Search results for: comprehensive care

Authors: Jean Paul M. Milambo

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Purpose: Aromatase inhibitors (AIs) are indicated in the treatment of hormone-receptive breast cancer in postmenopausal women in various settings. Studies have shown cardiovascular events in some developed countries. To date the data is sparce for evidence-based recommendations in African clinical settings due to lack of cancer registries, capacity building and surveillance systems. Therefore, this study was conducted to assess the feasibility of HyBeacon® probe genotyping adjunctive to standard care for timely prediction and diagnosis of Aromatase inhibitors (AIs) associated adverse events in breast cancer survivors in Africa. Methods: Cross sectional study was conducted to assess the knowledge of POCT among six African countries using online survey and telephonically contacted. Incremental cost effectiveness ratio (ICER) was calculated, using diagnostic accuracy study. This was based on mathematical modeling. Results: One hundred twenty-six participants were considered for analysis (mean age = 61 years; SD = 7.11 years; 95%CI: 60-62 years). Comparison of genotyping from HyBeacon® probe technology to Sanger sequencing showed that sensitivity was reported at 99% (95% CI: 94.55% to 99.97%), specificity at 89.44% (95% CI: 87.25 to 91.38%), PPV at 51% (95%: 43.77 to 58.26%), and NPV at 99.88% (95% CI: 99.31 to 100.00%). Based on the mathematical model, the assumptions revealed that ICER was R7 044.55. Conclusion: POCT using HyBeacon® probe genotyping for AI-associated adverse events maybe cost effective in many African clinical settings. Integration of preventive measures for early detection and prevention guided by different subtype of breast cancer diagnosis with specific clinical, biomedical and genetic screenings may improve cancer survivorship. Feasibility of POCT was demonstrated but the implementation could be achieved by improving the integration of POCT within primary health cares, referral cancer hospitals with capacity building activities at different level of health systems. This finding is pertinent for a future envisioned implementation and global scale-up of POCT-based initiative as part of risk communication strategies with clear management pathways.

Keywords: breast cancer, diagnosis, point of care, South Africa, aromatase inhibitors

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Authors: Bahram Talebjedi, Emily Earl, Mina Hoorfar

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One of the issues that arises with microscale lab-on-a-chip technology is that the laminar flow within the microchannels limits the mixing of fluids. To combat this, micromixers have been introduced as a means to try and incorporate turbulence into the flow to better aid the mixing process. This study presents an electroosmotic micromixer that balances vortex generation and degeneration with the inlet flow velocity to greatly increase the mixing efficiency. A comprehensive parametric study was performed to evaluate the role of the relevant parameters on the mixing efficiency. It was observed that the suggested micromixer is perfectly suited for biological applications due to its low pressure drop (below 10 Pa) and low shear rate. The proposed micromixer with optimized working parameters is able to attain a mixing efficiency of 95% in a span of 0.5 seconds using a frequency of 10 Hz, a voltage of 0.7 V, and an inlet velocity of 0.366 mm/s.

Keywords: microfluidics, active mixer, pulsed AC electroosmosis flow, micromixer

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Authors: Andreas Kapardis, Maria Krambia-Kapardis, Sofia Michaelides-Mateou

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Corruption and economic crime is a serious problem affecting the sustainability of businesses in the 21st century. Nowadays, many corruption or fraud cases come to light thanks to whistleblowers. This article will first discuss the concept of whistleblowing as well as some relevant legislation enacted around the world. Secondly, it will discuss the findings of a survey of whistleblowers or could-have-been whistleblowers. Finally, suggestions for the development of a comprehensive whistleblowing framework will be considered. Whistleblowing can be described as expressing a concern about a wrongdoing within an organization, such as a corporation, an association, an institution or a union. Such concern must be in the public interest and in good faith and should relate to the cover up of matters that could potentially result in a miscarriage of justice, a crime, criminal offence and threats to health and safety. Whistleblowing has proven to be an effective anti-corruption mechanism and a powerful tool that helps deterring fraud, violations, and malpractices within organizations, corporations and the public sector. Research in the field of whistleblowing has concentrated on the reasons for whistleblowing and financial bounties; the effectiveness of whistleblowing; whistleblowing being a prosocial behavior with a psychological perspective and consequences; as a tool in protecting shareholders, saving lives and billions of dollars of public funds. Whilst, no other study of whistleblowing has been carried out on whistleblowers or intended whistleblowers. The study reported in the current paper analyses the findings of 74 whistleblowers or intended whistleblowers, the reasons behind their decision to blow the whistle, or not to proceed to blow the whistle and any regrets they may have had. In addition a profile of a whistleblower is developed concerning their age, gender, marital and family status and position in an organization. Lessons learned from the intended whistleblowers and in response to the questions if they would be willing to blow the whistle again show that enacting legislation to protect the whistleblower is not enough. Similarly, rewarding the whistleblower does not appear to provide the whistleblower with an incentive since the majority noted that “work ethics is more important than financial rewards”. We recommend the development of a comprehensive and holistic framework for the protection of the whistleblower and to ensure that remedial actions are immediately taken once a whistleblower comes forward. The suggested framework comprises (a) hard legislation in ensuring the whistleblowers follow certain principles when blowing the whistle and, in return, are protected for a period of 5 years from being fired, dismissed, bullied, harassed; (b) soft legislation in establishing an agency to firstly ensure psychological and legal advice is provided to the whistleblowers and secondly any required remedial action is immediately taken to avert the undesirable events reported by a whistleblower from occurring and, finally; (c) mechanisms to ensure the coordination of actions taken.

