Search results for: perception of burden

Authors: Nabila Farhin, Israt Jahan

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Despite the feminisation of the global health force, women mostly engage in nursing, midwifery and community health workers (HWs), and the posts like surgeons, doctors, and specialists are generally male-dominated. It is also prominent in Bangladesh, where female HWs witness systematic workplace inequalities, discrimination, and underpayment. The Covid-19 pandemic put unsurmountable pressure on HWs as they had to serve in high-risk workplaces as frontliners. The already disadvantaged female HWs shouldered the same burden, were overworked without adequate occupational health and safety measures (OSH) and risked their lives. Acknowledging their vulnerable workplace conditions, the World Health Organization (WHO) and International Labour Organization (ILO) circulated a few specialised guidelines amid the peril. Bangladesh tried to adhere to international guidelines while formulating pandemic management strategies. In reality, the already weak and understaffed health sector collapsed with the patient influx and many HWs got infected and died in the line of duty, exposing the high-risk nature of the work. Unfortunately, the gender-segregated data of infected HWs are absent. This qualitative research investigates whether the existing laws of Bangladesh are adequate in protecting female HWs as frontliners in high-risk workplaces during the Covid-19 pandemic. The paper first examines international labour laws safeguarding female frontline HWs. It also analyses the specialised Covid-19 pandemic guidelines protecting their interests. Finally, the research investigates the compliance of Bangladesh as per international legal guidance during the pandemic. In doing so, it explores the domestic laws, professional guidelines for HWs and pandemic response strategies. The paper critically examines the primary sources like international and national statutes, rules, regulations and guidelines. Secondary sources like authoritative journal articles, books and newspaper reports are contextually analysed in line with the objective of the paper. The definition of HW is ambiguous in the labour laws of Bangladesh. It leads to confusion regarding the extent of legal protection rendered to female HWs at private hospitals in high-risk situations. The labour laws are not applicable in Public hospitals, as the employees follow the public service rules. Unfortunately, the country has no specialised law to protect HWs in high-risk workplaces, and the professional guidelines for HWs also remain inadequate in this regard. Even though the pandemic management strategies highlight some protective measures in high-risk situations, they only deal with HWs who are pregnant or have underlying health issues. No specialised protective guidelines can be found for female HWs as frontliners. Therefore, the laws are insufficient and failed to render adequate legal protection to female frontline HWs during the pandemic. The country also lacks comprehensive health legislation and uniform institutional and professional guidelines, preventing them from accessing grievance mechanisms. Hence, the female HWs felt victimised while duty-bound to serve in high-risk workplaces without adequate safeguards. Bangladesh should clarify the definition of HWs and standardise the service rules for providing medical care in high-risk workplaces. The research also recommends adequate health legislation and specialised legal protection to safeguard female HWs in future emergencies.

Keywords: female health workers (HWs), high-risk workplaces, Covid-19 pandemic, Bangladesh

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Authors: Leander Van Neste, Kirk Wojno

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The innate immune system reacts to foreign insult in several unique ways, one of which is phagocytosis of perceived threats such as cancer, bacteria, and viruses. The goal of this study was to look for evidence of phagocytosed RNA from tumor cells in circulating monocytes. While all monocytes possess phagocytic capabilities, the non-classical CD14+/FCGR3A+ monocytes and the intermediate CD14++/FCGR3A+ monocytes most actively remove threatening ‘external’ cellular materials. Purified CD14-positive monocyte samples from fourteen patients recently diagnosed with clinically localized prostate cancer (PCa) were investigated by single-cell RNA sequencing using the 10X Genomics protocol followed by paired-end sequencing on Illumina’s NovaSeq. Similarly, samples were processed and used as controls, i.e., one patient underwent biopsy but was found not to harbor prostate cancer (benign), three young, healthy men, and three men previously diagnosed with prostate cancer that recently underwent (curative) radical prostatectomy (post-RP). Sequencing data were mapped using 10X Genomics’ CellRanger software and viable cells were subsequently identified using CellBender, removing technical artifacts such as doublets and non-cellular RNA. Next, data analysis was performed in R, using the Seurat package. Because the main goal was to identify differences between PCa patients and ‘control’ patients, rather than exploring differences between individual subjects, the individual Seurat objects of all 21 patients were merged into one Seurat object per Seurat’s recommendation. Finally, the single-cell dataset was normalized as a whole prior to further analysis. Cell identity was assessed using the SingleR and cell dex packages. The Monaco Immune Data was selected as the reference dataset, consisting of bulk RNA-seq data of sorted human immune cells. The Monaco classification was supplemented with normalized PCa data obtained from The Cancer Genome Atlas (TCGA), which consists of bulk RNA sequencing data from 499 prostate tumor tissues (including 1 metastatic) and 52 (adjacent) normal prostate tissues. SingleR was subsequently run on the combined immune cell and PCa datasets. As expected, the vast majority of cells were labeled as having a monocytic origin (~90%), with the most noticeable difference being the larger number of intermediate monocytes in the PCa patients (13.6% versus 7.1%; p<.001). In men harboring PCa, 0.60% of all purified monocytes were classified as harboring PCa signals when the TCGA data were included. This was 3-fold, 7.5-fold, and 4-fold higher compared to post-RP, benign, and young men, respectively (all p<.001). In addition, with 7.91%, the number of unclassified cells, i.e., cells with pruned labels due to high uncertainty of the assigned label, was also highest in men with PCa, compared to 3.51%, 2.67%, and 5.51% of cells in post-RP, benign, and young men, respectively (all p<.001). It can be postulated that actively phagocytosing cells are hardest to classify due to their dual immune cell and foreign cell nature. Hence, the higher number of unclassified cells and intermediate monocytes in PCa patients might reflect higher phagocytic activity due to tumor burden. This also illustrates that small numbers (~1%) of circulating peripheral blood monocytes that have interacted with tumor cells might still possess detectable phagocytosed tumor RNA.

Keywords: circulating monocytes, phagocytic cells, prostate cancer, tumor immune response

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Authors: Ana Luiza Aranha

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This paper contributes to the discussions that consider corruption as a challenge to the establishment of more democratically inclusive societies in Latin America. The paper advocates an intrinsic connection between democratic principles and corruption control – it is only possible to achieve just forms of democratic life if accountability institutions are able to control corruption, and therefore control the political exclusions that it brings. Departing from a non-trivial approach to corruption, and recognizing a gap in democratic theory when thinking about this phenomenon, corruption is understood as the breakdown of the democratic inclusive rule, whereby political decisions are made (and actions were taken) in spite of those potentially affected by them. Based on this idea, this paper proposes a new way of measuring corruption, moving away from usual aggregate measures – such as the Corruption Perception Index – and case studies of corruption scandals. The main argument sustains that corruption is intrinsically connected with the ability to be accountable and to provide public justification for the political conduct. The point advocated is that corruption involves a dimension of political exclusion. It generates a private benefit which is, from a democratic point of view, illegitimate, since it benefits some at the expense of the decisions made by the political community. Corruption is then a form of exclusion based on deception and opacity - for corruption, there is no plausible justification. Empirically, the paper uses the audit reports produced by the Brazilian anti-corruption agency (the CGU - Office of the Comptroller General) in its Inspections From Public Lotteries Program to exemplify how we can use this definition to separate corruption cases from mismanagement irregularities. On one side, there is poor management and inefficiencies, and, on the other, corruption, defined by the implausibility of public justifications – because the public officials would have to publicize illegitimate privileges and undue advantages. CGU reports provide the justifications given by the public officials for the irregularities found and also the acceptance or not by the control agency of these justifications. The analysis of this dialogue – between public officials and control agents – makes it possible to divide the irregularities on those that can be publicly justified versus those that cannot. In order to hold public officials accountable for their actions, making them responsible for the exclusions that they may cause (such as corruption), the accountability institutions fulfil an important role in reinforcing and empowering democracy and its basic inclusive condition.

