Search results for: rural healthcare settings

Authors: Nahid Ferdousi

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Juvenile justice is a key component of the child rights to keep the best interest and completely different from criminal justice. After independence of Bangladesh in 1971, the Children Act 1974 and the Children Rules 1976 were considered as the basic law for juvenile justice which written before many international instruments on children’s rights came into existence, did not align with the international mandate set by those instruments. These Acts were not really child rights-based and modern concept such as diversion, restorative justice and community-based rehabilitation has not developed accordingly. In this backdrop, government has enacted the new Children Act 2013 and introduced extensive reforms to the juvenile justice system in Bangladesh. The Act has been adopted with the provisions for child-friendly juvenile courts in each district and different kinds of child-oriented practices in a number of settings, such as, child affairs police officer, probation officer, national child welfare board, diversion, alternative preventive measures on the basis of international principles. Prior to the Act, there had been a number of High Court rulings which considered the international standards for juvenile justice. But the recent reforms to juvenile justice system hail a new commitment to the country’s international obligations to its children and a change in the philosophy guiding the treatment of offender children. This is high time to create an effective juvenile justice system for the 21st century in Bangladesh by the proper implementation of the Children Act 2013. Additionally, the new Children Rules should be enacted and juvenile courts along with correctional institutions should be established in each district in Bangladesh. This study assesses the juvenile justice reforms in Bangladesh over the five decades (1974-2014) and focuses on changes that will improve the system as a whole and enable us to better achieve the ends of fair juvenile justice.

Keywords: Juvenile justice reforms, international obligations, child-oriented practices, commitment of the state

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Authors: Dante J. Dorantes-González, Aldrin Balsa-Yepes

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Existing learning techniques such as problem-based learning, project-based learning, or case study learning are learning techniques that focus mainly on technical details, but give no specific guidelines on learner’s experience and emotional learning aspects such as arousal salience and valence, being emotional states important factors affecting engagement and retention. Some approaches involving emotion in educational settings, such as social and emotional learning, lack neuroscientific rigorousness and use of specific neurobiological mechanisms. On the other hand, neurobiology approaches lack educational applicability. And educational approaches mainly focus on cognitive aspects and disregard conditioning learning. First, authors start explaining the reasons why it is hard to learn thoughtfully, then they use the method of neurobiological mapping to track the main limbic system functions, such as the reward circuit, and its relations with perception, memories, motivations, sympathetic and parasympathetic reactions, and sensations, as well as the brain cortex. The authors conclude explaining the major finding: The mechanisms of nonconscious learning and the triggers that guarantee long-term memory potentiation. Afterward, the educational framework for practical application and the instructors’ guidelines are established. An implementation example in engineering education is given, namely, the study of tuned-mass dampers for earthquake oscillations attenuation in skyscrapers. This work represents an original learning technique based on nonconscious learning mechanisms to enhance long-term memories that complement existing cognitive learning methods.

Keywords: emotion, emotion-enhanced memory, learning technique, STEM

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Authors: R. Oleko, A. Saraceni

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The aim of this research is to provide a rigorous evaluation of the existing academic productivity in relation to value proposition and creation in networked environments. Bibliometrics is a vigorous approach used to structure existing literature in an objective and reliable manner. To that aim, a thorough bibliometric analysis was performed in order to assess the large volume of the information encountered in a structured and reliable manner. A clear distinction between networks and service networks was considered indispensable in order to capture the effects of each network’s type properties on value creation processes. Via the use of bibliometric parameters, this review was able to capture the state-of-the-art in both value proposition and value creation consecutively. The results provide a rigorous assessment of the annual scientific production, the most influential journals, and the leading corresponding author countries. By means of citation analysis, the most frequently cited manuscripts and countries for each network type were identified. Moreover, by means of co-citation analysis, existing collaborative patterns were detected through the creation of reference co-citation networks and country collaboration networks. Co-word analysis was also performed in order to provide an overview of the conceptual structure in both networks and service networks. The acquired results provide a rigorous and systematic assessment of the existing scientific output in networked settings. As such, they positively contribute to a better understanding of the distinct impact of service networks on value proposition and value creation when compared to regular networks. The implications derived can serve as a guide for informed decision-making by practitioners during network formation and provide a structured evaluation that can stand as a basis for future research in the field.

Keywords: bibliometrics, co-citation analysis, networks, service networks, value creation, value proposition

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Authors: Amirhossein Lotfi, Huaizhong Li, Dzung Viet Dao

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Interest in natural fiber-reinforced composites (NFRC) is progressively growing both in terms of academia research and industrial applications thanks to their abundant advantages such as low cost, biodegradability, eco-friendly nature and relatively good mechanical properties. However, their widespread use is still presumed as challenging because of the specificity of their non-homogeneous structure, limited knowledge on their machinability characteristics and parameter settings, to avoid defects associated with the machining process. The present work is aimed to investigate the effect of the cutting tool geometry and material on the drilling-induced delamination, thrust force and hole quality produced when drilling a fully biodegradable flax/poly (lactic acid) composite laminate. Three drills with different geometries and material were used at different drilling conditions to evaluate the machinability of the fabricated composites. The experimental results indicated that the choice of cutting tool, in terms of material and geometry, has a noticeable influence on the cutting thrust force and subsequently drilling-induced damages. The lower value of thrust force and better hole quality was observed using high-speed steel (HSS) drill, whereas Carbide drill (with point angle of 130^o) resulted in the highest value of thrust force. Carbide drill presented higher wear resistance and stability in variation of thrust force with a number of holes drilled, while HSS drill showed the lower value of thrust force during the drilling process. Finally, within the selected cutting range, the delamination damage increased noticeably with feed rate and moderately with spindle speed.