Keywords: whistleblowing, business ethics, legislation, business

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Authors: Xu Qian

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This abstract explores the importance of building resilience within families and offers evidence-based strategies for promoting positive parenting and enhancing emotional well-being. It emphasizes the role of effective communication, conflict resolution, and fostering a supportive environment to strengthen family bonds and promote healthy child development. Introduction: The well-being and resilience of families play a crucial role in fostering healthy child development and promoting overall emotional well-being. This abstract highlights the significance of nurturing resilient families and provides evidence-based strategies for positive parenting. By focusing on effective communication, conflict resolution, and creating a supportive environment, families can strengthen their bonds and enhance emotional well-being for both parents and children. Methods: This abstract draws upon a comprehensive review of existing research and literature on resilient families, positive parenting, and emotional well-being. The selected studies employ various methodologies, including surveys, interviews, and longitudinal observations, to investigate the factors contributing to family resilience and the strategies that promote positive parenting practices. The findings from these studies serve as the foundation for the strategies discussed in this abstract. Results: The results of the reviewed studies demonstrate that effective communication within families is a key factor in building resilience and promoting emotional well-being. Open and honest communication allows family members to express their thoughts, feelings, and concerns, fostering trust and understanding. Conflict resolution skills, such as active listening, compromise, and problem-solving, are vital in managing conflicts constructively and preventing negative consequences on family dynamics and children's well-being. Creating a supportive environment that nurtures emotional well-being is another critical aspect of promoting resilient families. This includes providing emotional support, setting clear boundaries, and promoting positive discipline strategies. Research indicates that consistent and responsive parenting approaches contribute to improved self-regulation skills, emotional intelligence, and overall mental health in children. Discussion: The discussion centers on the implications of these findings for promoting positive parenting and emotional well-being. It emphasizes the need for parents to prioritize self-care and seek support when facing challenges. Parental well-being directly influences the quality of parenting and the overall family environment. By attending to their own emotional needs, parents can better meet the needs of their children and create a nurturing atmosphere. Furthermore, the importance of fostering resilience in children is highlighted. Resilient children are better equipped to cope with adversity, adapt to change, and thrive in challenging circumstances. By cultivating resilience through supportive relationships, encouragement of independence, and providing opportunities for growth, parents can foster their children's ability to bounce back from setbacks and develop essential life skills. Conclusion: In conclusion, nurturing resilient families is crucial for positive parenting and enhancing emotional well-being. This abstract presents evidence-based strategies that emphasize effective communication, conflict resolution, and creating a supportive environment. By implementing these strategies, parents can strengthen family bonds, promote healthy child development, and enhance overall family resilience. Investing in resilient families not only benefits individual family members but also contributes to the well-being of the broader community.

Keywords: childrearing families, family education, children's mental health, positive parenting, emotional health

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Authors: Zaffar Hayat Nawaz Khan

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In the face of growing environmental concerns, the need for sustainable practices has become increasingly urgent. This paper aims to explore the path towards a greener and more resilient future by examining key strategies and initiatives that address environmental challenges. The paper begins by analyzing the current state of the environment, highlighting the various concerns such as climate change, deforestation, pollution, and depletion of natural resources. It emphasizes the need for immediate action and proposes a comprehensive approach to tackle these issues. Furthermore, the paper delves into the concept of resilience and its importance in creating a sustainable future. It discusses the need to build resilient systems and communities that can withstand and adapt to environmental shocks and stresses. The paper highlights the role of innovation, technology, and policy frameworks in promoting resilience and fostering a greener and more sustainable future.

Keywords: environmental concerns, ustainable development, greener future, energy, waste management

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Authors: S. A. Naeini, M. Mortezaee

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The purpose of this paper is to investigate the effect of fine grain content in soil and its plastic properties on soil liquefaction potential. For this purpose, the conditions for considering the fine grains effect and percentage of plastic fine on the liquefaction resistance of saturated sand presented by researchers has been investigated. Then, some comprehensive results of all the issues raised by some researchers are stated. From these investigations it was observed that by increasing the percentage of cohesive fine grains in the sandy soil (up to 20%), the maximum shear strength decreases and by adding more fine- grained percentage, the maximum shear strength of the resulting soil increases but never reaches the amount of clean sand.

Keywords: fine-grained, liquefaction, plasticity, shear strength, sand

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Authors: Nahla Elsherbiny, Ahmed Ahmed, Hamada Mohammed, Mohamed Ali

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Background: The enterococci may be considered as opportunistic agents particularly in immunocompromised patients. It is one of the top three pathogens causing many healthcare associated infections (HAIs). Resistance to several commonly used antimicrobial agents is a remarkable characteristic of most species which may carry various genes contributing to virulence. Objectives: to determine the prevalence of enterococci species in different intensive care units (ICUs) causing health care-associated infections (HAIs), intestinal carriage and environmental contamination. Also, to study the antimicrobial susceptibility pattern of the isolates with special reference to vancomycin resistance. In addition to phenotypic and genotypic detection of gelatinase, cytolysin and biofilm formation among isolates. Patients and Methods: This study was carried out in the infection control laboratory at Assiut University Hospitals over a period of one year. Clinical samples were collected from 285 patients with various (HAIs) acquired after admission to different ICUs. Rectal swabs were taken from 14 cases for detection of enterococci carriage. In addition, 1377 environmental samples were collected from the surroundings of the patients. Identification was done by conventional bacteriological methods and confirmed by analytical profile index (API). Antimicrobial sensitivity testing was performed by Kirby Bauer disc diffusion method and detection of vancomycin resistance was done by agar screen method. For the isolates, phenotypic detection of cytolysin, gelatinase production and detection of biofilm by tube method, Congo red method and microtiter plate. We performed polymerase chain reaction (PCR) for detection of some virulence genes (gelE, cylA, vanA, vanB and esp). Results: Enterococci caused 10.5% of the HAIs. Respiratory tract infection was the predominant type (86.7%). The commonest species were E.gallinarum (36.7%), E.casseliflavus (30%), E.faecalis (30%), and E.durans (3.4 %). Vancomycin resistance was detected in a total of 40% (12/30) of those isolates. The risk factors associated with acquiring vancomycin resistant enterococci (VRE) were immune suppression (P= 0.031) and artificial feeding (P= 0.008). For the rectal swabs, enterococci species were detected in 71.4% of samples with the predominance of E. casseliflavus (50%). Most of the isolates were vancomycin resistant (70%). Out of a total 1377 environmental samples, 577 (42%) samples were contaminated with different microorganisms. Enterococci were detected in 1.7% (10/577) of total contaminated samples, 50% of which were vancomycin resistant. All isolates were resistant to penicillin, ampicillin, oxacillin, ciprofloxacin, amikacin, erythromycin, clindamycin and trimethoprim-sulfamethaxazole. For the remaining antibiotics, variable percentages of resistance were reported. Cytolysin and gelatinase were detected phenotypically in 16% and 48 % of the isolates respectively. The microtiter plate method showed the highest percentages of detection of biofilm among all isolated species (100%). The studied virulence genes gelE, esp, vanA and vanB were detected in 62%, 12%, 2% and 12% respectively, while cylA gene was not detected in any isolates. Conclusions: A significant percentage of enterococci was isolated from patients and environments in the ICUs. Many virulence factors were detected phenotypically and genotypically among isolates. The high percentage of resistance, coupled with the risk of cross transmission to other patients make enterococci infections a significant infection control issue in hospitals.