Keywords: accountability, brazil, corruption, democracy

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Authors: Derya Gül Ünlü, Oguz Kuş

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The branding of a country means that the country has its own position different from other countries in its region and thus it is perceived more specifically. It is made possible by the branding efforts of a country and the uniqueness of all the national structures, by presenting it in a specific way, by creating the desired image and attracting tourists and foreign investors. Establishing a national brand involves, in a sense, the process of managing the perceptions of the citizens of the other country about the target country, by structuring the image of the country permanently and holistically. By this means, countries are not easily affected by their crisis of international relations. Therefore, within the scope of the research that will be carried out from this point, it is aimed to show how the warplane downing crisis between Turkey and Russia is perceived on social media. The Russian warplane was downed by Turkey on November 24, 2015, on the grounds that Turkey violated the airspace on the Syrian border. Whereupon the relations between the two countries have been tensed, and Russia has called on its citizens not to go to Turkey and citizens in Turkey to return to their countries. Moreover, relations between two countries have been weakened, for example, tourism tours organized in Russia to Turkey and visa-free travel were canceled and all military dialogue was cut off. After the event, various news sites on social media published plenty of news related to topic and the readers made various comments about the event and Turkey. In this context, an investigation into the perception of Turkey's national brand before and after the warplane downing crisis has been conducted. through comments fetched from the reports on the BBC World, and from Al Jazeera English news sites on Facebook accounts, which takes place widely in the social media. In order to realize study, user comments were fetched from jet downing-related news which are published on Facebook fan-page of BBC World Service, and Al Jazeera English. Regarding this, all the news published between 24.10.2015-24.12.2015 and containing Turk and Turkey keyword in its title composed data set of our study. Afterwards, comments written to these news were analyzed via text mining technique. Furthermore, by sentiment analysis, it was intended to reveal reader’s emotions before and after the crisis.

Keywords: Al Jazeera English, BBC World, country branding, social media, text mining

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Authors: Anketa Kumar, Rajantheran Al Muniandy, Rishabh Kumar

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For centuries, Indian costumes are admired for their great aesthetics, functional and narrative qualities. The purpose of the current study is to investigate the role of costumes as visual narratives in Hindi Cinema as Filmmaking is simply one of the most recent manifestations of the human desire to tell stories in which costume acts as a tool to be read as an Intertext by the viewers watching the films. The problem that promoted this study arose when clothes become an interesting topic when examined within the social structures in which they are worn. It is this visual image of dress worn by the character that is investigated in this research through Hindi Cinema of the 1960s, which was a reflection of the society in the realistic form. This research intends to integrate the application of Roland Barthes Semiotic theory in analyzing main movie characters in the National Award-Winning Hindi movie Mughal e Azam (1960). The research helps in filling the gap between the singular level of interpretation and another level that offers a solution towards bridging the gap in viewers' manifold interpretation of a particular movie product. This study focuses on how visual appearance communicates for building up of perception and can relate to notions of realism, defining cultural identity and status in the society. The research methodology is subjected analytical technique that employs in this research is qualitative and descriptive in nature with the use of the Freeze frame technique. The portrayal of costumes is explained with Barthes' principles of Semiotics. The freeze-frame technique stops the motion of the film on a single frame and allows the chosen image to be read as a still photograph. The finding during this research into costume portrayal in the movie was that freezing the frame in midst of running the films attracted attention towards intricate costume details, leading to record the nuanced observations of this minutiae during the movie. Given that during the application of interpretation while watching K Asif’s Mughal e Azam focused on certain aspects of costumes of the king. On the same idea, further research can be employed to strengthen the relation between costumes and visual narration.

Keywords: character portrayal, costumes, Indian cinema, semiotics, visual significance

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Authors: Robert Jedrys, Zdzislaw Kobos, Justyna Skrzynska, Zbigniew Wochynski

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Professions connected to aviation require an assessment of the suitability of health, psychological and psychomotor skills and overall physical fitness of the organism, who applies. Assessment of the physical condition is conducted by the committees consisting of aero-medical specialists in clinical medicine and aviation. In addition, psychological predispositions should be evaluated by specialized psychologists familiar with the specifics of the tasks and requirements for the various positions in aviation. Both, physical abilities and general physical fitness of candidates for aviation shall be assessed during the selection exams, which also test the ability to deal with stress what is very important in aviation. Hence, the mentioned exams in physical education not only help to judge on the ranking in candidates in terms of their efficiency and performance, but also allows to evaluate the functioning under stress measured using psychological tests. Moreover, before-test stress is a predictors of successfulness in the next stages of education and practical training in the aviation. The aim of the study was to evaluate the influence of temperamental traits on strategies used for coping with stress during selection exams in physical education, deciding on admission to aviation school. The study involved 30 candidates for fighter pilot training in aviation school . To evaluate the temperament 'The Formal Characteristics of Behavior-Temperament Inventory' (FCB-TI) by B. Zawadzki and J.Strelau was used. To determine the pattern of coping with stress 'The Coping Inventory for Stressful Situations' (CISS) to N. S. Endler and J. D. A. Parker were engaged. Study of temperament and styles of coping with stress was conducted directly before the exam selection of physical education. The results were analyzed with 'Statistica 9' program. The studies showed that:-There is a negative correlation between such a temperament feature as 'perseverance' and preferred style of coping with stress concentrated on the task (r = -0.590; p < 0.004); -There is a positive correlation between such a feature of temperament as 'emotional reactivity,' and preference to deal with a stressful situation with ‘style centered on emotions’ (r = 0.520; p <0.011); -There is a negative correlation between such a feature of temperament as ‘strength’ and ‘style of coping with stress concentrated on emotions’ (r = -0.580; p < 0.004). Studies indicate that temperament traits determine the perception of stress and preferred coping styles used during the selection, as during the exams in physical education.

Keywords: aviation, physical education, stress, temperamental traits

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Authors: Piotr Tylec, Julia Wierzbicka, Natalia Gajewska, Krzysztof Przeczek, Grzegorz Torbicz, Alicja Dudek, Magdalena Pisarska-Adamczyk, Mateusz Wierdak, Michal Pedziwiatr

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Introduction: Many patients have described changes in taste perception after weight loss surgery. However, little data is available about short term changes in taste after surgery. Aim: We aimed to evaluate short-term changes in taste preference after bariatric surgeries in comparison to colorectal surgeries. Material and Methods: Between April 2018 and April 2019, a total of 121 bariatric patients and 63 controls participated. Bariatric patients underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric by-pass. Controls underwent oncological colorectal surgeries. Patients who developed clinical complications requiring restriction of oral intake after surgery or withdraw their consent were excluded from the study. In the end, 85 bariatric patients and 44 controls were included. In all of them, the 16-item ERAS Protocol was applied. Using 10-points Numeric Rating Scale (1-10) patients completed questionnaire and rated their appetite and thirst (1 - no appetite/not thirsty, 10 – normal appetite/very thirsty) and flavoured standardized liquids' taste (1- horrible, 10-very tasty) and food images for the 6 group of taste (sweet, umami, sour, spicy, bitter and salty) (1 - not appetizing, 10 - very appetizing) preoperatively and on the first postoperative day. Data were analysed with Statistica 13.0 PL. Results: Analysed group consist of 129 patients (85 bariatric, 44 controls). Mean age and BMI in a research group was 44.91 years old, 46.22 kg/m² and in control group 62.09 years old, 25.87 kg/m², respectively. Our analysis revealed significant differences in changes of appetite between both groups (research: -4.55 ± 3.76 vs. control: -0.85 ± 4.37; p < 0.05), ratings bitter (research: 0.60 ± 2.98 vs. control: -0.88 ± 2.58; p < 0.05) and salty (research: 1.20 ± 3.50 vs. control: -0.52 ± 2.90; p < 0.05) flavoured liquids and ratings for sweet (research: 1.62 ± 3.31 vs. control: 0.01 ± 2.63; p < 0.05) and bitter (research: 1.21 ± 3.15 vs. control: -0.09 ± 2.25; p < 0.05) food images. There were statistically significant results in the ratings of other images, but in comparison to the control group, they were not statistically significant. Conclusion: The study showed that bariatric surgeries quickly decreases appetite and desire to eat certain types of food, such as salty. Moreover, the bitter taste was more desirable in the research group in comparison to control group. Nevertheless, the sweet taste was more appetible in the bariatric group than in control.

