Search results for: trauma-focused cognitive behavioral therapy

Authors: Lusi Susanti, Prima Fithri

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The rapid growth of Indonesia population is directly proportional to the energy needs of the country, but not all of Indonesian population can relish the electricity. Indonesia's electrification ratio is still around 80.1%, which means that approximately 19.9% of households in Indonesia have not been getting the flow of electrical energy. Household electricity consumptions in Indonesia are generally still dominated by the public urban. In the city of Padang, West Sumatera, Indonesia, about 94.10% are power users of government services (PLN). The most important thing of the issue is human resources efficient energy. User behavior in utilizing electricity becomes significant. However repair solution will impact the user's habits sustainable energy issues. This study attempts to identify the user behavior and lifestyle that affect household electricity consumption and to evaluate the potential for energy saving. The behavior component is frequently underestimated or ignored in analyses of household electrical energy end use, partly because of its complexity. It is influenced by socio-demographic factors, culture, attitudes, aesthetic norms and comfort, as well as social and economic variables. Intensive questioner survey, in-depth interview and statistical analysis are carried out to collect scientific evidences of the behavioral based changes instruments to reduce electricity consumption in household sector. The questioner was developed to include five factors assuming affect the electricity consumption pattern in household sector. They are: attitude, energy price, household income, knowledge and other determinants. The survey was carried out in Padang, West Sumatra Province Indonesia. About 210 questioner papers were proportionally distributed to households in 11 districts in Padang. Stratified sampling was used as a method to select respondents. The results show that the household size, income, payment methods and size of house are factors affecting electricity saving behavior in residential sector. Household expenses on electricity are strongly influenced by gender, type of job, level of education, size of house, income, payment method and level of installed power. These results provide a scientific evidence for stakeholders on the potential of controlling electricity consumption and designing energy policy by government in residential sector.

Keywords: electricity, energy saving, household, behavior, policy

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Authors: Shohreh Rahimi Lascokalayeh, Hasan Yousefnia, Mojtaba Tajik, Samaneh Zolghadri, Bentehoda Abdolhosseini

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In this study, the production of terbium-161 as new therapeutic radionuclide was investigated using TALYS1.6& EMPIRE 3.2 codes. For this purpose, cross section for the reactions reactor to produce 161Tb were extracted by mean of this code In the following step, stopping power of the reactions reactor was calculated by SRIM code. The best reaction in the production of 161Tb is160 Gd(d,n)161Tb Production yield of the 161Tb was obtained by utilization of MATLAB calculation code and based on the charged particle reaction formalism.The results showed that Production yield of the 161Tb was obtained 0.8 (mci/ A*h).

Keywords: terbium161, TALYS1.6, EMPIRE3.2, yield, cross-section

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Authors: Chrislaura Carmo, Luca Deiana, Mafalda Laranjo, Abilio Sobral, Armando Cordova

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Photodynamic therapy (PDT) is currently used for the treatment of malignancies and premalignant tumors. It is based on the capture of a photosensitizing molecule (PS) which, when excited by light at a certain wavelength, reacts with oxygen and generates oxidizing species (radicals, singlet oxygen, triplet species) in target tissues, leading to cell death. BODIPY (4,4-difluoro-4-bora-3a,4a-diaza-s-indaceno) derivatives are emerging as important candidates for photosensitizer in photodynamic therapy of cancer cells due to their high triplet quantum yield. Today these dyes are relevant molecules in photovoltaic materials and fluorescent sensors. In this study, it will be demonstrated the possibility that BODIPY can be covalently linked to thioglycolic acid through the click reaction. Thiol−ene click chemistry has become a powerful synthesis method in materials science and surface modification. The design of biobased allyl-terminated precursors with high renewable carbon content for the construction of the thiol-ene polymer networks is essential for sustainable development and green chemistry. The work aims to synthesize the BODIPY (10-(4-(allyloxy) phenyl)-2,8-diethyl-5,5-difluoro-1,3,7,9-tetramethyl-5H-dipyrrolo[1,2-c:2',1'-f] [1,3,2] diazaborinin-4-ium-5-uide) and to click reaction with Thioglycolic acid. BODIPY was synthesized by the condensation reaction between aldehyde and pyrrole in dichloromethane, followed by in situ complexation with BF3·OEt2 in the presence of the base. Then it was functionalized with allyl bromide to achieve the double bond and thus be able to carry out the click reaction. The thiol−ene click was performed using DMPA (2,2-Dimethoxy-2-phenylacetophenone) as a photo-initiator in the presence of UV light (320–500 nm) in DMF at room temperature for 24 hours. Compounds were characterized by standard analytical techniques, including UV-Vis Spectroscopy, 1H, 13C, 19F NMR and mass spectroscopy. The results of this study will be important to link BODIPY to polymers through the thiol group offering a diversity of applications and functionalization. This new molecule can be tested as third-generation photosensitizers, in which the dye is targeted by antibodies or nanocarriers by cells, mainly in cancer cells, PDT and Photodynamic Antimicrobial Chemotherapy (PACT). According to our studies, it was possible to visualize a click reaction between allyl BODIPY and thioglycolic acid. Our team will also test the reaction with other thiol groups for comparison. Further, we will do the click reaction of BODIPY with a natural polymer linked with a thiol group. The results of the above compounds will be tested in PDT assays on various lung cancer cell lines.

Keywords: bodipy, click reaction, thioglycolic acid, allyl, thiol-ene click

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Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta

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Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.

Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care

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Authors: N. Didiş Körhasan, D. Kaltakçı Gürel

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Many students have difficulty in learning physics from elementary to university level. In addition, students' expectancy, attitude, and motivation may be influenced negatively with their experience (failure) and prejudice about physics learning. For this reason, physics educators, who are also physics teachers, search for the best ways to make students' learning of physics easier by considering cognitive, affective, and psychomotor issues in learning. This research critically discusses the history of physics education, fundamental pedagogical approaches, and models to teach physics, and transformation of physics education with recent research.

Keywords: pedagogy, physics, physics education, science education

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Authors: Daniel Vargas-Herrera, Ivette Caldelas, Fernando Brambila-Paz, Rodrigo Montufar-Chaveznava

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In this paper, we present a virtual reality application for neurorehabilitation. This application was developed using the Unity SDK integrating the Oculus Rift and Leap Motion devices. Essentially, it consists of three stages according to the kind of rehabilitation to carry on: ocular rehabilitation, head/neck rehabilitation, and eye-hand coordination. We build three scenes for each task; for ocular and head/neck rehabilitation, there are different objects moving in the field of view and extended field of view of the user according to some patterns relative to the therapy. In the third stage the user must try to touch with the hand some objects guided by its view. We report the primer results of the use of the application with healthy people.

Keywords: virtual reality, interactive technologies, video games, neurorehabilitation

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Authors: Michael McMahon

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The use of media (video/animation/graphics) has long been used by athletes, coaches, and sports scientists to analyse and improve performance in technical skills and team tactics. Sports educators are increasingly open to the use of technology to support coach and learner development. However, an overreliance is a concern., This paper is part of a larger Ph.D. study looking into these new challenges for Sports Educators. Most notably, how to exploit the deep-learning potential of Digital Media among expert learners, how to instruct sports educators to create effective media content that fosters deep learning, and finally, how to make the process manageable and cost-effective. Central to the study is Richard Mayers Cognitive Theory of Multimedia Learning. Mayers Multimedia Learning Theory proposes twelve principles that shape the design and organization of multimedia presentations to improve learning and reduce cognitive load. For example, the Prior Knowledge principle suggests and highlights different learning outcomes for Novice and Non-Novice learners, respectively. Little research, however, is available to support this principle in modified domains (e.g., sports tactics and strategy). As a foundation for further research, this paper compares and contrasts a range of contemporary multimedia sports coaching content and assesses how they perform as learning tools for Strategic and Tactical Play Acquisition among elite sports practitioners. The stress tests applied are guided by Mayers's twelve Multimedia Learning Principles. The focus is on the elite athletes and whether current coaching digital media content does foster improved sports learning among this cohort. The sport of Gaelic Football was selected as it has high strategic and tactical play content, a wide range of Practitioner skill levels (Novice to Elite), and also a significant volume of Multimedia Coaching Content available for analysis. It is hoped the resulting data will help identify and inform the future instructional content design and delivery for Sports Practitioners and help promote best design practices optimal for different levels of expertise.

Keywords: multimedia learning, e-learning, design for learning, ICT

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Authors: Lakmini Wijesooriya, Vicki Chalker, Jessica Day, Priyantha Perera, N. P. Sunil-Chandra

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M. pneumoniae has been identified as an etiology for exacerbation of asthma (EQA), although viruses play a major role in EOA. M. pneumoniae infection is treated empirically with macrolides, and its antibiotic sensitivity is not detected routinely. Characterization of the organism by genotyping and determination of macrolide resistance is important epidemiologically as it guides the empiric antibiotic treatment. To date, there is no such characterization of M. pneumoniae performed in Sri Lanka. The present study describes the characterization of M. pneumoniae detected from a child with EOA following a screening of 100 children with EOA. Of the hundred children with EOA, M. pneumoniae was identified only in one child by Real-Time polymerase chain reaction (PCR) test for identifying the community-acquired respiratory distress syndrome (CARDS) toxin nucleotide sequences. The M. pneumoniae identified from this patient underwent detection of macrolide resistance via conventional PCR, amplifying and sequencing the region of the 23S rDNA gene that contains single nucleotide polymorphisms that confer resistance. Genotyping of the isolate was performed via nested Multilocus Sequence Typing (MLST) in which eight (8) housekeeping genes (ppa, pgm, gyrB, gmk, glyA, atpA, arcC, and adk) were amplified via nested PCR followed by gene sequencing and analysis. As per MLST analysis, the M. pneumoniae was identified as sequence type 14 (ST14), and no mutations that confer resistance were detected. Resistance to macrolides in M. pneumoniae is an increasing problem globally. Establishing surveillance systems is the key to informing local prescriptions. In the absence of local surveillance data, antibiotics are started empirically. If the relevant microbiological samples are not obtained before antibiotic therapy, as in most occasions in children, the course of antibiotic is completed without a microbiological diagnosis. This happens more frequently in therapy for M. pneumoniae which is treated with a macrolide in most patients. Hence, it is important to understand the macrolide sensitivity of M. pneumoniae in the setting. The M. pneumoniae detected in the present study was macrolide sensitive. Further studies are needed to examine a larger dataset in Sri Lanka to determine macrolide resistance levels to inform the use of macrolides in children with EOA. The MLST type varies in different geographical settings, and it also provides a clue to the existence of macrolide resistance. The present study enhances the database of the global distribution of different genotypes of M. pneumoniae as this is the first such characterization performed with the increased number of samples to determine macrolide resistance level in Sri Lanka. M. pneumoniae detected from a child with exacerbation of asthma in Sri Lanka was characterized as ST14 by MLST and no mutations that confer resistance were detected.