Keywords: natural fiber reinforced composites, delamination, thrust force, machinability

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Authors: Amy Darwin, Claire Blacklock

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Background: Existing literature about delivering evidence-based mental health and psychosocial support (MHPSS) in emergency settings is limited. It is difficult to monitor and evaluate the approach to MHPSS in informal refugee camps such as ‘The Jungle’ in Calais, where there are multiple service providers and where the majority of providers are volunteers. AIM: To identify experiences of MHPSS delivery by service providers in an informal camp environment in Calais, France and describe MHPSS barriers and opportunities in this type of setting. Method: Qualitative semi-structured interviews were conducted with 13 individuals from different organisations offering MHPSS in Calais and analysed using conventional content analysis. Results: Unsafe, uncertain and unsanitary conditions in the camp meant MHPSS was difficult to implement, and such conditions contributed to the poor mental health of the residents. The majority of MHPSS was offered by volunteers who lacked resources and training, and there was no overall official camp leadership which meant care was poorly coordinated and monitored. Strong relationships existed between volunteers and camp residents, but volunteers felt frustrated that they could not deliver the kind of MHPSS that they felt residents required. Conclusion: While long-term volunteers had built supportive relationships with camp residents, lack of central coordination and leadership of MHPSS services and limited access to trained professionals made implementation of MHPSS problematic. Similarly, the camp lacked the necessary infrastructure to meet residents’ basic needs. Formal recognition of the camp, and clear central leadership were identified as necessary steps to improving MHPSS delivery.

Keywords: calais, mental health, refugees, the jungle, MHPSS

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Authors: Ida Ngurah

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Indonesia is one of the most prone disaster countries, which has earthquake, tsunami or high wave, flood and landslide as well as volcano eruption and drought. Disaster risk reduction has been developing extensively and comprehensively, particularly after tsunami hit in 2004. Yet, saving people live including children and youth from disaster risk is still far from succeed. Poor management of environment, poor development of policy and high level of corruption has become challenges for Indonesia to save its people from disaster impact. Indonesia is struggling to ensure its future best investment, children and youth to have better protection when disaster strike in school hours and have basic knowledge on disaster risk reduction. The program of safe school is being initiated and developed by Plan Indonesia since 2010, yet this effort still needs to be elaborated. This paper is reviewing sporadic safe school programs that have been implemented or currently being implemented Plan Indonesia in few areas of Indonesia, including both rural and urban setting. Methods used are in-depth interview with dedicated person for the program from Plan Indonesia and its implementing patners and analysis of project documents. The review includes program’s goal and objectives, implementation activity, result and achievement as well as its monitoring and evaluation scheme. Moreover, paper will be showing challenges, lesson learned and best practices of the program. Eventually, paper will come up with recommendation for strategy for better implementation of safe school program in Indonesia.

Keywords: disaster impact, safe school, programs, children, youth

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Authors: Nathaniel Wanmi, O. M. Samuel, N. Plang, P. O. Brenda

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The wild helmeted guinea fowl has in recent time been used for research in the field of anatomy because of its peculiarity from other domesticated species of avian. Eggs of the wild helmeted guinea fowl are considered to be nutritious and has been used for medicinal purposes in some rural settlements in Nigeria. Eggs of the wild helmeted guinea fowl were purchased from hunters and taken to the National Veterinary Research Institution (NVRI) for incubation. Immediately fresh eggs were purchased, it was kindle using high powered light because of its thick egg shell and only eggs which have not started developing will be incubated and that marks the first day of incubation. On day 3 of incubation, large patches of appears redden on the surface of the egg yolk. These congested sites, develop around portion were future embryo will formed. Blood vessel were first, observed on day 4 of incubation and as days on, as embryo increases in size, blood vessels increase as well. The point of embryo implantation is evident first; by formation of congested areas and most importantly, a single zone of circular red rim. This mark the point of implantation. Blood vessels of the wild helmeted guinea fowl develops from the surface of the egg yolk, which appears initially as small strips of line. Blood vessels connects to the site of embryo implantation on day 3 of incubation. Blood vessel is the first structure to be form prior to the manifestation of the embryo.

Keywords: brain, development, helmeted, incubation

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Authors: Patricia Kopetz

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Too often our youngest children with disabilities receive diagnostic labels and accompanying treatment plans based upon perceptions that the children are of limited aptitude and/or ambition. However, children of varied-ability levels who are diagnosed with ‘multiple disabilities,’ can participate and excel in school-based instruction that aligns with their desires, interests, and fortitude – criteria components not foretold by scores on standardized assessments. The paper represents theoretical work in Special Education Innovative Instruction, and includes presenting research materials, some developed by the author herself. The majority of students with disabilities are now served in general education settings in the United States, embracing inclusive practices in our schools. ‘There is now a stronger call for special education to step up and improve efficiency, implement evidence-based practices, and provide greater accountability on key performance indicators that support successful academic and post-school outcomes for students with disabilities.’ For example, in the United States, the Office of Special Education Programs (OSEP) is focusing on results-driven indicators to improve outcomes for students with disabilities. School personnel are appreciating the implications of research-driven approaches for students diagnosed with multiple disabilities, and aim to align their practices toward such focus. The paper presented will provide updates on current theoretical principles and perspectives, and explore advancements in latest, evidence-based and results-driven instructional practices that can motivate children with multiple disabilities to advance their skills and engage in learning activities that as nonconventional, innovative, and proven successful.