Keywords: bariatric surgery, general surgery, obesity, taste preference

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Authors: Yee-May Chan

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In recent decades, it is observed that social work agencies have participated actively, and thus, have gradually been more influential in social work education in Hong Kong. The neo-liberal welfare ideologies and changing funding mode have transformed the landscape in social work practice and have also had a major influence on the fieldwork environment in Hong Kong. The aim of this research is to explore the educational role of social work agencies and examine in particular whether they are able to enhance or hinder critical reflective learning in fieldwork. In-depth interviews with 15 frontline social workers and managers in different social work agencies were conducted to collect their views and experience in helping social work students in fieldwork. The overall findings revealed that under the current social welfare context most social workers consider that the most important role of social work agencies in fieldwork is to help students prepare to fit-in the practice requirements and work within agencies’ boundary. The fit-for-purpose and down-to-earth view of fieldwork practice is seen as prevalent among most social workers. This narrow perception of agency’s role seems to be more favourable to competence-based approaches. In contrast, though critical reflection has been seen as important in addressing the changing needs of service users, the role of enhancing critical reflective learning has not been clearly expected or understood by most agency workers. The notion of critical reflection, if considered, has been narrowly perceived in fieldwork learning. The findings suggest that the importance of critical reflection is found to be subordinate to that of practice competence. The lack of critical reflection in the field is somehow embedded in the competence-based social work practice. In general, social work students’ critical reflection has not been adequately supported or enhanced in fieldwork agencies, nor critical reflective practice has been encouraged in fieldwork process. To address this situation, the role of social work agencies in fieldwork should be re-examined. To maximise critical reflective learning in the field, critical reflection as an avowed objective in fieldwork learning should be clearly stated. Concrete suggestions are made to help fieldwork agencies become more prepared to critical reflective learning. It is expected that the research can help social work communities to reflect upon the current realities of fieldwork context and to identify ways to strengthen agencies’ capacities to enhance critical reflective learning and practice of social work students.

Keywords: competence-based social work, critical reflective learning, fieldwork agencies, neo-liberal welfare

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Authors: Peeyush Verma, Anil Kumar, Anju Rawlley, Chanchal Mehra

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India's school-going population is largely served by an educational system that is, in most rural parts, stuck with methods that emphasize rote learning, endless examinations, and monotonous classroom activities. Rural government schools are generally seen as having poor infrastructure, poor support system and low motivation for teaching as well as learning. It was experienced during the survey of this project that there is lesser motivation of rural boys and girls to attend their schools and still less likely chances to study science, tabooed as “difficult”. An experiment was conducted with the help of Rural Knowledge Network Project through Department of Science and Technology, Govt of India in five remote villages of Sehore District in Madhya Pradesh (India) during 2012-2015. These schools are located about 50-70 Km away from Bhopal, the capital of Madhya Pradesh and can distinctively qualify as average rural schools. Three tier methodology was adapted to unfold the experiment. In first tier randomly selected boys and girls from these schools were taken to a daylong visit to the Regional Science Centre located in Bhopal. In second tier, randomly selected half of those who visited earlier were again taken to the Science Centre to make models of Science. And in third tier, all the boys and girls studying science were exposed to video lectures and study material through web. The results have shown an interesting face towards learning science among youths in rural schools through peer learning or incremental learning. The students who had little or no interest in learning science became good learners and queries started pouring in from the neighbourhood village as well as a few parents requested to take their wards in the project to learn science. The paper presented is a case study of the experiment conducted in five rural schools of Sehore District. It reflects upon the methodology of developing awareness and interest among students and finally engaging them in popularising science through peer-to-peer learning using incremental learning elements. The students, who had a poor perception about science initially, had changed their attitude towards learning science during the project period. The results of this case, however, cannot be generalised unless replicated in the same setting elsewhere.

Keywords: popularisation of science, science temper, incremental learning, peer-to-peer learning

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Authors: Seynabou Toure, Oumar Diop, Kidiyo Kpalma, Amadou S. Maiga

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Color and texture are the two most determinant elements for perception and recognition of the objects in an image. For this reason, color and texture analysis find a large field of application, for example in image classification and segmentation. But, the pioneering work in texture analysis was conducted on grayscale images, thus discarding color information. Many grey-level texture descriptors have been proposed and successfully used in numerous domains for image classification: face recognition, industrial inspections, food science medical imaging among others. Taking into account color in the definition of these descriptors makes it possible to better characterize images. Color texture is thus the subject of recent work, and the analysis of color texture images is increasingly attracting interest in the scientific community. In optical remote sensing systems, sensors measure separately different parts of the electromagnetic spectrum; the visible ones and even those that are invisible to the human eye. The amounts of light reflected by the earth in spectral bands are then transformed into grayscale images. The primary natural colors Red (R) Green (G) and Blue (B) are then used in mixtures of different spectral bands in order to produce RGB images. Thus, good color texture discrimination can be achieved using RGB under controlled illumination conditions. Some previous works investigate the effect of using different color space for color texture classification. However, the selection of the best performing color space in land-sea segmentation is an open question. Its resolution may bring considerable improvements in certain applications like coastline detection, where the detection result is strongly dependent on the performance of the land-sea segmentation. The aim of this paper is to present the results of a study conducted on different color spaces in order to show the best-performing color space for land-sea segmentation. In this sense, an experimental analysis is carried out using five different color spaces (RGB, XYZ, Lab, HSV, YCbCr). For each color space, the Haar wavelet decomposition is used to extract different color texture features. These color texture features are then used for Fusion of Over Segmentation (FOOS) based classification; this allows segmentation of the land part from the sea one. By analyzing the different results of this study, the HSV color space is found as the best classification performance while using color and texture features; which is perfectly coherent with the results presented in the literature.

Keywords: classification, coastline, color, sea-land segmentation

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Authors: Martial Amou

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This study was carried out to assess the situation of households’ livelihood under a changing climate pattern in the Zio district of Togo, West Africa. The study examined three important aspects: (i) assessment of households’ livelihood situation under a changing climate pattern, (ii) farmers’ perception and understanding of local climate change, (iii) determinants of adaptation strategies undertaken in cropping pattern to climate change. To this end, secondary sources of data, and survey data collected from 235 farmers in four villages in the study area were used. Adapted conceptual framework from Sustainable Livelihood Framework of DFID, two steps Binary Logistic Regression Model and descriptive statistics were used in this study as methodological approaches. Based on Sustainable Livelihood Approach (SLA), various factors revolving around the livelihoods of the rural community were grouped into social, natural, physical, human, and financial capital. Thus, the study came up that households’ livelihood situation represented by the overall livelihood index in the study area (34%) is below the standard average households’ livelihood security index (50%). The natural capital was found as the poorest asset (13%) and this will severely affect the sustainability of livelihood in the long run. The result from descriptive statistics and the first step regression (selection model) indicated that most of the farmers in the study area have clear understanding of climate change even though they do not have any idea about greenhouse gases as the main cause behind the issue. From the second step regression (output model) result, education, farming experience, access to credit, access to extension services, cropland size, membership of a social group, distance to the nearest input market, were found to be the significant determinants of adaptation measures undertaken in cropping pattern by farmers in the study area. Based on the result of this study, recommendations are made to farmers, policy makers, institutions, and development service providers in order to better target interventions which build, promote or facilitate the adoption of adaptation measures with potential to build resilience to climate change and then improve rural livelihood.

