Search results for: two-sided differences
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4320

Search results for: two-sided differences

1710 Critical Factors Influencing Effective Communication Among Stakeholders on Construction Project Delivery in Jigawa State, Nigeria

Authors: Shazali Abdulahi

Abstract:

Project planning is the first phase in project life cycle which relates to the use of schedules such as Gantt charts to plan and subsequently report the project progress within the project environment. Likewise, project execution is the third phase in project lifecycle, is the phase where the work of the project must get done correctly and it’s the longest phase in the project lifecycle therefore, they must be effectively communicated, now today Communication has become the crucial element of every organization. During construction project delivery, information needs to be accurately and timely communicating among project stakeholders in order to realize the project objective. Effective communication among stakeholders during construction project delivery is one of the major factors that impact construction project delivery. Therefore, the aim of the research work is to examine the critical factors influencing effective communication among stakeholders on construction project delivery from the perspective of construction professionals (Architects, Builders, Quantity surveyors, and Civil engineers). A quantitative approach was adopted. This entailed the used of structured questionnaire to one (108) construction professionals in public and private organization within dutse metropolis. Frequency, mean, ranking and multiple linear regression using SPSS vision 25 software were used to analyses the data. The results show that Leadership, Trust, Communication tools, Communication skills, Stakeholders involvement, Cultural differences, and Communication technology were the most critical factors influencing effective communication among stakeholders on construction project delivery. The hypothesis revealed that, effective communication among stakeholders has significant effects on construction project delivery. This research work will profit the construction stakeholders in construction industry, by providing adequate knowledge regarding the factors influencing effective communication among stakeholders, so that necessary steps to be taken to improve project performance. Also, it will provide knowledge about the appropriate strategies to employ in order to improve communication among stakeholders.

Keywords: effetive communication, ineffective communication, stakeholders, project delivery

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1709 Psychological Assessment of Living Kidney Donors: A Systematic Review

Authors: Valentina Colonnello, Paolo Maria Russo

Abstract:

Living kidney donation requires psychological evaluation and ongoing follow-up. A crucial aspect of this evaluation is assessing the social functioning of donors after donation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a review of quantitative and qualitative studies on the psychological assessment of living kidney donors' social functioning. The majority of quantitative studies examining the long-term social health post-donation have primarily utilized the Short Form Health Survey (SF) and the World Health Organization Quality of Life-BREF (WHOQoL-BREF) questionnaires. These studies have indicated that donors' social functioning and relationships either remained stable post-donation or returned to pre-donation levels. In some instances, donors' social functioning even surpassed that of the general population. Qualitative studies, conducted through interviews and focus groups, have revealed donors' experiences and emotional concerns that are often overlooked in quantitative analyses. Specifically, qualitative analysis has identified two main themes: "connecting to others" and "acknowledgment and social support." Our review highlights that the majority of published quantitative studies on donors have employed measures of social functioning that may not fully capture donors' experiences and needs. It underscores the importance of further investigation in quantitative studies to assess donors' actual social health and psychological needs accurately. Overall, this review provides valuable insights into specific constructs that warrant deeper exploration in quantitative studies concerning the assessment of donors' social health and psychological well-being.

Keywords: reported outcomes, personalized medicine, individual differences, emotions, psychological assessment

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1708 Sib-Care and Attachment in Zambia and the Netherlands

Authors: Haatembo Mooya

Abstract:

Cross-culturally, exclusive maternal care of infants is an exception, rather than a rule. In most traditional non-Western societies, child care is shared within the family while in most middle class Western societies parents tend to rely more on ‘hired hands’ for support. In both contexts however, a common caregiver is the sibling. Despite this, the phenomenon of sib-care has remained relatively understudied. Cultural and gender differences in sib-care and attachment were explored using a retrospective survey instrument comparing Zambian and Dutch college students. The total study sample (N = 394) comprised of 200 Zambian students from the University of Zambia and 194 Dutch students from Leiden University, the Netherlands. We tested four main hypotheses. Firstly, we hypothesized that the Zambian subjects performed more sib-care than Dutch subjects. Secondly we hypothesized that female participants performed more sib-care than males participants, both among the Zambian and Dutch subjects, especially when parents are not at home. Thirdly, we hypothesized that larger family size was associated with more sib-care. Finally, we hypothesized that securely attached participants performed more sib-care than their less securely attached peers. Results indicated that sib-care was prevalent in both Zambian and Dutch samples. Zambian subjects performed more sib-care than Dutch subjects, with females performing more sib-care than males, both when parents were at home (F(2, 244) = 62.09, p < .01) and when parents were not at home (F(2, 237) = 51.28, p < .01). We also found that family size and attachment related avoidance and anxiety were not significant predictors of sib-care. It is concluded that sib-care is understudied, not only in Africa but also in Western societies and that females perform more sib-care than males, especially when the parents are not at home. In addition, attachment related avoidance and anxiety appear to be more related to the quality than the quantity of sib-care provided.

