Search results for: healthcare settings

Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

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Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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Authors: Tamar Arieli

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Cross-border cooperation has long been hailed as a means for stabilizing and normalizing relations between former enemies. Cooperation in problem-solving and realizing of local interests in post-conflict environments can indeed serve as a basis for developing dialogue and meaningful relations between neighbors across borders. Hence the potential for formerly sealed borders to serve as a basis for generating local and national perceptions of interdependence and as a buffer against the resume of conflict. Central questions which arise for policy-makers and third parties are how to facilitate cross-border cooperation and which areas of cooperation best serve to normalize post-conflict border regions. The Israel-Jordan border functions as a post-conflict border, in that it is a peaceful border since the 1994 Israel-Jordan peace treaty yet cross-border relations are defined but the highly securitized nature of the border region and the ongoing Arab-Israel regional conflict. This case study is based on long term qualitative research carried out in the border regions of both Israel and Jordan, which mapped and analyzed cross-border in a wide range of activities – social interactions sponsored by peace-facilitating NGOs, government sponsored agricultural cooperation, municipal initiated emergency planning in cross-border continuous urban settings, private cross-border business ventures and various environmental cooperative initiatives. These cooperative initiatives are evaluated through multiple interviews carried out with initiators and partners in cross-border cooperation as well as analysis of documentation, funding and media. These cooperative interactions are compared based on levels of cross-border local and official awareness and involvement as well as sustainability over time. This research identifies environmental cooperation as the most sustainable area of cross- border cooperation and as most conducive to generating perceptions of regional interdependence. This is a variation to the ‘New Middle East’ vision of business-based cooperation leading to conflict amelioration and regional stability. Environmental cooperation serving the public good rather than personal profit enjoys social legitimization even in the face of widespread anti-normalization sentiments common in the post-conflict environment. This insight is examined in light of philosophical and social aspects of the natural environment and its social perceptions. This research has theoretical implications for better understanding dynamics of cooperation and conflict, as well as practical ramifications for practitioners in border region policy and management.

Keywords: borders, cooperation, post-conflict, security

Procedia PDF Downloads 314

Authors: Sadeg M. Ghnia, Mahmud Alghattawi

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The NC-210 study area is located in Atshan Saddle between both Ghadamis and Murzuq basins, west Libya. The preserved Palaeozoic successions are predominantly clastics reaching thickness of more than 20,000 ft in northern Ghadamis Basin depocenter. The Carboniferous series consist of interbedded sandstone, siltstone, shale, claystone and minor limestone deposited in a fluctuating shallow marine to brackish lacustrine/fluviatile environment which attain maximum thickness of over 5,000ft in the area of Atshan Saddle and recorded 3,500 ft. in outcrops of Murzuq Basin flanks. The Carboniferous strata was uplifted and eroded during Late Paleozoic and early Mesozoic time in northern Ghadamis Basin and Atshan Saddle. The M'rar Formation age is Tournaisian to Late Serpukhovian based on palynological markers and contains about 12 cycles of sandstone and shale deposited in shallow to outer neritic deltaic settings. The hydrocarbons in the M'rar reservoirs possibly sourced from the Lower Silurian and possibly Frasinian radioactive hot shales. The M'rar Formation lateral, vertical and thickness distribution is possibly influenced by the reactivation of Tumarline Strik-Slip fault and its conjugate faults. A pronounced structural paleohighs and paleolows, trending SE & NW through the Gargaf Saddle, is possibly indicative of the present of two sub-basins in the area of Atshan Saddle. A number of identified seismic reflectors from existing 2D seismic covering Atshan Saddle reflect M’rar deltaic 12 sandstone cycles. M’rar7, M’rar9, M’rar10 and M’rar12 are characterized by high amplitude reflectors, while M’rar2 and M’rar6 are characterized by medium amplitude reflectors. These horizons are productive reservoirs in the study area. Available seismic data in the study area contributed significantly to the identification of M’rar potential traps, which are prominently 3- way dip closure against fault zone. Also seismic data indicates the presence of a significant strikeslip component with the development of flower-structure. The M'rar Formation hydrocarbon discoveries are concentrated mainly in the Atshan Saddle located in southern Ghadamis Basin, Libya and Illizi Basin in southeast of Algeria. Significant additional hydrocarbons may be present in areas adjacent to the Gargaf Uplift, along structural highs and fringing the Hoggar Uplift, providing suitable migration pathways.

Keywords: hydrocarbon potential, stratigraphy, Ghadamis basin, seismic, well data integration

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Authors: Rafael Castilho Carvalho, Edjair de Souza Mota

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As the largest contributor to the biogeochemical functioning of the Earth system, the Amazon Rainforest has the greatest biodiversity on the planet, harboring about 15% of all the world's flora. Recognition and preservation are the focus of research that seeks to mitigate drastic changes, especially anthropic ones, which irreversibly affect this biome. Functional and low-cost monitoring alternatives to reduce these impacts are a priority, such as those using technologies such as Low Power Wide Area Networks (LPWAN). Promising, reliable, secure and with low energy consumption, LPWAN can connect thousands of IoT devices, and in particular, LoRa is considered one of the most successful solutions to facilitate forest monitoring applications. Despite this, the forest environment, in particular the Amazon Rainforest, is a challenge for these technologies, requiring work to identify and validate the use of technology in a real environment. To investigate the feasibility of deploying LPWAN in remote water quality monitoring of rivers in the Amazon Region, a LoRa-based test bed consisting of a Lora transmitter and a LoRa receiver was set up, both parts were implemented with Arduino and the LoRa chip SX1276. The experiment was carried out at the Federal University of Amazonas, which contains one of the largest urban forests in Brazil. There are several springs inside the forest, and the main goal is to collect water quality parameters and transmit the data through the forest in real time to the gateway at the uni. In all, there are nine water quality parameters of interest. Even with a high collection frequency, the amount of information that must be sent to the gateway is small. However, for this application, the battery of the transmitter device is a concern since, in the real application, the device must run without maintenance for long periods of time. With these constraints in mind, parameters such as Spreading Factor (SF) and Coding Rate (CR), different antenna heights, and distances were tuned to better the connectivity quality, measured with RSSI and loss rate. A handheld spectrum analyzer RF Explorer was used to get the RSSI values. Distances exceeding 200 m have soon proven difficult to establish communication due to the dense foliage and high humidity. The optimal combinations of SF-CR values were 8-5 and 9-5, showing the lowest packet loss rates, 5% and 17%, respectively, with a signal strength of approximately -120 dBm, these being the best settings for this study so far. The rains and climate changes imposed limitations on the equipment, and more tests are already being conducted. Subsequently, the range of the LoRa configuration must be extended using a mesh topology, especially because at least three different collection points in the same water body are required.

