Search results for: crisis interventions

Authors: Klara Strecker

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During times of globalization, socioeconomic systems have become connected across the world through global supply chains. As a result, consumption and production locations have increasingly become spatially decoupled. This decoupling leads to complex entanglements of systems and sustainability challenges across distances -entanglements which can be conceptualized as telecouplings. Through telecouplings, people and environments across the world have become closely connected, bringing challenges as well as opportunities. Some argue that telecoupling dynamics started taking shape during times of colonization when resources were first traded across the world. An example of such a telecoupling is that of the rose. Every third rose sold in Europe is grown in Kenya and enters the European market through the Dutch flower auction system. Many Kenyan farms are Dutch-owned, closely entangling Kenya and the Netherlands through the trade of roses. Furthermore, the globalization of the flower industry and the resulting shift of production away from the Netherlands and towards Kenya has led to significant changes in the Dutch horticulture sector. However, the sustainability effects of this rose telecoupling is limited neither to the horticulture sector nor to the Netherlands and Kenya. Alongside the flow of roses between these countries come complex financial, knowledge-based, and regulatory flows. The rose telecoupling also creates spillover effects to other countries, such as Ethiopia, and other industries, such as Kenyan tourism. Therefore, telecoupling dynamics create complex entanglements that cut across sectors, environments, communities, and countries, which makes effectively governing and managing telecouplings and their sustainability implications challenging. Indeed, sustainability can no longer be studied in spatial and temporal isolation. This paper aims to map the rose telecoupling’s complex environmental and social interactions to identify points of tension guiding sustainability-targeted interventions. Mapping these interactions will provide a more holistic understanding of the sustainability challenges involved in the Dutch-Kenyan rose trade. This interdisciplinary telecoupling approach reframes and integrates interdisciplinary knowledge about the rose trade between the Netherlands, Kenya, and beyond.

Keywords: Dutch-Kenyan rose trade, globalization, socio-ecological system, sustainability, telecoupling

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Authors: Vaishali Sharma

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The research is an attempt to hunt a scientific and objective method to transform Ajmer's traditional walled city into a living cultural heritage space, exploring urban management methods to elevate local economy and social space in relation to specific cultural-based initiatives. Ajmer is among the oldest and religiously diverse settlements in Rajasthan, that has seen superimposed developments through the eras. With numerous agencies operating towards the development of the town core of Ajmer, it becomes essential to structure development changes in tune with the transformations and the existing heritage. The study was radio-controlled by the subsequent analysis question: What is the way to overcome the genetic social and economic stress inside the communities and revive public life? In order to create necessary interventions at the neighbourhood level, fifteen neighbourhoods were identified. Each of those was analyzed relatively on three major dimensions: Heritage, Social and Local Economy. Each dimension was further broken down into multiple sub-aspects for an overall and exhaustive understanding. The average median values of the responses were used to develop a color-coded matrix to represent the scores in an exceedingly structured quantified manner, moreover, linking it to the spatial structure. Respondent perceptions on numerous dimensions were additionally recorded, so that the proposals are inclusive in nature. The goals are targeted at Ajmer's traditional walled towns, which will make it easier for the community to regulate the rapid transformations and commercialization occurring within the space. The study recommends the necessity for accrued support in methods and policies from the non-public sector, businesses as well as local stakeholders. An expansion, revitalization and maintenance of the major business and heritage corridors, for an increased local and visitor experience, can produce an impetus for promotion of the intangible heritage, to spur the local economic processes, conservation of heritage precincts and upward development.

Keywords: cultural heritage, economic revitalization, neighbourhoods in walled cities, social space, tangible and intangible heritage

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Authors: Balkibekova Venera Serikpaevna

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Background: Autism Spectrum Disorder (ASD) poses significant challenges in both diagnosis and treatment. Existing therapeutic interventions often target specific symptoms, necessitating the exploration of alternative approaches. This study investigates the RITM (Rhythm Integration Tapping Music) developed by Balkibekova, aiming to create imitation, social engagement and a wide range of emotions through brain development. Methods: A randomized controlled trial was conducted with 100 participants diagnosed with ASD, aged 1 to 4 years. Participants were randomly assigned to either the RITM therapy group or a control group receiving standard care. The RITM therapy, rooted in tapping rhythm to music such as: marche on the drums, waltz on bells, lullaby on musical triangle, dancing on tambourine, polka on wooden spoons. Therapy sessions were conducted over a 3 year period, with assessments at baseline, midpoint, and post-intervention. Results: Preliminary analyses reveal promising outcomes in the RITM therapy group. Participants demonstrated significant improvements in social interactions, speech understanding, birth of speech, and adaptive behaviors compared to the control group. Careful examination of subgroup analyses provides insights into the differential effectiveness of the RITM approach across various ASD profiles. Conclusions: The findings suggest that RITM therapy, as developed by Balkibekova, holds promise as intervention for ASD. The integrative nature of the approach, addressing multiple domains simultaneously, may contribute to its efficacy. Further research is warranted to validate these preliminary results and explore the long-term impact of RITM therapy on individuals with ASD. This abstract presents a snapshot of the research, emphasizing the significance, methodology, key findings, and implications of the RITM therapy method for consideration in an autism conference.

Keywords: RITM therapy, tapping rhythm, autism, mirror neurons, bright emotions, social interactions, communications

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Authors: Ässia Boukhatmi, Roger Nyffenegger

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The expansion of solar energy as a means to address the climate crisis is undisputed, but the increasing number of new photovoltaic (PV) modules being put on the market is simultaneously leading to increased challenges in terms of managing the growing waste stream. Many of the discarded modules are still fully functional but are often damaged by improper handling after disassembly or not properly tested to be considered for a second life. In addition, the collection rate for dismantled PV modules in several European countries is only a fraction of previous projections, partly due to the increased number of illegal exports. The underlying problem for those market imperfections is an insufficient data exchange between the different actors along the PV value chain, as well as the limited traceability of PV panels during their lifetime. As part of the Horizon 2020 project CIRCUSOL, an asset database prototype was developed to tackle the described problems. In an iterative process applying the design science research methodology, different business models, as well as the technical implementation of the database, were established and evaluated. To explore the requirements of different stakeholders for the development of the database, surveys and in-depth interviews were conducted with various representatives of the solar industry. The proposed database prototype maps the entire value chain of PV modules, beginning with the digital product passport, which provides information about materials and components contained in every module. Product-related information can then be expanded with performance data of existing installations. This information forms the basis for the application of data analysis methods to forecast the appropriate end-of-life strategy, as well as the circular economy potential of PV modules, already before they arrive at the recycling facility. The database prototype could already be enriched with data from different data sources along the value chain. From a business model perspective, the database offers opportunities both in the area of reuse as well as with regard to the certification of sustainable modules. Here, participating actors have the opportunity to differentiate their business and exploit new revenue streams. Future research can apply this approach to further industry and product sectors, validate the database prototype in a practical context, and can serve as a basis for standardization efforts to strengthen the circular economy.