Keywords: mycoplasma pneumoniae, Sri Lanka, characterization, macrolide resistance

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Authors: Ivana Prochazkova

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Cognitive linguistics offers biblical scholarship a specific methodological tool for analysis and interpretation of metaphorical expressions. Its methodology makes it possible to study processes involved in constructing the meaning of individual metaphorical expressions and whole conceptual metaphors; to analyze their function in the text; to follow the semantic development of concepts and conceptual domains, and to trace semantic changes and their motivation. The legal language in the Hebrew canon is extremely specific and formalized. Especially in the preambles to the collections of laws in the Pentateuch, more general considerations of the motif of keeping and breaking the law are encountered. This is also true in the psalms and wisdom literature. Legal theory and the philosophy of law deal with these motifs today. Metaphors play an important role in texts that reflect on more general issues. The purpose of this conference contribution is to write all over the central metaphorical concept, conceptual metaphor ךרד תורה (TORAH/LAW IS A JOURNEY), its function in the Torah and principal trends of the further development in the Prophets and the Writings. The conceptual metaphor תורה ךרד (TORAH/LAW IS A JOURNEY) constitutes a coherent system in conjunction with other metaphors that include e.g., conceptual metaphors נחה תורה (TORAH/LAW LEADS); its variant רעה תורה (TORAH IS A SHEPHERD/GUIDE); מקור תורה (TORAH/LAW IS A FOUNTAIN/A SOURCE OF LIFE). Some conceptual metaphors are well known, and their using are conventional (עשׁר תורה TORAH/LAW IS RICHES, שׂשׂון תורה TORAH/LAW IS DELIGHT, דבשׁ תורה TORAH/LAW IS HONEY, שׁמשׁ תורה TORAH/LAW IS SUN ). But some conceptual metaphors are by its occurrence innovative and unique (e.g., שׁריון תורה TORAH /LAW IS BODY ARMOR, כובע תורה TORAH /LAW IS A HELMET, בגד תורה TORAH/LAW IS A GARMENT, etc.). There will be given examples. Conceptual metaphors will be described by means of some 'metaphorical vehicles,' which are Hebrew expressions in the source domain that are repeatedly used in metaphorical conceptualizations of the target domain(s). Conceptual metaphors will be further described by means of 'generic narrative structures,' which are the particular aspects of a conceptual metaphor that emerge during the metaphorical structuring of concepts. They are the units of the metaphorical vehicles – the Hebrew expressions in the source domain – that structure concepts in much the same way that the conceptual metaphor in the target domain does. And finally, they will be described by means of the network of correspondences that exist between metaphorical vehicles – or generic metaphorical structures – and the Hebrew expressions in the target domain.

Keywords: cognitive theology, conceptual metaphor in the Old Testament, conceptual metaphors of the Torah, conceptual domain of law, righteousness, and justice

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Authors: Fatemeh Jannesarvatan, Ghazaal Parastooei, Jimmy frerejan, Saedeh Mokhtari, Peter Van Rosmalen

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Medical and dental education increasingly emphasizes the acquisition, integration, and coordination of complex knowledge, skills, and attitudes that can be applied in practical situations. Instructional design approaches have focused on using real-life tasks in order to facilitate complex learning in both real and simulated environments. The Four component instructional design (4C/ID) model has become a useful guideline for designing instructional materials that improve learning transfer, especially in health profession education. The objective of this study was to apply the 4C/ID model in the creation of virtual patients (VPs) that dental students can use to practice their clinical management and clinical reasoning skills. The study first explored the context and concept of complication factors and common errors for novices and how they can affect the design of a virtual patient program. The study then selected key dental information and considered the content needs of dental students. The design of virtual patients was based on the 4C/ID model's fundamental principles, which included: Designing learning tasks that reflect real patient scenarios and applying different levels of task complexity to challenge students to apply their knowledge and skills in different contexts. Creating varied learning materials that support students during the VP program and are closely integrated with the learning tasks and students' curricula. Cognitive feedback was provided at different levels of the program. Providing procedural information where students followed a step-by-step process from history taking to writing a comprehensive treatment plan. Four virtual patients were designed using the 4C/ID model's principles, and an experimental design was used to test the effectiveness of the principles in achieving the intended educational outcomes. The 4C/ID model provides an effective framework for designing engaging and successful virtual patients that support the transfer of knowledge and skills for dental students. However, there are some challenges and pitfalls that instructional designers should take into account when developing these educational tools.

Keywords: 4C/ID model, virtual patients, education, dental, instructional design

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Authors: I. Witbooi, J. De Smidt, A. Oelofse

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Negative emotions that are common in depression are coupled with the activation of the corrugator supercilli and procerus muscles in the glabellar region of the face. This research investigated the impact of OnabotulinumtoxinA (BOTOX) in the improvement of emotional states in depressed subjects by relaxing the mentioned muscles. The aim of the study was to investigate the effectiveness of BOTOX treatment for glabellar frown lines as an adjunctive therapy for Major Depressive Disorder (MDD) and to improve the quality of life and self-esteem of the subjects. It is hypothesized that BOTOX treatment for glabellar frown lines reduces depressive symptoms significantly and therefore augment conventional antidepressant medication. Forty-five (45) subjects diagnosed with MDD were assigned to a treatment (n = 15), placebo (n = 15), and control (n = 15) group. The treatment group received BOTOX injection, while the placebo group received saline injection into the Procerus and Corrugator supercilli muscles with follow-up visits every 3 weeks (weeks 3, 6 and 12 respectively). The control group received neither BOTOX nor saline injections and were only interviewed again on the 12th week. To evaluate the effect of BOTOX treatment in the glabellar region on depressive symptoms, the Montgomery-Asberg Depression Rating (MADRS) scale and the Beck Depression Inventory (BDI) were used. The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) and Rosenberg Self-Esteem Scale (RSES) were used in the assessment of self-esteem and quality of life. Participants were followed up for a 12 week period. The expected primary outcome measure is the response to treatment, and it is defined as a ≥ 50% reduction in MADRS score from baseline. Other outcome measures include a clinically significant decrease in BDI scores and the increase in quality of life and self-esteem respectively. Initial results show a clear trend towards such differences. Results showed trends towards expected differences. Patients in the Botox group had a mean MADRS score of 14.0 at 3 weeks compared to 20.3 of the placebo group. This trend was still visible at 6 weeks with the Botox and placebo group scoring an average of 10 vs. 18 respectively. The mean difference in MDRS scores from baseline to 3 weeks were 9.3 and 2.0 for the Botox and placebo group respectively. Similarly, the BDI scores were lower in the Botox group (17.25) compared to the placebo group (19.43). The two self-esteem questionnaires showed expected results at this stage with the RSES 19.1 in the Botox group compared to 18.6 in the placebo group. Similarly, the Botox patients had a higher score for the Q-LES-Q-SF of 49.2 compared to 46.1 for the placebo group. Conclusions: Initial results clearly demonstrated that the use of Botox had positive effects on both scores of depressions and that of self-esteem when compared to a placebo group.

