Search results for: palliative care approach

Authors: Maatouk Mohamed, Nouira Mariem

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: Mykah W. Sumoldao, Maria Erissa C. Susa, Triny Cate M. Telan, Christian Arvin M. Torres, Jasmine I. Udasco, Franceis Jeramil M. Walis, Shellyn S. Wandagan, Janine May M. Warding, Queenie Diana Rose P. Zalun Hope Lulet A. Lomioan

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This descriptive phenomenological study explored the lived experiences of the primary caregiver of schizophrenia patients at the Acute Crisis Intervention Service in Cagayan Valley Medical Center. The research aimed to understand the emotional, physical, and financial challenges these primary caregivers face. Data was gathered through interviews with nine (9) primary caregivers and analyzed using Colaizzi’s seven-step method. Two main themes emerged: Experience/ Challenges (Emotional, Physical, and Financial Challenges) and Managing Mechanisms (Support Systems and Resilience and Commitment). The study found that primary caregivers deal with a complex mix of difficulties, often with limited resources. They rely heavily on personal strength, faith, family, friends and community support to manage their roles. The findings highlighted the need for better support systems to ease primary caregivers' burdens. Financial aid, respite care, and mental health support are crucial for improving primary caregivers' quality of life and the care they provide. Additionally, raising awareness about primary caregivers' challenges can foster a supportive community, with more help from local organizations and government entities. Thus, this study provided insights into the caregiving experiences of those supporting schizophrenia patients. It emphasized the importance of practical support and emotional resilience. By addressing these needs, a more supportive environment can be created, benefiting both primary caregivers and their patients.

Keywords: primary caregiver burden, mental health, primary caregiver well-being, primary caregiver

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Authors: Vaiyapuri Subbarayn Periasamy, Jegan Athinarayanan, Ali A. Alshatwi

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The widespread use of Titanium oxide nanoparticles (TiO2-NPs), now are found with different physic-chemical properties (size, shape, chemical properties, agglomeration, etc.) in many processed foods, agricultural chemicals, biomedical products, food packaging and food contact materials, personal care products, and other consumer products used in daily life. Growing evidences have been highlighted that there are risks of physico-chemical properties dependent toxicity with special attention to “TiO2-NPs and human immune system”. Unfortunately, agglomeration and aggregation have frequently been ignored in immuno-toxicological studies, even though agglomeration and aggregation would be expected to affect nanotoxicity since it changes the size, shape, surface area, and other properties of the TiO2-NPs. In this present investigation, we assessed the immune toxic effect of TiO2-NPs on human immune cells Total WBC including Lymphocytes (T cells (CD3+), T helper cells (CD3+, CD4+), Suppressor/cytotoxic T cells (CD3+/CD8+) and NK cells (CD3-/CD16+ and CD56+), Monocytes (CD14+, CD3-) and B lymphocytes (CD19+, CD3-) in order to find the immunological response (IL1A, IL1B, IL2 IL-4, IL5 IL-6, IL-10, IL-12, IL-13, IFN-γ, TGF-β, and TNF-a) and redox gene regulation (TNF, p53, BCl-2, CAT, GSTA4, TNF, CYP1A, POR, SOD1, GSTM3, GPX1, and GSR1)-linking physicochemical properties with special reference to agglomeration of TiO2-NPs. Our findings suggest that TiO2-NPs altered cytokine production, enhanced phagocytic indexing, metabolic stress through specific immune regulatory- genes expression in different WBC subsets and may contribute to pro-inflammatory response. Although TiO2-NPs have great advantages in the personal care products, biomedical, food and agricultural products, its chronic and acute immune-toxicity still need to be assessed carefully with special reference to food and environmental safety.

Keywords: TiO2 nanoparticles, oxidative stress, cytokine, human immune cells

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Authors: Serge Rohmer

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This paper proposes a progressive participatory observation that can be used as a sociological investigation within communities. The usefulness of participant observation in sociological projects is first asserted, particularly in an urban context. Competencies, know-how and interpersonal skills are then explained before to detail the progressive approach, consisting of four levels of observation. The progressive participatory observation is applied to an experimental project to set up a permaculture urban micro-farm with residents of a priority neighbourhood. Feedback on the experiment has identified several key recommendations for implementing the approach.

Keywords: participatory observation, observation scale, priority neighbourhood, urban sociology

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Authors: Kveta Olsanova, Gina Cook, Marija Zlatic

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This paper discusses the theoretical framework suggesting the dependencies between luxury brands’ CSR (Corporate Social Responsibility) variables and the purchase intention of luxury shoppers. The framework is based on a literature review and in-depth individual interviews with a sample of luxury users and buyers. The measures of the model are based on existing research and the authors' qualitative research results. The model suggests that purchase intention in the luxury segment is dependent on the luxury values (symbolic, experiential, functional and social), individual sustainable dimension (composed of societal, environmental and economic variables) and awareness of the brand’s CSR, the last two relationships being potentially moderated by certain conditions such as demographics and general attitudes towards CSR and sustainability. The model’s output is in the formulation of several hypotheses, to be tested in an upcoming quantitative study. The qualitative phase indicated that the perceived symbolic, functional and experiential value dimensions of luxury brands were stronger drivers of purchase intention compared to the sustainable dimension. The contribution of the research consists of highlighting CSR’s impact on customer purchase intent as a potential implication for luxury brand management due to two aspects: (i) consumer awareness of the existing CSR activities of luxury brands is low, and this might be challenged by the demands of Gen Z entrants into the lux industry as they are known for their positive approach to CSR; (ii) the UN’s SDGs will bring CSR to the attention of all industries, including currently 'CSR silent' segments represented by luxury. Our research should contribute to incorporation of strategic CSR into the policies and strategies of the luxury segment by providing evidence that luxury customers do care.

