contraceptive methods. The women participants were tape-recorded, and data were transcribed and then analysed using Dedoose software, where themes were categorised into mother and child themes. Results: Women perceived DMPA SC SI as uniquely private, convenient, and less painful when self-injected. In terms of privacy, women in Mulanje and Ntchisi especially appreciated that self-injecting allowed them to use covertly from partners. Some men do not allow their spouses to use modern contraceptive methods; hence women prefer to use them covertly. “… but I first reach out to men because the strongest power is answered by men (MJ015).” In addition, women reported that SI offers privacy from family/community and less contact with healthcare providers. These aspects of privacy were especially valued in areas where there is a high degree of mistrust around family planning and among those who feel judged or antagonized purchasing contraception, such as young unmarried women. Women also valued the convenience SI provided in terms of their ability to save time by injecting themselves at home rather than visiting a healthcare provider and having more reliable access to contraception, particularly in the face of stockouts. SI allows for stocking up on doses to accommodate shifting work schedules in case of future stockouts or hard times, such as the period of COVID-19, where there was a limitation in the movement of the people. Conclusion: Our findings suggest that SI may meet the needs of many women in Malawi as long as the barriers are eliminated. The barriers women mentioned include fear of self-inject and proper storage of the DMPA SC SI, and these barriers can be eliminated by proper training. The findings also set the scene for policy revision and direction at a national level and integrate the approach with national family planning strategies in Malawi. Findings provide insights that may guide future implementation strategies, strengthen non-clinic family planning access programs and stimulate continued research.

Keywords: family planning, Malawi, Sayana press, self-injection

Procedia PDF Downloads 65

Authors: Agnieszka Antończyk, MałGorzata Ochota, Wojciech Niżański, ZdzisłAw Kiełbowicz

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The goal of the cesarean section (CS) is the delivery of healthy, vigorous pups with the provision of surgical plane anesthesia, appropriate analgesia, and rapid recovery of the dam. In human medicine, spinal or epidural anesthesia is preferred for a cesarean section as associated with a lower risk of neonatal asphyxia and the need for resuscitation. Nevertheless, the specificity of veterinary patients makes the application of regional anesthesia as a sole technique impractical, thus to obtain patient compliance the general anesthesia is required. This study aimed to compare the influence of balanced (inhalant with epidural) and inhalant anesthesia on neonatal umbilical cord blood gas (UCBG) parameters and vitality (modified Apgar scoring). The bitches (31) undergoing elective CS were enrolled in this study. All females received a single dose of 0.2 mg/kg s.c. Meloxicam. Females were randomly assigned into two groups: Gr I (Isoflurane, n=16) and Gr IE (Isoflurane plus Epidural, n=15). Anesthesia was induced with propofol at 4-6 mg/kg to effect, and maintained with isoflurane in oxygen; in IE group epidural anesthesia was also done using lidocaine (3-4 mg/kg) into the lumbosacral space. CSs were performed using a standard mid-line approach. Directly after the puppy extraction, the umbilical cord was double clamped before the placenta detachment. The vessels were gently stretched between forceps to allow blood sampling. At least 100 mcl of mixed umbilical cord blood was collected into a heparinized syringe for further analysis. The modified Apgar scoring system (AS) was used to objectively score neonatal health and vitality immediately after birth (before first aid or neonatal care was instituted), at 5 and 20 min after birth. The neonates were scored as normal (AS 7-10), weak (AS 4-6), or critical (AS 0-3). During surgery, the IE group required a lower isoflurane concentration compared to the females in group I (MAC 1.05±0.2 and 1.4±0.13, respectively, p<0.01). All investigated UCBG parameters were not statistically different between groups. All pups had mild acidosis (pH 7.21±0.08 and 7.21±0.09 in Gr I and IE, respectively) with moderately elevated pCO2 (Gr I 57.18±11.48, Gr IE 58.74±15.07), HCO3- on the lower border (Gr I 22.58±3.24, Gr IE 22.83±3.6), lowered BE (Gr I -6.1±3.57, Gr IE -5.6±4.19) and mildly elevated level of lactates (Gr I 2.58±1.48, Gr IE2.53±1.03). The glucose levels were above the reference limits in both groups of puppies (74.50±25.32 in Gr I, 79.50±29.73 in Gr IE). The initial Apgar score results were similar in I and IE groups. However, the subsequent measurements of AS revealed significant differences between both groups. Puppies from the IE group received better AS scores at 5 and 20 min compared to the I group (6.86±2.23 and 8.06±2.06 vs 5.11±2.40 and 7.83±2.05, respectively). The obtained results demonstrated that administration of epidural anesthesia reduced the requirement for isoflurane in dams undergoing cesarean section and did not affect the neonatal umbilical blood gas results. Moreover, newborns from the epidural anesthesia group were scored significantly higher in AS at 5 and 20 min, indicating their better vitality and quicker improvement post-surgery.