Keywords: childhood special education, educational technology , innovative instruction, multiple disabilities

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Authors: Maria Granados

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Information technology (IT) facilitates the management of knowledge in organisations through the effective leverage of collective experience and knowledge of employees. This supports information processing needs, as well as enables and facilitates sense-making activities of knowledge workers. The study of IT support for knowledge management (KM) has been carried out mainly in larger organisations where resources and competitive conditions can trigger the use of KM. However, there is still a lack of understanding on how IT can support the management of knowledge under different organisational settings influenced by: constant tensions between social and economic objectives, more focus on sustainability than competiveness, limited resources, and high levels of democratic participation and intrinsic motivations among employees. All these conditions are presented in Social Enterprises (SEs), which are normally micro and small businesses that trade to tackle social problems, improve communities, people’s life chances, and the environment. Thus, their importance to society and economies is increasing. However, there is still a need for more understanding of how these organisations operate, perform, innovate and scale-up. This knowledge is crucial to design and provide accurate strategies to enhance the sector and increase its impact and coverage. To obtain a conceptual and empirical understanding of how IT can facilitate KM in the particular organisational conditions of SEs, a quantitative study was conducted with 432 owners and senior members of SEs in UK, underpinned by 21 interviews. The findings demonstrated how IT was supporting more the recovery and storage of necessary information in SEs, and less the collaborative work and communication among enterprise members. However, it was established that SEs were using cloud solutions, web 2.0 tools, Skype and centralised shared servers to manage informally their knowledge. The possible impediments for SEs to support themselves more on IT solutions can be linked mainly to economic and human constraints. These findings elucidate new perspectives that can contribute not only to SEs and SE supporters, but also to other businesses.

Keywords: social enterprises, knowledge management, information technology, collaboration, small firms

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Authors: Hanen Filali, Mohamed Hachicha

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Treated grey water (TGW) reuse emerged as an alternative resource to meet the growing demand for water for agricultural irrigation and reduce the pressure on limited existing fresh water. However, this reuse needs adapted management in order to avoid environmental and health risks. In this work, the treatment of grey water (GW) was studied from a cyclic treatment system that we designed and implemented in the greenhouse of National Research Institute for Rural Engineering, Water and Forests (INRGREF). This system is composed of three levels for treatment (TGW 1, TGW 2, and TGW 3). Each level includes a sandy soil box. The use of grey water was moderated depending on the chemical and microbiological quality obtained. Different samples of soils and treated grey water were performed and analyzed for 14 irrigation cycles. TGW through cyclic treatment showed physicochemical parameters like pH, electrical conductivity (EC), chemical oxygen demand (COD), biological oxygen demand (BOD5) in the range of 7,35-7,91, 1,69-5,03 dS/m, 102,6-54,2 mgO2/l, and 31,33-15,74 mgO2/l, respectively. Results showed a reduction in the pollutant load with a significant effect on the three treatment levels; however, an increase in salinity was observed during all irrigation cycles. Microbiological results showed good grey water treatment with low health risk on irrigated soil. Treated water quality was below permissible Tunisian standards (NT106.03), and treated water is suitable for non-potable options.

Keywords: treated grey water, irrigation, cyclic treatment, soils, physico-chemical parameters, microbiological parameters

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Authors: Emmanuel Iyamuremye

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Extreme rainfall events have caused significant damage to agriculture, ecology, and infrastructure, disruption of human activities, injury, and loss of life. They also have significant social, economic, and environmental consequences because they considerably damage urban as well as rural areas. Early detection of extreme maximum rainfall helps to implement strategies and measures, before they occur, hence mitigating the consequences. Extreme value theory has been used widely in modeling extreme rainfall and in various disciplines, such as financial markets, the insurance industry, failure cases. Climatic extremes have been analyzed by using either generalized extreme value (GEV) or generalized Pareto (GP) distributions, which provides evidence of the importance of modeling extreme rainfall from different regions of the world. In this paper, we focused on Peak Over Thresholds approach, where the Poisson-generalized Pareto distribution is considered as the proper distribution for the study of the exceedances. This research also considers the use of the generalized Pareto (GP) distribution with a Poisson model for arrivals to describe peaks over a threshold. The research used statistical techniques to fit models that used to predict extreme rainfall in Kigali. The results indicate that the proposed Poisson-GP distribution provides a better fit to maximum monthly rainfall data. Further, the Poisson-GP models are able to estimate various return levels. The research also found a slow increase in return levels for maximum monthly rainfall for higher return periods, and further, the intervals are increasingly wider as the return period is increasing.

Keywords: exceedances, extreme value theory, generalized Pareto distribution, Poisson generalized Pareto distribution

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Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi

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Introduction: Identifying sexual health needs, developing appropriate plans, and delivering services to meet those needs is an essential component of health programs for women, men, and children all over the world, especially in poor countries. Main Subject: The aim of this study was to describe the needs of sexual health from the viewpoint of health policymakers in Iran. Methods: A qualitative study using thematic content analysis was designed and conducted. Data gathering was conducted through semi-structured, in-depth interviews with 25 key informants within the healthcare system. Key informants were selected through both purposive and snowball sampling. MAXQUDA software (version 10) was used to facilitate transcription, classification of codes, and conversion of data into meaningful units, by the process of reduction and compression. Results: The analysis of narratives and information categorized sexual health needs into five categories: culturalization of sexual health discourse, sexual health care services, sexual health educational needs, sexual health research needs, and organizational needs. Conclusion: Identifying and explaining sexual health needs is an important factor in determining the priority of sexual health programs and identification of barriers to meet these needs. This can help other policymakers and health planners to develop appropriate programs to promote sexual and reproductive health.