Keywords: CSR, luxury shoppers, purchase intention, sustainability

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Authors: Zainab A. Bu Sinnah, David I. Graham

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The Lattice Boltzmann Method has been developed and used to simulate both steady and unsteady fluid flow problems such as turbulent flows, multiphase flow and flows in the vascular system. As an example, the study of blood flow and its properties can give a greater understanding of atherosclerosis and the flow parameters which influence this phenomenon. The blood flow in the vascular system is driven by a pulsating pressure gradient which is produced by the heart. As a very simple model of this, we simulate plane channel flow under periodic forcing. This pulsatile flow is essentially the standard Poiseuille flow except that the flow is driven by the periodic forcing term. Moment boundary conditions, where various moments of the particle distribution function are specified, are applied at solid walls. We used a second-order single relaxation time model and investigated grid convergence using two distinct approaches. In the first approach, we fixed both Reynolds and Womersley numbers and varied relaxation time with grid size. In the second approach, we fixed the Womersley number and relaxation time. The expected second-order convergence was obtained for the second approach. For the first approach, however, the numerical method converged, but not necessarily to the appropriate analytical result. An explanation is given for these observations.

Keywords: Lattice Boltzmann method, single relaxation time, pulsatile flow, moment based boundary condition

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Authors: May Bazzi, Shafik Tokmaj, Younes Saberi, Mats Geijer, Tony Jurkiewicz, Patrik Sund, Anna Bjällmark

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Mobile radiography, employing portable X-ray equipment, has become a routine procedure within hospital settings, with chest X-rays in intensive care units standing out as the most prevalent mobile X-ray examinations. This approach is not limited to hospitals alone, as it extends its benefits to imaging patients in various settings, particularly those too frail to be transported, such as elderly care residents in nursing homes. Moreover, the utility of mobile X-ray isn't confined solely to traditional healthcare recipients; it has proven to be a valuable resource for vulnerable populations, including the homeless, drug users, asylum seekers, and patients with multiple co-morbidities. Mobile X-rays reduce patient stress, minimize costly hospitalizations, and offer cost-effective imaging. While studies confirm its reliability, further research is needed, especially regarding image quality. Recent advancements in lightweight equipment with enhanced battery and detector technology provide the potential for nearly handheld radiography. The main aim of this study was to evaluate a new lightweight mobile X-ray system with two different detectors and compare the image quality with a modern stationary system. Methods: A total of 74 images of the chest (chest anterior-posterior (AP) views and chest lateral views) and pelvic/hip region (AP pelvis views, hip AP views, and hip cross-table lateral views) were acquired on a whole-body phantom (Kyotokagaku, Japan), utilizing varying image parameters. These images were obtained using a stationary system - 18 images (Mediel, Sweden), a mobile X-ray system with a second-generation detector - 28 images (FDR D-EVO II; Fujifilm, Japan) and a mobile X-ray system with a third-generation detector - 28 images (FDR D-EVO III; Fujifilm, Japan). Image quality was assessed by visual grading analysis (VGA), which is a method to measure image quality by assessing the visibility and accurate reproduction of anatomical structures within the images. A total of 33 image criteria were used in the analysis. A panel of two experienced radiologists, two experienced radiographers, and two final-term radiographer students evaluated the image quality on a 5-grade ordinal scale using the software Viewdex 3.0 (Viewer for Digital Evaluation of X-ray images, Sweden). Data were analyzed using visual grading characteristics analysis. The dose was measured by the dose-area product (DAP) reported by the respective systems. Results: The mobile X-ray equipment (both detectors) showed significantly better image quality than the stationary equipment for the pelvis, hip AP and hip cross-table lateral images with AUCVGA-values ranging from 0.64-0.92, while chest images showed mixed results. The number of images rated as having sufficient quality for diagnostic use was significantly higher for mobile X-ray generation 2 and 3 compared with the stationary X-ray system. The DAP values were higher for the stationary compared to the mobile system. Conclusions: The new lightweight radiographic equipment had an image quality at least as good as a fixed system at a lower radiation dose. Future studies should focus on clinical images and consider radiographers' viewpoints for a comprehensive assessment.