Keywords: apgar scoring, balanced anesthesia, cesarean section, umbilical blood gas

Procedia PDF Downloads 177

Authors: Diana Mitova, Krassimir Mitrev

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To prepare the current generation for the future, education systems need to change. It implies a way of learning that meets the demands of the times and the environment in which we live. Productive interaction in the educational process implies an interactive learning environment and the possibility of personal development of learners based on communication and mutual dialogue, cooperation and good partnership in decision-making. Students need not only theoretical knowledge, but transferable skills that will help them to become inventors and entrepreneurs, to implement ideas. STEM education , is now a real necessity for the modern school. Through learning in a "learning company", students master examples from classroom practice, simulate real life situations, group activities and apply basic interactive learning strategies and techniques. The learning company is the subject of this study, reduced to entrepreneurship training in STEM - technologies that encourage students to think outside the traditional box. STEM learning focuses the teacher's efforts on modeling entrepreneurial thinking and behavior in students and helping them solve problems in the world of business and entrepreneurship. Learning based on the implementation of various STEM projects in extracurricular activities, experiential learning, and an interdisciplinary approach are means by which educators better connect the local community and private businesses. Learners learn to be creative, experiment and take risks and work in teams - the leading characteristics of any innovator and future entrepreneur. This article presents some European policies on STEM and entrepreneurship education. It also shares best practices for training company training , with the integration of STEM in the learning company training environment. The main results boil down to identifying some advantages and problems in STEM entrepreneurship education. The benefits of using integrative approaches to teach STEM within a training company are identified, as well as the positive effects of project-based learning in a training company using STEM. Best practices for teaching entrepreneurship through extracurricular activities using STEM within a training company are shared. The following research methods are applied in this research paper: Theoretical and comparative analysis of principles and policies of European Union countries and Bulgaria in the field of entrepreneurship education through a training company. Experiences in entrepreneurship education through extracurricular activities with STEM application within a training company are shared. A questionnaire survey to investigate the motivation of secondary vocational school students to learn entrepreneurship through a training company and their readiness to start their own business after completing their education. Within the framework of learning through a "learning company" with the integration of STEM, the activity of the teacher-facilitator includes the methods: counseling, supervising and advising students during work. The expectation is that students acquire the key competence "initiative and entrepreneurship" and that the cooperation between the vocational education system and the business in Bulgaria is more effective.

Keywords: STEM, entrepreneurship, training company, extracurricular activities

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Authors: Nada Verdel, Tomaz Rijavec, Albin Pintar, Ales Lapanje