Keywords: sexual health, sexual health needs, policy makers, health system, qualitative study

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: Villiam Ambong, Kevin Banawag, Wynne Shane Bugatan, Mark Alvin Jay Carpio, Hwan Hee Choi, Moises Kevin Chungalao

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This survey research investigated the perception of primary school teachers on the efficacy of MTB-MLE in SLU-LES, Baguio City. SLU-LES has a total of 21 primary school teachers who served as respondents of this study in an attempt to answer the major questions regarding the efficacy of MTB-MLE among primary school teachers. A questionnaire was used in collecting the data which were analyzed using weighted mean and ANOVA. The questionnaire was validated by a statistician and it was administered to a school which does not differ from the intended respondents for further validation of the items. Findings revealed from the intended respondents that they perceive MTB-MLE as effective; however, they do not prefer the use of Mother Tongue as a medium of instruction. A research on the same topic was conducted in Ibadan, Nigeria by Dr. David O. Fakeye and although his respondents were students; the results came out that the respondents do perceive MTB-MLE to be efficacious. The results of this study also showed that years of teaching experience and the number of languages spoken by the teachers have no bearing on the preference of the respondents between MT medium and English medium gave that the respondents are in melting pot community. Comparative studies between rural and urban schools are encouraged. Future researchers should include questions that elicit reasons of the respondents on the efficacy of mother tongue as well as their preference between mother tongue medium and English.

Keywords: mother tongue, primary teachers, perception, multilingual education

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Authors: Nevila Bardhi, Joanna Magda, Kolapo Alex-Oni, Slavenka Sedlar, Paromita Hore

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The New York City Department of Health and Mental Hygiene (NYC DOHMH) receives blood lead test results for NYC residents and conducts lead poisoning case investigations for individuals with elevated blood lead levels exposed to lead occupationally and non-occupationally. To (1) improve participant engagement, (2) aid the identification of potential lead sources, and (3) better tailor recommendations to reduce lead exposure, Motivational Interviewing (MI) techniques were incorporated during risk assessment interviews of non-pregnant adults by DOHMH’s Adult Lead Poisoning Prevention (ALP) Program. MI is an evidence-based counselling method used in clinical settings that have been effective in promoting behavior change by resolving ambivalence and enhancing motivation in treating both physiological and psychological health conditions. The incorporation of MI techniques in the ALP risk assessment interview was effective in improving the identification of lead sources for non-pregnant adult cases, thus, allowing for the opportunity to better tailor lead poisoning prevention recommendations. The embedding of MI cues in the ALP risk assessment interview also significantly increased engagement in the interview process, resulting in approximately 50 more interviews conducted per year and a decrease in interview refusals during case investigations. Additionally, the pre-MI interview completion rate was 57%, while the post-MI Interview completion rate was 68%. We recommend MI techniques to be used by other lead poisoning prevention programs during lead poisoning investigations in similar diverse populations.

Keywords: lead poisoning prevention, motivational interviewing, behavior change, lead poisoning risk factors, self-efficacy

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Authors: Villiam C. Ambong, Kevin G. Banawag, Wynne Shane B. Bugatan, Mark Alvin Jay R. Carpio, Hwan Hee Choi, Moses Kevin L. Chungalao

Abstract:

This survey research investigated the perception of primary school teachers on the efficacy of MTB-MLE in SLU-LES, Baguio City. SLU-LES has a total of 21 primary school teachers who served as the respondents of this study in an attempt to answer three major questions regarding the efficacy of MTB-MLE among primary school teachers. A questionnaire was used in collecting the data which were analyzed using weighted mean and ANOVA. The questionnaire was validated by a statistician and it was administered to a school which does not differ from the intended respondents for further validation of the items. Findings revealed from the intended respondents that they perceive MTB-MLE as effective; however, they do not prefer the use of Mother Tongue as medium of instruction. A research of the same topic was conducted in Ibadan, Nigeria by Dr. David O. Fakeye and although his respondents were students; the results came out that the respondents do perceive MTB-MLE to be efficacious. The results of this study also showed that years of teaching experience and number of languages spoken by the teachers have no bearing on the preference of the respondents between MT medium and English medium given that the respondents are in a melting pot community. Comparative studies between rural schools and urban schools are encouraged. Future researches should include questions that elicit reasons of the respondents on the efficacy of mother tongue as well as their preference between mother tongue medium and English.

Keywords: mother tongue, primary teachers, perception, multilingual education

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Authors: Yee Hooi Min, Abdul Hadi, M. N., A. G. Kay Dora

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Form-finding has to be carried out for tensioned fabric structure in order to determine the initial equilibrium shape under prescribed support condition and pre-stress pattern. Tensioned fabric structures are normally designed to be in the form of equal tensioned surface. Tensioned fabric structure is highly suited to be used for realizing surfaces of complex or new forms. However, research study on a new form as a tensioned fabric structure has not attracted much attention. Another source of inspiration minimal surface which could be adopted as form for tensioned fabric structure is very crucial. The aim of this study is to propose initial equilibrium shape of tensioned fabric structures in the form of Monkey Saddle. Computational form-finding is frequently used to determine the possible form of uniformly stressed surfaces. A tensioned fabric structure must curve equally in opposite directions to give the resulting surface a three dimensional stability. In an anticlastic doubly curved surface, the sum of all positive and all negative curvatures is zero. This study provides an alternative choice for structural designer to consider the Monkey Saddle applied in tensioned fabric structures. The results on factors affecting initial equilibrium shape can serve as a reference for proper selection of surface parameter for achieving a structurally viable surface. Such in-sight will lead to improvement of rural basic infrastructure, economic gains, sustainability of built environment and green technology initiative.