Keywords: antimicrobial resistance, enterococci, ICUs, virulence factors

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Authors: Yan Yan, Erhong Sun, Lin Peng, Xuchun Ye

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Aims: The present study aimed to explore Intensive Care Unit(ICU) nurses’ mental workload (MWL) and associated factors with it in performing human-machine tasks. Background: A wide range of emerging technologies have penetrated widely in the field of health care, and ICU nurses are facing a dramatic increase in nursing human-machine tasks. However, there is still a paucity of literature reporting on the general MWL of ICU nurses performing human-machine tasks and the associated influencing factors. Methods: A cross-sectional survey was employed. The data was collected from January to February 2021 from 9 tertiary hospitals in 6 provinces (Shanghai, Gansu, Guangdong, Liaoning, Shandong, and Hubei). Two-stage sampling was used to recruit eligible ICU nurses (n=427). The data were collected with an electronic questionnaire comprising sociodemographic characteristics and the measures of MWL, self-efficacy, system usability, and task difficulty. The univariate analysis, two-way analysis of variance(ANOVA), and a linear mixed model were used for data analysis. Results: Overall, the mental workload of ICU nurses in performing human-machine tasks was medium (score 52.04 on a 0-100 scale). Among the typical nursing human-machine tasks selected, the MWL of ICU nurses in completing first aid and life support tasks (‘Using a defibrillator to defibrillate’ and ‘Use of ventilator’) was significantly higher than others (p < .001). And ICU nurses’ MWL in performing human-machine tasks was also associated with age (p = .001), professional title (p = .002), years of working in ICU (p < .001), willingness to study emerging technology actively (p = .006), task difficulty (p < .001), and system usability (p < .001). Conclusion: The MWL of ICU nurses is at a moderate level in the context of a rapid increase in nursing human-machine tasks. However, there are significant differences in MWL when performing different types of human-machine tasks, and MWL can be influenced by a combination of factors. Nursing managers need to develop intervention strategies in multiple ways. Implications for practice: Multidimensional approaches are required to perform human-machine tasks better, including enhancing nurses' willingness to learn emerging technologies actively, developing training strategies that vary with tasks, and identifying obstacles in the process of human-machine system interaction.

Keywords: mental workload(MWL), nurse, ICU, human-machine, tasks, cross-sectional study, linear mixed model, China

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Authors: Iris Maria Velez Osorio

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There has been in the last decade a concern about the environment, particularly about clean and enough water for human consumption but, some enterprises had some trouble to understand the limited resources in the environment. This research tries to understand how some industries are better oriented to the preservation of the environment through investment for strategic management of scarce resources and try in the best way possible, the contaminants. It was made an industry classification since four different group of theories for Corporate Social Responsibility agree with variables of: investment in environmental care, water protection, and residues treatment finding different levels of commitment with CSR.

Keywords: corporate social responsibility, environment, strategic management, water

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Authors: Amanda Aliende da Matta

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In different fields, there are people who have something that stands out. In the educational world, for example, it is clear when some teachers have something: they are the best teachers, but this is not directly attributed to their disciplines, methodologies, etc. It is that they have something that captivates, inspires, and motivates. But we also find this something in other contexts. In this thesis, the interest is in something that some marginalized people, such as Ab (fictitious name), have. Ab was born in a rural community and saw the lifestyle of his family change drastically as a consequence of structural changes in his village. The community became impoverished, and together with a group of teenagers, he decided to migrate to Spain in search of opportunities. His best friend drowned during the crossing. After arriving, he lived in indecent conditions and felt unsafe. He now suffers from anxiety and frequently faints from it. Yet, he’s linked to Joves x la pau (a Christian project, although he is a Muslim), distributing food for people who live on the streets every Thursday afternoon. When he asked about what happens on cold and rainy days, he explained simply: "if it rains, I distribute the food, and immediately I get home, take a bath, and sleep warm under my roof. That is when we most have to go." This something he has will be called caring. And one of the general objectives of the thesis is to discover what are the meaning structures of this caring what is the lived experience of this caring. In this communication, preliminary results of an Applied Hermeneutic Phenomenology (AHP) study on the lived experience of caring as a vulnerable person are presented. The research means to answer what is the lived experience of caring as a vulnerable person. That is, to describe and explain what it is like to caregive for a vulnerable person, what it is, essentially, to caregive for a vulnerable person, what makes the lived experience of caregiving for a vulnerable person different from any other. In order to investigate the meaning of the phenomenon of caregiving as a vulnerable person, as already stated, the method used will be Applied Hermeneutic Phenomenology (AHP). We base ourselves, initially, on the proposal of Raquel Ayala-Carabajo and Max Van Manen. As Van Manen (1990) explains, AHP is a method that works essentially through fieldwork, with the collection of data on lived experience (experiential material). It is a phenomenology of practice. We here present the provisional themes we found: caregiving as a vulnerable person is seeing yourself in the other, identifying with the care-receiver; Caregiving as a vulnerable person is putting the other’s need before oneself’s; Caregiving as a vulnerable person is temporarily overcoming your weaknesses to make yourself strong for the other; Caregiving as a vulnerable person is going beyond the conventional approach; and Caregiving as a vulnerable person is taking responsibility even if it’s not yours.