Keywords: adjunctive therapy, depression, glabellar area, OnabotulinumtoxinA

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Authors: Evgeny E. Tereshatov

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Astatine-211 is considered one of the most promising radionuclides for Targeted Alpha Therapy. In order to develop reliable procedures to label biomolecules and utilize efficient delivery vehicle principles, one should understand the main chemical characteristics of astatine. The short half-life of 211At (~7.2 h) and absence of any stable isotopes of this element are limiting factors towards studying the behavior of astatine. Our team has developed a procedure for rapid and efficient isolation of astatine from irradiated bismuth material in nitric acid media based on 3-octanone and 1-octanol extraction chromatography resins. This process has been automated and it takes 20 min from the beginning of the target dissolution to the At-211 fraction elution. Our next step is to consider commercially available chromatography resins and their applicability in astatine purification in the same media. Results obtained along with the corresponding sorption mechanisms will be discussed.

Keywords: astatine-211, chromatography, automation, mechanism, radiopharmaceuticals

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Authors: Ann Devitt, Mairead Brady, Markus Lamest, Stephen Gomez

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This study set out to explore the use of an online collaborative serious game for student learning in a postgraduate introductory marketing module. The simulation game aimed to bridge the theory-practice divide in marketing by allowing students to apply theory in a safe, simulated marketplace. This study addresses the following research questions: Does an online marketing simulation game engage students higher order cognitive skills? Does collaborative activity required develop students’ “soft” skills, such as communication and negotiation? What specific affordances of the online simulation promote learning? This qualitative case study took place in 2014 with 40 postgraduate students on a Business Masters Programme. The two-week intensive module combined lectures with collaborative activity on a marketing simulation game, MMX from Pearsons. The game requires student teams to compete against other teams in a marketplace and design a marketing plan to maximize key performance indicators. The data for this study comprise essays written by students after the module reflecting on their learning on the module. A thematic analysis was conducted of the essays using the following a priori theme sets: 6 levels of the cognitive domain of Blooms taxonomy; 5 principles of Cooperative Learning; affordances of simulation environments including experiential learning; motivation and engagement; goal orientation. Preliminary findings would strongly suggest that the game facilitated students identifying the value of theory in practice, in particular for future employment; enhanced their understanding of group dynamics and their role within that; and impacted very strongly, both positively and negatively on motivation. In particular the game mechanics of MMX, which hinges on the correct identification of a target consumer group, was identified as a key determinant of extrinsic and intrinsic motivation for learners. The findings also suggest that the situation of the simulation game within a broader module which required post-game reflection was valuable in identifying key learning of marketing concepts in both the positive and the negative experiences of the game.

Keywords: simulation, marketing, serious game, cooperative learning, bloom's taxonomy

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Authors: Elisa Menardo, Margherita Pasini, Margherita Brondino

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A growing body of empirical research from different areas of inquiry suggests that brief contact with natural environment restore mental resources. The Attention Restoration Theory (ART) is the widespread used and empirical founded theory developed to explain why exposure to nature helps people to recovery cognitive resources. It assumes that contact with nature allows people to free (and then recovery) voluntary attention resources and thus allows them to recover from a cognitive fatigue situation. However, it was suggested that some people could have more cognitive benefit after exposure to urban environment. The objective of this study is to report the results of a meta-analysis on studies (peer-reviewed articles) comparing the restorativeness (the quality to be restorative) perceived in natural environments than those perceived in urban environments. This meta-analysis intended to estimate how much nature environments (forests, parks, boulevards) are perceived to be more restorativeness than urban ones (i.e., the magnitude of the perceived restorativeness’ difference). Moreover, given the methodological difference between study, it studied the potential role of moderator variables as participants (student or other), instrument used (Perceived Restorativeness Scale or other), and procedure (in laboratory or in situ). PsycINFO, PsycARTICLES, Scopus, SpringerLINK, Web of Science online database were used to identify all peer-review articles on restorativeness published to date (k = 167). Reference sections of obtained papers were examined for additional studies. Only 22 independent studies (with a total of 1371 participants) met inclusion criteria (direct exposure to environment, comparison between one outdoor environment with natural element and one without natural element, and restorativeness measured by self-report scale) and were included in meta-analysis. To estimate the average effect size, a random effect model (Restricted Maximum-likelihood estimator) was used because the studies included in the meta-analysis were conducted independently and using different methods in different populations, so no common effect-size was expected. The presence of publication bias was checked using trim and fill approach. Univariate moderator analysis (mixed effect model) were run to determine whether the variable coded moderated the perceived restorativeness difference. Results show that natural environments are perceived to be more restorativeness than urban environments, confirming from an empirical point of view what is now considered a knowledge gained in environmental psychology. The relevant information emerging from this study is the magnitude of the estimated average effect size, which is particularly high (d = 1.99) compared to those that are commonly observed in psychology. Significant heterogeneity between study was found (Q(19) = 503.16, p < 0.001;) and studies’ variability was very high (I2[C.I.] = 96.97% [94.61 - 98.62]). Subsequent univariate moderator analyses were not significant. Methodological difference (participants, instrument, and procedure) did not explain variability between study. Other methodological difference (e.g., research design, environment’s characteristics, light’s condition) could explain this variability between study. In the mine while, studies’ variability could be not due to methodological difference but to individual difference (age, gender, education level) and characteristics (connection to nature, environmental attitude). Furthers moderator analysis are working in progress.