Keywords: business model, circular economy, database, design science research, solar industry

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Authors: Lubisi L. V., Madumo M. B., Mudau N. P., Makhuvele L., Sibuyi M. M.

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Background and Aims: Learners with disabilities can be integrated into mainstream schools, whereas there are those learners that are accommodated in special schools based on the support needs they require. These needs, among others, pertain to access to high-intensity therapeutic support by physiotherapists, occupational therapists, and speech therapists. However, access to physiotherapists in low- and middle-income countries is limited, and this creates a knowledge gap in identifying, to the best of our knowledge, best practice patterns aligned with physiotherapy at special schools. This gap compromises the quality of support to be rendered towards strengthening rehabilitation and optimising the participation of learners with disabilities in special schools. The aim of the scoping review was to map the evidence on practice patterns employed by physiotherapists at special schools for learners with disabilities. Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. Key terms regarding physiotherapy practice patterns for learners with disabilities at special schools were used to search the literature on the databases. Literature was sourced from Google Scholar, EBSCO, PEDro, PubMed, and Research Gate from 2013 to 2023. A total of 28 articles were initially retrieved and after a process of screening and exclusion, nine articles were included. All the researchers reviewed the articles for eligibility. Articles were initially screened based on the titles, followed by full text. Articles written in English or translated into English mentioned physical / physiotherapy interventions in special schools, both published and unpublished, were included. A qualitative data extraction template was developed and an inductive approach to thematic data analysis was used for included articles to see which themes emerged. Results: Three themes emerged after inductive thematic data analysis. 1. Collaboration with educators, parents, and therapists 2. Family Centred Approach 3. Telehealth. Conclusion: Collaboration is key in delivering therapeutic support to learners with disabilities at special schools. Physiotherapists need to be collaborators at the level of interprofessional and transprofessional. In addition, they need to explore technology to work remotely, especially when learners become absent physically from school.

Keywords: learners with disabilities, special school, physiotherapists, therapeutic support

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Authors: Kwizera Mireille, Kharesh Ahmed Al-Khadher

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This paper explores the critical issue of girls' and women's right to education, exploring the challenges they face in accessing and benefiting from quality education. Gender disparities in education have persisted globally, hindering social progress and sustainable development. The fundamental importance of education in empowering individuals and promoting gender equality is acknowledged, making it imperative to address the disparities that hinder girls' and women's educational opportunities. The paper discusses various factors contributing to these disparities, including cultural norms(common in third-world countries), socio-economic constraints, and systemic biases. Drawing on a wide range of scholarly sources, empirical studies, and reports from international organizations, this paper highlights the broader societal benefits of educating girls and women, ranging from improved health outcomes to enhanced economic development and greater social and political participation. The paper further outlines strategies and initiatives aimed at overcoming these challenges. These include policy interventions, community-based programs, and international collaborations that work towards eliminating gender-based discrimination in educational settings. The paper emphasizes the significance of not only ensuring access but also fostering an inclusive and safe learning environment that encourages girls and women to thrive academically and personally. By analyzing successful case studies and best practices from around the world, the paper offers insights into effective approaches that can be adopted to enhance girls' and women's right to education globally. Furthermore, it emphasizes the importance of raising awareness of girl's and women's education. In conclusion, this paper underscores the urgency of prioritizing and protecting the educational rights of girls and women's right to education as a fundamental human right and catalyst for gender equality. It calls for a concerted effort from governments, NGOs, educational institutions, and society as a whole to create an equitable and empowering educational landscape that contributes to gender equality and sustainable development.

Keywords: empowerment, gender equality, inclusive education, right to education

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Authors: Elżbieta Turska

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Introduction: One of the most difficult times in a person’s life is adolescence. The experiences in this period may shape the future life of this person to a large extent. This is the reason why many young people experience sadness, dejection, hopelessness, sense of worthlessness, as well as losing interest in various activities and social relationships, all of which are often classified as mood disorders. As many as 15-40% adolescents experience depressed moods and for most of them they resolve and are not carried into adulthood. However, (5-6%) of those affected by mood disorders develop the depressive syndrome and as many as (1-3%) develop full-blown clinical depression. Materials: A large questionnaire was given to 2508 students, aged 13–16 years old, and one of its parts was the Burns checklist, i.e. the standard test for identifying depressed mood. The questionnaire asked about many aspects of the student’s life, it included a total of 53 questions, most of which had subquestions. It is important to note that the data suffered from many problems, the most important of which were missing data and collinearity. Aim: In order to identify the correlates of mood disorders we built predictive models which were then trained and validated. Our aim was not to be able to predict which students suffer from mood disorders but rather to explore the factors influencing mood disorders. Methods: The problems with data described above practically excluded using all classical statistical methods. For this reason, we attempted to use the following Artificial Intelligence (AI) methods: classification trees with surrogate variables, random forests and xgboost. All analyses were carried out with the use of the mlr package for the R programming language. Resuts: The predictive model built by classification trees algorithm outperformed the other algorithms by a large margin. As a result, we were able to rank the variables (questions and subquestions from the questionnaire) from the most to least influential as far as protection against mood disorder is concerned. Thirteen out of twenty most important variables reflect the relationships with parents. This seems to be a really significant result both from the cognitive point of view and also from the practical point of view, i.e. as far as interventions to correct mood disorders are concerned.