Keywords: applied hermeneutic phenomenology, care ethics, hermeneutics, phenomenology

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Authors: Thomas Suarez, Anne-Sophie Grenouilleau, Erwan Autin, Alexandre Biosse-Duplan, Emmanuelle Blondet, Laurence Chazalette, Marie Coniel, Agnes Dessaigne, Sylvie Lascols, Andrea Lasserre, Candice Legris, Pierre Liot, Aline Metais, Karine Petitprez, Christophe Varlet, Christian Saout

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Background: The role of biological sex and gender identity -whether assigned or chosen- as health determinants are far from a recent discovery: several reports have stressed out how being a woman or a man could affect health on various scales. However, taking it into consideration beyond stereotypes and rigid binary assumptions still seems to be a work in progress. Method: The report is a synthesis on a variety of specific topics, each of which was studied by a specialist from the French National Authority for Health (HAS), through an analysis of existing literature on both healthcare policy construction process and instruments (norms, data analysis, clinical trials, guidelines, and professional practices). This work also implied a policy analysis of French recent public health laws and a retrospective study of guidelines with a gender mainstreaming approach. Results: The analysis showed that though sex and gender were well-known determinants of health, their consideration by both public policy and health operators was often incomplete, as it does not incorporate how sex and gender interact, as well as how they interact with other factors. As a result, the health and social care systems and their professionals tend to reproduce some stereotypical and inadequate habits. Though the data available often allows to take sex and gender into consideration, such data is often underused in practice guidelines and policy formulation. Another consequence is a lack of inclusiveness towards transgender or intersex persons. Conclusions: This report first urges for raising awareness of all the actors of health, in its broadest definition, that sex and gender matter beyond first-look conclusions. It makes a series of recommendations in order to reshape policy construction in the health sector on the one hand and to design public health instruments to make them more inclusive regarding sex and gender on the other hand. The HAS finally committed to integrate sex and gender preoccupations in its workings methods, to be a driving force in the spread of these concerns.

Keywords: biological sex, determinants of health, gender, healthcare policy instruments, social accompaniment

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Authors: Mohammed Huraysi

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This research will investigate the historical coverage of foreign issues in U.S. newspapers. The study will focus on three main areas, which are coverage of wars, foreign leaders, and human rights in foreign countries, and analyze them by applying the framing theory to news stories about Saudi Arabia, used as a case study, within two different newspapers over some time Wall Street Journal and The New York Times will be investigated and representative of two distinct newspaper orientations, which are conservative and liberal ideological orientations. By the end of this research study, comprehensive coverage of these topics in U.S. newspapers from past to present will be provided, leading to an ability to discover consistency or lack thereof, explain the present, and devise future expectations.

Keywords: framing theory, US newspapers, historical research, Saudi Arabia

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Authors: Peter Carter

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Comprehensive climate change indicators and trends inform the state of the climate (system) with respect to present and future climate change scenarios and the urgency of mitigation and adaptation. With data records now going back for many decades, indicator trends can complement model projections. They are provided as datasets by several climate monitoring centers, reviewed by state of the climate reports, and documented by the IPCC assessments. Up-to-date indicators are provided here. Rates of change are instructive, as are extremes. The indicators include greenhouse gas (GHG) emissions (natural and synthetic), cumulative CO2 emissions, atmospheric GHG concentrations (including CO2 equivalent), stratospheric ozone, surface ozone, radiative forcing, global average temperature increase, land temperature increase, zonal temperature increases, carbon sinks, soil moisture, sea surface temperature, ocean heat content, ocean acidification, ocean oxygen, glacier mass, Arctic temperature, Arctic sea ice (extent and volume), northern hemisphere snow cover, permafrost indices, Arctic GHG emissions, ice sheet mass, sea level rise, and stratospheric and surface ozone. Global warming is not the most reliable single metric for the climate state. Radiative forcing, atmospheric CO2 equivalent, and ocean heat content are more reliable. Global warming does not provide future commitment, whereas atmospheric CO2 equivalent does. Cumulative carbon is used for estimating carbon budgets. The forcing of aerosols is briefly addressed. Indicator interactions are included. In particular, indicators can provide insight into several crucial global warming amplifying feedback loops, which are explained. All indicators are increasing (adversely), most as fast as ever and some faster. One particularly pressing indicator is rapidly increasing global atmospheric methane. In this respect, methane emissions and sources are covered in more detail. In their application, indicators used in assessing safe planetary boundaries are included. Indicators are considered with respect to recent published papers on possible catastrophic climate change and climate system tipping thresholds. They are climate-change-policy relevant. In particular, relevant policies include the 2015 Paris Agreement on “holding the increase in the global average temperature to well below 2°C above pre-industrial levels and pursuing efforts to limit the temperature increase to 1.5°C above pre-industrial levels” and the 1992 UN Framework Convention on Climate change, which has “stabilization of greenhouse gas concentrations in the atmosphere at a level that would prevent dangerous anthropogenic interference with the climate system.”

Keywords: climate change, climate change indicators, climate change trends, climate system change interactions

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Authors: Zuzana Crhová, Karel Kolman, Drahomíra Pavelková

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Knowledge is considered as an important asset which can help organizations to create competitive advantage. The necessity of taking care of these assets is more important in these days – in days of turbulent changes in business environment. Knowledge could facilitate adaption to constant changes. The aim of this paper is to describe how the knowledge sharing can be supported in the manufacturing companies. The methods of case studies and grounded theory were used to present information gained by carrying out semi-structured interviews. Results show that knowledge sharing is supported in very similar ways in respondent companies.