Keywords: IoT, LPWAN, LoRa, coverage, loss rate, forest

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Authors: Derek Wardle, Tarik Al-Shemmeri, Neil Packer

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This paper presents a small tube/wire type electrostatic precipitator (ESP). In the ESPs present form, particle charging and collecting voltages and airflow rates were individually varied throughout 200 ambient temperature test runs ranging from 10 to 30 kV in increments on 5 kV and 0.5 m/s to 1.5 m/s, respectively. It was repeatedly observed that, at input air velocities of between 0.5 and 0.9 m/s and voltage settings of 20 kV to 30 kV, the collection efficiency remained above 95%. The outcomes of preliminary tests at combustion flue temperatures are, at present, inconclusive although indications are that there is little or no drop in comparable performance during ideal test conditions. A limited set of similar tests was carried out during which the collecting electrode was grounded, having been disconnected from the static generator. The collecting efficiency fell significantly, and for that reason, this approach was not pursued further. The collecting efficiencies during ambient temperature tests were determined by mass balance between incoming and outgoing dry PM. The efficiencies of combustion temperature runs are determined by analysing the difference in opacity of the flue gas at inlet and outlet compared to a reference light source. In addition, an array of Leit tabs (carbon coated, electrically conductive adhesive discs) was placed at inlet and outlet for a number of four-day continuous ambient temperature runs. Analysis of the discs’ contamination was carried out using scanning electron microscopy and ImageJ computer software that confirmed collection efficiencies of over 99% which gave unequivocal support to all the previous tests. The average efficiency for these runs was 99.409%. Emissions collected from a woody biomass combustion unit, classified to a diameter of 100 µm, were used in all ambient temperature trials test runs apart from two which collected airborne dust from within the laboratory. Sawdust and wood pellets were chosen for laboratory and field combustion trials. Video recordings were made of three ambient temperature test runs in which the smoke from a wood smoke generator was drawn through the precipitator. Although these runs were visual indicators only, with no objective other than to display, they provided a strong argument for the device’s claimed efficiency, as no emissions were visible at exit when energised.  The theoretical performance of ESPs, when applied to the geometry and configuration of the tested model, was compared to the actual performance and was shown to be in good agreement with it.

Keywords: electrostatic precipitators, air quality, particulates emissions, electron microscopy, image j

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Authors: Xiao Yang, Ji Zhang, Yingli Song, Hui Huang, Jing Zhang, Yan Wang, Rongrong Han, Zhixuan Xiang, Lu Chen, Lingling Gao

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Aim and Objectives: To examine physical activity self-efficacy, identify its predictors, and further explore the mechanism of action among the predictors in mainland Chinese pregnant women with high risk for gestational diabetes mellitus (GDM). Background: Physical activity could protect pregnant women from developing GDM. Physical activity self-efficacy was the key predictor of physical activity. Design: A cross-sectional study was conducted from October 2021 to May 2022 in Zhengzhou, China. Methods: 252 eligible pregnant women completed the Pregnancy Physical Activity Self-efficacy Scale, the Social Support for Physical Activity Scale, the Knowledge on Physical Activity Questionnaire, the 7-item Generalized Anxiety Disorder scale, the Edinburgh Postnatal Depression Scale, and a socio-demographic data sheet. Multiple linear regression was applied to explore the predictors of physical activity self-efficacy. Structural equation modeling was used to explore the mechanism of action among the predictors. Results: Chinese pregnant women with a high risk for GDM reported a moderate level of physical activity self-efficacy. The best-fit regression analysis revealed four variables explained 17.5% of the variance in physical activity self-efficacy. Social support for physical activity was the strongest predictor, followed by knowledge of the physical activity, intention to do physical activity, and anxiety symptoms. The model analysis indicated that knowledge of physical activity could release anxiety and depressive symptoms and then increase physical activity self-efficacy. Conclusion: The present study revealed a moderate level of physical activity self-efficacy. Interventions targeting pregnant women with high risk for GDM need to include the predictors of physical activity self-efficacy. Relevance to clinical practice: To facilitate pregnant women with high risk for GDM to engage in physical activity, healthcare professionals may find assess physical activity self-efficacy and intervene as soon as possible on their first antenatal visit. Physical activity intervention programs focused on self-efficacy may be conducted in further research.

Keywords: physical activity, gestational diabetes, self-efficacy, predictors

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Authors: Patrice Conner

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Nanotechnologies have enormous potential to contribute to human flourishing in responsible and sustainable ways. They are rapidly developing field of science, technology and innovation. As enabling technologies, their full scope of applications is potentially very wide. Major implications are expected in many areas, e.g. healthcare, information and communication technologies, energy production and storage, materials science/chemical engineering, manufacturing, environmental protection, consumer products, etc. However, nanotechnologies are unlikely to realize their full potential unless their associated societal and ethical issues are adequately attended. Namely nanotechnologies and nanoparticles may expose humans and the environment to new health risks, possibly involving quite different mechanisms of interference with the physiology of human and environmental species. One of the building blocks of the ‘safe, integrated and responsible’ approach is standardization. Both the Economic and Social Committee and the European Parliament have highlighted the importance to be attached to standardization as a means to accompany the introduction on the market of nanotechnologies and nanomaterials, and a means to facilitate the implementation of regulation. ISO and CEN have respectively started in 2005 and 2006 to deal with selected topics related to this emerging and enabling technology. In the beginning of 2010, EC DG ‘Enterprise and Industry’ addressed the mandate M/461 to CEN, CENELEC and ETSI for standardization activities regarding nanotechnologies and nanomaterials. Thus CEN/TC 352 ‘Nanotechnologies’ has been asked to take the leadership for the coordination in the execution of M/461 (46 topics to be standardized) and to contact relevant European and International Technical committees and interested stakeholders as appropriate (56 structures have been identified). Prior requests from M/461 deal with characterization and exposure of nanomaterials and any matters related to Health, Safety and Environment. Answers will be given to: - What are the structures and how they work? - Where are we right now and how work is going from now onwards? - How CEN’s work and targets deal with and interact with global matters in this field?

Keywords: characterization, environmental protection, exposure, health risks, nanotechnologies, responsible and sustainable ways, safety

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Authors: Dorit Alt, Nirit Raichel

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Educational practice is continually subjected to renewal needs, due mainly to the growing proportion of information communication technology, globalization of education, and the pursuit of quality. These types of renewal needs require developing updated instructional and assessment practices that put a premium on adaptability to the emerging requirements of present society. However, university instruction is criticized for not coping with these new challenges while continuing to exemplify the traditional instruction. In order to overcome this critical inadequacy between current educational goals and instructional methods, the LLAF consortium (including 16 members from 8 countries) is collaborating to create a curricular reform for lifelong learning (LLL) in teachers' education, health care and other applied fields. This project aims to achieve its objectives by developing, and piloting models for training students in LLL and promoting meaningful learning activities that could integrate knowledge with the personal transferable skills. LLAF has created a practical guide for teachers containing updated pedagogical strategies and assessment tools based on the constructivist approach for learning. This presentation will be limited to teachers' education only and to the contribution of a pre-pilot research aimed at providing a scale designed to measure constructivist activities in higher education learning environments. A mix-method approach was implemented in two phases to construct the scale: The first phase included a qualitative content analysis involving both deductive and inductive category applications of students' observations. The results foregrounded eight categories: knowledge construction, authenticity, multiple perspectives, prior knowledge, in-depth learning, teacher- student interaction, social interaction and cooperative dialogue. The students' descriptions of their classes were formulated as 36 items. The second phase employed structural equation modeling (SEM). The scale was submitted to 597 undergraduate students. The goodness of fit of the data to the structural model yielded sufficient fit results. This research elaborates the body of literature by adding a category of in-depth learning which emerged from the content analysis. Moreover, the theoretical category of social activity has been extended to include two distinctive factors: cooperative dialogue and social interaction. Implications of these findings for the LLAF project are discussed.