Keywords: mood disorders, adolescents, family, artificial intelligence

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Authors: Madhvi Bhayani

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Introduction: Due to the rapid pace of urbanization, the urban health issues have become one of the significant threats to future development in India. It also poses serious repercussions on the citizen’s health. As urbanization in India is increasing at an unprecedented rate and it has generated the urban health crisis among the city dwellers especially the urban poor. The increasing proportion of the urban poor and vulnerable to the health indicators worse than the rural counterparts, they face social and financial barriers in accessing healthcare services and these conditions make human health at risk. The Local as well as the State and National governments are alike tackling with the challenges of urbanization as it has become very essential for the government to provide the basic necessities and better infrastructure that make life in cities safe and healthy. Thus, the paper argues that if no major realistic steps are taken with immediate effect, the citizens will face a huge burden of health hazards. Aim: This paper attempts to analyze the current infrastructure, government planning, and its future policy, it also discusses the challenges and outcomes of urbanization on health and its impact on it and it will also predict the future trend with regard to disease burden in the urban areas. Methods: The paper analyzes on the basis of the secondary data by taking into consideration the connection between the Rapid Urbanization and Public Health Challenges, health and health care system and its services delivery to the citizens especially to the urban poor. Extensive analyses of government census reports, health information and policy, the government health-related schemes, urban development and based on the past trends, the future status of urban infrastructure and health outcomes are predicted. The social-economic and political dimensions are also taken into consideration from regional, national and global perspectives, which are incorporated in the paper to make realistic predictions for the future. Findings and Conclusion: The findings of the paper show that India suffers a lot due to the double burden of rapidly increasing in diseases and also growing health inequalities and disparities in health outcomes. Existing tools of governance of urban health are falling short to provide the better health care services. They need to strengthen the collaboration and communication among the state, national and local governments and also with the non-governmental partners. Based on the findings the policy implications are then described and areas for future research are defined.

Keywords: health care, urbanization, urban health, service delivery

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Authors: M. R. Bhuiyan, S. M. M. Hossain, M. Z. Islam

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Autism Spectrum Disorder (ASD) is the fastest growing serious developmental disorder characterized by social deficits, communicative difficulties, and repetitive behaviors. ASD is an emerging public health issue globally which is associated with huge financial burden to the family, community and the nation. The aim of this study was to assess the financial burden of family for the children with Autism spectrum Disorder. This cross-sectional study was carried out from July 2015 to June 2016 among 154 children with ASD to assess the financial burden of family. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique. Majority (73.4%) children were male and mean (±SD) age was 6.66 ± 2.97 years. Most (88.8%) of the children were from urban areas with average monthly family income Tk. 41785.71±23936.45. Average monthly direct cost of the children was Tk.17656.49 ± 9984.35, while indirect cost was Tk. 13462.90 ± 9713.54 and total treatment cost was Tk. 23076.62 ± 15341.09. Special education cost (Tk. 4871.00), cost of therapy (Tk. 4124.07) and travel cost (Tk. 3988.31) were the major types of direct cost, while loss of income (Tk.14570.18) was the chief indirect cost incurred by the families. The study found that majority (59.8%) of the children attended special schools were incurred Tk.20001-78700 as total treatment cost, which were statistically significant (p<0.001). Again, families with higher monthly family income incurred higher treatment cost (r=0.526, p<0.05). Difference between mean direct and indirect cost was found significant (t=4.190, df=61, p<0.001). According to the analysis of variance, mean difference of father’s educational status among direct cost (F=10.337, p<0.001) and total treatment cost (F=7.841, p<0.001), which were statistically significant. The study revealed that maximum children with ASD were under five years, three-fourth were male. According to monthly family income, maximum family were in middle class. The study recommends cost effective interventions and financial safety-net measures to reduce the financial burden of families for the children with ASD.

Keywords: autism spectrum disorder, financial burden, direct cost, indirect cost, special education

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Authors: Kunkanit Sutamchai, Kate E. Rowlands

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Recent public ethical scandals in many organizations around the world have raised concern about organizational ethics, which have, in turn, made ethical behaviors and conducts on the part of leaders become more critical topics in organizational studies. However, current research on the benefits of mindfulness within the workplace contexts has predominantly focused on stress reduction and work performance enhancement, while the aspects of ethical behavior development have been far less investigated in mindfulness research in the organizational and management fields. Only recently has there been an emerging call for organizational researchers and practitioners to study mindfulness concepts and practices from the original Buddhist perspectives given that ethics is regarded as a foundation for Buddhist mindfulness. Yet little, if any, empirical research on the contributions of mindfulness practices to ethical leadership has been done in Eastern Buddhist contexts. Therefore, this study aims to explore the extent to which and how Buddhist-based mindfulness practices can influence organizational leaders’ ethical values and practices. On this basis, Thailand was selected as a context of study due to a predominantly Buddhist society and culture. Qualitative data were gathered through in-depth semi-structured interviews with twenty executive leaders from various private organizations in Thailand, who practice Buddhist-based mindfulness meditation regularly. The findings from this study shed light on the role Buddhist-based mindfulness practices can play in promoting ethical behavior among executive leaders in Thailand. The results also suggest that ethical values and practices influenced by Buddhist-based mindfulness practices are well aligned with the elements appeared in the inter-disciplinary and cross-cultural ethical leadership framework, namely: humane, justice, sustainability and responsibility, and moderation. This study concludes that the integration of ethical dimensions to mindfulness practices may provide promising opportunities for ethical leadership development, particularly in the context of Thailand. This could contribute significantly to the future development of both organizations and society at large. The study also suggests that mindfulness interventions in organizational contexts should place more explicit emphasis on ethics. This may be done by relating the ethical principles underlying Buddhist-based mindfulness to other ethical systems in different contexts and cultures where they can be aligned.