Keywords: sibling, sib-care, attachment, Africa, Zambia, the Netherlands

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1707 Callous-Unemotional Traits in Preschoolers: Distinct Associations with Empathy Subcomponents

Authors: E. Stylianopoulou, A. K. Fanti

Abstract:

Object: Children scoring high on Callous-Unemotional traits (CU traits) exhibit lack of empathy. More specifically, children scoring high on CU traits appear to exhibit deficits on affective empathy or deficits in other constructs. However, little is known about cognitive empathy, and it's relation with CU traits in preschoolers. Despite the fact that empathy is measurable at a very young age, relatively less study has focused on empathy in preschoolers than older children with CU traits. The present study examines the cognitive and affective empathy in preschoolers with CU traits. The aim was to examine the differences between cognitive and affective empathy in those individuals. Based on previous research in children with CU traits, it was hypothesized that preschoolers scoring high in CU traits will show deficits in both cognitive and affective empathy; however, more deficits will be detected in affective empathy rather than cognitive empathy. Method: The sample size was 209 children, of which 109 were male, and 100 were female between the ages of 3 and 7 (M=4.73, SD=0.71). From those participants, only 175 completed all the items. The Inventory of Callous-Unemotional traits was used to measure CU traits. Moreover, the Griffith Empathy Measure (GEM) Affective Scale and the Griffith Empathy Measure (GEM) Cognitive Scale was used to measure Affective and Cognitive empathy, respectively. Results: Linear Regression was applied to examine the preceding hypotheses. The results showed that generally, there was a moderate negative association between CU traits and empathy, which was significant. More specifically, it has been found that there was a significant and negative moderate relation between CU traits and cognitive empathy. Surprisingly, results indicated that there was no significant relation between CU traits and affective empathy. Conclusion: The current findings support that preschoolers show deficits in understanding others emotions, indicating a significant association between CU traits and cognitive empathy. However, such a relation was not found between CU traits and affective empathy. The current results raised the importance that there is a need for focusing more on cognitive empathy in preschoolers with CU traits, a component that seems to be underestimated till now.

Keywords: affective empathy, callous-unemotional traits, cognitive empathy, preschoolers

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1706 Wear Resistance and Thermal Stability of Tungsten Boride Layers Deposited by Magnetron Sputtering

Authors: Justyna Chrzanowska, Jacek Hoffman, Dariusz Garbiec, Łukasz Kurpaska, Piotr Denis, Tomasz Moscicki, Zygmunt Szymanski

Abstract:

Tungsten and boron compounds belong to the group of superhard materials and its hardness could exceed 40 GPa. In this study, the properties of the tungsten boride (WB) layers deposited in magnetron sputtering process are investigated. The sputtering process occurred from specially prepared targets that were composed of boron and tungsten mixed in molar ratio of 2.5 or 4.5 and sintered in spark plasma sintering process. WB layers were deposited on silicon (100) and stainless steel 304 substrates at room temperature (RT) or in 570 °C. Layers deposited in RT and in elevated temperature varied considerably. Layers deposited in RT are amorphous and have low adhesion. In contrast, the layers deposited in 570 °C are crystalline and have good adhesion. All deposited layers have a hardness about 40 GPa. Moreover, the friction coefficient of crystalline layers is 0.22 and wear rate is about 0.67•10-6 mm3N-1m-1. After material characterization the WB layers were annealed in argon atmosphere in 1000 °C for 1 hour. On the basis of X-Ray Diffraction analysis, it has been noted that the crystalline layers are thermally stable and do not change their phase composition, whereas the amorphous layers change their phase composition. Moreover, after annealing, on the surface of WB layers some cracks were observed. It is probably connected with the differences of the thermal expansion between the layer and the substrate. Despite of the presence of cracks, the wear resistance of annealed layers is still higher than the wear resistance of uncoated substrate. The analysis of the structure and properties of tungsten boride layers lead to the discussion about the application area of this material.