Keywords: case study, human resource management, knowledge, knowledge sharing

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Authors: Rakesh Dubey, Vaishali Bahl, Dalveer Kaur

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The spiralling urge for high rate data transmission over wireless mediums needs intelligent use of electromagnetic resources considering restrictions like power ingestion, spectrum competence, robustness against multipath propagation and implementation intricacy. Orthogonal frequency division multiplexing (OFDM) is a capable technique for next generation wireless communication systems. For such high rate data transfers there is requirement of proper allocation of resources like power and capacity amongst the sub channels. This paper illustrates various available methods of allocating power and the capacity requirement with the constraint of Shannon limit.

Keywords: Additive White Gaussian Noise, Multi-Carrier Modulation, Orthogonal Frequency Division Multiplexing (OFDM), Signal to Noise Ratio (SNR), Water Filling

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Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman

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Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.

Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room

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Authors: Sara Zelman, Courtney Meyer, Hiren Patel, Lisa Philpotts, Sue Lahey, Thomas Burke

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Background: As the global burden of disease shifts from infectious diseases to noncommunicable diseases, there is growing urgency to provide treatment for time-sensitive illnesses, such as ST-Elevation Myocardial Infarctions (STEMIs). The standard of care for STEMIs in developed countries is Percutaneous Coronary Intervention (PCI). However, this is inaccessible in resource-limited settings. Before the discovery of PCI, Streptokinase (STK) and other thrombolytic drugs were first-line treatments for STEMIs. STK has been recognized as a cost-effective and safe treatment for STEMIs; however, in settings which lack access to PCI, it has not become the established second-line therapy. A systematic literature review was conducted to geographically map the use of STK for STEMIs in resource-limited settings. Methods: Our literature review group searched the databases Cinhal, Embase, Ovid, Pubmed, Web of Science, and WHO’s Index Medicus. The search terms included ‘thrombolytics’ AND ‘myocardial infarction’ AND ‘resource-limited’ and were restricted to human studies and papers written in English. A considerable number of studies came from Latin America; however, these studies were not written in English and were excluded. The initial search yielded 3,487 articles, which was reduced to 3,196 papers after titles were screened. Three medical professionals then screened abstracts, from which 291 articles were selected for full-text review and 94 papers were chosen for final inclusion. These articles were then analyzed and mapped geographically. Results: This systematic literature review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with 18 of 94 studies taking place in India. Furthermore, 13 studies occurred in Pakistan, followed by Iran (6), Sri Lanka (5), Brazil (4), China (4), and South Africa (4). Conclusion: Our systematic review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with the highest utilization occurring in India. This demonstrates that even though STK has high utility for STEMI treatment in resource-limited settings, it still has not become the standard of care. Future research should investigate the barriers preventing the establishment of STK use as second-line treatment after PCI.

Keywords: cardiovascular disease, global health, resource-limited setting, ST-Elevation Myocardial Infarction, Streptokinase

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Authors: Anod H. Alhazmi, Hanaa A. Yamani

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The lack of digital transformation professionals could prevent Saudi Arabia’s universities from providing digital services. The task of understanding what digital skills are needed within an organization, measuring the existing skills, and developing or attracting talents is a complex task. This paper provides a comprehensive analysis of the digital transformation skills needed in the organizations who seek digital transformation and identifies the skills and competencies framework DigSC built on Skills Framework for the Informational Age (SFIA) framework that is adopted by the Ministry of Communications and Information Technology (MCIT) in Saudi Arabia. The framework adopted identifies the main digital transformation skills clusters, categories and levels of responsibilities for each job description to fill the gap between this requirement and the digital skills supplied by the Umm Alqura University (UQU).

Keywords: competencies, digital transformation, framework, skills, Umm Alqura university

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Authors: Peter Smolianov, Jed Smith, Lisa Chen, Steven Dion, Christopher Schoen, Jaclyn Norberg

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This study compared general conditioning and sport specific fitness tests used in China, European Union (EU), Russia, and the United States. A constant content comparison method was used to identify the differences. Data from the study indicated that there were shared test components, including aerobic fitness, muscular strength, endurance, and flexibility. However, the testing components and items, as well as the cut-off values of the analyzed tests varied by country for the same gender and age. Culturally unique methods of testing and preparing for the tests were identified. Additionally, evidence revealed support for lifelong fitness and long-term sport participation through comprehensive fitness and wellness guidelines for different age groups and through new internet-based technologies.

Keywords: fitness testing, global trends, new developments, worldwide comparison

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Authors: Anteneh Dagnachew Sewenet, Paola Pisano

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The concept of circular economy, circularity, and sustainability are interconnected and promote a more sustainable future. However, previous studies have mainly focused on each concept individually, neglecting the relationships and gaps in the existing literature. This study aims to integrate and link these concepts to expand the theoretical and practical methods of scholars and professionals in pursuit of sustainability. The aim of this systematic literature review is to comprehensively analyze and summarize the interconnections between circular economy, circularity, and sustainability. Additionally, it seeks to develop a conceptual framework that can guide practitioners and serve as a basis for future research. The review employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. A total of 78 articles were analyzed, utilizing the Scopus and Web of Science databases. The analysis involved summarizing and systematizing the conceptualizations of circularity and its relationship with the circular economy and long-term sustainability. The review provided a comprehensive overview of the interconnections between circular economy, circularity, and sustainability. Key themes, theoretical frameworks, empirical findings, and conceptual gaps in the literature were identified. Through a rigorous analysis of scholarly articles, the study highlighted the importance of integrating these concepts for a more sustainable future. This study contributes to the existing literature by integrating and linking the concepts of circular economy, circularity, and sustainability. It expands the theoretical understanding of how these concepts relate to each other and provides a conceptual framework that can guide future research in this field. The findings emphasize the need for a holistic approach in achieving sustainability goals. The data collection for this review involved identifying relevant articles from the Scopus and Web of Science databases. The selection of articles was made based on predefined inclusion and exclusion criteria. The PRISMA protocol guided the systematic analysis of the selected articles, including summarizing and systematizing their content. This study addressed the question of how circularity is conceptualized and related to both the circular economy and long-term sustainability. It aimed to identify the interconnections between these concepts and bridge the gap in the existing literature. The review provided a comprehensive analysis of the interconnections between the circular economy, circularity, and sustainability. It presented a conceptual framework that can guide practitioners in implementing circular economy strategies and serve as a basis for future research. By integrating these concepts, scholars, and professionals can enhance the theoretical and practical methods in pursuit of a more sustainable future. The findings emphasize the importance of taking a holistic approach to achieve sustainability goals and highlight conceptual gaps that can be addressed in future studies.