Keywords: Buddhism, ethical leadership, leadership development, mindfulness, Thailand, training

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Authors: Tony Feng, Rea Thomson, Kathryn Greenslade, Ross Medine, Jennifer Easterbrook, Calum Arthur, Matilda Powell-bowns

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There are clear guidelines on taking group and screen samples (G&S) for elective arthroplasty and major trauma. However, there is limited guidance on blood grouping for other trauma patients. The purpose of this study was to review the level of blood grouping at a major trauma centre and validate a protocol that limits the expensive processing of G&S samples. After reviewing the national guidance on transfusion samples in orthopaedic patients, data was prospectively collected for all orthopaedic admissions in the Royal Infirmary of Edinburgh between January to February 2023. The cause of admission, number of G&S samples processed on arrival and need for red cells was collected using the hospital blood bank. A new protocol was devised based on a multidisciplinary meeting which limited the requirement for G&S samples only to presentations in “category X”, including neck-of-femur fractures (NOFs), pelvic fractures and major trauma. A re-audit was completed between April and May after departmental education and institution of this protocol. 759 patients were admitted under orthopaedics in the major trauma centre across two separate months. 47% of patients were admitted with presentations falling in category X (354/759) and patients in this category accounted for 88% (92/104) of those requiring post-operative red cell transfusions. Of these, 51% were attributed to NOFs (47/92). In the initial audit, 50% of trauma patients outwith category X had samples sent (116/230), estimated to cost £3800. Of these 230 patients, 3% required post-operative transfusions (7/230). In the re-audit, 23% of patients outwith category X had samples sent (40/173), estimated to cost £1400, of which 3% (5/173) required transfusions. None of the transfusions in these patients in either audit were related to their operation and the protocol achieved an estimated cost saving of £2400 over one month. This study highlights the importance of sending samples for patients with certain categories of orthopaedic trauma (category X) due to the high demand for post-operative transfusions. However, the absence of transfusion requirements in other presentations suggests over-testing. While implementation of the new protocol has markedly reduced over-testing, additional interventions are required to reduce this further.

Keywords: blood transfusion, quality improvement, orthopaedics, trauma

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Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi

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Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.

Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research

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Authors: M. S. Riyazulla

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Since the dawn of the 21st century, there has been a perceptible decline in Islamic supremacy in world affairs, apart from the gradual waning of the amiable relations and relevance of Islamic countries in the International political arena. For a long, Islamic countries have been marginalised by the superpowers in the global conflicting issues. This was evident in the context of their recent invasions and interference in Afghanistan, Syria, Iraq, and Libya. The leading International Islamic organizations like the Arab League, Organization of Islamic Cooperation, Gulf Cooperation Council, and Muslim World League did not play any prominent role there in resolving the crisis that ensued due to the exogenous and endogenous causes. Hence, there is a need for Islamic countries to create a credible International Islamic organization that could dictate its terms and shape a new Islamic world order. The prominent Islamic countries are divided on ideological and religious fault lines. Their concord is indispensable to enhance their image and placate the relations with other countries and communities. The massive boon of oil and gas could be synergistically utilised to exhibit their omnipotence and eminence through constructive ways. The prevailing menace of Islamophobia could be abated through syncretic messages, discussions, and deliberations by the sagacious Islamic scholars with the other community leaders. Presently, as Muslims are at a crossroads, a dynamic leadership could navigate the agitated Muslim community on the constructive path and herald political stability around the world. The present political disorder, chaos, and economic challenges necessities a paradigm shift in approach to worldly affairs. This could also be accomplished through the advancement in science and technology, particularly space exploration, for peaceful purposes. The Islamic world, in order to regain its lost preeminence, should rise to the occasion in promoting peace and tranquility in the world and should evolve a rational and human-centric solution to global disputes and concerns. As a splendid contribution to humanity and for amicable international relations, they should devote all their resources and scientific intellect towards space exploration and should safely transport man from the Earth to the nearest and most accessible cosmic body, the Moon, within one hundred years as the mankind is facing the existential threat on the planet.

Keywords: carboniferous period, Earth, extinction, fossil fuels, global leaders, Islamic glory, international order, life, marginalization, Moon, natural catastrophes

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Authors: Nami Matsumoto

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This study explores the experiences of cross-linguistic medical encounters by patients, and their views of receiving language support therein, with a particular focus on Japanese-English cases. The aim of this study is to investigate the reason for the frequent use of a spouse as a communication mediator from a Japanese perspective, through a comparison with that of English speakers. This study conducts an empirical qualitative analysis of the accounts of informants. A total of 31 informants who have experienced Japanese-English cross-linguistic medical encounters were recruited in Australia and Japan for semi-structured in-depth interviews. A breakdown of informants is 15 English speakers and 16 Japanese speakers. In order to obtain a further insight into collected data, additional interviews were held with 4 Australian doctors who are familiar with using interpreters. This study was approved by the Australian National University Human Research Ethics Committee, and written consent to participate in this study was obtained from all participants. The interviews lasted up to over one hour. They were audio-recorded and subsequently transcribed by the author. Japanese transcriptions were translated into English by the author. An analysis of interview data found that patients value relationship in communication. Particularly, Japanese informants, who have an English-speaking spouse, value trust-based communication interventions by their spouse, regardless of the language proficiency of the spouse. In Australia, health care interpreters are required to abide by the national code of ethics for interpreters. The Code defines the role of an interpreter exclusively to be language rendition and enshrines the tenets of accuracy, confidentiality and professional role boundaries. However, the analysis found that an interpreter who strictly complies with the Code sometimes fails to render the real intentions of the patient and their doctor. Findings from the study suggest that an interpreter should not be detached from the context and should be more engaged in the needs of patients. Their needs are not always communicated by an interpreter when they simply follow a professional code of ethics. The concept of relationship-centred care should be incorporated in the professional practice of health care interpreters.

Keywords: health care, Japanese-English medical encounters, language barriers, trust

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Authors: Brendan Mooney

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Context: Feelings and emotions are commonly misunderstood and the terms often used interchangeably, leading to potential negative impacts on individuals' mental well-being and relationships. The distinction between these two fundamentally different experiences of human life is crucial for effective psychological practice and communication. Research Aim: The aim of this study is to outline the disparities between feelings and emotions, emphasising the significance of this differentiation in psychological practice to enhance clients' observation, decision-making, problem-solving, and communication skills. Methodology: This research utilises a conceptual model developed by the author in 2017 based on clinical experience, client observations, and feedback. The model serves to guide effective clinical practice by providing clear definitions and understanding of feelings versus emotions. Case study examples were utilised to support the efficacy of the model. Findings: The study highlights that recognising and expressing feelings rather than emotions is more empowering and conducive to resolving unresolved issues, thereby fostering better psychological well-being and interpersonal relationships. Theoretical Importance: This research underscores the importance of clarifying fundamental definitions related to feelings and emotions in enhancing psychological interventions and preventing various relationship conflicts and individual issues. Data Collection and Analysis Procedures: Data was collected through the author's clinical experience and interactions with clients, informing the development of the Feeling Emotions Mental (FEM) model. Analysis involved synthesising observations and feedback to elucidate the distinctions between feelings and emotions. Questions Addressed: What are the disparities between feelings and emotions? How does the confusion between these two fundamentally different experiences of human life impact individuals' mental well-being and relationships? Why is it essential to differentiate between feelings and emotions in psychological practice? Conclusion: The study advocates for a clear understanding of feelings versus emotions to support clients in addressing unresolved issues and improving their overall psychological functioning and communication skills, thereby preventing potential conflicts and relationship challenges.