Keywords: hard coatings, hard materials, magnetron sputtering, mechanical properties, tungsten boride

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1705 A Preliminary Analysis of Sustainable Development in the Belgrade Metropolitan Area

Authors: Slavka Zeković, Miodrag Vujošević, Tamara Maričić

Abstract:

The paper provides a comprehensive analysis of the sustainable development in the Belgrade Metropolitan Region - BMA (level NUTS 2) preliminary evaluating the three chosen components: 1) economic growth and developmental changes; 2) competitiveness; and 3) territorial concentration and industrial specialization. First, we identified the main results of development changes and economic growth by applying Shift-share analysis on the metropolitan level. Second, the empirical evaluation of competitiveness in the BMA is based on the analysis of absolute and relative values of eight indicators by Spider method. Paper shows that the consideration of the national share, industrial mix and metropolitan/regional share in total Shift share of the BMA, as well as economic/functional specialization of the BMA indicate very strong process of deindustrialization. Allocative component of the BMA economic growth has positive value, reflecting the above-average sector productivity compared to the national average. Third, the important positive role of metropolitan/regional component in decomposition of the BMA economic growth is highlighted as one of the key results. Finally, comparative analysis of the industrial territorial concentration in the BMA in relation to Serbia is based on location quotient (LQ) or Balassa index as a valid measure. The results indicate absolute and relative differences in decrease of industry territorial concentration as well as inefficiency of utilizing territorial capital in the BMA. Results are important for the increase of regional competitiveness and territorial distribution in this area as well as for improvement of sustainable metropolitan and sector policies, planning and governance on this level.

Keywords: Belgrade Metropolitan Area (BMA), comprehensive analysis / evaluation, economic growth, competitiveness, sustainable development

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1704 Characteristic Composition and Sensory Contributions of Acidic Aroma in Mainstream Cigarette Smoke of Cherry-Red Tobacco

Authors: Tian Yangyang, Xu Zihe, Lu Junping, Yang Jizhou, Xu Yiqun, Wang Jiansong, Chen Chao, Yang Mengmeng, Guo Jianhua, Mu Wenjun, Wang Guiyao, Xue Chaoqun, Liang Taibo, Hu Liwei

Abstract:

Cherry-red tobacco is receiving constant attention from cigarette enterprises because of its special flavor. This study aims to explore the material basis for the formation of the characteristic flavor of cherry-red tobacco and to clarify the distribution characteristics of the acidic aroma component groups in its mainstream smoke. In order to reach the aims of current study, this study employs GC/MS to examine the differences of distribution characteristics in particulate matter of mainstream cigarette smoke between cherry-red and common tobacco, meanwhile the aroma activity values (OVA) was used to compare the contribution of acidic aroma of cherry-red tobacco. The results showed that: 1) Isovaleric acid, acetic acid and butyric acid were the key acidic components in the mainstream smoke of the samples, followed by 3-methylvaleric acid, 4-methylvaleric acid and n-valeric acid. 2)Analysis of the release of these key sour fragrance components showed that the acidic aroma of "YUN 85" mainstream smoke was stronger than the leaf group, cherry-red tobacco was the weakest. In addition, aging had the effect of reducing the acidic components of cherry-red tobacco and the addition of cherry-red tobacco had little effect on the acidic components of the original leaf group. 3) For 14 acidic aroma(OAV>1) in smoke of cherry-red tobacco, 3-methylpentanoic acid, 4-methylpentanoic acid, pentanoic acid, and isovaleric acid were very prominent in contributing to acidic aroma, while pyruvic acid, 2-methylbutyric acid, hydrogenated acid, and propionic acid were less contribution.

Keywords: cherry-red tobacco, acidic aroma, GC/MS, mainstream cigarette smoke, odor activity value

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1703 The Effects of Parents’ Personality Traits and Family Variables on Aggressive Behavior in Children from the State of Kuwait

Authors: Eisa Al-Balhan

Abstract:

This study explores the effects of parents’ personality and family variables on aggressive behavior in children from the State of Kuwait. The sample of 117children aged between 6 and 10 years (M=7.79 years, SD =1.4 years),117 fathers, and 117mothers from Kuwait. The following tools were used: a) the Aggressive Behavior Scale for Children (ABSC), b) the Personality Scales Inventory (PSI), and c) the Family Climate Scale (FCS). The results show that there were significant differences between children with highly aggressive behavior and those with low aggressive behavior for most of the personality traits of the father and mother, as well as most of the family climate and its different dimensions according to the father’s knowledge and the mother’s knowledge. Furthermore, there was a significant difference between males and females in the total score of aggressive behavior, verbal aggression, physical aggression, self-aggression, and aggression toward others, with higher scores occurring among males. Most of the correlations of the children’s aggressive behavior were with the personality traits of the father. The personality traits of the mother, family climate, and most of its different dimensions according to the father's and mother's knowledge had significant negative correlations with the child's aggression. There was no effect of the mother's and father's education levels on their child’s aggressive behavior. There was a significant difference between normal families and separated families in the total score of aggressive behavior, verbal aggression, and self-aggression, with a higher score occurring among separated families, and there was no significant difference between the two groups in physical aggression and aggression towards others.