Keywords: anticlastic, curvatures, form-finding, initial equilibrium shape, minimal surface, tensioned fabric structure

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Authors: Priyanka R. Sagar

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Social economic status (SES) is a variable that denotes the social standing of a person in society, and quality of life is a measure of health, happiness, and comfort of an individual. During early 2020, the world was stuck by the blow of the COVID-19 pandemic resulting in minimal or no economic activities to takes place. The present research paper is an attempt to analyze the socioeconomic status and quality of life of construction workers dwelling in the sub-urban areas of Hoskote located in the Bengaluru rural district pre and post-COVID-19. It also tries to analyze the difference in these variables pre and post-COVID-19. The study uses a retrospective design and data collected through a questionnaire survey from the respondents of Hoskote. A total of 100 samples were collected, out of which 73% were men and 27% were women. The mean age group of the participants is 41.04 ± 6.97 years. The overall analysis of the study shows that there is a significant difference in the socioeconomic status of construction workers pre and post-COVID-19. The study shows SES of the workers pre-pandemic is higher than post-pandemic. The other variable is quality of life which consists of physical health, psychological health, social relationships, and environmental domains. The study depicts that the psychological domain alone has been impacted by the pandemic; workers had better mental health pre-COVID-19. The other domains, i.e., physical health, social relationship, and environment, remain unaffected.

Keywords: socio-economic status, quality of life, construction workers, COVID-19

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Authors: Mahera Abdulrahman

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Objective: Healthcare transformation from traditional to modern in the country recently prompted the need to address career choices, accreditation perception and satisfaction among medical residents. However, a concerted nationwide study to understand and address burnout in the medical residency program has not been conducted in the UAE and the region. Methods: A nationwide, multicenter, cross-sectional study was designed to evaluate professional burnout and depression among medical residents in order to address the gap. Results: Our results indicate that 75.5% (216/286) of UAE medical residents had moderate to high emotional exhaustion, 84% (249/298) had high depersonalization, and 74% (216/291) had a low sense of personal accomplishment. In aggregate, 70% (212/302) of medical residents were considered to be experiencing at least one symptom of burnout based on a high emotional exhaustion score or a high depersonalization score. Depression ranging from 6-22%, depending on the specialty was also striking given the fact the Arab culture lays high emphasis on family bonding. Interestingly 83% (40/48) of medical residents who had high scores for depression also reported burnout. Conclusion: Our data indicate that burnout and depression among medical residents is epidemic. There is an immediate need to address burnout through effective interventions at both the individual and institutional levels. It is imperative to reconfigure the approach to medical training for the well-being of the next generation of physicians in the Arab world.

Keywords: mental health, Gulf, Arab, residency training, burnout, depression

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Authors: Valerie Isaak

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Background: This study explores the effectiveness of refresher training sessions of an intervention program at reducing the employees’ risk of injury due to patient violence in a forensic psychiatric hospital. Methods: The original safety intervention program that consisted of a 3 days’ workshop was conducted in the maximum-security ward of a psychiatric hospital in Israel. Ever since the original intervention, annual refreshers were conducted, highlighting one of the safety elements covered in the original intervention. The study examines the effect of the intervention program along with the refreshers over a period of 10 years in four wards. Results: Analysis of the data demonstrates that beyond the initial reduction following the original intervention, refreshers seem to have an additional positive long-term effect, reducing both the number of violent incidents and the number of actual employee injuries in a forensic psychiatric hospital. Conclusions: We conclude that such an intervention program followed by refresher training would promote employees’ wellbeing. A healthy work environment is part of management’s commitment to improving employee wellbeing at the workplace.

Keywords: wellbeing, violence at work, intervention program refreshers, public sector mental healthcare

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Authors: Sally Heyeon Hwang

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Within decision theory, there are normative principles that dictate how one should act in addition to empirical theories of actual behavior. As a normative guide to one’s actual behavior, evidential or causal decision-theoretic equations allow one to identify outcomes with maximal utility values. The choice that each person makes, however, will, of course, differ according to varying assignments of weight and probability values. Regarding these different choices, it remains a subject of considerable philosophical controversy whether individual subjects have the capacity to exercise free will with respect to the assignment of probabilities, or whether instead the assignment is in some way constrained. A version of this question is given a precise form in Richard Jeffrey’s assumption that free will is necessary for Newcomb’s paradox to count as a decision problem. This paper will argue, against Jeffrey, that decision theory does not require the assumption of libertarian freedom. One of the hallmarks of decision-making is its application across a wide variety of contexts; the implications of a background assumption of free will is similarly varied. One constant across the contexts of decision is that there are always at least two levels of choice for a given agent, depending on the degree of prior constraint. Within the context of Newcomb’s problem, when the predictor is attempting to guess the choice the agent will make, he or she is analyzing the determined aspects of the agent such as past characteristics, experiences, and knowledge. On the other hand, as David Lewis’ backtracking argument concerning the relationship between past and present events brings to light, there are similarly varied ways in which the past can actually be dependent on the present. One implication of this argument is that even in deterministic settings, an agent can have more free will than it may seem. This paper will thus argue against the view that a stable background assumption of free will or determinism in decision theory is necessary, arguing instead for a compatibilist decision theory yielding a novel treatment of Newcomb’s problem.