Keywords: climate change, rural livelihood, cropping pattern, adaptation, Zio District

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Authors: Jacqueline Eleonora Ek, Michael Spiteri, Chris Giordimaina, Pierre Agius

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Background: Malta is known for being a key player as a frontline country with regard to irregular immigration from Africa to Europe. Every year the island experiences an influx of migrants as boat movement across the Mediterranean continues to be a humanitarian challenge. Irregular immigration and applying for asylum is both a lengthy and mentally demanding process. Those doing so are often faced with multiple challenges, which can adversely affect their mental health. Between January and August 2020, Malta disembarked 2 162 people rescued at sea, 463 of them between July & August. Given the small size of the Maltese islands, this regulation places a disproportionately large burden on the country, creating a backlog in the processing of asylum applications resulting in increased time periods of detention. These delays reverberate throughout multiple management pathways resulting in prolonged periods of detention and challenging access to health services. Objectives: To better understand the spatial dimensions of this humanitarian crisis, this study aims to assess disparities in the acute medical management of migrants presenting to the emergency department (ED) with acute mental health presentations as compared to that of local and non-local residents. Method: In this retrospective study, 17795 consecutive ED attendances were reviewed to look for acute mental health presentations. These were further evaluated to assess discrepancies in transportation routes to hospital, nature of presenting complaint, effects of language barriers, use of CT brain, treatment given at ED, availability of psychiatric reviews, and final admission/discharge plans. Results: Of the ED attendances, 92.3% were local residents, and 7.7% were non-locals. Of the non-locals, 13.8% were migrants, and 86.2% were other-non-locals. Acute mental health presentations were seen in 1% of local residents; this increased to 20.6% in migrants. 56.4% of migrants attended with deliberate self-harm; this was lower in local residents, 28.9%. Contrastingly, in local residents, the most common presenting complaint was suicidal thought/ low mood 37.3%, the incidence was similar in migrants at 33.3%. The main differences included 12.8% of migrants presenting with refused oral intake while only 0.6% of local residents presented with the same complaints. 7.7% of migrants presented with a reduced level of consciousness, no local residents presented with this same issue. Physicians documented a language barrier in 74.4% of migrants. 25.6% were noted to be completely uncommunicative. Further investigations included the use of a CT scan in 12% of local residents and in 35.9% of migrants. The most common treatment administered to migrants was supportive fluids 15.4%, the most common in local residents was benzodiazepines 15.1%. Voluntary psychiatric admissions were seen in 33.3% of migrants and 24.7% of locals. Involuntary admissions were seen in 23% of migrants and 13.3% of locals. Conclusion: Results showed multiple disparities in health management. A meeting was held between entities responsible for migrant health in Malta, including the emergency department, primary health care, migrant detention services, and Malta Red Cross. Currently, national quality-improvement initiatives are underway to form new pathways to improve patient-centered care. These include an interpreter unit, centralized handover sheets, and a dedicated migrant health service.

Keywords: emergency department, communication, health, migration

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Authors: Nihal Atif Salim

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To improve the quality of life in cities, a variety of interventions are used. Noise is a substantial and important sort of pollution that has a negative impact on the urban environment and human health. According to the complaint survey, it ranks second among environmental contamination complaints (conducted by EEAA in 2019). The most significant source of noise in the city is traffic noise. In order to improve the sound urban environment, many physical techniques are applied. In the local area, noise barriers are considered as one of the most appropriate physical techniques along existing traffic routes. Alexandria is Egypt's second-largest city after Cairo. It is located along the Mediterranean Sea, and El- Gish Road is one of the city's main arteries. It impacts the waterfront promenade that extends along with the city by a high level of traffic noise. The purpose of this paper is to clarify the design considerations for the most appropriate noise barrier type along with the promenade, with the goal of improving the Quality of Life (QOL) and the sonic urban environment specifically. The proposed methodology focuses on how noise affects human perception and the environment. Then it delves into the various physical noise control approaches. After that, the paper discusses sustainable design decisions making. Finally, look into the importance of incorporating sustainability into design decisions making. Three stages will be followed in the case study. The first stage involves doing a site inspection and using specific sound measurement equipment (a noise level meter) to measure the noise level along the promenade at many sites, and the findings will be shown on a noise map. The second step is to inquire about the site's user experience. The third step is to investigate the various types of noise barriers and their effects on QOL along existing routes in order to select the most appropriate type. The goal of this research is to evaluate the suitable design of noise barriers that fulfill environmental and social perceptions while maintaining a balanced approach to the noise issue in order to improve QOL along existing roadways in the local area.

Keywords: noise pollution, sonic urban environment, traffic noise, noise barrier, acoustic sustainability, noise reduction techniques

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Authors: Xiaoya Yi, Yi He, Zhao Lu, Yang Zhang

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In the process of rapid urbanization, many historical cities have undergone excessive demolition and construction under the protection and renewal mechanism. The original pattern of the city has been changed, the urban context has been cut off, and historical features have gradually been lost. The historical city gradually changed into the form of decentralization and fragmentation. The understanding of the ancient city includes two levels. The first one refers to the ancient city on the physical space, which defined an ancient city by its historic walls. The second refers to the public perception of the image, which is derived from people's spatial identification of the ancient city. In ancient China, people draw maps to show their way of understanding the city. Starting from ancient maps and exploring the spatial characteristics of traditional Chinese cities from the perspective of urban imagery is a key clue to understanding the spatial characteristics of historical cities on an overall level. The spatial characteristics of the urban image presented by the ancient map are summarized into two levels by typology. The first is the spatial pattern composed of the center, axis and boundary. The second is the space element that contains the city, street, and sign system. Taking the ancient city of Shipu as a typical case, the "city image" in the ancient map is analyzed as a prototype, and it is projected into the current urban space. The research found that after a long period of evolution, the historical spatial pattern of the ancient city has changed from “dominant” to “recessive control”, and the historical spatial elements are non-centralized and fragmented. The wall that serves as the boundary of the ancient city is transformed into “fragmentary remains”, the streets and lanes that serve as the axis of the ancient city are transformed into “structural remains”, and the symbols of the ancient city center are transformed into “site remains”. Based on this, the paper proposed the methods of controlling the protection of land boundaries, the protecting of the streets and lanes, and the selective restoring of the city wall system and the sign system by accurate assessment. In addition, this paper emphasizes the continuity of the ancient city's traditional spatial pattern and attempts to explore a holistic conservation method of the ancient city in the modern context.