Keywords: constructivist learning, higher education, mix-methodology, lifelong learning

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Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu

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SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.

Keywords: Covid-19, costs, hospital stay, military hospital

Procedia PDF Downloads 178

Authors: Zahid Ullah, Atlas Khan

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In today's data-driven world, the role of mathematics in bridging the gap between theory and applications is becoming increasingly vital. This abstract highlights the significance of mathematics as a powerful tool for analyzing, interpreting, and extracting meaningful insights from vast amounts of data. By integrating mathematical principles with real-world applications, researchers can unlock the full potential of data-driven decision-making processes. This abstract delves into the various ways mathematics acts as a bridge connecting theoretical frameworks to practical applications. It explores the utilization of mathematical models, algorithms, and statistical techniques to uncover hidden patterns, trends, and correlations within complex datasets. Furthermore, it investigates the role of mathematics in enhancing predictive modeling, optimization, and risk assessment methodologies for improved decision-making in diverse fields such as finance, healthcare, engineering, and social sciences. The abstract also emphasizes the need for interdisciplinary collaboration between mathematicians, statisticians, computer scientists, and domain experts to tackle the challenges posed by the data-driven landscape. By fostering synergies between these disciplines, novel approaches can be developed to address complex problems and make data-driven insights accessible and actionable. Moreover, this abstract underscores the importance of robust mathematical foundations for ensuring the reliability and validity of data analysis. Rigorous mathematical frameworks not only provide a solid basis for understanding and interpreting results but also contribute to the development of innovative methodologies and techniques. In summary, this abstract advocates for the pivotal role of mathematics in bridging theory and applications in a data-driven world. By harnessing mathematical principles, researchers can unlock the transformative potential of data analysis, paving the way for evidence-based decision-making, optimized processes, and innovative solutions to the challenges of our rapidly evolving society.

Keywords: mathematics, bridging theory and applications, data-driven world, mathematical models

Procedia PDF Downloads 75

Authors: Lun Lou, Jintu Fan

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While personal protective equipment (PPE) prevents the healthcare personnel from exposing to harmful surroundings, it creates a barrier to the dissipation of body heat and perspiration, leading to severe heat stress during prolonged exposure, especially in hot environments. It has been found that most of the existed personal cooling strategies have limitations in achieving effective cooling performance with long duration and lightweight. This work aimed to develop a lightweight (<1.0 kg) and less expensive wearable air cooling and dehumidifying system (WCDS) that can be applied underneath the protective clothing and provide 50W mean cooling power for more than 5 hours at 35°C environmental temperature without compromising the protection of PPE. For the WCDS, blowers will be used to activate an internal air circulation inside the clothing microclimate, which doesn't interfere with the protection of PPE. An air cooling and dehumidifying chamber (ACMR) with a specific design will be developed to reduce the air temperature and humidity inside the protective clothing. Then the cooled and dried air will be supplied to upper chest and back areas through a branching tubing system for personal cooling. A detachable ice cooling unit will be applied from the outside of the PPE to extract heat from the clothing microclimate. This combination allows for convenient replacement of the cooling unit to refresh the cooling effect, which can realize a continuous cooling function without taking off the PPE or adding too much weight. A preliminary thermal manikin test showed that the WCDS was able to reduce the microclimate temperature inside the PPE averagely by about 8°C for 60 minutes when the environmental temperature was 28.0 °C and 33.5 °C, respectively. Replacing the ice cooling unit every hour can maintain this cooling effect, while the longest operation duration is determined by the battery of the blowers, which can last for about 6 hours. This unique design is especially helpful for the PPE users, such as health care workers in infectious and hot environments when continuous cooling and dehumidifying are needed, but the change of protective clothing may increase the risk of infection. The new WCDS will not only improve the thermal comfort of PPE users but can also extend their safe working duration.

Keywords: personal thermal management, heat stress, ppe, health care workers, wearable device

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Authors: Ying Li, Rui Hu, Shizhen Chen, Xin Zhou, Yunhuang Yang

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Prostate cancer is one of the leading causes of cancer-related death among men. Prostate-specific antigen (PSA), a specific product of prostatic epithelial cells, is an important indicator of prostate cancer. Though PSA is not a specific serum biomarker for the screening of prostate cancer, it is recognized as an indicator for prostate cancer recurrence and response to therapy for patient’s post-prostatectomy. Since radical prostatectomy eliminates the source of PSA production, serum PSA levels fall below 50 pg/mL, and may be below the detection limit of clinical immunoassays (current clinical immunoassay lower limit of detection is around 10 pg/mL). Many clinical studies have shown that intervention at low PSA levels was able to improve patient outcomes significantly. Therefore, ultra-sensitive and precise assays that can accurately quantify extremely low levels of PSA (below 1-10 pg/mL) will facilitate the assessment of patients for the possibility of early adjuvant or salvage treatment. Currently, the commercially available ultra-sensitive ELISA kit (not used clinically) can only reach a detection limit of 3-10 pg/mL. Other platforms developed by different research groups could achieve a detection limit as low as 0.33 pg/mL, but they relied on sophisticated instruments to get the final readout. Herein we report a microfluidic platform for point-of-care (POC) detection of PSA with a detection limit of 0.5 pg/mL and without the assistance of any equipment. This platform is based on a previously reported volumetric-bar-chart chip (V-Chip), which applies platinum nanoparticles (PtNPs) as the ELISA probe to convert the biomarker concentration to the volume of oxygen gas that further pushes the red ink to form a visualized bar-chart. The length of each bar is used to quantify the biomarker concentration of each sample. We devised a long reading channel V-Chip (LV-Chip) in this work to achieve a wide detection window. In addition, LV-Chip employed a unique enzyme-free ELISA probe that enriched PtNPs significantly and owned 500-fold enhanced catalytic ability over that of previous V-Chip, resulting in a significantly improved detection limit. LV-Chip is able to complete a PSA assay for five samples in 20 min. The device was applied to detect PSA in 50 patient serum samples, and the on-chip results demonstrated good correlation with conventional immunoassay. In addition, the PSA levels in finger-prick whole blood samples from healthy volunteers were successfully measured on the device. This completely stand-alone LV-Chip platform enables convenient POC testing for patient follow-up in the physician’s office and is also useful in resource-constrained settings.