Keywords: decision theory, compatibilism, free will, Newcomb’s problem

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Authors: L. Krpalkova, N. O' Mahony, A. Carvalho, S. Campbell, S. Harapanahalli, J. Walsh

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The objective of this study was to determine the effects of environmental stressors on the performance of lactating dairy cows and discuss some future trends. There exists a relationship between the meteorological data and milk yield prediction accuracy in pasture-based dairy systems. New precision technologies are available and are being developed to improve the sustainability of the dairy industry. Some of these technologies focus on welfare of individual animals on dairy farms. These technologies allow the automatic identification of animal behaviour and health events, greatly increasing overall herd health and yield while reducing animal health inspection demands and long-term animal healthcare costs. The data set consisted of records from 489 dairy cows at two dairy farms and temperature measured from the nearest meteorological weather station in 2018. The effects of temperature on milk production and behaviour of animals were analyzed. The statistical results indicate different effects of temperature on milk yield and behaviour. The “comfort zone” for animals is in the range 10 °C to 20 °C. Dairy cows out of this zone had to decrease or increase their metabolic heat production, and it affected their milk production and behaviour.

Keywords: behavior, milk yield, temperature, precision technologies

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Authors: Pippa Sipanoun, Jo Wray, Kate Oulton, Faith Gibson

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Background: With rapidly evolving digital health innovation, there is a need for digital health transformation that is accessible and sustainable, that demonstrates utility for all stakeholders while maintaining data safety. Great Ormond Street Hospital for Children aimed to future-proof the hospital by transitioning to an electronic patient record (EPR) system with a tethered patient portal (MyGOSH) in April 2019. MyGOSH patient portal enables patients 12 years or older (with their parent's consent) to access their digital health data. This includes access to results, documentation, and appointments that facilitate communication with their care team. As part of the Going Digital Study conducted between 2018-2021, data were collected from a sample of all relevant stakeholders before and after EPR and MyGOSH implementation. Data collection reach was wide and included the hospital legal and ethics teams. Aims: This study aims to understand the ethical and legal implications of young people and their parents accessing their digital health data. Methods: A focus group was conducted. Recruited participants were members of the Great Ormond Street Hospital Paediatric Bioethics Centre. Participants included expert and lay members from the Committee from a variety of professional or academic disciplines. Written informed consent was provided by all participants (n=7). The focus group was recorded, transcribed verbatim, and analyzed using thematic analysis. Results: Six themes were identified: access, competence and capacity - granting access to the system; inequalities in access resulting in inequities; burden, uncertainty and responding to change - managing expectations; documenting, risks and data safety; engagement, empowerment and understanding – how to use and manage personal information; legal considerations and obligations. Discussion: If healthcare professionals are to empower young people to be more engaged in their care, the importance of including them in decisions about their health is paramount, especially when they are approaching the age of becoming the consenter for treatment. Complexities exist in assessing competence or capacity when granting system access, when disclosing sensitive information, and maintaining confidentiality. Difficulties are also present in managing clinician burden, managing user expectations whilst providing an equitable service, and data management that meets professional and legal requirements. Conclusion: EPR and tethered-portal implementation at Great Ormond Street Hospital for Children was not only timely, due to the need for a rapid transition to remote consultations during the COVID-19 pandemic, which would not have been possible had EPR/MyGOSH not been implemented, but also integral to the digital health revolution required in healthcare today. This study is highly relevant in understanding the complexities around young people and their parents accessing their digital health data and, although the focus of this research related to portal use and access, the findings translate to young people in the wider digital health context. Ongoing support is required for all relevant stakeholders following MyGOSH patient portal implementation to navigate the ethical and legal complexities. Continued commitment is needed to balance the benefits and burdens, promote inclusion and equity, and ensure portal utility for patient benefit, whilst maintaining an individualized approach to care.