Keywords: ancient city protection, ancient maps, Shipu ancient city, urban intention

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Authors: Salamatu Shaibu, Jan Hernning Sommer

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Integrating biodiversity conservation practices in mining landscapes ensures the continual provision of various ecosystem services to the dependent communities whilst serving as ecological insurance for corporate mining when purchasing reclamation security bonds. Climate hazards such as long dry seasons, erratic rainfall patterns, and extreme weather events contribute to biodiversity loss in addition to the impact due to mining. Both corporate mining and mine-fringe communities perceive the effect of climate on biodiversity from the context of the benefits they accrue, which motivate their conservation practices. In this study, pragmatic approaches including semi-structured interviews, field visual observation, and review were used to collect data on corporate mining employees and households of fringing communities in the southwestern mining hub. The perceived changes in the local climatic conditions and the consequences on environmental management practices that promote biodiversity conservation were examined. Using a thematic content analysis tool, the result shows that best practices such as concurrent land rehabilitation, reclamation ponds, artificial wetlands, land clearance, and topsoil management are directly affected by prolonging long dry seasons and erratic rainfall patterns. Excessive dust and noise generation directly affect both floral and faunal diversity coupled with excessive fire outbreaks in rehabilitated lands and nearby forest reserves. Proposed adaptive measures include engaging national conservation authorities to promote reforestation projects around forest reserves. National government to desist from using permit for mining concessions in forest reserves, engaging local communities through educational campaigns to control forest encroachment and burning, promoting community-based resource management to promote community ownership, and provision of stricter environmental legislation to compel corporate, artisanal, and small scale mining companies to promote biodiversity conservation.

Keywords: biodiversity conservation, climate hazards, corporate mining, mining landscapes

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Authors: Marie-Helena Docherty, Sion Edryd Williams

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The prevalence of diabetes mellitus is increasing worldwide. In Sub-Saharan Africa, type 2 diabetes represents over 90% of all types of diabetes with the number of diabetic patients expected to rise. This represents a huge economic burden in an area already contending with high rates of other significant diseases, including the highest worldwide prevalence of HIV. Diabetic complications considerably impact on morbidity and mortality. The epidemiological data for the region quotes high rates of retinopathy (7-63%), neuropathy (27-66%) and microalbuminuria (10-83%). It is therefore imperative that diabetic screening programmes are established. It is recognised that in many parts of the developing world the implementation and management of such programmes is limited by a lack of available resources. The International Diabetes Federation produced guidelines in 2012 taking these limitations into account suggesting that all diabetic patients should have access to basic screening. These guidelines are consistent with the national diabetic guidelines produced by the Lesotho Medical Council. However, diabetic care in Lesotho is delivered at the local level, with variable levels of quality. A cross sectional study was performed in the outpatient department of Maluti Hospital in Mapoteng, Lesotho, a busy rural hospital in the Berea district. Demographic data on gender, age and modality of treatment were collected over a six-week time period. Information regarding 3 basic screening parameters was obtained. These parameters included eye screening (defined as a documented ophthalmology review within the last 12 months), foot screening (defined as a documented foot health assessment by any health care professional within the last 12 months) and secondary prevention (defined as a documented blood pressure and lipid profile reading within the last 12 months). These parameters were selected on the basis of the absolute minimum level of resources in Maluti Hospital. Renal screening was excluded, as the hospital does not have access to reliable renal profile checks or urinalysis. There is however a fully functioning on-site ophthalmology department run by a senior ophthalmologist with the ability to provide retinal photography, retinal surgery and photocoagulation therapy. Data was collected on 183 type 2 diabetics. 112 patients were male and 71 were female. The average age was 43 years. 4 patients were diet controlled, 140 patients were on oral hypoglycaemic agents (metformin and/or glibenclamide), and 39 patients were on a combination of insulin and oral hypoglycaemics. In the preceding 12 months, 5 patients had undergone eye screening (3%), 24 patients had undergone foot screening (13%), and 31 patients had lipid profile testing (17%). All patients had a documented blood pressure reading (100%). Our results show that screening is poorly performed in the basic indicators suggested by the IDF and the Lesotho Medical Council. On the basis of these results, a screening programme was developed using the mnemonic SaFE; secondary prevention, foot and eye care. This is simple, memorable and transferable between healthcare professionals. In the future, the expectation would be to expand upon this current programme to include renal screening, and to further develop screening pertaining to secondary prevention.

Keywords: Africa, complications, rural, screening

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Authors: Edna Gnomblerou

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Given the current scale of corruption epidemic in West African economies, governments are seeking for immediate and effective measures to reduce the likelihood of the plague within the region. Generally, accountants and auditors are expected to help organizations in detecting illegal practices. However, their role in the fight against corruption is sometimes limited due to the collusive nature of corruption. The Denmark anti-corruption model shows that the implementation of additional controls over public accounts and independent efficient audits improve transparency and increase the probability of detection. This study is aimed at reviewing the existing anti-corruption policies of the Economic Commission of West African States (ECOWAS) as to observe the role attributed to accounting, auditing and other managerial practices in their anti-corruption drive. It further discusses the usefulness of accounting and auditing in helping anti-corruption commissions in controlling misconduct and increasing the perception to detect irregularities within public administration. The purpose of this initiative is to identify and assess the relevance of accounting and auditing in curbing corruption. To meet this purpose, the study was designed to answer the questions of whether accounting and auditing processes were included in the reviewed anti-corruption strategies, and if yes, whether they were effective in the detection process. A descriptive research method was adopted in examining the role of accounting and auditing in West African anti-corruption strategies. The analysis reveals that proper recognition of accounting standards and implementation of financial audits are viewed as strategic mechanisms in tackling corruption. Additionally, codes of conduct, whistle-blowing and information disclosure to the public are among the most common managerial practices used throughout anti-corruption policies to effectively and efficiently address the problem. These observations imply that sound anti-corruption strategies cannot ignore the values of including accounting and auditing processes. On one hand, this suggests that governments should employ all resources possible to improve accounting and auditing practices in the management of public sector organizations. On the other hand, governments must ensure that accounting and auditing practices are not limited to the private sector, but when properly implemented constitute crucial mechanisms to control and reduce corrupt incentives in public sector.

Keywords: accounting, anti-corruption strategy, auditing, ECOWAS

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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Authors: Ndumbe Eric Esongami, Manga Veronica Ebot, Foba Josepha Tendo, Yengong Fabrice Lamfu, Tiku David Tambe

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The prevalence and unpleasant nature of plastics pollution constantly observed on beach shore on stormy events has prompt researchers worldwide to thesis on sustainable economic and environmental designs on plastics, especially in Cameroon, a major touristic destination in the Central Africa Region. The inconsistent protocols develop by researchers has added to this burden, thus the morphological nature of microplastic remediation is a call for concerns. The prime aim of the study is to morphologically identify, quantify and forensically understands the distribution of each plastics polymer composition. Duplicates of 2×2 m (4m2) quadrants were sampled in each beach/month over 8 months period across five purposive beaches along the Limbe – Idenau coastline, Cameroon. Collected plastic samples were thoroughly washed and separation done using a 2 mm sieve. Only particles of size, < 2 mm, were considered and forward follow the microplastics laboratory analytical processes. Established step by step methodological procedures of particle filtration, organic matter digestion, density separation, particle extraction and polymer identification including microscope and were applied for the beach microplastics samples. Microplastics were observed in each sample/beach/month with an overall abundance of 241 particles/number weighs 89.15 g in total and with a mean abundance of 2 particles/m2 (0.69 g/m2) and 6 particles/month (2.0 g/m2). The accumulation of beach shoreline MPs rose dramatically towards decreasing size with microbeads and fiber only found in the < 1 mm size fraction. Approximately 75% of beach MPs contamination were found in LDB 2, LDB 1 and IDN beaches/average particles/number while the most dominant polymer type frequently observed also were PP, PE, and PS in all morphologically parameters analysed. Beach MPs accumulation significantly varied temporally and spatially at p = 0.05. ANOVA and Spearman’s rank correlation used shows linear relationships between the sizes categories considered in this study. In terms of polymer MPs analysis, the colour class recorded that white coloured MPs was dominant, 50 particles/number (22.25 g) with recorded abundance/number in PP (25), PE (15) and PS (5). The shape class also revealed that irregularly shaped MPs was dominant, 98 particles/number (30.5 g) with higher abundance/number in PP (39), PE (33), and PS (11). Similarly, MPs type class shows that fragmented MPs type was also dominant, 80 particles/number (25.25 g) with higher abundance/number in PP (30), PE (28) and PS (15). Equally, the sized class forward revealed that 1.5 – 1.99 mm sized ranged MPs had the highest abundance of 102 particles/number (51.77 g) with higher concentration observed in PP (47), PE (41), and PS (7) as well and finally, the weight class also show that 0.01 g weighs MPs was dominated by 98 particles/number (56.57 g) with varied numeric abundance seen in PP (49), PE (29) and PS (13). The forensic investigation of the pollution indicated that majority of the beach microplastic is sourced from the site/nearby area. The investigation could draw useful conclusions regarding the pathways of pollution. The fragmented microplastic, a significant component in the sample, was found to be sourced from recreational activities and partly from fishing boat installations and repairs activities carried out close to the shore.