Keywords: couples, mental, misinformation, misunderstanding, relationships

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Authors: Heena Akbar, Winnie Niumata, Danielle Gallegos

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Type 2 diabetes is a significant public health problem for Māori and Pasifika communities in Queensland, who are experiencing a higher burden of morbidity and mortality from the condition. Despite this higher burden, there are few initiatives that are culturally tailored to improve prevention and management. Modification of personal behaviors through women’s wellness programs aimed at early intervention has been shown to reduce the risk of developing complications in established type 2 diabetes and may reduce hospitalization rates from preventable complications related to this disease. The 24-week Pasifika Women’s Diabetes Wellness Program (PWDWP) was culturally co-designed and co-developed with Māori and Pasifika women with type 2 diabetes through a community-academia partnership in Queensland. Underpinned by Social Cognitive Theory and the Indigenous Pacific Health frameworks to include family culture & spirituality and integrating a collectivist and whānau (family) centered approach to self-care, the program takes into consideration the cultural shame associated with acknowledging the disease and tailors the interventions using talanoa (storytelling or conversation in a relational context) as the key strategy to come to a shared meaning for behavior change. The pilot trial is a 12-week intervention followed by a 12-week follow-up period conducted with 50 women with type 2 diabetes, 25 women who will receive the intervention and 25 women who will receive usual care. The pilot program provides in-person and virtual access to culturally supported prevention and self-management of Māori and Pasifika women with type 2 diabetes with the aim to improve healthy lifestyles and reduce late hospital presentations from diabetes-related complications for better diabetes-related outcomes. This study will test and evaluate the effectiveness of the PWDWP pilot trial in partnership with Māori & Pasifika community organizations and key stakeholders for improved glycated hemoglobin (HbA1c) levels associated with poor management of type 2 diabetes.

Keywords: culturally co-designed intervention, Indigenous methodology, Māori and Pasifika communities, type 2 diabetes self-management

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Authors: Neetika Mahajan, Awanish Shukla

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Entrepreneurship is key a driver to economic development. It opens opportunities for business startups and has potential to expand employment opportunities for many. Entrepreneurship gives ‘Purpose thriving’ approach towards society with new technologies and zeal to develop and compete in the market. There are many more advantages of entrepreneurship like freedom to scope of work and independence in setting own goals. Women contribute to nearly 50 percent of India’s population, constitute nearly 10 percent of a total number of entrepreneurs in India. Women are found to be better risk calculators, more ambitious and less prone to self-confidence. However, It is a hard fact that life has not been easy for women aspiring professional success. Gender parity is the biggest threat faced by female aspirant seeking new businesses. More challenges like socio-cultural barriers, insufficient financial assistance, etc. have been faced by the women of our country. To uplift the status of women in the society, a number of initiatives have been taken up by the Government of India. Initiatives like National Mission for Empowerment of Women by (Ministry of Women And Child Development) and SKILL INDIA aim to increase the technical skills and knowledge of women for tapping employment opportunities and self-confidence. Trade Related Entrepreneurship Assistance and Development (TREAD) Scheme and Mahila Coir Yojana are proposed by the Ministry of MSMEs aiming to facilitate employment opportunities for women and entrepreneurship development. This paper will aim to bring out the gaps and barriers, which are still resisting the potential women come upfront and start a new business irrespective of a number of initiatives being put by government of India. The aim is also to identify focus areas where further intervention is required and proposing suitable interventions. The methodology to take forward this research will include primary and secondary data collection from on ground survey to track various kind of challenges faced by aspirant women entrepreneurs. Insight will be put towards initiations by the government of India towards women empowerment and assistance to entrepreneurship. Scientific quantitative tools will be used to analyze collected information. The final output of the research shall focus on achieving the respective aims and objectives.

Keywords: women entrepreneurship, government programs and schemes, key challenges, economic development

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Authors: Håkon Riiber

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This paper explores the extent to which Russian ‘Active Measures’ play a role in contemporary Russian foreign policy and in what way the legacy of the Soviet Union is still apparent in these practices. The analysis draws on a set of case studies from the 21st century to examine these aspects, showing which ‘Active Measures’ features are old and which are new in the post-Cold War era. The paper highlights that the topic has gained significant academic and political interest in recent years, largely due to the aggressive posture of the Russian Federation on the world stage, exemplified through interventions in Estonia, Georgia, and Ukraine and interference in several democratic elections in the West. However, the paper argues that the long-term impact of these measures may have unintended implications for Russia. While Russia is unlikely to stop using Active Measures, increased awareness of the exploitation of weaknesses, institutions, or other targets may lead to greater security measures and an ability to identify and defend against these activities. The paper contends that Soviet-style ‘Active Measures’ from the Cold War era have been modernized and are now utilized to create an advantageous atmosphere for further exploitation to support contemporary Russian foreign policy. It offers three key points to support this argument: the reenergized legacy of the Cold War era, the use of ‘Active Measures’ in a number of cases in the 21st century, and the applicability of AM to the Russian approach to foreign policy. The analysis reveals that while this is not a new Russian phenomenon, it is still oversimplified and inaccurately understood by the West, which may result in a decreased ability to defend against these activities and limit the unwarranted escalation of the ongoing security situation between the West and Russia. The paper concludes that the legacy of Soviet-era Active Measures continues to influence Russian foreign policy, and modern technological advances have only made them more applicable to the current political climate. Overall, this paper sheds light on the important issue of Russian ‘Active Measures’ and the role they play in contemporary Russian foreign policy. It emphasizes the need for increased awareness, understanding, and security measures to defend against these activities and prevent further escalation of the security situation between the West and Russia.