Keywords: circularity, circular economy, sustainability, innovation

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Authors: Ibrahim Abubakar Alkali, Abubakar Sarkile Kawuwa, Ibrahim Sani Khalil

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The concept of space and function forms the bedrock for spatial configuration in architectural design. Thus, the effectiveness and functionality of an architectural product depends their cordial relationship. This applies to all buildings especially to a hospital ward setting designed to accommodate various complex and diverse functions. Health care facilities design, especially an inpatient setting, is governed by many regulations and technical requirements. It is also affected by many less defined needs, particularly, response to culture and the need to provide for patient families’ presence and participation. The spatial configuration of the hospital ward setting in developing countries has no consideration for the patient’s families despite the significant role they play in promoting recovery. Attempts to integrate facilities for patients’ families have always been challenging, especially in developing countries like Nigeria, where accommodation for inpatients is predominantly in an open ward system. In addition, the situation is compounded by culture, which significantly dictates healthcare practices in Africa. Therefore, achieving such a hospital ward setting that is patient and family-centered requires careful assessment of family care actions and transaction spaces so as to arrive at an evidence based solution. Therefore, the aim of this study is to identify how hospital ward spaces can be reconfigured to provide for sustainable family integration. In achieving this aim, a qualitative approach using the principles of behavioral mapping was employed in male and female medical wards of the Federal Teaching Hospital (FTH) Gombe, Nigeria. The data obtained was analysed using classical and comparative content analysis. Patients’ families have been found to be a critical component of hospital ward design that cannot be undermined. Accordingly, bedsides, open yards, corridors and foyers have been identified as patient families’ transaction spaces that require design attention. Arriving at sustainable family integration can be achieved by revisiting the design requirements of the family transaction spaces based on the findings in order to avoid the rowdiness of the wards and uncoordinated sprawl.

Keywords: caregiving, design basics, family integration, hospital ward, sustainability

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Authors: S. Werrlich, E. Eichstetter, K. Nitsche, G. Notni

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Augmented Reality (AR) is a strong growing research topic in different training domains such as medicine, sports, military, education and industrial use cases like assembly and maintenance tasks. AR claims to improve the efficiency and skill-transfer of training tasks. This paper gives a comprehensive overview of evaluations using AR for assembly and maintenance training tasks published between 1992 and 2017. We search in a structured way in four different online databases and get 862 results. We select 17 relevant articles focusing on evaluating AR-based training applications for assembly and maintenance tasks. This paper also indicates design guidelines which are necessary for creating a successful application for an AR-based training. We also present five scientific limitations in the field of AR-based training for assembly tasks. Finally, we show our approach to solve current research problems using Design Science Research (DSR).

Keywords: assembly, augmented reality, survey, training

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Authors: Rajkumar Ghosh, Shyama Pada Gorai

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Access to safe drinking water is a fundamental human right; however, regions like Purulia, Bankura, Birbhum, Malda, Dinajpur in West Bengal, India, face formidable challenges due to heightened fluoride levels. This paper delves into the hurdles of fresh drinking water production, presenting comprehensive solutions derived from literature reviews, field surveys, and scientific analyses. Encompassing fluoride-affected areas in Purulia, Bankura, Birbhum, Malda, North-South Dinajpur, and South 24 Parganas, the study emphasizes an integrated and sustainable approach. Employing a multidisciplinary methodology, combining scientific analysis and community engagement, the study identifies key factors influencing water quality and proposes sustainable strategies. Elevated fluoride concentrations exceeding international health standards (Purulia: 0.126 – 8.16 mg/L, Bankura: 0.1 – 12.2 mg/L, Malda: 0.1 – 4.54 mg/L, Birbhum: 0.023 – 18 mg/L) necessitate urgent intervention. Infrastructure deficiencies impede water treatment and distribution, while limited awareness obstructs community participation. The proposed solutions embrace advanced water treatment technologies, infrastructure development, community education, and sustainable water management practices. This comprehensive effort aims to provide clean drinking water, safeguarding the health of affected populations. Building on these foundations, the study explores the potential of rooftop rainwater harvesting as an effective and sustainable strategy to mitigate challenges in fresh drinking water production. By addressing fluoride contamination concerns and promoting community involvement, this approach presents a holistic solution to water quality issues in affected regions. The findings underscore the importance of integrating sustainable practices with community engagement to achieve long-term water security in Purulia, Bankura, Birbhum, Malda, North-South Dinajpur, and South 24 Parganas. This study serves as a cornerstone for further research and policy development, addressing fluoride contamination's impact on public health in affected areas. Recommendations include the establishment of long-term monitoring programs to assess the effectiveness of implemented solutions and conducting health impact studies to understand the long-term effects of fluoride contamination on the local population.