Keywords: mobile x-ray, visual grading analysis, radiographer, radiation dose

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Authors: Ya-Ching Fu, An-Kuo Chou, Boon-Fatt Tan, Chi-Nien Chen, Wen-Chien Yang, Pou-Leng Cheong

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Blind oro-/naso-pharyngeal suction and feeding tube placement are very common practices in neonatal intensive care unit. Though esophageal perforation is a rare complication of these instrumentations, its prevalence is highest in extremely premature neonates. Due to its association with significant morbidity (including respiratory deterioration, pneumothorax, and sepsis) and even mortality, it is an important issue to prevent this iatrogenic complication in the field of premature care. We demonstrate an esophageal perforation in an extreme-low-birth-weight neonate after oro-gastric tube placement. This female baby weighing 680 grams was delivered by caesarean section at 25 weeks of gestational age. She initially received oro-tracheal intubation with mechanical ventilation which was smoothly weaned to non-invasive positive-pressure ventilation at 7-day-old. However, after insertion of a 5-French oro-gastric tube, the baby’s condition suddenly worsened with apnea requiring mechanical ventilation. Her chest radiogram showed the oro-gastric tube in right pleural space, and thus another oro-gastric tube was replaced, and its position was radiographically confirmed. The malpositioned tube was then removed. The baby received 2-week course of intravenous antibiotics for her esophageal perforation. Feeding was then reintroduced and increased to full feeds in a smooth course. She was discharged at 107-day-old. Esophageal perforation in newborn is very rare. Sudden respiratory deterioration in a neonate after naso-/oro-gastric tube placement should alarm us to consider esophageal perforation, and further radiological investigation is required for the diagnosis. Tube materials, patient condition, and age are major risk factors of esophageal perforation. The use of softer tube material, such as silicone, in extreme premature baby might prevent this fetal complication.

Keywords: esophageal perforation, preterm, newborn, feeding tube

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Authors: Kitty Kioskli, Nineta Polemi

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Evaluating the levels of cyber-security risks within an enterprise is most important in protecting its information system, services and all its digital assets against security incidents (e.g. accidents, malicious acts, massive cyber-attacks). The existing risk assessment methodologies (e.g. eBIOS, OCTAVE, CRAMM, NIST-800) adopt a technical approach considering as attack factors only the capability, intention and target of the attacker, and not paying attention to the attacker’s psychological profile and personality traits. In this paper, a socio-technical approach is proposed in cyber risk assessment, in order to achieve more realistic risk estimates by considering the personality traits of the attackers. In particular, based upon principles from investigative psychology and behavioural science, a multi-dimensional, extended, quantifiable model for an attacker’s profile is developed, which becomes an additional factor in the cyber risk level calculation.

Keywords: attacker, behavioural models, cyber risk assessment, cybersecurity, human factors, investigative psychology, ISO27001, ISO27005

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Authors: Francky Fouedjio

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Multivariate geostatistical data have become omnipresent in the geosciences and pose substantial analysis challenges. One of them is the grouping of data locations into spatially contiguous clusters so that data locations within the same cluster are more similar while clusters are different from each other, in some sense. Spatially contiguous clusters can significantly improve the interpretation that turns the resulting clusters into meaningful geographical subregions. In this paper, we develop an agglomerative hierarchical clustering approach that takes into account the spatial dependency between observations. It relies on a dissimilarity matrix built from a non-parametric kernel estimator of the spatial dependence structure of data. It integrates existing methods to find the optimal cluster number and to evaluate the contribution of variables to the clustering. The capability of the proposed approach to provide spatially compact, connected and meaningful clusters is assessed using bivariate synthetic dataset and multivariate geochemical dataset. The proposed clustering method gives satisfactory results compared to other similar geostatistical clustering methods.

Keywords: clustering, geostatistics, multivariate data, non-parametric

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Authors: Hussain Ali, Ahmad Ali, Syed Rashid Ali

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The maternal mortality is one of the basic health issues faced by rural women in Pakistan. There are various structural and socio-cultural determinants which confine women to domestic sphere. Such mobility restriction compels women for home delivery which causes high maternal mortality and morbidity. However, it is hard to find out the research findings and well-organized literature that explain the cultural factors act as determinant to home delivery among Pakhtun women. The overall objective of this research is to study men’s decision making within the household in Pakhtun society as determinant of home delivery among Pakhtun women in Khyber Pakhtunkhwa province of Pakistan. In the present study, researchers used the quantitative research design in which the data are collected through household survey technique from (n=503) ever-married women having reproductive age (15-49 years) by using interview schedule. The data are analyzed through SPSS, and binary logistic regression was applied to draw the association between home as a place of delivery and men’s decision making in the Pakhtun society. The results show that majority (76%) of the husbands are key decision makers about the home delivery due to their superior position within household. Similarly, majority (88%) Pakhtun women prefer to stay in home for their delivery due to their dependency on husband’s decision. The researcher concludes that men are key decision makers in Pakhtun society and their decisions affect women maternal health care. Similarly, the women are in subordinate position, and their limited decision making in the domestic sphere are greatly responsible for home delivery which causing high maternal mortality rate in the study area. In order to achieve Sustainable Development Goal No. 3, the study recommends empowering women in the decision making about accessing and utilizing maternal health care services and given financial autonomy to them.