Keywords: meta-analysis, natural environments, perceived restorativeness, urban environments

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Authors: Aneesha Fonseca, Arij Daas, Muhammed Abdulkader

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Transient intraocular pressure (IOP) rise is a common occurrence after glaucoma laser procedures. However, this pressure spike usually lasts only a few days. We describe a case of a 60-year-old Caucasian gentleman who underwent selective laser trabeculoplasty (SLT) in both eyes for ocular hypertension previously treated with Bimatoprost and Timolol and developed a sustained raised IOP. His IOP rose from 34 and 33 mmHg pre-laser to 48 and 42 mmHg after SLT in the right and left eye, respectively. Even after maximum medical therapy (Bimatoprost, Timolol, Brinzolamide Apraclonidine, and oral Acetozolamide), his IOP remained at 32 and 28mmHg. A provisional diagnosis of trabeculitis was made, and topical Ketorolac was commenced in addition to the IOP-lowering medications. Within a week, his IOP came down to 21 and 18mmHg in the right and left eye, respectively.

Keywords: complications, selective laser trabeculoplasty, sustained pressure rise, trabeculitis

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Authors: Andrew D. Henshaw, James M. Austin

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Introduction: Human trafficking is an increasingly serious transnational criminal enterprise and social security issue. Despite ongoing efforts to mitigate the phenomenon and a significant expansion of security scrutiny over past decades, it is not receding. This is true for many nations in Southeast Asia, widely recognized as the global hub for trafficked persons, including men, women, and children. Clearly, human trafficking is difficult to address because there are numerous drivers, causes, and motivators for it to persist, such as non-military and non-traditional security challenges, i.e., climate change, global warming displacement, and natural disasters. These make displaced persons and refugees particularly vulnerable. The issue is so large conservative estimates put a dollar value at around $150 billion-plus per year (Niethammer, 2020) spanning sexual slavery and exploitation, forced labor, construction, mining and in conflict roles, and forced marriages of girls and women. Coupled with corruption throughout military, police, and civil authorities around the world, and the active hands of powerful transnational criminal organizations, it is likely that such figures are grossly underestimated as human trafficking is misreported, under-detected, and deliberately obfuscated to protect those profiting from it. For example, the 2022 UN report on human trafficking shows a 56% reduction in convictions in that year alone (UNODC, 2022). Our Approach: To better understand this, our research utilizes a bespoke methodology. Applying a JAM (Juxtaposition Assessment Matrix), which we previously developed to detect flows of dark money around the globe (Henshaw, A & Austin, J, 2021), we now focus on the human trafficking paradigm. Indeed, utilizing a JAM methodology has identified key indicators of human trafficking not previously explored in depth. Being a set of structured analytical techniques that provide panoramic interpretations of the subject matter, this iteration of the JAM further incorporates behavioral and driver indicators, including the employment of Open-Source Artificial Intelligence (OS-AI) across multiple collection points. The extracted behavioral data was then applied to identify non-traditional indicators as they contribute to human trafficking. Furthermore, as the JAM OS-AI analyses data from the inverted position, i.e., the viewpoint of the traffickers, it examines the behavioral and physical traits required to succeed. This transposed examination of the requirements of success delivers potential leverage points for exploitation in the fight against human trafficking in a new and novel way. Findings: Our approach identified new innovative datasets that have previously been overlooked or, at best, undervalued. For example, the JAM OS-AI approach identified critical 'dark agent' lynchpins within human trafficking that are difficult to detect and harder to connect to actors and agents within a network. Our preliminary data suggests this is in part due to the fact that ‘dark agents’ in extant research have been difficult to detect and potentially much harder to directly connect to the actors and organizations in human trafficking networks. Our research demonstrates that using new investigative techniques such as OS-AI-aided JAM introduces a powerful toolset to increase understanding of human trafficking and transnational crime and illuminate networks that, to date, avoid global law enforcement scrutiny.

Keywords: human trafficking, open-source intelligence, transnational crime, human security, international human rights, intelligence analysis, JAM OS-AI, Dark Money

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Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

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Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

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Authors: Oya Umit Yemisci, Nur Saracgil Cosar, Tubanur Ozturk Sisman, Selin Ozen