Keywords: forensic analysis, beach MPs, particle/number, polymer composition, cameroon

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Authors: Supriyo Das, Elbir Jove, Ajay Singh, Sophie Corbet, Noel Carr, Martin Deetz

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Water is a critical commodity in the healthcare and medical field. The utility of medical-grade water spans from washing surgical equipment, drug preparation to the key element of life-saving therapy such as hydrotherapy and hemodialysis for patients. A properly treated medical water reduces the bioburden load and mitigates the risk of infection, ensuring patient safety. However, any compromised condition during the production of medical-grade water can create a favorable environment for microbial growth putting patient safety at high risk. Therefore, proper upstream treatment of the medical water is essential before its application in healthcare, pharma and medical space. Reverse Osmosis (RO) is one of the most preferred treatments within healthcare industries and is recommended by all International Pharmacopeias to achieve the quality level demanded by global regulatory bodies. The RO process can remove up to 99.5% of constituents from feed water sources, eliminating bacteria, proteins and particles sizes of 100 Dalton and above. The combination of RO with other downstream water treatment technologies such as Electrodeionization and Ultrafiltration meet the quality requirements of various pharmacopeia monographs to produce highly purified water or water for injection for medical use. In the reverse osmosis process, the water from a liquid with a high concentration of dissolved solids is forced to flow through an especially engineered semi-permeable membrane to the low concentration side, resulting in high-quality grade water. However, these specially engineered RO membranes need to be sanitized either chemically or at high temperatures at regular intervals to keep the bio-burden at the minimum required level. In this paper, we talk about Dupont´s FilmTec Heat Sanitizable Reverse Osmosis membrane (HSRO) for the production of medical-grade water. An HSRO element must be pre-conditioned prior to initial use by exposure to hot water (80°C-85°C) for its stable performance and to meet the manufacturer’s specifications. Without pre-conditioning, the membrane will show variations in feed pressure operations and salt rejection. The paper will discuss the critical variables of pre-conditioning steps that can affect the overall performance of the HSRO membrane and demonstrate the data to support the need for pre-conditioning of HSRO elements. Our preliminary data suggests that there can be up to 35 % reduction in flow due to initial heat treatment, which also positively affects the increase in salt rejection. The paper will go into detail about the fundamental understanding of the performance change of HSRO after the pre-conditioning step and its effect on the quality of medical water produced. The paper will also discuss another critical point, “regular hot water sanitization” of these HSRO membranes. Regular hot water sanitization (at 80°C-85°C) is necessary to keep the membrane bioburden free; however, it can negatively impact the performance of the membrane over time. We will demonstrate several data points on hot water sanitization using FilmTec HSRO elements and challenge its robustness to produce quality medical water. The last part of this paper will discuss the construction details of the FilmTec HSRO membrane and features that make it suitable to pre-condition and sanitize at high temperatures.

Keywords: heat sanitizable reverse osmosis, HSRO, medical water, hemodialysis water, water for Injection, pre-conditioning, heat sanitization

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Authors: Mohammed E. A. Brixi Nigassa, Nassima Labdelli, Ahmed Slami, Arnaud Pothier, Sofiane Soulimane

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According to the world health organization (WHO), there are almost 285 million people with visual disability, 39 million of these people are blind. Nevertheless, there is a code for these people that make their life easier and allow them to access information more easily; this code is the Braille code. There are several commercial devices allowing braille reading, unfortunately, most of these devices are not ergonomic and too expensive. Moreover, we know that 90 % of blind people in the world live in low-incomes countries. Our contribution aim is to concept an original microactuator for Braille reading, as well as being ergonomic, inexpensive and lowest possible energy consumption. Nowadays, the piezoelectric device gives the better actuation for low actuation voltage. In this study, we focus on piezoelectric (PZT) material which can bring together all these conditions. Here, we propose to use one matrix composed by six actuators to form the 63 basic combinations of the Braille code that contain letters, numbers, and special characters in compliance with the standards of the braille code. In this work, we use a finite element model with Comsol Multiphysics software for designing and modeling this type of miniature actuator in order to integrate it into a test device. To define the geometry and the design of our actuator, we used physiological limits of perception of human being. Our results demonstrate in our study that piezoelectric actuator could bring a large deflection out-of-plain. Also, we show that microactuators can exhibit non uniform compression. This deformation depends on thin film thickness and the design of membrane arm. The actuator composed of four arms gives the higher deflexion and it always gives a domed deformation at the center of the deviceas in case of the Braille system. The maximal deflection can be estimated around ten micron per Volt (~ 10µm/V). We noticed that the deflection according to the voltage is a linear function, and this deflection not depends only on the voltage the voltage, but also depends on the thickness of the film used and the design of the anchoring arm. Then, we were able to simulate the behavior of the entire matrix and thus display different characters in Braille code. We used these simulations results to achieve our demonstrator. This demonstrator is composed of a layer of PDMS on which we put our piezoelectric material, and then added another layer of PDMS to isolate our actuator. In this contribution, we compare our results to optimize the final demonstrator.

Keywords: Braille code, comsol software, microactuators, piezoelectric

Procedia PDF Downloads 347

Authors: Sum Lau, Wing Chung Cleo Lau, Wing Yan Chu, Long Ching Ip, Wan Yin Lo, Jo Long Sam Yau, Ka Ho Hui, Sze Yi Mak

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Biomedical engineering (BME) is an interdisciplinary subject where knowledge about biology and medicine is applied to novel applications, solving clinical problems. This subject is crucial for cities such as Hong Kong, where the burden on the medical system is rising due to reasons like the ageing population. Hong Kong, who is actively boosting technological advancements in recent years, sets BME, or biotechnology, as a major category, as reflected in the 2018-19 Budget, where biotechnology was one of the four pillars for development. Over the years, while resources in terms of money and space have been provided, there has been a lack of talents expressed by both the academia and industry. While exogenous factors, such as COVID, may have hindered talents from outside Hong Kong to come, endogenous factors should also be considered. In particular, since there are already a few local universities offering BME programmes, their curriculum or style of education requires to be reviewed to intensify the network of the BME community and support post-academic career development. It was observed that while undergraduate (UG) studies focus on knowledge teaching with some technical training and postgraduate (PG) programmes concentrate on upstream research, the programmes are generally confined to the academic sector and lack connections to the industry. In light of that, a “Biomedical Innovation and Outreach Programme 2022” (“B.I.O.2022”) was held to connect students and professors from academia with clinicians and engineers from the industry, serving as a comparative approach to conventional education methods (UG and PG programmes from tertiary institutions). Over 100 participants, including undergraduates, postgraduates, secondary school students, researchers, engineers, and clinicians, took part in various outreach events such as conference and site visits, all held from June to July 2022. As a case study, this programme aimed to tackle the aforementioned problems with the theme of “4Cs” (connection, communication, collaboration, and commercialisation). The effectiveness of the programme is investigated by its ability to serve as an adult and continuing education and the effectiveness of causing social change to tackle current societal challenges, with the focus on tackling the lack of talents engaging in biomedical engineering. In this study, B.I.O.2022 is found to be able to complement the traditional educational methods, particularly in terms of knowledge exchange between the academia and the industry. With enhanced communications between participants from different career stages, there were students who followed up to visit or even work with the professionals after the programme. Furthermore, connections between the academia and industry could foster the generation of new knowledge, which ultimately pointed to commercialisation, adding value to the BME industry while filling the gap in terms of human resources. With the continuation of events like B.I.O.2022, it provides a promising starting point for the development and relationship strengthening of a BME community in Hong Kong, and shows potential as an alternative way of adult education or learning with societal benefits.