Keywords: home delivery, men’s decision, Pakhtun women, subordinate position

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Authors: Batool Ismaeel, Umair Farooq, Saad Mushtaq

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Construction projects in the oil industry can be very complex, having unknown outcomes and uncertainties that cannot be easily predicted. Each project has its unique risks generated by a number of factors which, if not controlled, will impact the successful completion of the project mainly in terms of schedule, cost, quality, and safety. This paper highlights the historic risks associated with projects in the south and east region of Kuwait Oil Company (KOC) collated from the company’s lessons learned database. Starting from Contract Award through to handover of the project to the Asset owner, the gaps in project execution in terms of managing risk will be brought to discussion and where a well-defined systematic approach in project risk management reflecting many claims, change of scope, exceeding budget, delays in engineering phase as well as in the procurement and fabrication of long lead items should be adopted. This study focuses on a proposed feasible approach in risk management for engineering, procurement and construction (EPC) level projects including the various stakeholders involved in executing the works from International to local contractors and vendors in KOC. The proposed approach covers the areas categorized into organizational, design, procurement, construction, pre-commissioning, commissioning and project management in which the risks are identified and require management and mitigation. With the effective deployment and implementation of the proposed risk management system and the consideration of it as a vital key in achieving the project’s target, the outcomes will be more predictable in the future, and the risk triggers will be managed and controlled. The correct resources can be allocated on a timely basis for the company for avoiding any unpredictable outcomes during the execution of the project. It is recommended in this paper to apply this risk management approach as an integral part of project management and investigate further in the future, the effectiveness of this proposed system for newly awarded projects and compare the same with those projects of similar budget/complexity that have not applied this approach to risk management.

Keywords: construction, project completion, risk management, uncertainties

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Authors: Katja Mikhailovich, Barbara Pamphilon

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Farmer training in Papua New Guinea has focused mainly on technology transfer approaches. This has primarily benefited men and often excluded women whose literacy, low education and role in subsistence crops has precluded participation in formal training. The paper discusses an approach that uses both a brokerage model of agricultural extension to link smallholders with private sector agencies and an innovative family team’s approach that aims to support the economic empowerment of women in families and encourages sustainable and gender equitable farming and business practices.

Keywords: women, economic development, agriculture, training

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Authors: Jaan-Willem Simon, Bertram Stier, Brett Bednarcyk, Evan Pineda, Stefanie Reese

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Textile composites, in which the reinforcing fibers are woven or braided, have become very popular in numerous applications in aerospace, automotive, and maritime industry. These textile composites are advantageous due to their ease of manufacture, damage tolerance, and relatively low cost. However, physics-based modeling of the mechanical behavior of textile composites is challenging. Compared to their unidirectional counterparts, textile composites introduce additional geometric complexities, which cause significant local stress and strain concentrations. Since these internal concentrations are primary drivers of nonlinearity, damage, and failure within textile composites, they must be taken into account in order for the models to be predictive. The macro-scale approach to modeling textile-reinforced composites treats the whole composite as an effective, homogenized material. This approach is very computationally efficient, but it cannot be considered predictive beyond the elastic regime because the complex microstructural geometry is not considered. Further, this approach can, at best, offer a phenomenological treatment of nonlinear deformation and failure. In contrast, the mesoscale approach to modeling textile composites explicitly considers the internal geometry of the reinforcing tows, and thus, their interaction, and the effects of their curved paths can be modeled. The tows are treated as effective (homogenized) materials, requiring the use of anisotropic material models to capture their behavior. Finally, the micro-scale approach goes one level lower, modeling the individual filaments that constitute the tows. This paper will compare meso- and micro-scale approaches to modeling the deformation, damage, and failure of textile-reinforced polymer matrix composites. For the mesoscale approach, the woven composite architecture will be modeled using the finite element method, and an anisotropic damage model for the tows will be employed to capture the local nonlinear behavior. For the micro-scale, two different models will be used, the one being based on the finite element method, whereas the other one makes use of an embedded semi-analytical approach. The goal will be the comparison and evaluation of these approaches to modeling textile-reinforced composites in terms of accuracy, efficiency, and utility.

Keywords: multiscale modeling, continuum damage model, damage interaction, textile composites

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Authors: Nisar Ahmad, Xuyi, Ali Akbar

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As healthcare systems worldwide strive for improvement, the integration of advanced health information systems (HIS) has emerged as a pivotal strategy. This study aims to investigate the critical role of leadership in the implementation and enhancement of HIS in Chinese hospitals and how such leadership can drive improvements in patient outcomes and overall healthcare satisfaction. We propose a comprehensive study to be conducted across various hospitals in China, targeting healthcare professionals as the primary population. The research will leverage established theories of transformational leadership and technology acceptance to underpin the analysis. In our approach, data will be meticulously gathered through surveys and interviews, focusing on the experiences and perceptions of healthcare professionals regarding HIS implementation and its impact on patient care. The study will utilize SPSS and SmartPLS software for robust data analysis, ensuring precise and comprehensive insights into the correlation between leadership effectiveness and HIS success. We hypothesize that strong, visionary leadership is essential for the successful adoption and optimization of HIS, leading to enhanced patient outcomes and increased satisfaction with healthcare services. By applying advanced statistical methods, we aim to identify key leadership traits and practices that significantly contribute to these improvements. Our research will provide actionable insights for policymakers and healthcare administrators in China, offering evidence-based recommendations to foster leadership that champions HIS and drives continuous improvement in healthcare delivery. This study will contribute to the global discourse on health information systems, emphasizing the future role of leadership in transforming healthcare environments and outcomes.