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Chronic autoimmune thyroiditis (AIT) may result in a wide spectrum of reversible abnormalities in the neuromuscular function. Usually, proximal muscle-related symptoms and neuropathic findings such as mild axonal peripheral neuropathy have been reported. Sympathetic skin responses are useful in evaluating sudomotor activity of the unmyelinated sympathetic fibers of the autonomic nervous system. Neurocognitive impairment may also be a prominent feature of hypothyroidism, particularly in elderly patients. Electromyographic reaction times as a highly sensitive parameter provides. Objective data concerning cognitive and motor functions. The aim of this study was to evaluate peripheral nerve functions, sympathetic skin response and electroneuromyographic (ENMG) reaction times in euthyroid and subclinically hypothyroid patients with a diagnosis of AIT and compare to those of a control group. Thirty-five euthyroid, 19 patients with subclinical hypothyroidism and 35 age and sex-matched healthy subjects were included in the study. Motor and sensory nerve conduction studies, sympathetic skin responses recorded from hand and foot by stimulating contralateral median nerve and simple reaction times by stimulating tibial nerve and recording from extensor indicis proprius muscle were performed to all patients and control group. Only median nerve sensory conduction velocities of the forearm were slower in patients with AIT compared to the control group (p=0.019). Otherwise, nerve conduction studies and sympathetic skin responses showed no significant difference between the patients and the control group. However, reaction times were shorter in the healthy subjects compared to AIT patients. Prolongation in the reaction times may be considered as a parameter reflecting the alterations in the cognitive functions related to the primary disease process in AIT. Combining sympathetic skin responses with more quantitative tests such as cardiovascular tests and sudomotor axon reflex testing may allow us to determine higher rates of involvement of the autonomic nervous system in AIT.

Keywords: sympathetic skin response, simple reaction time, chronic autoimmune thyroiditis

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Authors: Soniya Nityanand, Ekta Minocha, Manali Jain, Rohit Anthony Sinha, Chandra Prakash Chaturvedi

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Amniotic fluid stem cells (AFSC) have been shown to contribute towards the amelioration of Acute Renal Failure (ARF), but the mechanisms underlying the renoprotective effect are largely unknown. Therefore, the main goal of the current study was to evaluate the therapeutic efficacy of AFSC in a cisplatin-induced rat model of ARF and to investigate the underlying mechanisms responsible for its renoprotective effect. To study the therapeutic efficacy of AFSC, ARF was induced in Wistar rats by an intra-peritoneal injection of cisplatin, and five days after administration, the rats were randomized into two groups and injected with either AFSC or normal saline intravenously. On day 8 and 12 after cisplatin injection, i.e., day 3 and day7 post-therapy respectively, the blood biochemical parameters, histopathological changes, apoptosis and expression of pro-apoptotic, anti-apoptotic and autophagy-related proteins in renal tissues were studied in both groups of rats. Administration of AFSC in ARF rats resulted in improvement of renal function and attenuation of renal damage as reflected by significant decrease in blood urea nitrogen, serum creatinine levels, tubular cell apoptosis as assessed by Bax/Bcl2 ratio, and expression of the pro-apoptotic proteins viz. PUMA, Bax, cleaved caspase-3 and cleaved caspase-9 as compared to saline-treated group. Furthermore, in the AFSC-treated group as compared to saline-treated group, there was a significant increase in the activation of autophagy as evident by increased expression of LC3-II, ATG5, ATG7, Beclin1 and phospho-AMPK levels with a concomitant decrease in phospho-p70S6K and p62 expression levels. To further confirm whether the protective effects of AFSC on cisplatin-induced apoptosis were dependent on autophagy, chloroquine, an autophagy inhibitor was administered by the intra-peritoneal route. Chloroquine administration led to significant reduction in the anti-apoptotic effects of the AFSC therapy and further deterioration in the renal structure and function caused by cisplatin. Collectively, our results put forth that AFSC ameliorates cisplatin-induced ARF through induction of autophagy and inhibition of apoptosis. Furthermore, the protective effects of AFSC were blunted by chloroquine, highlighting that activation of autophagy is an important mechanism of action for the protective role of AFSC in cisplatin-induced renal injury.

Keywords: amniotic fluid stem cells, acute renal failure, autophagy, cisplatin

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Authors: Joan Edwards, J. Lawlor

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Technological innovation is frequently defined in terms of bringing a new invention to market through a relatively straightforward process of diffusion. In reality, this process is complex and non-linear in nature, and includes social and cognitive factors that influence the development of an emerging technology and its related market or environment. As recent studies contend technological trajectory is part of technological paradigms, which arise from the expectations and desires of industry agents and results in co-evolution, it may be realised that social factors play a major role in the development of a technology. It is conjectured that collective social behaviour is fuelled by individual motivations and expectations, which inform the possibilities and uses for a new technology. The individual outlook highlights the issues present at the micro-level of developing a technology. Accordingly, this may be zoomed out to realise how these embedded social structures, influence activities and expectations at a macro level and can ultimately strategically shape the development and use of a technology. These social factors rely on communication to foster the innovation process. As innovation may be defined as the implementation of inventions, technological change results from the complex interactions and feedback occurring within an extended environment. The framework presented in this paper, recognises that social mechanisms provide the basis for an iterative dialogue between an innovator, a new technology, and an environment - within which social and cognitive ‘identity-shaping’ elements of the innovation process occur. Identity-shaping characteristics indicate that an emerging technology has a performative nature that transforms, alters, and ultimately configures the environment to which it joins. This identity–shaping quality is termed as ‘performative’. This paper examines how technologies evolve within a socio-technological sphere and how 'performativity' facilitates the process. A framework is proposed that incorporates the performative elements which are identified as feedback, iteration, routine, expectations, and motivations. Additionally, the concept of affordances is employed to determine how the role of the innovator and technology change over time - constituting a more conducive environment for successful innovation.

Keywords: affordances, framework, performativity, strategic innovation

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Authors: Vinicius R. Domingues, Luan C. S. M. Ozelim

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The statistical study has become indispensable for various fields of knowledge. Not any different, in Geotechnics the study of probabilistic and statistical methods has gained power considering its use in characterizing the uncertainties inherent in soil properties. One of the situations where engineers are constantly faced is the definition of a probability distribution that represents significantly the sampled data. To be able to discard bad distributions, goodness-of-fit tests are necessary. In this paper, three non-parametric goodness-of-fit tests are applied to a data set computationally generated to test the goodness-of-fit of them to a series of known distributions. It is shown that the use of normal distribution does not always provide satisfactory results regarding physical and behavioral representation of the modeled parameters.