Keywords: point-of-care detection, microfluidics, PSA, ultra-sensitive

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Authors: Denisa Mackova, Andrea Pokorna

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The management of postoperative pain is a meaningful part of quality care. The experience and knowledge of registered nurses in postoperative pain management can be influenced by local know-how. Therefore, the research helps to understand the cultural differences between two countries with the aim of evaluating the management of postoperative pain management among the nurses from the Czech Republic and the Kingdom of Saudi Arabia. Both countries have different procedures on managing postoperative pain and the research will provide an understanding of both the advantages and disadvantages of the procedures and also highlight the knowledge and experience of registered nurses in both countries. Between the Czech Republic and the Kingdom of Saudi Arabia, the expectation is for differing results in the usage of opioid analgesia for the patients postoperatively and in the experience of registered nurses with Patient Controlled Analgesia. The aim is to evaluate the knowledge and awareness of registered nurses and to merge the data with the postoperative pain management in the early postoperative period in the Czech Republic and the Kingdom of Saudi Arabia. Also, the aim is to assess the knowledge and experience of registered nurses by using Patient Controlled Analgesia and epidural analgesia treatment in the early postoperative period. The criteria for those providing input into the study, are registered nurses, working in surgical settings (standard departments, post-anesthesia care unit, day care surgery or ICU’s) caring for patients in the postoperative period. Method: Research is being conducted by questionnaires. It is a quantitative research, a comparative study of registered nurses in the Czech Republic and the Kingdom of Saudi Arabia. Questionnaire surveys were distributed through an electronic Bristol online survey. Results: The collection of the data in the Kingdom of Saudi Arabia has been completed successfully, with 550 respondents, 77 were excluded and 473 respondents were included for statistical data analysis. The outcome of the research is expected to highlight the differences in treatment through Patient Controlled Analgesia, with more frequent use in the Kingdom of Saudi Arabia. A similar assumption is expected for treatment conducted by analgesia. We predict that opioids will be used more regularly in the Kingdom of Saudi Arabia, whilst therapy through NSAID’s being the most common approach in the Czech Republic. Discussion/Conclusion: The majority of respondents from the Kingdom of Saudi Arabia were female registered nurses from a multitude of nations. We are expecting a similar split in gender between the Czech Republic respondents; however, there will be a smaller number of nationalities. Relevance for research and practice: Output from the research will assess the knowledge, experience and practice of patient controlled analgesia and epidural analgesia treatment. Acknowledgement: This research was accepted and affiliated to the project: Postoperative pain management, knowledge and experience registered nurses (Czech Republic and Kingdom of Saudi Arabia) – SGS05/2019-2020.

Keywords: acute postoperative pain, epidural analgesia, nursing care, patient controlled analgesia

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Authors: Rangika Perera, Shyamani Hettiarachchi, Fran Hagstrom

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Dyslexia is the most common reading reading-related difficulty among the school school-aged population and currently, 5-10% are showing the features of dyslexia in Sri Lanka. As there is an insufficient number of speech and language pathologists in the country and few speech and language pathologists working in government mainstream school settings, these children who are at risk of dyslexia are not receiving enough quality early intervention services to develop their reading skills. As teachers are the key professionals who are directly working with these children, using them as the primary facilitators to improve their reading skills will be the most effective approach. This study aimed to identify the efficacy of a two and half a day of intensive training provided to fifteen mainstream government school teachers of grade two classes. The goal of the training was to enhance their knowledge of dyslexia and provide full classroom skills training that could be used to support the development of the students’ reading competencies. A closed closed-ended multiple choice questionnaire was given to these teachers pre and -post-training to measure teachers’ knowledge of dyslexia, the areas in which these children needed additional support, and the best strategies to facilitate reading competencies. The data revealed that the teachers’ knowledge in all areas was significantly poorer prior to the training and that there was a clear improvement in all areas after the training. The gain in target areas of teaching skills selected to improve the reading skills of children was evaluated through peer feedback. Teachers were assigned to three groups and expected to model how they were going to introduce the skills in recommended areas using researcher developed, validated and reliability reliability-tested materials and the strategies which were introduced during the training within the given tasks. Peers and the primary investigator rated teachers’ performances and gave feedback on organizational skills, presentation skills of materials, clarity of instruction, and appropriateness of vocabulary. After modifying their skills according to the feedback the teachers received, they were expected to modify and represent the same tasks to the group the following day. Their skills were re-evaluated by the peers and primary investigator using the same rubrics to measure the improvement. The findings revealed a significant improvement in their teaching skills development. The data analysis of both knowledge and skills gains of the teachers was carried out using quantitative descriptive data analysis. The overall findings of the study yielded promising results that support intensive training as a method for improving teachers’ knowledge and teaching skill development for use with children in a whole class intervention setting who are at risk of dyslexia.

Keywords: Dyslexia, knowledge, teaching skills, training program

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Authors: Snigdha Sahai, Devaki Chikkavenkatappa Yellappa

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This study outlines approaches for testing and validating stochastic models used in epidemiology, focusing on the integration and functional testing of simulation code. It details methods for combining simple functions into comprehensive simulations, distinguishing between deterministic and stochastic components, and applying tests to ensure robustness. Techniques include isolating stochastic elements, utilizing large sample sizes for validation, and handling special cases. Practical examples are provided using R code to demonstrate integration testing, handling of incorrect inputs, and special cases. The study emphasizes the importance of both functional and defensive programming to enhance code reliability and user-friendliness.

Keywords: computational epidemiology, epidemiology, public health, infectious disease modeling, statistical analysis, health data analysis, disease transmission dynamics, predictive modeling in health, population health modeling, quantitative public health, random sampling simulations, randomized numerical analysis, simulation-based analysis, variance-based simulations, algorithmic disease simulation, computational public health strategies, epidemiological surveillance, disease pattern analysis, epidemic risk assessment, population-based health strategies, preventive healthcare models, infection dynamics in populations, contagion spread prediction models, survival analysis techniques, epidemiological data mining, host-pathogen interaction models, risk assessment algorithms for disease spread, decision-support systems in epidemiology, macro-level health impact simulations, socioeconomic determinants in disease spread, data-driven decision making in public health, quantitative impact assessment of health policies, biostatistical methods in population health, probability-driven health outcome predictions

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Authors: Mohammed Amin, Debra Kerr, Yacoba Atiase, Andrea Driscoll

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Background: Physical activity (PA) is a major component of diabetes self-care management; although this is often stressed to patients, many adults with Type 2 Diabetes Mellitus (T2DM)lead sedentary lifestyles, and barriers exist for uptake of PA. Aim: To explore opinions of healthcare professionals about barriers to PA for adults with T2DM in Ghana. Methods: This qualitative descriptive study included 13healthcare professionals (3 Physiotherapists, 3 exercise physiologists, 3 nurses, and 4 physicians) who provide care to individuals with T2DM in Ghana. Data was collected by semi-structured interviews. The social cognitive theory guided the design of the interview schedule. Data was analysed using thematic analysis. Results: Four main themeswere identified: 1) Individual-related factors, 2) Interpersonal factors, 3) Environment-related factors, and 4) Health system-related factors. Fear of injury, existing co-morbidities, and lack of time make it difficult for people with T2DM to engage in PA. Lack of family support, fear of social ridicule, and cultural beliefs prevent uptake of PA. Poorly designed community spaces, including safe walkways and lack of exercise facilities, inhibit PA participation. Few physical therapists and physical therapy centres exist to support PA participation among people with T2DM. Some nurses and doctors lack adequate knowledge to deliver proper PA education to clients, thereby making clients lack the needed support. Conclusion: Adults with T2DM may be restricted from partaking in PA arising from personal and external factors. This study has identified that barriers to exercise need consideration when designing PA programs that aim to improve health outcomes for people with T2DM in Ghana.