Keywords: health information systems, leadership, patient outcomes, healthcare satisfaction

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Authors: Cara DiGirolamo

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In his 2017 Ph.D. thesis, script doctor David Baboulene presented a theory of fiction in which differences in the knowledge states between participants in a literary experience, including reader, author, and characters, create many story elements, among them suspense, expectations, subtext, theme, metaphor, and allegory. This theory can be adjusted and modeled by incorporating a formal pragmatic approach that understands narrative as a speech act with a conversational function. This approach requires both the Speaker and the Listener to be understood as participants in the discourse. It also uses theories of cooperativity and the QUD to identify the existence of implicit questions. This approach predicts that what an effective literary narrative must do: provide a conversational context early in the story so the reader can engage with the text as a conversational participant. In addition, this model incorporates schema theory. Schema theory is a cognitive model for learning and processing information about the world and transforming it into functional knowledge. Using this approach can extend the QUD model. Instead of describing conversation as a form of information gathering restricted to question-answer sets, the QUD can include knowledge modeling and understanding as a possible outcome of a conversation. With this model, Baboulene’s “Knowledge Gaps” can provide real insight into storytelling as a conversational move, and extend the QUD to be able to simply and effectively apply to a more diverse set of conversational interactions and also to narrative texts.

Keywords: literature, speech acts, QUD, literary theory

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Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

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Authors: Melanie Adrian, Elspeth McCulloch, Emily-Jean Gallant

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Resources -financial, physical, and human- are increasingly constrained in higher education. University classes are getting bigger, and the concomitant grading burden on faculty is growing rapidly. Multiple-choice exams are seen by some as one solution to these changes. How much students retain, however, and what their testing experience is, continues to be debated. Are multiple-choice exams serving students well, or are they bearing the burden of these developments? Is there a way to address both the resource constraints and make these types of exams more meaningful? In short, how do we engender evaluation methods for large-scale classes that provide opportunities for heightened student learning and enrichment? The following article lays out a testing approach we have employed in four iterations of the same third-year law class. We base our comments in this paper on our initial observations as well as data gathered from an ethics-approved study looking at student experiences. This testing approach provides students with multiple opportunities for revision (thus increasing chances for long term retention), is both individually and collaboratively driven (thus reflecting the individual effort and group effort) and is automatically graded (thus draining limited institutional resources). We found that overall students appreciated the approach and found it more ‘humane’, that it notably reduced pre-exam and intra-exam stress levels, increased ease, and lowered nervousness.

Keywords: exam, higher education, multiple-choice, law

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Authors: Steeve Mercier, Joan Netten, Olivier Massé

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The traditional lack of success of most Canadian students in the regular French program in attaining the ability to communicate spontaneously led to the conceptualization of a modified program. This program, called Intensive French, introduced and evaluated as an experiment in several school districts, formed the basis for the creation of a more effective approach for the development of skills in a second/foreign language and literacy: the Neurolinguistic Approach (NLA).The NLA expresses the major change in the understanding of how communication skills are developed: learning to communicate spontaneously in a second language depends on the reuse of structures in a variety of cognitive situations to express authentic messages rather than on knowledge of the way a language functions. Put differently, it prioritises the acquisition of implicit competence over the learning of grammatical knowledge. This is achieved by the adoption of a literacy-based approach and an increase in intensity of instruction.Besides having strong support empirically from numerous experiments, the NLA has sound theoretical foundation, as it conforms to research in neurolinguistics. The five pedagogical principles that define the approach will be explained, as well as the differences between the NLA and the paradigm on which most current resources and teaching strategies are based. It is now 25 years since the original research occurred. The use of the NLA, as it will be shown, has expanded widely. With some adaptations, it is used for other languages and in other milieus. In Canada, classes are offered in mandarin, Ukrainian, Spanish and Arabic, amongst others. It has also been used in several indigenous communities, such as to restore the use of Mohawk, Cri and Dene. Its use has expanded throughout the world, as in China, Japan, France, Germany, Belgium, Poland, Russia, as well as Mexico. The Intensive French program originally focussed on students in grades 5 or 6 (ages 10 -12); nowadays, the programs based on the approach include adults, particularly immigrants entering new countries. With the increasing interest in inclusion and cultural diversity, there is a demand for language learning amongst pre-school and primary children that can be successfully addressed by the NLA. Other current experiments target trilingual schools and work with Inuit communities of Nunavik in the province of Quebec.