Keywords: Russian espionage, active measures, disinformation, Russian intelligence

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Authors: Florian Tille, Heide Weishaar, Bernhard Gibis, Susanne Schnitzer

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Introduction: The quality of patient-doctor communication and of written health information is central to organizational health literacy (HL). Whether patients understand their doctors’ explanations and textual material on health, however, is understudied. This study identifies the overall levels of patient understanding of health information and its associations with patients’ social characteristics in outpatient health care in Germany. Materials & Methods: This analysis draws on data collected via a 2017 national health survey with a sample of 6,105 adults. Quality of communication was measured for consultations with general practitioners (GPs) and specialists (SPs) via the Ask Me 3 program questions, and through a question on written health material. Correlations with social characteristics were explored employing bivariate and multivariate logistic regression analyses. Results: Over 90% of all respondents reported that they had understood their doctors’ explanations during the last consultation. Failed understanding was strongly correlated with patients’ very poor health (Odds Ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10; ref. excellent/very good health), current health problem (OR: 6.54, CI: 1.70–25.12; ref. preventive examination) and age 65 years and above (OR: 2.97, CI: 1.10–8.00; ref. 18 to 34 years). Fewer patients answered they understood written material well (86.7% for las visit at GP, 89.7% at SP). Understanding written material poorly was highly associated with basic education (OR: 4.20, CI: 2.76–6.39; ref. higher education) and 65 years old and above (OR: 2.66, CI: 1.43–4.96). Discussion: Overall ratings of oral patient-doctor communication and written communication of health information are high. Yet, a considerable share of patients reports not-understanding their doctors and poor understanding of the written health-related material. Interventions that can contribute to improving organizational HL in outpatient care in Germany include HL training for doctors, reducing system barriers to easily-accessible health information for patients and combining oral and written health communication means. Conclusion: This work adds to the study of organizational HL in Germany. To increase patient understanding of health-relevant information and thereby possibly reduce health disparities, meeting the communication needs especially of persons in different age groups, with basic education and in very poor health is suggested.

Keywords: health survey, organizational health literacy, patient-doctor communication, social characteristics, outpatient care, Ask Me 3

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Authors: Kougioumtzis Konstantin, Rylander Pär, Karlsteen Magnus

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Ball skills as a subset of fundamental motor skills are predictors for performance in sports. Currently, most tools evaluate ball skills utilizing subjective ratings. The aim of this study was to examine the psychometric properties of a newly developed instrument to objectively measure ball handling skills (BHS-test) utilizing digital instrument. Participants were a convenience sample of 213 adolescents (age M = 17.1 years, SD =3.6; 55% females, 45% males) recruited from upper secondary schools and invited to a sports hall for the assessment. The 8-item instrument incorporated both accuracy-based ball skill tests and repetitive-performance tests with a ball. Testers counted performance manually in the four tests (one throwing and three juggling tasks). Furthermore, assessment was technologically enhanced in the other four tests utilizing a ball machine, a Kinect camera and balls with motion sensors (one balancing and three rolling tasks). 3D printing technology was used to construct equipment, while all results were administered digitally with smart phones/tablets, computers and a specially constructed application to send data to a server. The instrument was deemed reliable (α = .77) and principal component analysis was used in a random subset (53 of the participants). Furthermore, latent variable modeling was employed to confirm the structure with the remaining subset (160 of the participants). The analysis showed good factorial-related validity with one factor explaining 57.90 % of the total variance. Four loadings were larger than .80, two more exceeded .76 and the other two were .65 and .49. The one factor solution was confirmed by a first order model with one general factor and an excellent fit between model and data (χ² = 16.12, DF = 20; RMSEA = .00, CI90 .00–.05; CFI = 1.00; SRMR = .02). The loadings on the general factor ranged between .65 and .83. Our findings indicate good reliability and construct validity for the BHS-test. To develop the instrument further, more studies are needed with various age-groups, e.g. children. We suggest using the BHS-test for diagnostic or assessment purpose for talent development and sports participation interventions that focus on ball games.

Keywords: ball-handling skills, ball-handling ability, technologically-enhanced measurements, assessment

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Authors: Wafaa Kamal Isaac

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This paper attempts to shed light upon the stereotypical images of marginalized black women as shown through the poetry of Rita Dove. Meanwhile, it explores how stereotypical images held by the society and public perceptions perpetuate the marginalization of black women. Dove is considered one of the most fundamental African-American poets who devoted her writings to explore the problem of identity that confronted marginalized women in America. Besides tackling the issue of black women’s stereotypical images, this paper focuses upon the psychological damage which the black women had suffered from due to their stripped identity. In ‘Thomas and Beulah’, Dove reflects the black woman’s longing for her homeland in order to make up for her lost identity. This poem represents atavistic feelings deal with certain recurrent images, both aural and visual, like the image of Beulah who represents the African-American woman who searches for an identity, as she is being denied and humiliated one in the newly founded society. In an attempt to protest against the stereotypical mule image that had been imposed upon black women in America, Dove in ‘On the Bus with Rosa Parks’ tries to ignite the beaten spirits to struggle for their own rights by revitalizing the rebellious nature and strong determination of the historical figure ‘Rosa Parks’ that sparked the Civil Rights Movement. In ‘Daystar’, Dove proves that black women are subjected to double-edged oppression; firstly, in terms of race as a black woman in an unjust white society that violates her rights due to her black origins and secondly, in terms of gender as a member of the female sex that is meant to exist only to serve man’s needs. Similarly, in the ‘Adolescence’ series, Dove focuses on the double marginalization which the black women had experienced. It concludes that the marginalization of black women has resulted from the domination of the masculine world and the oppression of the white world. Moreover, Dove’s ‘Beauty and the Beast’ investigates the African-American women’s problem of estrangement and identity crisis in America. It also sheds light upon the psychological consequences that resulted from the violation of marginalized women’s identity. Furthermore, this poem shows the black women’s self-debasement, helplessness, and double consciousness that emanate from the sense of uprootedness. Finally, this paper finds out that the negative, debased and inferior stereotypical image held by the society did not only contribute to the marginalization of black women but also silenced and muted their voices.