Keywords: type 2 diabetes, physical activity, exercise, ghana, qualitative, barriers

Procedia PDF Downloads 135

Authors: Sharvari Parikh

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Climate change has always been looked upon as a threat. Increased use of fossil fuels, depletion of bio diversity, certain human activities, rising levels of Greenhouse Gas (GHG) emissions are the factors that have caused climate change. Climate change is creating new risks and aggravating the existing ones. The paper focuses on breaking the stereotypical perception of climate change and draws attention towards the constructive side of it. Researches around the world have concluded that climate change has provided us with many untapped opportunities. The next 15 years will be crucial, as it is in our hands whether we are able to grab these opportunities or just let the situation get worse. The world stands at a stage where we cannot think of making a choice between averting climate change and promoting growth and development. In fact, the solution to climate change itself has got economic opportunities. The data evidences from the paper show how we can create the opportunity to improve the lives of the world’s population at large through structural change which will promote environment friendly investments. Rising Investment in green energy and increased demand of climate friendly products has got ample of employment opportunities. Old technologies and machinery which are employed today lack efficiency and demand huge maintenance because of which we face high production cost. This can be drastically brought down by adaptation of Green technologies which are more accessible and affordable. Overall GDP of the world has been heavily affected in aggravating the problems arising out of increasing weather problems. Shifting to green economy can not only eliminate these costs but also build a sound economy. Accelerating the economy in direction of low-carbon future can lessen the burdens such as subsidies for fossil fuels, several public debts, unemployment, poverty, reduce healthcare expenses etc. It is clear that the world will be dragged into the ‘Darker phase’ if the current trends of fossil fuels and carbon are being consumed. Switching to Green economy is the only way in which we can lift the world from darker phase. Climate change has opened the gates for ‘Green and Clean economy’. It will also bring countries of the world together in achieving the common goal of Green Economy.

Keywords: climate change, economic opportunities, green economy, green technology

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Authors: Desta Kebede Ayana, Lies Sercu, Demelash Mengistu

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The study is set in Ethiopia, a sub-Saharan multilingual, multiethnic African country, which has seen a significant increase in the number of universities in recent years. The aim of this growth is to provide access to education for all cultural and linguistic groups across the country. However, there are challenges in promoting intercultural competence among students in this diverse context. The aim of the study is to investigate the interculturalization of Ethiopian Higher Education Institutions as perceived by university lecturers and administrators. In particular, the study aims to determine the level of support for this educational innovation and gather suggestions for its implementation and institutionalization. The researchers employed semi-structured interviews with administrators and lecturers from two large Ethiopian universities to gather data. Thematic analysis was utilized for coding and analyzing the interview data, with the assistance of the NVIVO software. The findings obtained from the grounded analysis of the interview data reveal that while there are opportunities for interculturalization in the curriculum and campus life, support for educational innovation remains low. Administrators and lecturers also emphasize the government's responsibility to prioritize interculturalization over other educational innovation goals. The study contributes to the existing literature by examining an under-researched population in an under-researched context. Additionally, the study explores whether Western perspectives of intercultural competence align with the African context, adding to the theoretical understanding of intercultural education. The data for this study was collected through semi-structured interviews conducted with administrators and lecturers from two large Ethiopian universities. The interviews allowed for an in-depth exploration of the participants' views on interculturalization in higher education. Thematic analysis was applied to the interview data, allowing for the identification and organization of recurring themes and patterns. The analysis was conducted using the NVIVO software, which aided in coding and analyzing the data. The study addresses the extent to which administrators and lecturers support the interculturalization of Ethiopian Higher Education Institutions. It also explores their suggestions for implementing and institutionalizing intercultural education, as well as their perspectives on the current level of institutionalization. The study highlights the challenges in interculturalizing Ethiopian universities and emphasizes the need for greater support and prioritization of intercultural education. It also underscores the importance of considering the African context when conceptualizing intercultural competence. This research contributes to the understanding of intercultural education in diverse contexts and provides valuable insights for policymakers and educational institutions aiming to promote intercultural competence in higher education settings.

Keywords: administrators, educational change, Ethiopia, intercultural competence, lecturers

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Authors: Usharani Rathinam

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Although policies directing inclusion of marginalized were in effect, majority of chronically impoverished in India belonged to schedule caste and schedule tribes. Also, taking into account that poverty is gendered; destitute women belonged to lower social order whose need is not largely highlighted at policy level. This paper discusses on social relations poverty which highlights on how social order that existed structurally in the society can perpetuate chronic poverty, followed by a critical review on social inclusion policies of India, its merits and demerits in addressing chronic poverty. Multiple case study design is utilized to address this concern in four districts of India; Jhansi, Tikamgarh, Cuddalore and Anantapur. These four districts were selected by purposive sampling based on the criteria; the district should either be categorized as a backward district or should have a history of high poverty rate. Qualitative methods including eighty in-depth interviews, six focus group discussions, six social mapping procedures and three key informant interviews were conducted in 2011, at each of the locations. Analysis of the data revealed that irrespective of gender, schedule castes and schedule tribe participants were found to be chronically poor in all districts. Caste based discrimination is exhibited at both micro and macro levels; village and institutional levels. At village level, lower caste respondents had lesser access to public resources. Also, within institutional settings, due to confiscation, unequal access to resources is noticed, especially in fund distribution. This study found that half of the budget intended for schedule caste and schedule tribes were confiscated by upper caste administrative staffs. This implies that power based on social hierarchy marginalize lower caste participants from accessing better economic, social, and political benefits, that had led them to suffer long term poverty. This study also explored the traditional ties between caste, social structure and bonded labour as a cause of long-term poverty. Though equal access is being emphasized in constitutional rights, issues at micro level have not been reflected in formulation of these rights. Therefore, it is significant for a policy to consider the structural complexity and then focus on issues such as equal distribution of assets and infrastructural facilities that will reduce exclusion and foster long-term security in areas such as employment, markets and public distribution.