Keywords: neuroeducation, neurolinguistic approach, literacy, second language acquisition, plurilingualism, foreign language teaching and learning

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Authors: Zahra Kouzehgari

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Since the early emergence of chaos theory in the 1970s in mathematics and physical science, it has increasingly been developed and adapted in social sciences as well. The non-linear and dynamic characteristics of the theory make it a useful conceptual framework to interpret the complex social systems behavior. Regarding chaotic approach principals, sensitivity to initial conditions, dynamic adoption, strange attractors and unpredictability this paper aims to examine whether chaos approach could interpret the ancient social changes. To do this, at first, a brief history of the chaos theory, its development and application in social science as well as the principals making the theory, then its application in archaeological since has been reviewed. The study demonstrates that although based on existing archaeological records reconstruct the whole social system of the human past, the non-linear approaches in studying social complex systems would be of a great help in finding general order of the ancient societies and would enable us to shed light on some of the social phenomena in the human history or to make sense of them.

Keywords: archaeology, non-linear approach, chaos theory, ancient social systems

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Authors: Dongming Feng, Fangyin Zhang, Liling Cao

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Horizontally curved steel-concrete composite box girders are extensively used in highway bridges. They consist of reinforced concrete deck on top of prefabricated steel box section beam which exhibits a high torsional rigidity to resist torsional effects induced by the curved structural geometry. This type of structural system is often constructed in two stages. The composite section will take the tension mainly by the steel box and, the compression by the concrete deck. The steel girders are delivered in large pre-fabricated U-shaped sections that are designed for ease of construction. They are then erected on site and overlaid by cast-in-place reinforced concrete deck. The functionality of the composite section is not achieved until the closed section is formed by fully cured concrete. Since this kind of composite section is built in two stages, the erection of the open steel box presents some challenges to contractors. When the reinforced concrete slab is cast-in-place, special care should be taken on bracings that can prevent the open U-shaped steel box from global and local buckling. In the case of multiple steel boxes, the design detailing should pay enough attention to the installation requirement of the bracings connecting adjacent steel boxes to prevent the global buckling. The slope in transverse direction and grade in longitudinal direction will result in some local deformation of the steel boxes that affect the connection of the bracings. During the design phase, it is common for engineers to model the curved composite box girder using one-dimensional beam elements. This is adequate to analyze the global behavior, however, it is unable to capture the local deformation which affects the installation of the field bracing connection. The presence of the local deformation may become a critical component to control the construction tolerance, and overlooking this deformation will produce inadequate structural details that eventually cause misalignment in field and erection failure. This paper will briefly describe the construction issues we encountered in real structures, investigate the difference between beam element modeling and shell/solid element modeling, and their impact on the different construction stages. P-delta effect due to the slope and curvature of the composite box girder is analyzed, and the secondary deformation is compared to the first-order response and evaluated for its impact on installation of lateral bracings. The paper will discuss the rational approach to prepare construction documents and recommendations are made on the communications between engineers, erectors, and fabricators to smooth out construction process.

Keywords: buckling, curved composite box girder, stage construction, structural detailing

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Authors: Sky Chou, Joseph C. Chen

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This paper focuses on using Six Sigma methodologies to improve the surface roughness of a manufactured part produced by the CNC milling machine. It presents a case study where the surface roughness of milled aluminum is required to reduce or eliminate defects and to improve the process capability index C_p and C_pk for a CNC milling process. The six sigma methodology, DMAIC (design, measure, analyze, improve, and control) approach, was applied in this study to improve the process, reduce defects, and ultimately reduce costs. The Taguchi-based six sigma approach was applied to identify the optimized processing parameters that led to the targeted surface roughness specified by our customer. A L₉ orthogonal array was applied in the Taguchi experimental design, with four controllable factors and one non-controllable/noise factor. The four controllable factors identified consist of feed rate, depth of cut, spindle speed, and surface roughness. The noise factor is the difference between the old cutting tool and the new cutting tool. The confirmation run with the optimal parameters confirmed that the new parameter settings are correct. The new settings also improved the process capability index. The purpose of this study is that the Taguchi–based six sigma approach can be efficiently used to phase out defects and improve the process capability index of the CNC milling process.

Keywords: CNC machining, six sigma, surface roughness, Taguchi methodology

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Authors: A. Dinelka Panagoda, Bathiya Bandara, Chamod Wijetunga, Chathura Malinda, Lakmal Rupasinghe, Chethana Liyanapathirana

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This research takes us forward with the concepts of Federated Learning and Software-Defined Networking (SDN) to introduce an efficient malware detection technique and provide a mitigation mechanism to give birth to a resilient and automated healthcare sector network system by also adding the feature of extended privacy preservation. Due to the daily transformation of new malware attacks on hospital Integrated Clinical Environment (ICEs), the healthcare industry is at an undefinable peak of never knowing its continuity direction. The state of blindness by the array of indispensable opportunities that new medical device inventions and their connected coordination offer daily, a factor that should be focused driven is not yet entirely understood by most healthcare operators and patients. This solution has the involvement of four clients in the form of hospital networks to build up the federated learning experimentation architectural structure with different geographical participation to reach the most reasonable accuracy rate with privacy preservation. While the logistic regression with cross-entropy conveys the detection, SDN comes in handy in the second half of the research to stack up the initial development phases of the system with malware mitigation based on policy implementation. The overall evaluation sums up with a system that proves the accuracy with the added privacy. It is no longer needed to continue with traditional centralized systems that offer almost everything but not privacy.