Keywords: Kolmogorov-Smirnov test, Anderson-Darling test, Cramer-Von-Mises test, nonparametric adherence tests

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Authors: Roger WUMBA

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The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients. In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk. Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of ,100 cells/mm³, and no antiretroviral therapy (ART), respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of ,100 cells/mm³, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal parasites. Rural areas, public toilets, and exposure to farm pigs were the univariate risk factors present in the 28 cases with opportunistic intestinal parasites. In logistic regression analysis, a CD4 count of ,100 cells/mm³ (OR = 4.60; 95% CI 1.70–12.20; P = 0.002), no ART (OR = 5.00; 95% CI 1.90–13.20; P , 0.001), and exposure to surface water (OR = 2.90; 95% CI 1.01–8.40; P = 0.048) were identified as the significant and independent determinants for the presence of opportunistic intestinal parasites. E. bieneusi and Cryptosporidium are becoming more prevalent in Kinshasa, Congo. Based on the findings, we recommend epidemiology surveillance and prevention by means of hygiene, the emphasis of sensitive PCR methods, and treating opportunistic intestinal parasites that may be acquired through fecal–oral transmission, surface water, normal immunity, rural area-based person–person and animal–human nfection, and transmission of HIV. Therapy, including ART and treatment with fumagillin, is needed.

Keywords: diarrhea, enterocytozoon bieneusi, cryptosporidium hominis, cryptosporidium parvum, risk factors, africans

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Authors: Saeedeh Shahbazkhany

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Cancer is a terrible disease that, if not diagnosed early, therapy can be difficult while it is easily medicable if it is diagnosed in early stages. So it is very important for cancer diagnosis that medical procedures are performed. In this paper we introduce a new method. In this method, we only need pictures of healthy cells and cancer cells. In fact, where we suspect cancer, we take a picture of cells or tissue in that area, and then take some pictures of the surrounding tissues. Then, fractal dimension of images are calculated and compared. Cancer can be easily detected by comparing the fractal dimension of images. In this method, we use Matlab software.

Keywords: Matlab software, fractal dimension, cancer, surrounding tissues, cells or tissue, new method

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Authors: Junior Akunzi

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In the matter of patient treatment planning quality assurance in 3D conformational therapy (3D-CRT) and volumetric arc therapy (VMAT or RapidArc), the independent monitor unit verification calculation (MUVC) is an indispensable part of the process. Concerning 3D-CRT treatment planning, the MUVC can be performed manually applying the standard ESTRO formalism. However, due to the complex shape and the amount of beams in advanced treatment planning technic such as RapidArc, the manual independent MUVC is inadequate. Therefore, commercially available software such as RadCalc can be used to perform the MUVC in complex treatment planning been. Indeed, RadCalc (version 6.3 LifeLine Inc.) uses a simplified Clarkson algorithm to compute the dose contribution for individual RapidArc fields to the isocenter. The purpose of this project is the validation of RadCalc in 3D-CRT and RapidArc for treatment planning dosimetry quality assurance at Antoine Lacassagne center (Nice, France). Firstly, the interfaces between RadCalc and our treatment planning systems (TPS) Isogray (version 4.2) and Eclipse (version13.6) were checked for data transfer accuracy. Secondly, we created test plans in both Isogray and Eclipse featuring open fields, wedges fields, and irregular MLC fields. These test plans were transferred from TPSs according to the radiotherapy protocol of DICOM RT to RadCalc and the linac via Mosaiq (version 2.5). Measurements were performed in water phantom using a PTW cylindrical semiflex ionisation chamber (0.3 cm³, 31010) and compared with the TPSs and RadCalc calculation. Finally, 30 3D-CRT plans and 40 RapidArc plans created with patients CT scan were recalculated using the CT scan of a solid PMMA water equivalent phantom for 3D-CRT and the Octavius II phantom (PTW) CT scan for RapidArc. Next, we measure the doses delivered into these phantoms for each plan with a 0.3 cm³ PTW 31010 cylindrical semiflex ionisation chamber (3D-CRT) and 0.015 cm³ PTW PinPoint ionisation chamber (Rapidarc). For our test plans, good agreements were found between calculation (RadCalc and TPSs) and measurement (mean: 1.3%; standard deviation: ± 0.8%). Regarding the patient plans, the measured doses were compared to the calculation in RadCalc and in our TPSs. Moreover, RadCalc calculations were compared to Isogray and Eclispse ones. Agreements better than (2.8%; ± 1.2%) were found between RadCalc and TPSs. As for the comparison between calculation and measurement the agreement for all of our plans was better than (2.3%; ± 1.1%). The independent MU verification calculation software RadCal has been validated for clinical use and for both 3D-CRT and RapidArc techniques. The perspective of this project includes the validation of RadCal for the Tomotherapy machine installed at centre Antoine Lacassagne.

Keywords: 3D conformational radiotherapy, intensity modulated radiotherapy, monitor unit calculation, dosimetry quality assurance

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Authors: H. Yousefnia, A. Golabi Dezfuli, S. Zolghadri, M. Hosntalab

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Peptide receptor radionuclide therapy is nowadays used for the treatment of various abnormalities with somatostatin receptors. In this study, 166Ho-DOTATOC was prepared and the best conditions for its radiolabeling was obtained. For this purpose, a certain of DOTATOC was added to a vial containing 166Ho. various experiments by varying ligand concentration, pH, temperature and time were performed to determine the best conditions. Radiochemical purity of the complex was assessed by instant thin layer chromatography method utilizing 0.9% NaCl as the mobile phase. 166Ho-DOTATOC was prepared with radiochemical purity of higher than 95% at the optimized condition (pH=4, temperature: 95° C, time:30 min). In 0.9% NaCl, free Ho cation was developed at Rf of 0.8 while the complex was remained at the front of the paper.