Keywords: patient portal, young people and their parents, ethical, legal

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Authors: Claire Williams

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Randomised controlled Trials (RCTs) of efficacy are still perceived as the gold standard for the generation of evidence, and whilst advances in data collection methods are well developed, this progress has not been matched for the reporting of adverse events (AEs). Assessment and reporting of AEs in clinical trials are fraught with human error and inefficiency and are extremely time and resource intensive. Recent research conducted into the quality of reporting of AEs during clinical trials concluded it is substandard and reporting is inconsistent. Investigators commonly send reports to sponsors who are incorrectly categorised and lacking in critical information, which can complicate the detection of valid safety signals. In our presentation, we will describe an electronic data capture system, which has been designed to support clinical trial processes by reducing the resource burden on investigators, improving overall trial efficiencies, and making trials safer for patients. This proprietary technology was developed using expertise proven in the delivery of the world’s first prospective, phase 3b real-world trial, ‘The Salford Lung Study, ’ which enabled robust safety monitoring and reporting processes to be accomplished by the remote monitoring of patients’ EHRs. This technology enables safety alerts that are pre-defined by the protocol to be detected from the data extracted directly from the patients EHR. Based on study-specific criteria, which are created from the standard definition of a serious adverse event (SAE) and the safety profile of the medicinal product, the system alerts the investigator or study team to the safety alert. Each safety alert will require a clinical review by the investigator or delegate; examples of the types of alerts include hospital admission, death, hepatotoxicity, neutropenia, and acute renal failure. This is achieved in near real-time; safety alerts can be reviewed along with any additional information available to determine whether they meet the protocol-defined criteria for reporting or withdrawal. This active surveillance technology helps reduce the resource burden of the more traditional methods of AE detection for the investigators and study teams and can help eliminate reporting bias. Integration of multiple healthcare data sources enables much more complete and accurate safety data to be collected as part of a trial and can also provide an opportunity to evaluate a drug’s safety profile long-term, in post-trial follow-up. By utilising this robust and proven method for safety monitoring and reporting, a much higher risk of patient cohorts can be enrolled into trials, thus promoting inclusivity and diversity. Broadening eligibility criteria and adopting more inclusive recruitment practices in the later stages of drug development will increase the ability to understand the medicinal products risk-benefit profile across the patient population that is likely to use the product in clinical practice. Furthermore, this ground-breaking approach to AE detection not only provides sponsors with better-quality safety data for their products, but it reduces the resource burden on the investigator and study teams. With the data taken directly from the source, trial costs are reduced, with minimal data validation required and near real-time reporting enables safety concerns and signals to be detected more quickly than in a traditional RCT.

Keywords: more comprehensive and accurate safety data, near real-time safety alerts, reduced resource burden, safer trials

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Authors: B. Medani Amna, M. A. Elbadwi Samia, E. Amin Ahmed

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Variable plants present in nature are used by simple rural and urban people, researchers and drug manufacturers for medicinal purposes. Garad is one of the most commonly used in Sudan for both treatment and prophylaxis of infections in the respiratory, urinogenital tracts and the skin. Water exctracts from Acacia nilotica bods were used in this very experiment to test for their toxicity to Nubian goats at two dose rates under proper experimental conditions. The clinical, pathological, haematological and biological changes in Nubian goats given daily oral doses of 1 and 5 g/kg body weight of Acacia nilotica to two groups of test goats. The goats of the control group were undosed with Acacia nilotica.Other than the dose co-related mortality rates, the clinical signs were observed to be salivation, staggered gait, intermittent loss of voice and low appetite. On histopathological testing, the main lesions were hepatic centrolobular necrosis and fatty changes associated with the significant changes in GGT and ALP are indicating hepatic dysfunction.Renal malfunction is indicated by haemorrhages in addition to the change in the urea concentration. The congested, haemorrhagic, emphysematous, edematous and cyanotic lungs may contribute to the development of dyspnea. Acacia nilotica poisoning may lead to an immunosuppression pointed out by the lymphocyte infiltration. On evaluation of the above results, Acacia nilotica was considered toxic to Nubian goats at the above mentioned doses. Future work for Acacia nilotica was forwarded and practical implications of the result were highlighted.

Keywords: Acaia nilotica, toxicity data, Nubian goats, Garad

Procedia PDF Downloads 443

Authors: Tahmidul Islam

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Propensity Score Matching (PSM) technique has been widely used for estimating causal effect of treatment in observational studies. One major step of implementing PSM is estimating the propensity score (PS). Logistic regression model with additive linear terms of covariates is most used technique in many studies. Logistics regression model is also used with cubic splines for retaining flexibility in the model. However, choosing the functional form of the logistic regression model has been a question since the effectiveness of PSM depends on how accurately the PS been estimated. In many situations, the linearity assumption of linear logistic regression may not hold and non-linear relation between the logit and the covariates may be appropriate. One can estimate PS using machine learning techniques such as random forest, neural network etc for more accuracy in non-linear situation. In this study, an attempt has been made to compare the efficacy of Generalized Additive Model (GAM) in various linear and non-linear settings and compare its performance with usual logistic regression. GAM is a non-parametric technique where functional form of the covariates can be unspecified and a flexible regression model can be fitted. In this study various simple and complex models have been considered for treatment under several situations (small/large sample, low/high number of treatment units) and examined which method leads to more covariate balance in the matched dataset. It is found that logistic regression model is impressively robust against inclusion quadratic and interaction terms and reduces mean difference in treatment and control set equally efficiently as GAM does. GAM provided no significantly better covariate balance than logistic regression in both simple and complex models. The analysis also suggests that larger proportion of controls than treatment units leads to better balance for both of the methods.

Keywords: accuracy, covariate balances, generalized additive model, logistic regression, non-linearity, propensity score matching

Procedia PDF Downloads 345

Authors: Rajkumar Ghosh

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The Out-of-Sequence Thrust (OOST) is a common phenomenon in collisional tectonic settings like the Himalayas. These OOSTs are activated in different locations at different time frames. These OOST are linked with the multiple Himalayan Thrusts. Apart from minimal documentation in geological mapping for OOST, there exists a lack of field data to establish OOST in the field. This work has considered three thrusts from NW Himalaya in Himachal Pradesh with published data from other sources, allowing a re-examination for correlation of OOST. For the Sutlej section, the approach has been to do fieldwork and microstructural studies. The information related to the cross-cut signature of S/C- and relative time relation could help to predict the nature of OOST. The activation timing, along with the basis of identification of OOST in Higher Himalayan, was documented in various literature. Compilation of the Grain Boundary Migration (GBM) associated temperature range (400–750 °C) was documented from microstructural studies along the Jhakri-Chaura section. No such significant temperature variation across thrusts was observed. Strain variation paths using S Ʌ C angle measurement were carried out along the Jeori-Wangtu transect to distinguish overprinting structures for OOSTs. Near the Chaura Thrust (CT), angular variation of S Ʌ C was documented, and it varies within a range of 15° - 28 °. Along the NH22 (National Highway, 22), all tectonic units of the orogen are exposed in NW Himalaya, INDIA. But there are inherent difficulties in finding field evidence of OOST, largely due to the lack of adequate surface morphology, including topography and drainage pattern.