Keywords: software-defined network, federated learning, privacy, integrated clinical environment, decentralized learning, malware detection, malware mitigation

Procedia PDF Downloads 187

Authors: Keigo Nishitani, Kohei Mizuta Mizuta, Kazuyoshi Kurita, Yukinori Taniguchi

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To establish mass production process of Ti capsule which has Fe powder inside as magnetic hyperthermia implant, we assumed that Ti thin sheet can be drawn into a φ1.0 mm die hole through the medium of Fe Powder and becomes outer shell of capsule. This study discusses mechanism of powder assisted deep drawing process by both of numerical simulation and experiment. Ti thin sheet blank was placed on die, and was covered by Fe powder layer without pressurizing. Then upper punch was indented on the Fe powder layer, and the blank can be drawn into die cavity as pressurized powder particles were extruded into die cavity from behind of the drawn blank. Distinct Element Method (DEM) has been used to demonstrate the process. To identify bonding parameters on Fe particles which are cohesion, tensile bond stress and inter particle friction angle, axial and diametrical compression failure test of Fe powder compact was conducted. Several density ratios of powder compacts in range of 0.70 - 0.85 were investigated and relationship between mean stress and equivalent stress was calculated with consideration of critical state line which rules failure criterion in consolidation of Fe powder. Since variation of bonding parameters with density ratio has been experimentally identified, and good agreement has been recognized between several failure tests and its simulation, demonstration of powder assisted sheet forming by using DEM becomes applicable. Results of simulation indicated that indent/drawing length of Ti thin sheet is promoted by smaller Fe particle size, larger indent punch diameter, lower friction coefficient between die surface and Ti sheet and certain degrees of die inlet taper angle. In the deep drawing test, we have made die-set with φ2.4 mm punch and φ1.0 mm die bore diameter. Pure Ti sheet with 100 μm thickness, annealed at 650 deg. C has been tested. After indentation, indented/drawn capsule has been observed by microscope, and its length was measured to discuss the feasibility of this capsulation process. Longer drawing length exists on progressive loading pass comparing with the case of single stroke loading. It is expected that progressive loading has an advantage of which extrusion of powder particle into die cavity with Ti sheet is promoted since powder particle layer can be rebuilt while the punch is withdrawn from the layer in each loading steps. This capsulation phenomenon is qualitatively demonstrated by DEM simulation. Finally, we have fabricated Ti capsule which has Fe powder inside for magnetic hyperthermia cancer care treatment. It is concluded that suggested method is possible to use the manufacturing of Ti capsule implant for magnetic hyperthermia cancer care.

Keywords: metal powder compaction, metal forming, distinct element method, cancer care, magnetic hyperthermia

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Authors: Martin Hofmann, Diego Stutzer, Thomas Niederhauser, Juergen Burger

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Dental biofilm is the main etiologic factor for caries, periodontal and peri-implant infections. In addition to the risk of tooth loss, periodontitis is also associated with an increased risk of systemic diseases such as atherosclerotic cardiovascular disease and diabetes. For this reason, dental hygienists use ultrasonic scalers for prophylactic and periodontal care of the teeth. However, the current instruments are limited to their dimensions and operating frequencies. The innovative design of a planar ultrasonic transducer introduces a new type of dental scalers. The flat titanium-based design allows the mass to be significantly reduced compared to a conventional screw-mounted Langevin transducer, resulting in a more efficient and controllable scaler. For the development of the novel device, multi-physics finite element analysis was used to simulate and optimise various design concepts. This process was supported by prototyping and electromechanical characterisation. The feasibility and potential of a planar ultrasonic transducer have already been confirmed by our current prototypes, which achieve higher performance compared to commercial devices. Operating at the desired resonance frequency of 28 kHz with a driving voltage of 40 Vrms results in an in-plane tip oscillation with a displacement amplitude of up to 75 μm by having less than 8 % out-of-plane movement and an energy transformation factor of 1.07 μm/mA. In a further step, we will adapt the design to two additional resonance frequencies (20 and 40 kHz) to obtain information about the most suitable mode of operation. In addition to the already integrated characterization methods, we will evaluate the clinical efficiency of the different devices in an in vitro setup with an artificial biofilm pocket model.

Keywords: ultrasonic instrumentation, ultrasonic scaling, piezoelectric transducer, finite element simulation, dental biofilm, dental calculus

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Authors: H. Hentati, R. Abdelmoula, Li Jia, A. Maalej

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In this work, we present numerical simulations of the quasi-static crack propagation based on the variation approach. We perform numerical simulations of a piece of brittle material without initial crack. An alternate minimization algorithm is used. Based on these numerical results, we determine the influence of numerical parameters on the location of crack. We show the importance of trying to optimize the time of numerical computation and we present the first attempt to develop a simple numerical method to optimize this time.