Keywords: fluoride mitigation, rainwater harvesting, water quality, sustainable water management, community engagement

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Authors: Nir Nissim, Ran Yahalom, Tomer Lancewiki, Yuval Elovici, Boaz Lerner

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Background: Attackers increasingly take advantage of innocent users who tend to use USB devices casually, assuming these devices benign when in fact they may carry an embedded malicious behavior or hidden malware. USB devices have many properties and capabilities that have become the subject of malicious operations. Many of the recent attacks targeting individuals, and especially organizations, utilize popular and widely used USB devices, such as mice, keyboards, flash drives, printers, and smartphones. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched via USB devices. Significance: We propose USBWARE, a project that focuses on the vulnerabilities of USB devices and centers on the development of a comprehensive detection framework that relies upon a crucial attack repository. USBWARE will allow researchers and companies to better understand the vulnerabilities and attacks associated with USB devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The framework of USBWARE is aimed at accurate detection of both known and unknown USB-based attacks by a process that efficiently enhances the framework's detection capabilities over time. The framework will integrate two main security approaches in order to enhance the detection of USB-based attacks associated with a variety of USB devices. The first approach is aimed at the detection of known attacks and their variants, whereas the second approach focuses on the detection of unknown attacks. USBWARE will consist of six independent but complimentary detection modules, each detecting attacks based on a different approach or discipline. These modules include novel ideas and algorithms inspired from or already developed within our team's domains of expertise, including cyber security, electrical and signal processing, machine learning, and computational biology. The establishment and maintenance of the USBWARE’s dynamic and up-to-date attack repository will strengthen the capabilities of the USBWARE detection framework. The attack repository’s infrastructure will enable researchers to record, document, create, and simulate existing and new USB-based attacks. This data will be used to maintain the detection framework’s updatability by incorporating knowledge regarding new attacks. Based on our experience in the cyber security domain, we aim to design the USBWARE framework so that it will have several characteristics that are crucial for this type of cyber-security detection solution. Specifically, the USBWARE framework should be: Novel, Multidisciplinary, Trusted, Lightweight, Extendable, Modular and Updatable and Adaptable. Major Findings: Based on our initial survey, we have already found more than 23 types of USB-based attacks, divided into six major categories. Our preliminary evaluation and proof of concepts showed that our detection modules can be used for efficient detection of several basic known USB attacks. Further research, development, and enhancements are required so that USBWARE will be capable to cover all of the major known USB attacks and to detect unknown attacks. Conclusion: USBWARE is a crucial detection framework that must be further enhanced and developed.

Keywords: USB, device, cyber security, attack, detection

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Authors: B. Rusyidi

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Since 2009, the Indonesian Ministry of Social Affairs has been implementing Program Kesejahteraan Sosial Anak (PKSA) (Child Welfare Program) a conditional cash transfer program that targets neglected children, children with disabilities, street children, children in conflict with the law, and children in need of special protection, all from poor households. PKSA integrates three elements: Transfer of cash, care and social services through social workers, and institutional childcare assistance. This qualitative study analyzed the roles and the challenges of social workers in implementing PKSA and lays out recommendations to inform policy changes. Data were collected in late 2014 from national and local government and non-government child welfare agencies, social workers, and childcare institution representatives through interviews and Focused Group Discussions (FGDs). Field work took place in six districts in the provinces of Jakarta, Central Java and South Sulawesi. The study found that the social workers’ role was significant in facilitating cash transfer, providing education and guidance, and linking children and families to basic social services. This improved utilization of basic social services enhanced children and families’ behaviors and contributed to the well being of the children. However, only a small number of childcare institutions have social workers, leaving many children and families without care and social service linkages, depriving them of rehabilitative components to help them regain their social functions. Some social workers reported their struggles with heavy workloads, lack of professional competencies and training, limited job security, and inadequate professional acknowledgment from other professions. Parts of those challenges were due to the centralized nature of the program and the lack of shared vision and commitment about the child protection system among related government agencies both at the national and local levels. The study highlights the necessity to implement an integrated child protection system, decentralize the PKSA program, and increase the number, competence, case management, and management and monitoring of social workers. The most recent progress of the program and its impacts on social workers are also discussed.

Keywords: child protection, conditional cash transfer, program decentralization, social worker, working conditions

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Authors: Evelyn Kropfreiter, Roland Bernhard

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There has been an increased interest in school-based whole-child development in the Austrian education system in the last few years. Although there is a consensus among academics that teachers' beliefs are an essential component of their professional competence, there are hardly any studies in the German-speaking world examining teachers' beliefs about school-based character education. To close this gap, we are conducting a mixed methods study combining qualitative interviews and a questionnaire in Austria (doctoral thesis at the University of Salzburg). In this paper, we present preliminary insights into the quantitative strand of the project. In contrast to German-speaking countries, the Anglo-Saxon world has a long tradition of explicit character education in schools. There has been a rising interest in approaches focusing on a neo-Aristotelian form of character education in England. The Jubilee Centre strongly influences the "renaissance" of papers on neo-Aristotelian character education for Character and Virtues, founded in 2012. The quantitative questionnaire study (n = 264) is an online survey of teachers and school principals conducted in four different federal states in spring 2023. Most respondents (n = 264) from lower secondary schools (AHS-Unterstufe and Mittelschule) believe that character education in schools for 10-14-year-olds is more important for society than good exam results. Many teachers state that they consider themselves prepared to promote their students' personal development and life skills through their education and to attend further training courses. However, there are many obstacles in the education system to ensure that a comprehensive education reaches the students. Many teachers state that they consider themselves prepared to promote their students' character strengths and life skills through their education and to attend further training courses. However, there are many obstacles in the education system to ensure that a comprehensive education reaches the students. Among the most cited difficulties, teachers mention the time factor associated with an overcrowded curriculum and a strong focus on performance, which often leaves them needing more time to keep an eye on nurturing the whole person. The fact that character education is not a separate subject, and its implementation needs to be monitored also makes it challenging to implement it in everyday school life. Austrian teachers prioritize moral virtues such as compassion and honesty as character strengths in everyday school life and resilience and commitment in the next place. Our results are like those reported in other studies on teacher's beliefs about character education. They indicate that Austrian teachers want to teach character in their schools but see systemic constraints such as the curriculum, in which personality roles play a subordinate role, and the focus on performance testing in the school system and the associated lack of time as obstacles to fostering more character development in students.