Keywords: stereotypical images, marginalized women, Rita Dove, identity

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Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Sukhvinder Kaur, Jayanta Bora, Ashok Agarwal, Sangeeta Kaul

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Background: HIV and STI transmission can be prevented if condoms are used properly, but condom tear may lead to infections even if are used consistently. Studies reveal high rates of condom breakage among Female Sex Workers (FSWs). USAID PHFI-PIPPSE is piloting a prevention model among high risk groups at Thane district of Maharashtra, India by implementing prevention and advocacy efforts for such risk behaviors. The current analysis highlights the correlates of condom breakage among FSWs from Thane. Method: A Behavioral Tracking Survey was conducted in 2014-15 among 503 FSWs through probability-based two stage random sampling from 3,660 FSWs at 100 hotspots, to understand levels of high risk behaviors, awareness and exposure to prevention programs. Bi-variate and multivariate-logistic regression methods used to assess the association of condom breakage while having sex with age, STI occurrence, anal sex with clients and alcohol consumption. Only self-reported STIs (Genital sore/ulcer, yellowish/ greenish discharge from vagina with/without foul smell, lower abdominal pain without diarrhea/dysentery or menses) were considered. Major Findings: Results depicted FSWs who reported condom breakage while having sex with any type of partner (paying clients, non-paying partners and other than main partner husband/boyfriend) had significantly high number of STIs (42.3% vs 16.9 %, P, 0.000) and had started sexual relationship in <16 years of age (31.0% vs 16.4 %, P, 0.000). Multivariate analysis after controlling the age at sex, knowledge about HIV and literacy, highlighted significantly higher odds of condom breakage among FSWs who have reported currently suffering with STI [AOR 2.91, 95% CI 1.75 - 4.83; P, 0.000]; who had anal sex with their paying client [AOR 2.59, 95% CI 1.59 - 4.19; P, 0.000]; and who consumed alcohol in the last 12 months [AOR 1.89, 95% CI 1.01 - 3.53; P, 0.047]. Conclusion: Risky behavior like anal sex with paying clients and impact of alcohol while having sex are main factors for condom breakage among young sex workers; and condom breakage leads to STIs. Hence, program interventions should address measures for prevention of condom breakage for HIV/STI prevention.

Keywords: female sex workers, condom breakage, anal sex, young sex workers

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Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal

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Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.

Keywords: end of life care, geriatrics, palliative care, residency training skill

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Authors: Bryan Jefry Sabillon, Arlex Molina Cedillo

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Currently, the raise in the demand of electrical energy as a consequence of the development of technology and population growth, as well as some projections made by ‘La Agencia Internacional de la Energía’ (AIE) and research institutes, reveal alarming data about the expected raise of it in the next few decades. Because of this, something should be made to raise the awareness of the rational and efficient usage of this resource. Because of the global concern of providing electrical energy to isolated areas, projects consisting of energy generation using renewable resources are commonly carried out. On a socioeconomically and cultural point of view, it can be foreseen a positive impact that would result for the society to have this resource. This article is focused on the great potential that Honduras shows, as a country that is looking forward to produce renewable energy due to the crisis that it’s living nowadays. Because of this, we present a detailed research that exhibits the main necessities that the rural communities are facing today, to allay the negative aspects due to the scarcity of electrical energy. We also discuss which should be the type of electrical generation method to be used, according to the disposition, geography, climate, and of course the accessibility of each area. Honduras is actually in the process of developing new methods for the generation of energy; therefore, it is of our concern to talk about renewable energy, the exploitation of which is a global trend. Right now the countries’ main energetic generation methods are: hydrological, thermic, wind, biomass and photovoltaic (this is one of the main sources of clean electrical generation). The use of these resources was possible partially due to the studies made by the organizations that focus on electrical energy and its demand, such as ‘La Cooperación Alemana’ (GIZ), ‘La Secretaria de Energía y Recursos Naturales’ (SERNA), and ‘El Banco Centroamericano de Integración Económica’ (BCIE), which eased the complete guide that is to be used in the protocol to be followed to carry out the three stages of this type of projects: 1) Licences and Permitions, 2) Fincancial Aspects and 3) The inscription for the Protocol in Kyoto. This article pretends to take the reader through the necessary information (according to the difficult accessibility that each zone might present), about the best option of electrical generation in zones that are totally isolated from the net, pretending to use renewable resources to generate electrical energy. We finally conclude that the usage of hybrid systems of generation of energy for small remote communities brings about a positive impact, not only because of the fact of providing electrical energy but also because of the improvements in education, health, sustainable agriculture and livestock, and of course the advances in the generation of energy which is the main concern of this whole article.

Keywords: energy, isolated, renewable, accessibility

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Authors: Silvia Miele, Patrice Rusconi, Harriet Tenenbaum

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An increasingly multi-ethnic Europe has been pushing citizens’ boundaries on who should be entitled and to what extent to practise their own diversity. Indeed, according to a Standard Eurobarometer survey conducted in 2017, immigration is seen by Europeans as the most serious issue facing the EU, and a third of respondents reported they do not feel comfortable interacting with migrants from outside the EU. Many of these come from Muslim countries, accounting for 4.9% of Europe population in 2016. However, the figure is projected to rise up to 14% by 2050. Additionally, political debates have increasingly focused on Muslim immigrants, who are frequently portrayed as difficult to integrate, while nationalist parties across Europe have fostered the idea of insuperable cultural differences, creating an atmosphere of hostility. Using a 3 X 3 X 2 between-subjects design, it was investigated how people reason about endorsing religious and non-religious rights to minorities. An online survey has been administered to university students of three different countries (Italy, Spain and the UK) via Qualtrics, presenting hypothetical scenarios through a vignette methodology. Each respondent has been randomly allocated to one of the three following conditions: Christian, Muslim or non-religious (vegan) target. Each condition entailed three questions about children self-determination rights to exercise some control over their own lives and 3 questions about children nurturance rights of care and protection. Moreover, participants have been required to further elaborate on their answers via free-text entries and have been asked about their contact and quality of contact with the three targets, and to self-report religious, national and ethnic identification. Answers have been recorded on a Likert scale of 1-5, 1 being "not at all", 5 being "very much". A two-way ANCOVA will be used to analyse answers to closed-ended questions, while free-text answers will be coded and data will be dichotomised based on Social Cognitive Domain Theory for four categories: moral, social conventional and psychological reasons, and analysed via ANCOVAs. This study’s findings aim to contribute to the implementation of educational interventions and speak to the introduction of governmental policies on human rights.