Keywords: fracture mechanics, optimization, variation approach, mechanic

Procedia PDF Downloads 606

Authors: Nikolay P. Brayanov, Anna V. Stoynova

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Model-based development approach is gaining more support and acceptance. Its higher abstraction level brings simplification of systems’ description that allows domain experts to do their best without particular knowledge in programming. The different levels of simulation support the rapid prototyping, verifying and validating the product even before it exists physically. Nowadays model-based approach is beneficial for modelling of complex embedded systems as well as a generation of code for many different hardware platforms. Moreover, it is possible to be applied in safety-relevant industries like automotive, which brings extra automation of the expensive device certification process and especially in the software qualification. Using it, some companies report about cost savings and quality improvements, but there are others claiming no major changes or even about cost increases. This publication demonstrates the level of maturity and autonomy of model-based approach for code generation. It is based on a real live automotive seat heater (ASH) module, developed using The Mathworks, Inc. tools. The model, created with Simulink, Stateflow and Matlab is used for automatic generation of C code with Embedded Coder. To prove the maturity of the process, Code generation advisor is used for automatic configuration. All additional configuration parameters are set to auto, when applicable, leaving the generation process to function autonomously. As a result of the investigation, the publication compares the quality of generated embedded code and a manually developed one. The measurements show that generally, the code generated by automatic approach is not worse than the manual one. A deeper analysis of the technical parameters enumerates the disadvantages, part of them identified as topics for our future work.

Keywords: embedded code generation, embedded C code quality, embedded systems, model-based development

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Authors: C. Puangsawat, C. Limotai, P. Srikhachin

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Bio-psycho-social caring was required for promoting the quality of life of the patients with epilepsy (PWE), despite controlled seizures. Multifaceted issues emerge at the epilepsy clinic. Unpredicted seizures, antiepileptic drug compliance problems/adverse effects, psychiatric, and social problems are all needed to be explored and managed. The Nursing Service System (NSS) at the tertiary epilepsy clinic (TEC) was consequently developed for improving the clinical care for PWE. Case manager concept was integrated as the framework guiding the processes and strategies used for developing the NSS as well as the roles of the multidisciplinary team at the clinic. This study aimed to report the outcomes of the developed NSS integrated case manager concept. The processes of our developed NSS program included 1) screening for patient’s problems using questionnaire prior to seeing epileptologists i.e., assessing the patient’s risk to develop acute seizures at the clinic, issues related to medication use, and uncovered psychiatric and social problems; and 2) assigning the patients at risk to be evaluated and managed by appropriate team. Nurses specializing in epilepsy in coordination with the multidisciplinary team implemented the NSS to promote coordinated work among the team which consists of epileptologists, nurses, pharmacists, psychologists, and social workers. Determination of the role of each person and their responsibilities along with joint care plan were clearly established. One year after implementation, the rate of acute seizure occurrence at the clinic was decreased, and satisfactory feedback from the patients was received. In order to achieve an optimal goal to promote self-management behaviors in PWE, continuing the NSS and systematic assessment of its effectiveness is required.

Keywords: case manager concept, nursing service system, patients with epilepsy, quality of life

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Authors: Koninika Mukherjee, Dilwar Hussain

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Introduction: One of the most prevalent psychopathologies among the youth is social anxiety. The presence of comorbid disorders further complicates diagnosis and treatment. One of the most commonly co-occurring disorders, along with social anxiety, is related to eating behavior. Objective: Identifying the risk and protective factors and the mechanism through which the effect of these disorders might help in treatment and prevention. So, the stated objective of the present study is to investigate the role of fear of negative evaluation and social appearance anxiety in the relationship of parental bonding with social anxiety and comorbid disordered eating. Method: A cross-sectional study was conducted with 411 Indian undergraduates. Data collection was done with the help of self-report measures like the social interaction anxiety scale, parental bonding instrument, brief fear of negative evaluation, social appearance anxiety scale, and the eating attitudes test. SPSS Amos 22.0 version was used for path analyses. Results: Out of the different dimensions of parental bonding, only maternal care and the father’s granting of behavioural freedom proved significant in the development and maintenance of social anxiety and disordered eating behaviour and symptoms. Fear of negative evaluation and social appearance anxiety mediated the impact of the mother’s care on social anxiety and comorbid disordered eating. However, only fear of negative evaluation seemed to mediate the effect of paternal granting of behavioral freedom on social anxiety and comorbid issues. Implications: One of the vital contributions of this study is looking at perceived maternal and paternal bonding separately in the path model. Identifying parenting dimensions significantly related to social anxiety and comorbid disorders can aid in establishing consensus around operational definitions and in the formulation of comprehensive assessments. Future Directions: Future research can include both participant and parental perceptions of parental bonding.

Keywords: social anxiety, disordered eating, fear of negative evaluation, social appearance anxiety

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Authors: Vladimir S. Timofeev

Abstract:

In this article the problem of distributional moments estimation is considered. The new approach of moments estimation based on usage of the characteristic function is proposed. By statistical simulation technique, author shows that new approach has some robust properties. For calculation of the derivatives of characteristic function there is used numerical differentiation. Obtained results confirmed that author’s idea has a certain working efficiency and it can be recommended for any statistical applications.

Keywords: characteristic function, distributional moments, robustness, outlier, statistical estimation problem, statistical simulation

Procedia PDF Downloads 504