Keywords: character education, life skills, teachers' beliefs, virtues

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Authors: Adam J. Bowen

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Abstract— Should robots have rights or legal protections. Often debates concerning whether robots and AI should be afforded rights focus on conditions of personhood and the possibility of future advanced forms of AI satisfying particular intrinsic cognitive and moral attributes of rights-holding persons. Such discussions raise compelling questions about machine consciousness, autonomy, and value alignment with human interests. Although these are important theoretical concerns, especially from a future design perspective, they provide limited guidance for addressing the moral and legal standing of current and near-term AI that operate well below the cognitive and moral agency of human persons. Robots and AI are already being pressed into service in a wide range of roles, especially in healthcare and biomedical contexts. The design and large-scale implementation of robots in the context of core societal institutions like healthcare systems continues to rapidly develop. For example, we bring them into our homes, hospitals, and other care facilities to assist in care for the sick, disabled, elderly, children, or otherwise vulnerable persons. We enlist surgical robotic systems in precision tasks, albeit still human-in-the-loop technology controlled by surgeons. We also entrust them with social roles involving companionship and even assisting in intimate caregiving tasks (e.g., bathing, feeding, turning, medicine administration, monitoring, transporting). There have been advances to enable severely disabled persons to use robots to feed themselves or pilot robot avatars to work in service industries. As the applications for near-term AI increase and the roles of robots in restructuring our biomedical practices expand, we face pressing questions about the normative implications of human-robot interactions and collaborations in our collective worldmaking, as well as the moral and legal status of robots. This paper argues that robots operating in public and private spaces be afforded some protections as either moral patients or legal agents to establish prohibitions on robot abuse, misuse, and mistreatment. We already implement robots and embed them in our practices and institutions, which generates a host of human-to-machine and machine-to-machine relationships. As we interact with machines, whether in service contexts, medical assistance, or home health companions, these robots are first encountered in relationship to us and our respective roles in the encounter (e.g., surgeon, physical or occupational therapist, recipient of care, patient’s family, healthcare professional, stakeholder). This proposal aims to outline a framework for establishing limiting factors and determining the extent of moral or legal protections for robots. In doing so, it advocates for a relational approach that emphasizes the priority of mapping the complex contextually sensitive roles played and the relations in which humans and robots stand to guide policy determinations by relevant institutions and authorities. The relational approach must also be technically informed by the intended uses of the biomedical technologies in question, Design History Files, extensive risk assessments and hazard analyses, as well as use case social impact assessments.

Keywords: biomedical robots, robot ethics, robot laws, human-robot interaction

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Authors: Ketseas Dimitris

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In this work, we investigate the effect of noise on a classical two-degree-of-freedom pitch-plunge aeroelastic system. The inlet velocity of the flow is modelled as a stochastically varying parameter by the Ornstein-Uhlenbeck (OU) stochastic process. The system is a 2D airfoil, and the elastic problem is simulated using linear springs. We study the manifestation of Limit Cycle Oscillations (LCO) that correspond to the varying fluid velocity under the dynamic stall regime. We aim to delve into the unexplored facets of the classical pitch-plunge aeroelastic system, seeking a comprehensive understanding of how parametric noise influences the occurrence of LCO and expands the boundaries of its known behavior.

Keywords: aerodynamics, aeroelasticity, computational fluid mechanics, stall flutter, stochastical processes, limit cycle oscillation

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Authors: Farjina Malek, Julie King, Niki Edwards

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Across the globe more than a billion people live with a disability and a further billion people, mostly carers, are indirectly impacted. While prevalence data is problematic, it is estimated that more than 15% of the population in Bangladesh live with a disability. Disability service infrastructure in Bangladesh is under-developed; and consequently, the onus of care falls on family, especially on mothers. Within the caring role, mothers encounter many challenging experiences which are not only due to the lack of support delivered through the Bangladeshi health care system but also related to the existence of stigma and perception around disability in the Bangladeshi society. Within this perception, the causes of disability are mostly associated with 'God’s will'; 'possession of ghosts on the disabled person'; and 'karma or the result of past sins of the family members especially the mothers'. These beliefs are likely to have a significant impact on the well-being of mothers and their caring experience of children with disability. This is an ongoing qualitative study which is conducting in-depth interviews with 30 mothers from five districts (Dhaka, Mymensingh, Manikganj, Tangail, and Gazipur) of Bangladesh with the aim to explore the impact of social perception and stigma around physical disability on the caring role of the mothers of children with physical disability. The major findings of this study show that the social perception around disability and the social expectation from a mother regarding her caring role have a huge impact on the well-being of mothers. Mothers are mostly expected to take their child on their lap to prove that they are ‘good mother’. These practices of lifting their children with physical disability and keeping them on the lap for a long time often cause chronic back pain of the mothers. Existing social beliefs consider disability as a ‘curse’ and punishment for the ‘sins’ of the family members, most often by the mother. Mothers are blamed if they give birth to ‘abnormal’ children. This social construction creates stigma, and thus, the caring responsibility of mothers become more challenging. It also encourages the family and mothers to hide their children from the society and to avoid seeking accessible disability services. The mothers also compromise their careers and social interaction as they have to stay with their children at home, and that has a significant impact on personal wellbeing, income, and empowerment of the mothers. The research is informed by intersectional theory and employed an interpretive phenomenological methodology to explore mothers’ experience of caring their children with physical disability, and the contribution and impact of key relationships within the family and the intersection with community and services.

Keywords: mother, family carer, physical disability, children, social stigma, key relationship

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Authors: Sabrina Yulianti

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This study aims to explain the identity struggles of local religious communities in Indonesia. Local religion in Indonesia is not recognized by the government and is not incorporated into the official religion in Indonesia. This makes the local religions in Indonesia experienced the challenges and obstacles in fulfilling their rights as citizens of Indonesia. Challenges and barriers they experience such as: difficulty in making of the birth certificate and marriage. It is as experienced by one of the local religions namely Parmalim which located in North Sumatra. Not only difficulty in taking care of the bureaucracy as a citizen, but the local religion is seen as a minority and sometimes regarded as follower of deviate religion.

Keywords: local religion, faith, struggles, civilization, discrimination

Procedia PDF Downloads 388