Keywords: children's rights, Europe, migration, minority

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Authors: Rebecca M. Dagger, Katy Hadgraft, Matthew Teggart, Peter Angell

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Background: There is a growing body of evidence that demonstrates the association between sedentary behaviour, cardiometabolic risk and all-cause mortality. Since full time working adults spend approximately 8 hours per day in the workplace, interventions to reduce sedentary behaviour at work may alleviate some of the negative health outcomes associated with sedentary behaviour. The aims of this pilot study were to assess the impacts of using a Sit-Stand workstation on markers of cardiometabolic health in a cohort of desk workers. Methods: Twenty eight participants were recruited and randomly assigned to a control (n=5 males, 9 females, mean age 37 years ± 9.4 years) or intervention group (n= 5 males, 9 females, mean age 42 years ± 12.7 years). All participants attended the labs on 2 occasion’s pre and post intervention, following baseline measurements the intervention participants had the Sit Stand Workstations (Ergotron, USA) installed for a 10 week intervention period. The Sit Stand workstations allow participants to stand or sit at their usual workstation and participants were encouraged to the use the desk in a standing position at regular intervals throughout the working day. Cardiometabolic risk markers assessed were body mass, body composition (using bio impedance analysis; Tanita, Tokyo), fasting blood Total Cholesterol (TC), lipid profiles (HDL-C, LDL-C, TC: HDL-C ratio), triglycerides and fasting glucose (Cholestech LDX), resting systolic and diastolic blood pressure and resting heart rate. ANCOVA controlling for baseline values was used to assess the group difference in changes in risk markers between pre and post intervention. Results: The 10 week intervention was associated with significant reductions in some cardiometabolic risk factors. There were significant group effects on change in body mass (F (1,25)=5.915, p<0.05), total body fat percentage (F(1,25)=12.615, p<0.01), total fat mass (F (1,25)=6.954, p<0.05), and systolic blood pressure (F (1,25)=5.012, p<0.05). There were no other significant group effects on changes in other cardiometabolic risk markers. Conclusion: This pilot study highlights the importance of reducing sedentary behaviour in the workplace for reduction in cardiometabolic risk markers. Further research is required to support these findings.

Keywords: sedentary behaviour, caridometabolic risk, evidence, risk makers

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Authors: Sungpil Ha, Ju Yong Kang, Sangbaek Park, Seung-Ju Lee, Soo-Won Chae

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The growing number of obese patients in aging societies has led to an increase in the number of patients with knee medial osteoarthritis (OA). Artificial joint insertion is the most common treatment for knee medial OA. Surgery is effective for patients with serious arthritic symptoms, but it is costly and dangerous. It is also inappropriate way to prevent a disease as an early stage. Therefore Non-operative treatments such as toe-in gait are proposed recently. Toe-in gait is one of non-surgical interventions, which restrain the progression of arthritis and relieves pain by reducing knee adduction moment (KAM) to facilitate lateral distribution of load on to knee medial cartilage. Numerous studies have measured KAM in various foot progression angle (FPA), and KAM data could be obtained by motion analysis. However, variations in stress at knee cartilage could not be directly observed or evaluated by these experiments of measuring KAM. Therefore, this study applied motion analysis to major gait points (1st peak, mid –stance, 2nd peak) with regard to FPA, and to evaluate the effects of FPA on the human lower extremity, the finite element (FE) method was employed. Three types of gait analysis (toe-in, toe-out, baseline gait) were performed with markers placed at the lower extremity. Ground reaction forces (GRF) were obtained by the force plates. The forces associated with the major muscles were computed using GRF and marker trajectory data. MRI data provided by the Visible Human Project were used to develop a human lower extremity FE model. FE analyses for three types of gait simulations were performed based on the calculated muscle force and GRF. We observed the maximum stress point during toe-in gait was lower than the other types, by comparing the results of FE analyses at the 1st peak across gait types. This is the same as the trend exhibited by KAM, measured through motion analysis in other papers. This indicates that the progression of knee medial OA could be suppressed by adopting toe-in gait. This study integrated motion analysis with FE analysis. One advantage of this method is that re-modeling is not required even with changes in posture. Therefore another type of gait simulation or various motions of lower extremity can be easily analyzed using this method.

Keywords: finite element analysis, gait analysis, human model, motion capture

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Authors: Liat Shamri-Zeevi, Neta Ram-Vlasov

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Today the world as a whole is attempting to cope with the COVID-19, which has affected all facets of personal and social life from country-wide confinement to maintaining social distance and taking protective measures to maintain hygiene. One of the populations faced with the most severe restrictions is seniors. Various studies have shown that creativity plays a crucial role in dealing with crisis events. Painting - regardless of media - allows for emotional and cognitive processing of these situations, and enables the expression of experiences in a tangible creative way that conveys and endows meaning to the artwork. The current study was conducted in Israel immediately after a 6-week lockdown. It was designed to specifically examine the impact of the COVID-19 pandemic on the quality of life of elderly women as reflected in their artworks. The sample was composed of 21 Israeli women aged 60-90, in good mental health (without diagnosed dementia or Alzheimer's), all of whom were Hebrew-speaking, and retired with an extended family, who indicated that they painted and had engaged in artwork on an ongoing basis throughout the lockdown (from March 12 to May 30, 2020). The participants' artworks were collected, and a semi-structured in-depth interview was conducted that lasted one to two hours. The participants were asked about their feelings during the pandemic and the artworks they produced during this time, and completed a questionnaire on well-being and mental health. The initial analysis of the interviews and artworks revealed themes related to the specific role of each piece of artwork. The first theme included notions that the artwork was an activity and a framework for doing, which supported positive emotions, and provided a sense of vitality during the closure. Most of the participants painted images of nature and growth which were ascribed concrete and symbolic meaning. The second theme was that the artwork enabled the processing of difficult and /or conflicting emotions related to the situation, including anxiety about death and loneliness that were symbolically expressed in the artworks, such as images of the Corona virus and the respiratory machines. The third theme suggested that the time and space prompted by the lockdown gave the participants time for a gathering together of the self, and freed up time for creative activities. Many participants stated that they painted more and more frequently during the Corona lockdown. At the conference, additional themes and findings will be presented.

Keywords: Corona virus, artwork, quality of life of elderly

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Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: dilator, sexually active, vaginal dilation, vaginal stenosis

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