Keywords: caste, inclusion policies, India, social order

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Authors: Margarida Porfírio Tomás, Paula Pereira, José Manuel Palma Oliveira

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The decline in employment rates across sectors like industry and construction is exacerbated by an aging workforce. This has far-reaching implications for the economy, including skills gaps, labour shortages, productivity challenges due to physical limitations, and workplace safety concerns. To sustain the workforce and pension systems, technology plays a pivotal role. Robots provide valuable support to human workers, and effective human-robot interaction is essential. FORTIS, a Horizon project, aims to address these challenges by creating a comprehensive Human-Robot Interaction (HRI) solution. This solution focuses on multi-modal communication and multi-aspect interaction, with a primary goal of maintaining a human-centric approach. By meeting the needs of both human workers and robots, FORTIS aims to facilitate efficient and safe collaboration. The project encompasses three key activities: 1) A Human-Centric Approach involving data collection, annotation, understanding human behavioural cognition, and contextual human-robot information exchange. 2) A Robotic-Centric Focus addressing the unique requirements of robots during the perception and evaluation of human behaviour. 3) Ensuring Human-Robot Trustworthiness through measures such as human-robot digital twins, safety protocols, and resource allocation. Factor Social, a project partner, will analyse psycho-physiological signals that influence human factors, particularly in hazardous working conditions. The analysis will be conducted using a combination of case studies, structured interviews, questionnaires, and a comprehensive literature review. However, the adoption of novel technologies, particularly those involving human-robot interaction, often faces hurdles related to acceptance. To address this challenge, FORTIS will draw upon insights from Social Sciences and Humanities (SSH), including risk perception and technology acceptance models. Throughout its lifecycle, FORTIS will uphold a human-centric approach, leveraging SSH methodologies to inform the design and development of solutions. This project received funding from European Union’s Horizon 2020/Horizon Europe research and innovation program under grant agreement No 101135707 (FORTIS).

Keywords: skills gaps, productivity challenges, workplace safety, human-robot interaction, human-centric approach, social sciences and humanities, risk perception

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Authors: Austin Vander Wel, Katherin Vargas Henao

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Washington, DC, is a city in which Spanish, along with several other minority languages, is prevalent not only among tourists but also those living within city limits. In response to this linguistic diversity and DC’s adoption of the Language Access Act in 2004, the Washington Metropolitan Area Transit Authority (WMATA) committed to addressing the need for equal linguistic representation and established a five-step plan to provide the best multilingual information possible for public transportation users. The current study, however, strongly suggests that this de jure policy does not align with the reality of Spanish’s representation on DC public transportation–although perhaps doing so in an unexpected way. In order to investigate Spanish’s de facto representation and how it contrasts with de jure policy, this study implements a linguistic landscapes methodology that takes critical language-policy as its theoretical framework (Tollefson, 2005). Specifically concerning de facto representation, it focuses on the discrepancies between digital spaces and the actual physical spaces through which users travel. These digital vs. in situ conditions are further analyzed by separately addressing aural and visual modalities. In digital spaces, data was collected from WMATA’s website (visual) and their bilingual hotline (aural). For in situ spaces, both bus and metro areas of DC public transportation were explored, with signs comprising the visual modality and recordings, driver announcements, and interactions with metro kiosk workers comprising the aural modality. While digital spaces were considered to successfully fulfill WMATA’s commitment to representing Spanish as outlined in the de jure policy, physical spaces show a large discrepancy between what is said and what is done, particularly regarding the bus system, in addition to the aural modality overall. These discrepancies in situ spaces place Spanish speakers at a clear disadvantage, demanding additional resources and knowledge on the part of residents with limited or no English proficiency in order to have equal access to this public good. Based on our critical language-policy analysis, while Spanish is represented as a right in the de jure policy, its implementation in situ clearly portrays Spanish as a problem since those seeking bilingual information can not expect it to be present when and where they need it most (Ruíz, 1984; Tollefson, 2005). This study concludes with practical, data-based steps to improve the current situation facing DC’s public transportation context and serves as a model for responding to inadequate enactment of de jure policy in other language policy settings.

Keywords: Urban landscape, language access, critical-language policy, spanish, public transportation

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Authors: Annunziata Albano

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Intimate Partner Violence (IPV) and Non-Partner Sexual Violence (NPSV) are still the most common forms of interpersonal violence against women today, and numerous studies have shown how they can affect women's physical and psychological well-being, frequently leading to depression, posttraumatic stress disorder (PTSD), and substance abuse. The primary goal of Italian Anti-Violence Centres (AVCs) is to provide an appropriate context for women to embark on a personalised path out of violence by providing various services such as listening groups, psychological and legal support, housing support in collaboration with shelters, work orientation, and specific support in the case of minor children. However, their physical environment is frequently overlooked, partly because these centres are typically established in pre-existing buildings and have a limited budget. Several studies on healthcare design and mental health, on the other hand, emphasise the potential of the built environment to facilitate healing by providing a restorative setting that aids in coping with stress and traumatic experiences, investigating the positive role of natural features and sensorial qualities such as light, colours, sound, and smell. This research aims to collect and summarise the key evidence-based principles derived from a multidisciplinary literature review about interior design elements that can help women recover after their traumatic experience. Furthermore, the study examines multiple case studies of Italian AVCs through the lens of previously determined principles, to understand how and whether these guidelines have been applied and which outcomes can provide relevant insights for design practice, with an emphasis on sensory qualities, usually overlooked in favour of other requirements. The outlined guidelines may serve as a framework for various typologies of services provided to women who are the victims of interpersonal violence, such as women's crisis centres and shelters.

Keywords: anti-violence centres, environmental psychology, interior design, interpersonal violence, restorative environments

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Authors: Daniel Todorov, Anton Hinkov, Petya Angelova, Kalina Shishkova, Venelin Tsvetkov, Stoyan Shishkov

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Human herpes viruses (HHV) are ubiquitous pathogens with a pandemic spread across the globe. HHV type 1 is the main causative agent of cold sores and fever blisters around the mouth and on the face, whereas HHV type 2 is generally responsible for genital herpes outbreaks. The treatment of both viruses is more or less successful with antivirals from the nucleoside analogues group. Their wide application increasingly leads to the emergence of resistant mutants In the past, medicinal plants have been used to treat a number of infectious and non-infectious diseases. Their diversity and ability to produce the vast variety of secondary metabolites according to the characteristics of the environment give them the potential to help us in our warfare with viral infections. The variable chemical characteristics and complex composition is an advantage in the treatment of herpes since the emergence of resistant mutants is significantly complicated. The screening process is difficult due to the lack of standardization. That is why it is especially important to follow the mechanism of antiviral action of plants. On the one hand, it may be expected to interact with its compounds, resulting in enhanced antiviral effects, and the most appropriate environmental conditions can be chosen to maximize the amount of active secondary metabolites. During our study, we followed the activity of various plant extracts on the viral replication cycle as well as their effect on the extracellular virion. We obtained our results following the logical sequence of the experimental settings - determining the cytotoxicity of the extracts, evaluating the overall effect on viral replication and extracellular virion.During our research, we have screened a variety of plant extracts for their antiviral activity against both virus replication and the virion itself. We investigated the effect of the extracts on the individual stages of the viral replication cycle - viral adsorption, penetration and the effect on replication depending on the time of addition. If there are positive results in the later experiments, we had studied the activity over viral adsorption, penetration and the effect of replication according to the time of addition. Our results indicate that some of the extracts from the Lamium album have several targets. The first stages of the viral life cycle are most affected. Several of our active antiviral agents have shown an effect on extracellular virion and adsorption and penetration processes. Our research over the last decade has shown several curative antiviral plants - some of which are from the Lamiacea family. The rich set of active ingredients of the plants in this family makes them a good source of antiviral preparation.