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Objectives: White water circuits of woodfree paper mills contain suspended, dissolved, and colloidal particles, such as cellulose, starch, paper sizings, and dyes. By closing the white water circuits, these particles start to accumulate and affect the production. Due to high amount of organic matter that scavenge radicals and adsorbs onto catalyst surfaces, treatment of white water with photocatalysis is inappropriate. The most suitable approach should be bioaugmentation-assisted bioremediation. Accordingly, objectives were: - to isolate bacteria capable of degrading organic compounds used for the papermaking process - to select the most active bacteria for bioaugmentation. Status: The state-of-the-art of bioaugmentation of pulp and paper mill effluents is mostly based on biodegradation of lignin. Whereas in white water circuits of woodfree paper mills only papermaking compounds are present. As far as one can tell from the literature, the study on degradation activities of bacteria for all possible compounds of the papermaking process is a novelty. Methodology: The main parameters of the selected white water were systematically analyzed during a period of two months. Bacteria were isolated on selective media with particular carbon source. Organic substances used as carbon source either enter white water circuits as base paper or as recycled broke. The screening of bacterial activities for starch, cellulose, latex, polyvinyl alcohol, alkyl ketene dimers, and resin acids was followed by addition of lugol. Degraders of polycyclic aromatic dyes were selected by cometabolism tests; cometabolism is simultaneous biodegradation of two compounds, in which the degradation of the second compound depends on the presence of the first. The obtained strains were identified by 16S rRNA sequencing. Findings: 335 autochthonous strains were isolated on plates with selected carbon source. The isolated strains were selected according to degradation of the particular carbon source. The ultimate degraders of cationic starch, cellulose, and sizings are Pseudomonas sp. NV-CE12-CF and Aeromonas sp. NV-RES19-BTP. The most active strains capable of degrading azo dyes are Aeromonas sp. NV-RES19-BTP and Sphingomonas sp. NV-B14-CF. Klebsiella sp. NV-Y14A-BTP degrade polycyclic aromatic direct blue 15 and also yellow dye, Agromyces sp. NV-RED15A-BF and Cellulosimicrobium sp. NV-A4-BF are specialists for whitener and Aeromonas sp. NV-RES19-BTP is general degrader of all compounds. To the white water adapted bacteria were isolated and selected according to their degradation activities for particular organic substances. Mostly isolated bacteria are specialized to lower the competition in the microbial community. Degraders of readily-biodegradable compounds do not degrade recalcitrant polycyclic aromatic dyes and vice versa. General degraders are rare.

Keywords: bioaugmentation, biodegradation of azo dyes, cometabolism, smart wastewater treatment technologies

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Authors: Thomas J. Bell III

Abstract:

This paper explores the value of assimilating certification training within a traditional course curriculum. This innovative approach is believed to increase stakeholder value within the Computer Information System program at Texas Wesleyan University. Stakeholder value is obtained from increased job marketability and critical thinking skills that create employment-ready graduates. This paper views value as first developing the capability to earn an industry-recognized certification, which provides the student with more job placement compatibility while allowing the use of critical thinking skills in a liberal arts business program. Graduates with industry-based credentials are often given preference in the hiring process, particularly in the information technology sector. And without a pioneering curriculum that better prepares students for an ever-changing employment market, its educational value is dubiously questioned. Since certifications are trending in the hiring process, academic programs should explore the viability of incorporating certification training into teaching pedagogy and courses curriculum. This study will examine the use of the balanced scorecard across four performance dimensions (financial, customer, internal process, and innovation) to measure the stakeholder value of certification training within a traditional course curriculum. The balanced scorecard as a strategic management tool may provide insight for leveraging resource prioritization and decisions needed to achieve various curriculum objectives and long-term value while meeting multiple stakeholders' needs, such as students, universities, faculty, and administrators. The research methodology will consist of quantitative analysis that includes (1) surveying over one-hundred students in the CIS program to learn what factor(s) contributed to their certification exam success or failure, (2) interviewing representatives from the Texas Workforce Commission to identify the employment needs and trends in the North Texas (Dallas/Fort Worth) area, (3) reviewing notable Workforce Innovation and Opportunity Act publications on training trends across several local business sectors, and (4) analyzing control variables to identify specific correlations between industry alignment and job placement to determine if a correlation exists. These findings may provide helpful insight into impactful pedagogical teaching techniques and curriculum that positively contribute to certification credentialing success. And should these industry-certified students land industry-related jobs that correlate with their certification credential value, arguably, stakeholder value has been realized.

Keywords: certification exam teaching pedagogy, exam preparation, testing techniques, exam study tips, passing certification exams, embedding industry certification and curriculum alignment, balanced scorecard performance evaluation

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Authors: Pirta Palola, Richard Bailey, Lisa Wedding