Keywords: out-of-sequence thrust (OOST), main central thrust (MCT), south tibetan detachment system (STDS), jhakri thrust (JT), sarahan thrust (ST), chaura thrust (CT), higher himalaya (HH), greater himalayan crystalline (GHC)

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Authors: C. F. Jones Couto

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The implementation of quality Physical Education (PE) inspires and instils lasting healthy behavioural patterns, hence have the potential as an educational tool to teach values in today’s society. The goal of PE should be to contribute to the acceptance of the infinite qualities of South Africa’s (RSA) diversity and to claim RSA’s diversity as a source of strength that forms a universal bond of a common set of values. There is a global change in the interaction of children with their environment; their lives are shaped by forces that do not necessarily assist them in learning and applying values. In most countries today, the responsibility for developing values is assigned to schools in formal teaching settings. Values-based education offers an investment in individual and societal improvement through attendance to a values framework. The aim of this qualitative research is to develop a PE programme aligned with the current South African curriculum, enriched with values of Olympism and Ubuntuism, and to present PE teacher training workshops (TTW). Participatory action research will be used as the basis of how data will be collected, analysed, and presented on an ongoing, cyclical basis. PE teachers from different schools in the Tshwane District of RSA will participate as they can best inform the research questions and enhance the understanding of the phenomenon under study. The outcomes of using PE as a tool to teach values can propose recommendations to the Department of Basic Education of RSA to improve and implement a quality PE curriculum that is applicable to practice and that will optimize the chances of meeting the South African National Curriculum Statement standards. A PE programme with the aim of holistic development, based on the values of Olympism and Ubuntuism, can strive to ensure that the values set out in RSA’s constitution are part of PE organization, planning, and teaching at each South African school.

Keywords: olympism, physical education, teacher training, ubuntuism, values-based education

Procedia PDF Downloads 85

Authors: Leah Samples

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Barriers to participation persist for people with disabilities despite a long history of legislation designed to support equal opportunity for people with disabilities. Historically, the focus has been solely placed on structural barriers, but newer research highlights the importance of looking at social and informational barriers to participation. Collectively, these barriers prevent people with disabilities from fully engaging in community life and consequently from achieving full citizenship. Disability is crucial to understanding the meaning of citizenship. Drawing upon the influences of feminist, critical race and human rights theorists, citizenship can be defined as a set of rights and responsibilities that an individual has because they are a part of a community. However, when those rights are taken away or denied one’s citizenship is in question. Employing this definition of citizenship allows one to examine how barriers to citizenship present themselves in societies that are built on an ideal of a non-disabled person. To understand at a deeper level how this notion of citizenship manifests itself, this study seeks to unearth commonly experienced barriers to participation in the lives of visually-impaired adults in everyday environments. The purpose of this qualitative study is to explore commonly-experienced barriers to participation in the lives of visually impaired adults in leisure settings (e.g. restaurants, stores, etc.). Thirty adults with visual impairments participated in semi-structured interviews, as well as participant observations. The results suggest that barriers to participation are still pervasive in everyday environments and subsequently have an adverse effect on participation and belonging for people with visual impairments. This study highlights the importance of exploring and acknowledging the daily tensions that persons with disabilities face in their communities. A full exploration of these tensions is necessary in order to develop solutions and tools to create more just communities for everyone.

Keywords: barriers, citizenship, belonging, everyday environments

Procedia PDF Downloads 394

Authors: Renata Kurpiewska-Korbut

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Making an assumption that the use and sharing of data generated in humanitarian action constitute a core function of humanitarian organizations, the paper analyzes the position of the largest Polish humanitarian non-governmental organizations in the humanitarian data ecosystem in Ukraine and their approach to non-personal and personal data management since February of 2022. Both expert interviews and document analysis of non-profit organizations providing a direct response in the Ukrainian crisis context, i.e., the Polish Humanitarian Action, Caritas, Polish Medical Mission, Polish Red Cross, and the Polish Center for International Aid and the applicability of theoretical perspective of contingency theory – with its central point that the context or specific set of conditions determining the way of behavior and the choice of methods of action – help to examine the significance of data complexity and adaptive approach to data management by relief organizations in the humanitarian supply chain network. The purpose of this study is to determine how the existence of well-established and accurate internal procedures and good practices of using and sharing data (including safeguards for sensitive data) by the surveyed organizations with comparable human and technological capabilities are implemented and adjusted to Ukrainian humanitarian settings and data infrastructure. The study also poses a fundamental question of whether this crisis experience will have a determining effect on their future performance. The obtained finding indicate that Polish humanitarian organizations in Ukraine, which have their own unique code of conduct and effective managerial data practices determined by contingencies, have limited influence on improving the situational awareness of other assistance providers in the data ecosystem despite their attempts to undertake interagency work in the area of data sharing.

Keywords: humanitarian data ecosystem, humanitarian data management, polish NGOs, Ukraine

Procedia PDF Downloads 74