Keywords: human herpes virus, antiviral activity, Lamium album, Nepeta nuda

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Authors: Sara Saboonian, Pierre Filion

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There are two distinct planning approaches attempting to transform the North American suburb so as to reduce its adverse environmental impacts. The first one, the recentralization approach, proposes intensification, multi-functionality and more reliance on public transit and walking. It thus offers an alternative to the prevailing low-density, spatial specialization and automobile dependence of the North American suburb. The second approach concentrates instead on the provision of green infrastructure, which rely on natural systems rather than on highly engineered solutions to deal with the infrastructure needs of suburban areas. There are tensions between these two approaches as recentralization generally overlooks green infrastructure, which can be space consuming (as in the case of water retention systems), and thus conflicts with the intensification goals of recentralization. The research investigates three Canadian planned suburban centres in the Greater Toronto Area, where recentralization is the current planning practice, despite rising awareness of the benefits of green infrastructure. Methods include reviewing the literature on green infrastructure planning, a critical analysis of the Ontario provincial plans for recentralization, surveying residents’ preferences regarding alternative suburban development models, and interviewing officials who deal with the local planning of the three centres. The case studies expose the difficulties in creating planned suburban centres that accommodate green infrastructure while adhering to recentralization principles. Until now, planners have been mostly focussed on recentralization at the expense of green infrastructure. In this context, the frequent lack of compatibility between recentralization and the space requirements of green infrastructure explains the limited presence of such infrastructures in planned suburban centres. Finally, while much attention has been given in the planning discourse to the economic and lifestyle benefits of recentralization, much less has been made of the wide range of advantages of green infrastructure, which explains limited public mobilization over the development of green infrastructure networks. The paper will concentrate on ways of combining recentralization with green infrastructure strategies and identify the aspects of the two approaches that are most compatible with each other. The outcome of such blending will marry high density, public-transit oriented developments, which generate walkability and street-level animation, with the presence of green space, naturalized settings and reliance on renewable energy. The paper will advance a planning framework that will fuse green infrastructure with recentralization, thus ensuring the achievement of higher density and reduced reliance on the car along with the provision of critical ecosystem services throughout cities. This will support and enhance the objectives of both green infrastructure and recentralization.

Keywords: environmental-based planning, green infrastructure, multi-functionality, recentralization

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Authors: Balaji Devanathan, Gokul G., Raveena Divya, Abhishek Yadav, Sudhir K. Gupta

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Background: Age estimation is a common problem in administrative settings, medico legal cases, and among athletes competing in different sports. Age estimation is a problem in medico legal problems that arise in hospitals when there has been a criminal abortion, when consenting to surgery or a general physical examination, when there has been infanticide, impotence, sterility, etc. Medical imaging progress has benefited forensic anthropology in various ways, most notably in the area of determining bone age. An efficient method for researching the epiphyseal union and other differences in the body's bones and joints is multi-slice computed tomography. There isn't a significant database on Indians available. So to obtain an Indian based database author has performed this original study. Methodologies: The appearance and fusion of ossification centre of sternoclavicular joint is evaluated, and grades were assigned accordingly. Using MSCT scans, we examined the relationship between the age of the deceased and alterations in the sternoclavicular joint during the appearance and union in 500 instances, 327 men and 173 females, in the age range of 0 to 25 years. Results: According to our research in both the male and female groups, the ossification centre for the medial end of the clavicle first appeared between the ages of 18.5 and 17.1 respectively. The age range of the partial union was 20.4 and 20.2 years old. The earliest age of complete fusion was 23 years for males and 22 years for females. For fusion of their sternebrae into one, age range is 11–24 years for females and 17–24 years. The fusion of the third and fourth sternebrae was completed by 11 years. The fusions of the first and second and second and third sternebrae occur by the age of 17 years. Furthermore, correlation and reliability were carried out which yielded significant results. Conclusion: With numerous exceptions, the projected values are consistent with a large number of the previously developed age charts. These variations may be caused by the ethnic or regional heterogeneity in the ossification pattern among the population under study. The pattern of bone maturation did not significantly differ between the sexes, according to the study. The study's age range was 0 to 25 years, and for obvious reasons, the majority of the occurrences occurred in the last five years, or between 20 and 25 years of age. This resulted in a comparatively smaller study population for the 12–18 age group, where age estimate is crucial because of current legal requirements. It will require specialized PMCT research in this age range to produce population standard charts for age estimate. The medial end of the clavicle is one of several ossification foci that are being thoroughly investigated since they are challenging to assess with a traditional X-ray examination. Combining the two has been shown to be a valid result when it comes to raising the age beyond eighteen.

Keywords: age estimation, sternoclavicular joint, medial clavicle, computed tomography

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Authors: Ruben Peralta, Sam Thomas, Nazia Hirani, Ayman El-Menyar, Hassan Al-Thani, Mohammed Al-Thani, Mohammed Al-Hajjaj, Rafael Consunji

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Moderate to severe work-related injuries [WRI's] are a leading cause of trauma admission in Qatar but information on risk factors for their incidence are lacking. This study aims to document and analyze the predictive characteristics for WRI to inform the creation of targeted interventions to improve worker safety in Qatar. This study was conducted as part of the NPRP grant # 7 - 1120 - 3 - 288, titled "A Unified Registry for Occupational Injury Prevention in Qatar”. 266 workers were interviewed using a standard questionnaire, during ‘World Day for Safety and Health at Work’, a Ministry of Public Health event, none refused interview. Nurses and doctors from the Hamad Trauma Center conducted the interviews. Questions were translated into the worker’s native language when it was deemed necessary. Standard information on epidemiologic characteristics and incidence of work-related injury were collected and compared between nationalities and those injured versus those not injured. 262 males and 4 females were interviewed. 17 [6.4%] reported a WRI in the last 24 months. More than half of the injured worked in construction [59%] followed by water supply [11.8%]. Factors significantly associated with recent injury were: Working for a company with > 500 employees and speaking Hindi. Protective characteristics included: Being from the Philippines or Sri Lanka, speaking Arabic, working in healthcare, an office or trading and company size between 100-500 employees. Years of schooling and working in Qatar were not predictive factor for WRI. The findings from this survey should guide future research that will better define worker populations at an increased risk for WRI and inform recruiters and sending countries. A focus on worker language skills, interventions in the construction industry and occupational safety in large companies is needed.