Keywords: biomedical engineering, adult education for social change, comparative methods and principles, lifelong learning, faced problems, promises, challenges and pitfalls

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Authors: Chun-Lin Zhang, Min Wan

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With the upgrade development of the tourism industry from the simple sightseeing tour to the leisure and vacation, people's travel idea has undergone a fundamental change. More and more people begin to pursue liberal and personal tourism, so self-driving tourism has become the main form of current tourism activities. With the self-driving tourism representing the general trend, the importance of convenient tourism transportation and perfect road traffic signs have become more and more prominent. A clear urban road traffic signs can help visitors quickly identify the direction and distance to the tourism destination. The purpose of this article is analyzing the planning of urban road traffic signs which can bring positive impact on the participation in the recreation involved of self-driving tourists. The content of this article is divided into three parts. Based on the literature review and theoretical analysis, the first part constructs a structural variance model. The model is from three dimensions: the attention of the self-driving tourists to the urban traffic signs along the road, the perception of the self-driving tourists to the road traffic signs itself, the perceptions of the self-driving tourists to the tourism destination information on the traffic signs. Through this model, the paper aims to explore the influence of the urban road traffic signs to the leisure psychological involvement and leisure behavior involvement of the self-driving tourists. The second part aims to verify through the hypothesis model the questionnaire survey and come to preliminary conclusions. The preliminary conclusions are as follows: firstly, the color, shape, size, setting mode and occurrence frequency of urban road traffic sign have significant influence on the leisure psychological involvement and leisure behavior involvement of the self-driving tourists. Secondly, the influence on the leisure behavior involvement is obviously higher than the influence on the leisure psychological involvement. Thirdly, the information about the tourism destination marked on the urban road traffic signs has not obviously influence on the leisure psychological involvement, but it has distinct influence on the leisure behavior involvement of self-driving tourists. The third part puts forward that the planning of urban road traffic signs should focus on the angle of the impact of road traffic signs on people's psychology and behavior. On the basis of the above conclusions, the paper researches the color, shape, size, setting mode and information labeling of urban road traffic signs so that they can preferably satisfy the demand of the leisure involvement of self-driving tourists.

Keywords: leisure involvement, self-driving tourism, structural equation, urban road traffic signs

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Authors: Tanja Ecken, Laura Fricke, Anika Steger, Maren M. Michaelsen, Tobias Esch

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Studies and applied experiences evidence severe and traumatic accidents to not only require physical rehabilitation and recovery but also to necessitate a psychological adaption and reorganization to the changed living conditions. Neurobiological models underpinning the experience of happiness and satisfaction postulate life shocks to potentially enhance the experience of happiness and life satisfaction, i.e., posttraumatic growth (PTG). This present study aims to provide an in-depth understanding of the underlying psychological processes of PTG and to outline its consequences on subjective happiness and life satisfaction. To explore the aforementioned, Esch’s (2022) ABC Model was used as guidance for the development of a questionnaire assessing changes in happiness and life satisfaction and for a schematic model postulating the development of PTG in the context of paraplegia. Two-stage qualitative interview procedures explored participants’ experiences of paraplegia. Specifically, narrative, semi-structured interviews (N=28) focused on the time before and after the accident, the availability of supportive resources, and potential changes in the perception of happiness and life satisfaction. Qualitative analysis (Grounded Theory) indicated an initial phase of reorganization was followed by a gradual psychological adaption to novel, albeit reduced, opportunities in life. Participants reportedly experienced a ‘compelled’ slowing down and elements of mindfulness, subsequently instilling a sense of gratitude and joy in relation to life’s presumed trivialities. Despite physical limitations and difficulties, participants reported an enhanced ability to relate to oneself and others and a reduction of perceived every day nuisances. Concluding, PTG can be experienced in response to severe, traumatic life events and has the potential to enrich the lives of affected persons in numerous, unexpected and yet challenging ways. PTG appears to be spectrum comprised of an interplay of internal and external resources underpinned by neurobiological processes. Participants experienced PTG irrelevant of age, gender, marital status, income or level of education.

Keywords: inhibition theory, posttraumatic growth, trauma, stress, life satisfaction, subjective happiness, traumatic life events, paraplegia

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Authors: Victoria H. Hamilton

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Charles Bonnet Syndrome (CBS) is when a person experiences pseudohallucinations that fill in visual information from any type of sight loss. CBS arises from an epiphenomenal process, with the physical actions of sight resulting in the mental formations of images. These pseudohallucinations—referred to as visions by the CBS community—manifest in a wide range of forms, from complex scenes to simple geometric shapes. To share these unique visual experiences, a remote co-creation website was created where CBS participants communicated their lived experiences. This created a reflexive process, and we worked to produce true representations of these interesting and little-known phenomena. Digital reconstruction of the visions is utilised as it echoes the vivid, experiential movie-like nature of what is being perceived. This paper critically analyses co-creation as a method for making digital assets. The implications of the participants' vision impairments and the application of ethical safeguards are examined in this context. Important to note, this research is of a medical syndrome for a non-medical, practice-based design. CBS research to date is primarily conducted by the ophthalmic, neurological, and psychiatric fields and approached with the primary concerns of these specialties. This research contributes a distinct approach incorporating practice-based digital design, autoethnography, and phenomenology. Autoethnography and phenomenology combine as a foundation, with the first bringing understanding and insights, balanced by the second philosophical, bigger picture, and established approach. With further refining, it is anticipated that the research may be applied to other conditions. Conditions where articulating internal experiences proves challenging and the use of digital methods could aid communication. Both the research and CBS communities will benefit from the insights regarding the relationship between cognitive perceptions and the vision process. This research combines the digital visualising of visions with interest in the link between metaphor, embodied cognition, and image. The argument for a link between CBS visions and metaphor may appear evident due to the cross-category mapping of images that is necessary for comprehension. They both are— CBS visions and metaphors—the experience of picturing images, often with lateral connections and imaginative associations.