Keywords: Ho-166, neuroendocrine, octreotide, quality control

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Authors: Miguel Nino

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When considering the challenges of a changing and demanding globalizing world, it is important to reflect on how university students will be prepared for the realities of internationalization, marketization and intercultural conversation. The present study is an interdisciplinary program designed to respond to the needs of the global community. The proposal bridges the humanities and science through three different fields: Languages, graphic design and computer science, specifically, fundamentals of programming such as python, java script and software animation. Therefore, the goal of the four year program is twofold: First, enable students for intercultural communication between English and other languages such as Spanish, Mandarin, French or German. Second, students will acquire knowledge in practical software and relevant employable skills to collaborate in assisted computer projects that most probable will require essential programing background in interpreted or compiled languages. In order to become inclusive and constructivist, the cognitive linguistics approach is suggested for the three different fields, particularly for languages that rely on the traditional method of repetition. This methodology will help students develop their creativity and encourage them to become independent problem solving individuals, as languages enhance their common ground of interaction for culture and technology. Participants in this course of study will be evaluated in their second language acquisition at the Intermediate-High level. For graphic design and computer science students will apply their creative digital skills, as well as their critical thinking skills learned from the cognitive linguistics approach, to collaborate on a group project design to find solutions for media web design problems or marketing experimentation for a company or the community. It is understood that it will be necessary to apply programming knowledge and skills to deliver the final product. In conclusion, the program equips students with linguistics knowledge and skills to be competent in intercultural communication, where English, the lingua franca, remains the medium for marketing and product delivery. In addition to their employability, students can expand their knowledge and skills in digital humanities, computational linguistics, or increase their portfolio in advertising and marketing. These students will be the global human capital for the competitive globalizing community.

Keywords: curriculum, international, languages, technology

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

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Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: advanced palliative aquatics care, magnetic field therapy, medical device, research design

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Authors: Dana Zelicha

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A 6-week mindfulness programme was launched to improve the well being and performance of 20 managers (including the supervisor) of an international corporation in London. A unique assessment methodology was customised to the organisation’s needs, measuring four parameters: prioritising skills, listening skills, mindfulness levels and happiness levels. All parameters showed significant improvements (p < 0.01) post intervention, with a remarkable increase in listening skills and mindfulness levels. Although corporate mindfulness programmes have proven to be effective, the challenge remains the low engagement levels at home and the implementation of these tools beyond the scope of the intervention. This study has offered an innovative approach to enforce home engagement levels, which yielded promising results. The programme launched with a 2-day introduction intervention, which was followed by a 6-week training course (1 day a week; 2 hours each). Participants learned all basic principles of mindfulness such as mindfulness meditations, Mindfulness Based Stress Reduction (MBSR) techniques and Mindfulness Based Cognitive Therapy (MBCT) practices to incorporate into their professional and personal lives. The programme contained experiential mindfulness meditations and innovative mindfulness tools (OWBA-MT) created by OWBA - The Well Being Agency. Exercises included Mindful Meetings, Unitasking and Mindful Feedback. All sessions concluded with guided discussions and group reflections. One fundamental element of this programme was engagement level outside of the workshop. In the office, participants connected with a mindfulness buddy - a team member in the group with whom they could find support throughout the programme. At home, participants completed online daily mindfulness forms that varied according to weekly themes. These customised forms gave participants the opportunity to reflect on whether they made time for daily mindfulness practice, and to facilitate a sense of continuity and responsibility. At the end of the programme, the most engaged team member was crowned the ‘mindful maven’ and received a special gift. The four parameters were measured using online self-reported questionnaires, including the Listening Skills Inventory (LSI), Mindfulness Attention Awareness Scale (MAAS), Time Management Behaviour Scale (TMBS) and a modified version of the Oxford Happiness Questionnaire (OHQ). Pre-intervention questionnaires were collected at the start of the programme, and post-intervention data was collected 4-weeks following completion. Quantitative analysis using paired T-tests of means showed significant improvements, with a 23% increase in listening skills, a 22% improvement in mindfulness levels, a 12% increase in prioritising skills, and an 11% improvement in happiness levels. Participant testimonials exhibited high levels of satisfaction and the overall results indicate that the mindfulness programme substantially impacted the team. These results suggest that 6-week mindfulness programmes can improve employees’ capacities to listen and work well with others, to effectively manage time and to experience enhanced satisfaction both at work and in life. Limitations noteworthy to consider include the afterglow effect and lack of generalisability, as this study was conducted on a small and fairly homogenous sample.

Keywords: corporate mindfulness, listening skills, organisational well being, prioritising skills, mindful leadership

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Authors: Maha Hamoud Alatawi

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Drawing on the work of John McLeod and Ariel Watson, this paper explains the relationship between narrative and psychotherapy in two plays by the Irish playwright Conor McPherson. Dublin Carol presents John’s chequered past through his reminiscences of alcohol addiction and Shining City tells the story of John who is haunted by the ghost of his wife, recently died in a car accident, and who seeks the help of Ian, a therapist. At first, the significance of storytelling as an integral part of Irish culture is highlighted. Such a tradition features prominently in contemporary Irish drama. The paper concludes that it is the power of narrative and its therapeutic impact and not the act of psychotherapy and treatment which brings signs of change to characters’ lives.

Keywords: Conor McPherson, drama, psychotherapy, storytelling

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