Keywords: occupational injury, prevention, safety, trauma, work related injury

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Authors: Saliha Ozcan

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Technology has become an integral part of our lives, aiding individuals in accessing higher order competencies, such as global awareness, creativity, collaborative problem solving, and self-directed learning. Students need to acquire these competencies, often referred to as 21st century skills, in order to adapt to a fast changing world. Today, an ever-increasing number of schools are exploring how engagement through telecollaboration can support language learning and promote 21st century skill development in classrooms. However, little is known regarding how telecollaboration may influence the way students acquire 21st century skills. In this paper, we aim to shed light to the potential implications of telecollaborative practices in acquisition of 21st century skills. In our context, telecollaboration, which might be carried out in a variety of settings both synchronously or asynchronously, is considered as the process of communicating and working together with other people or groups from different locations through online digital tools or offline activities to co-produce a desired work output. The study presented here will describe and analyse the implementation of a telecollaborative project between two high school classes, one in Spain and the other in Sweden. The students in these classes were asked to carry out some joint activities, including creating an online platform, aimed at raising awareness of the situation of the Syrian refugees. We conduct a qualitative study in order to explore how language, culture, communication, and technology merge into the co-construction of knowledge, as well as supporting the attainment of the 21st century skills needed for network-mediated communication. To this end, we collected a significant amount of audio-visual data, including video recordings of classroom interaction and external Skype meetings. By analysing this data, we verify whether the initial pedagogical design and intended objectives of the telecollaborative project coincide with what emerges from the actual implementation of the tasks. Our findings indicate that, as well as planned activities, unplanned classroom interactions may lead to acquisition of certain 21st century skills, such as collaborative problem solving and self-directed learning. This work is part of a wider project (KONECT, EDU2013-43932-P; Spanish Ministry of Economy and Finance), which aims to explore innovative, cross-competency based teaching that can address the current gaps between today’s educational practices and the needs of informed citizens in tomorrow’s interconnected, globalised world.

Keywords: 21st century skills, telecollaboration, language learning, network mediated communication

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Authors: Mahmoud M. AbuAlSamen, Tamam El-Elimat

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Amid the economic crisis in Jordan, the Jordanian government has opted for a knowledge economy where education is promoted as a mean for economic development. University education usually comes at the expense of study-related stress that may adversely impact the health of students. Since stress is a latent variable that is difficult to measure, a valid tool should be used in doing so. The effort-reward imbalance (ERI) is a model used as a measurement tool for occupational stress. The model was built on the notion of reciprocity, which relates ‘effort’ to ‘reward’ through the mediating ‘over-commitment’. Reciprocity assumes equilibrium between both effort and reward, where ‘high’ effort is adequately compensated with ‘high’ reward. When this equilibrium is violated (i.e., high effort with low reward), this may elicit negative emotions and stress, which have been correlated to adverse health conditions. The theory of ERI was established in many different parts of the world, and associations with chronic diseases and the health of workers were explored at length. While much of the effort-reward imbalance was investigated in work conditions, there has been a growing interest in understanding the validity of the ERI model when applied to other social settings such as schools and universities. The ERI questionnaire was developed in Arabic recently to measure ERI among high school teachers. However, little information is available on the validity of the ERI questionnaire in university students. A cross-sectional study was conducted on 833 students in Jordan to measure the validity and reliability of the ERI questionnaire in Arabic among university students. Reliability, as measured by Cronbach’s alpha of the effort, reward, and overcommitment scales, was 0.73, 0.76, and 0.69, respectively, suggesting satisfactory reliability. The factorial structure was explored using principal axis factoring. The results fitted a five-solution model where both the effort and overcommitment were uni-dimensional while the reward scale was three-dimensional with its factors, namely being ‘support’, ‘esteem’, and ‘security’. The solution explained 56% of the variance in the data. The established ERI theory was replicated with excellent validity in this study. The effort-reward ratio in university students was 1.19, which suggests a slight degree of failed reciprocity. The study also investigated the association of effort, reward, overcommitment, and ERI with participants’ demographic factors and self-reported health. ERI was found to be significantly associated with absenteeism (p < 0.0001), past history of failed courses (p=0.03), and poor academic performance (p < 0.001). Moreover, ERI was found to be associated with poor self-reported health among university students (p=0.01). In conclusion, the Arabic ERI questionnaire is reliable and valid for use in measuring effort-reward imbalance in university students in Jordan. The results of this research are important in informing higher education policy in Jordan.

Keywords: effort-reward imbalance, factor analysis, validity, self-reported health

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Authors: D. M. Lewis, L. Frisby, U. Stead

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Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

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Authors: Freja Rydahl Rasmussen, Naja Villadsen, Stig Koust

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Air purifiers have become widely implemented in a wide range of settings, including households, schools, institutions, and hospitals, as they tackle the pressing issue of indoor air pollution. With their ability to enhance indoor air quality and create healthier environments, air purifiers are particularly vital when ventilation options are limited. These devices incorporate a diverse array of technologies, including HEPA filters, active carbon filters, UV-C light, photocatalytic oxidation, and ionizers, each designed to combat specific pollutants and improve air quality within enclosed spaces. However, the safety of air purifiers has not been investigated thoroughly, and many questions still arise when applying them. Certain air purification technologies, such as UV-C light or ionization, can unintentionally generate undesirable byproducts that can negatively affect indoor air quality and health. It is well-established that these technologies can inadvertently generate nanoparticles or convert common gaseous compounds into harmful ones, thus exacerbating air pollution. However, the formation of byproducts can vary across products, necessitating further investigation. There is a particular concern about the formation of the carcinogenic substance formaldehyde from common gases like acetone. Many air purifiers use mechanical filtration to remove particles, dust, and pollen from the air. Filters need to be replaced periodically for optimal efficiency, resulting in an additional cost for end-users. Currently, there are no guidelines for filter lifespan, and replacement recommendations solely rely on manufacturers. A market screening revealed that manufacturers' recommended lifespans vary greatly (from 1 month to 10 years), and there is a need for general recommendations to guide consumers. Activated carbon filters are used to adsorb various types of chemicals that can pose health risks or cause unwanted odors. These filters have a certain capacity before becoming saturated. If not replaced in a timely manner, the adsorbed substances are likely to be released from the filter through off-gassing or losing adsorption efficiency. The goal of this study is to investigate the lifespan of filters as well as investigate the potentially harmful effects of air purifiers. Understanding the lifespan of filters used in air purifiers and the potential formation of harmful byproducts is essential for ensuring their optimal performance, guiding consumers in their purchasing decisions, and establishing industry standards for safer and more effective air purification solutions. At this time, a selection of air purifiers has been chosen, and test methods have been established. In the following 3 months, the tests will be conducted, and the results will be ready for presentation later.

Keywords: air purifiers, activated carbon filters, byproducts, clean air, indoor air quality

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