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Societies and economies worldwide fundamentally depend on natural capital. Alarmingly, natural capital assets are quickly depreciating, posing an existential challenge for humanity. The development of robust natural capital accounting systems is essential for transitioning towards sustainable economic systems and ensuring sound management of capital assets. However, the accurate, equitable and comprehensive estimation of natural capital asset stocks and their accounting values still faces multiple challenges. In particular, the representation of socio-cultural values held by groups or communities has arguably been limited, as to date, the valuation of natural capital assets has primarily been based on monetary valuation methods and assumptions of individual rationality. People relate to and value the natural environment in multiple ways, and no single valuation method can provide a sufficiently comprehensive image of the range of values associated with the environment. Indeed, calls have been made to improve the representation of multiple types of value (instrumental, intrinsic, and relational) and diverse ontological and epistemological perspectives in environmental valuation. This study addresses this need by establishing a novel valuation framework, Environmental Value Functions (EVF), that allows for the integration of multiple types of value in natural capital accounting systems. The EVF framework is based on the estimation and application of value functions, each of which describes the relationship between the value and quantity (or quality) of an ecosystem component of interest. In this framework, values are estimated in terms of change relative to the current level instead of calculating absolute values. Furthermore, EVF was developed to also support non-marginalist conceptualizations of value: it is likely that some environmental values cannot be conceptualized in terms of marginal changes. For example, ecological resilience value may, in some cases, be best understood as a binary: it either exists (1) or is lost (0). In such cases, a logistic value function may be used as the discriminator. Uncertainty in the value function parameterization can be considered through, for example, Monte Carlo sampling analysis. The use of EVF is illustrated with two conceptual examples. For the first time, EVF offers a clear framework and concrete methodology for the representation of multiple types of value in natural capital accounting systems, simultaneously enabling 1) the complementary use and integration of multiple valuation methods (monetary and non-monetary); 2) the synthesis of information from diverse knowledge systems; 3) the recognition of value incommensurability; 4) marginalist and non-marginalist value analysis. Furthermore, with this advancement, the coupling of EVF and ecosystem modeling can offer novel insights to the study of spatial-temporal dynamics in natural capital asset values. For example, value time series can be produced, allowing for the prediction and analysis of volatility, long-term trends, and temporal trade-offs. This approach can provide essential information to help guide the transition to a sustainable economy.

Keywords: economics of biodiversity, environmental valuation, natural capital, value function

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Authors: Marzieh Ahmadi, Ruhullah Alikhan Gorgani

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The usual methods of measuring regional inequalities can not reflect the internal changes of the country in terms of their displacement in different development groups, and the indicators of inequalities are not effective in demonstrating the dynamics of the distribution of inequality. For this purpose, this paper examines the dynamics of the urban inertial transport in the country during the period of 2006-2016 using the CIRD multidimensional index and stochastic kernel density method. it firstly selects 25 indicators in five dimensions including macroeconomic conditions, science and innovation, environmental sustainability, human capital and public facilities, and two-stage Principal Component Analysis methodology are developed to create a composite index of inequality. Then, in the second stage, using a nonparametric analytical approach to internal distribution dynamics and a stochastic kernel density method, the convergence hypothesis of the CIRD index of the Iranian provinces center is tested, and then, based on the ergodic density, long-run equilibrium is shown. Also, at this stage, for the purpose of adopting accurate regional policies, the distribution dynamics and process of convergence or divergence of the Iranian provinces for each of the five. According to the results of the first Stage, in 2006 & 2016, the highest level of development is related to Tehran and zahedan is at the lowest level of development. The results show that the central cities of the country are at the highest level of development due to the effects of Tehran's knowledge spillover and the country's lower cities are at the lowest level of development. The main reason for this may be the lack of access to markets in the border provinces. Based on the results of the second stage, which examines the dynamics of regional inequality transmission in the country during 2006-2016, the first year (2006) is not multifaceted and according to the kernel density graph, the CIRD index of about 70% of the cities. The value is between -1.1 and -0.1. The rest of the sequence on the right is distributed at a level higher than -0.1. In the kernel distribution, a convergence process is observed and the graph points to a single peak. Tends to be a small peak at about 3 but the main peak at about-0.6. According to the chart in the final year (2016), the multidimensional pattern remains and there is no mobility in the lower level groups, but at the higher level, the CIRD index accounts for about 45% of the provinces at about -0.4 Take it. That this year clearly faces the twin density pattern, which indicates that the cities tend to be closely related to each other in terms of development, so that the cities are low in terms of development. Also, according to the distribution dynamics results, the provinces of Iran follow the single-density density pattern in 2006 and the double-peak density pattern in 2016 at low and moderate inequality index levels and also in the development index. The country diverges during the years 2006 to 2016.

Keywords: Urban Disparity, CIRD Index, Convergence, Distribution Dynamics, Random Kernel Density

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Authors: Paul Feyi Waboso

Abstract:

This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.

Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition

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