Keywords: Charles Bonnet Syndrome, digital design, visual hallucinations, visual perception

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Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Nurulhikma Md Isa, Intan Elya Suka, Nur Farhana Roslan, Chew Bee Lynn

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The evolutionarily conserved N-end rule pathway marks proteins for degradation by the Ubiquitin Proteosome System (UPS) based on the nature of their N-terminal residue. Proteins with a destabilizing N-terminal residue undergo a series of condition-dependent N-terminal modifications, resulting in their ubiquitination and degradation. Intensive research has been carried out in Arabidopsis previously. The group VII Ethylene Response Factor (ERFs) transcription factors are the first N-end rule pathway substrates found in Arabidopsis and their role in regulating oxygen sensing. ERFs also function as central hubs for the perception of gaseous signals in plants and control different plant developmental including germination, stomatal aperture, hypocotyl elongation and stress responses. However, nothing is known about the role of this pathway during fruit development and ripening aspect. The plant model system Arabidopsis cannot represent fleshy fruit model system therefore tomato is the best model plant to study. PROTEOLYSIS6 (PRT6) is an E3 ubiquitin ligase of the N-end rule pathway. Two homologs of PRT6 sequences have been identified in tomato genome database using the PRT6 protein sequence from model plant Arabidopsis thaliana. Homology search against Ensemble Plant database (tomato) showed Solyc09g010830.2 is the best hit with highest score of 1143, e-value of 0.0 and 61.3% identity compare to the second hit Solyc10g084760.1. Further homology search was done using NCBI Blast database to validate the data. The result showed best gene hit was XP_010325853.1 of uncharacterized protein LOC101255129 (Solanum lycopersicum) with highest score of 1601, e-value 0.0 and 48% identity. Both Solyc09g010830.2 and uncharacterized protein LOC101255129 were genes located at chromosome 9. Further validation was carried out using BLASTP program between these two sequences (Solyc09g010830.2 and uncharacterized protein LOC101255129) to investigate whether they were the same proteins represent PRT6 in tomato. Results showed that both proteins have 100 % identity, indicates that they were the same gene represents PRT6 in tomato. In addition, we used two different RNAi constructs that were driven under 35S and Polygalacturonase (PG) promoters to study the function of PRT6 during tomato developmental stages and ripening processes.

Keywords: ERFs, PRT6, tomato, ubiquitin

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Authors: Athanasios A. Gavrilidis, Mihai R. Nita, Larissa N. Stoia, Diana A. Onose

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Contemporary global environmental challenges must be primarily addressed at local levels. Cities are under continuous pressure as they must ensure high quality of life levels for their citizens and at the same time to adapt and address specific environmental issues. Innovative solutions using natural features or mimicking natural systems are endorsed by the scientific community as efficient approaches for both mitigating climate change effects and the decrease of environmental quality and for maintaining high standards of living for urban dwellers. The aim of this study was to assess whether Romanian cities’ authorities are considering nature-based innovation as solutions for their planning, management, and environmental issues. Data were gathered by applying 140 questionnaires to urban authorities throughout the country. The questionnaire was designed for assessinglocal policy makers’ perspective over the efficiency of nature-based innovations as a tool to address specific challenges. It also focused on extracting data about financing sources and challenges they must overcome for adopting nature-based approaches. The gather results from the municipalities participating in our study were statistically processed, and they revealed that Romanian city managers acknowledge the benefits of nature-based innovations, but investments in this sector are not on top of their priorities. More than 90% of the selected cities have agreed that in the last 10 years, their major concern was to expand the grey infrastructure (roads and public amenities) using traditional approaches. When asked how they would react if faced with different socio-economic and environmental challenges, local urban managers indicated investments nature-based solutions as a priority only in case of biodiversity loss and extreme weather, while for other 14 proposed scenarios, they would embrace the business-as-usual approach. Our study indicates that while new concepts of sustainable urban planning emerge within the scientific community, local authorities need more time to understand and implement them. Without the proper knowledge, personnel, policies, or dedicated budgets, local administrators will not embrace nature-based innovations as solutions for their challenges.

Keywords: nature based innovations, perception analysis, policy making, urban planning

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Authors: Irene H. Maralit

Abstract:

Warning labels have been found to inform smokers about the health hazards of smoking, encourage smokers to quit, and prevent nonsmokers from starting to smoke. Warning labels on tobacco products are an ideal way of communicating with smokers. Since the intervention is delivered at the time of smoking, nearly all smokers are exposed to warning labels and pack-a-day smokers could be exposed to the warnings more than 7,000 times per year. Given the reach and frequency of exposure, the proponents want to know the effect of warning labels on smoking behavior. Its aims to identify the profile of the smokers associated with its behavioral variables that best describe the users’ perception. The behavioral variables are AVOID, THINK RISK and FORGO. This research study aims to determine if there is significant relationship between the effect of warning labels on cigarette package on Consumer behavior when grouped according to profile variable. The researcher used quota sampling to gather representative data through purposive means to determine the accurate representation of data needed in the study. Furthermore, the data was gathered through the use of a self-constructed questionnaire. The statistical method used were Frequency count, Chi square, multi regression, weighted mean and ANOVA to determine the scale and percentage of the three variables. After the analysis of data, results shows that most of the respondents belongs to age range 22–28 years old with percentage of 25.3%, majority are male with a total number of 134 with percentage of 89.3% and single with total number of 79 and percentage of 52.7%, mostly are high school graduates with total number of 59 and percentage of 39.3, with regards to occupation, skilled workers have the highest frequency of 37 with 24.7%, Majority of the income of the respondents falls under the range of Php 5,001-Php10,000 with 50.7%. And also with regards to the number of sticks consumed per day falls under 6–10 got the highest frequency with 33.3%. The respondents THINK RISK factor got the highest composite mean which is 2.79 with verbal interpretation of agree. It is followed by FORGO with 2.78 composite mean and a verbal interpretation of agree and AVOID variable with composite mean of 2.77 with agree as its verbal interpretation. In terms of significant relationship on the effects of cigarette label to consumer behavior when grouped according to profile variable, sex and occupation found to be significant.

Keywords: consumer behavior, smokers, warning labels, think risk avoid forgo

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Authors: Miriam Borchardt, Agata M. Ritter, Macaliston G. da Silva, Mauricio N. de Carvalho, Giancarlo M. Pereira

Abstract:

This paper aims to analyze the barriers faced by social enterprises and based on that to propose a social business model framework that helps them to leverage their businesses and the social value delivered. A business model for social enterprises should amplify the value perception including social value for the beneficiaries while generating enough profit to escalate the business. Most of the social value beneficiaries are people from the base of the economic pyramid (BOP) or the ones that have specific needs. Because of this, products and services should be affordable to consumers while solving social needs of the beneficiaries. Developing products and services with social value require tie relationship among the social enterprises and universities, public institutions, accelerators, and investors. Despite being focused on social value and contributing to the beneficiaries’ quality of life as well as contributing to the governments that cannot properly guarantee public services and infrastructure to the BOP, many barriers are faced by the social enterprises to escalate their businesses. This is a work in process and five micro- and small-sized social enterprises in Brazil have been studied: (i) one has developed a kit for cervical uterine cancer detection to allow the BOP women to collect their own material and deliver to a laboratory for U$1,00; (ii) other has developed special products without lactose and it is about 70% cheaper than the traditional brands in the market; (iii) the third has developed prosthesis and orthosis to surplus needs that health public system have not done efficiently; (iv) the fourth has produced and commercialized menstrual panties aiming to reduce the consumption of dischargeable ones while saving money to the consumers; (v) the fifth develops and commercializes clothes from fabric wastes in a partnership with BOP artisans. The preliminary results indicate that the main barriers are related to the public system to recognize these products as public money that could be saved if they bought products from these enterprises instead of the multinational pharmaceutical companies, to the traditional distribution system (e.g. pharmacies) that avoid these products because of the low or non-existing profit, to the difficulty buying raw material in small quantities, to leverage investment by the investors, to cultural barriers and taboos. Interesting strategies to reduce the costs have been observed: some enterprises have focused on simplifying products, others have invested in partnerships with local producers and have developed their machines focusing on process efficiency to leverage investment by the investors.

Keywords: base of the pyramid, business model, social business, social business model, social enterprises

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