Keywords: aggressive behavior, personality traits of parents, family variables, parents

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1702 Utilization of Manila Clam Shells (Venerupis Philippinarum) and Raffia Palm Fiber (Raphia Farinifera) as an Additive in Producing Concrete Roof Tiles

Authors: Sofina Faith C. Navarro, Luke V. Subala, Rica H. Gatus, Alfonzo Ramon DG. Burguete

Abstract:

Roof tiles, as integral components of buildings, play a crucial role in protecting structures from many things. The study focuses on the production of sustainable roof tiles that address the waste disposal challenges associated with Manila clam shells and mitigate the environmental impact of conventional roof tile materials. Various concentrations of roof tiles are developed, incorporating different proportions of powdered clam shell that contains calcium carbonate and shredded raffia palm fiber. Subsequently, the roof tiles are cast using standard methods and transported to the University of the Philippines Institute of Civil Engineering (UP-ICE) for flexural strength testing. In conclusion, the research aimed to assess the flexural durability of concrete roof tiles with varying concentrations of Raffia Palm Fiber and Manila Clam Shells additives. The findings indicate notable differences in maximum load capacities among the specimens, with C3.1 emerging as the concentration with the highest load-bearing capacity at 313.59729 N. This concentration, with a flexural strength of 2.15214, is identified as the most durable option, with a slightly heavier weight of 1.10 kg. On the other hand, C2.2, with a flexural strength of 0.366 and a weight of 0.80 kg, is highlighted for its impressive durability performance while maintaining a lighter composition. Therefore, for the production of concrete roof tile, C3.1 is recommended for optimal durability, while C2.2 is suggested as a preferable option considering both durability and lightweight characteristics.

Keywords: raffia palm fiber, flexural strength, lightweightness, Manila Clam Shells

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1701 Utilization of Manila Clam Shells (Venerupis Philippinarum) and Raffia Palm Fiber (Raphia Farinifera) as an Additive in Producing Concrete Roof Tiles

Authors: Alfonzo Ramon Burguete, Rica Gatus, Sofina Faith Navarro, Luke Subala

Abstract:

Roof tiles, as integral components of buildings, play a crucial role in protecting structures from many things. The study focuses on the production of sustainable roof tiles that address the waste disposal challenges associated with Manila clam shells and mitigate the environmental impact of conventional roof tile materials. Various concentrations of roof tiles are developed, incorporating different proportions of powdered clam shell that contains calcium carbonate and shredded raffia palm fiber. Subsequently, the roof tiles are cast using standard methods and transported to the University of the Philippines Institute of Civil Engineering (UP-ICE) for flexural strength testing. In conclusion, the research aimed to assess the flexural durability of concrete roof tiles with varying concentrations of Raffia Palm Fiber and Manila Clam Shells additives. The findings indicate notable differences in maximum load capacities among the specimens, with C3.1 emerging as the concentration with the highest load-bearing capacity at 313.59729 N. This concentration, with a flexural strength of 2.15214, is identified as the most durable option, with a slightly heavier weight of 1.10 kg. On the other hand, C2.2, with a flexural strength of 0.366 and a weight of 0.80 kg, is highlighted for its impressive durability performance while maintaining a lighter composition. Therefore, for the production of concrete roof tile C3.1 is recommended for optimal durability, while C2.2 is suggested as a preferable option considering both durability and lightweight characteristics.

Keywords: manila clam shells, raffia palm fiber, flexural strength, lightweightness

Procedia PDF Downloads 56
1700 House Facades and Emotions: Exploring the Psychological Impact of Architectural Features

Authors: Nour Tawil, Sandra Weber, Kirsten K. Roessler, Martin Mau, Simone Kuhn

Abstract:

The link between “quality” residential environments and human health and well-being has long been proposed. While the physical properties of a sound environment have been fairly defined, little focus has been given to the psychological impact of architectural elements. Recently, studies have investigated the response to architectural parameters, using measures of physiology, brain activity, and emotion. Results showed different aspects of interest: detailed and open versus blank and closed facades, patterns in perceiving different elements, and a visual bias for capturing faces in buildings. However, in the absence of a consensus on methodologies, the available studies remain unsystematic and face many limitations regarding the underpinning psychological mechanisms. To bridge some of these gaps, an online study was launched to investigate design features that influence the aesthetic judgement and emotional evaluation of house facades, using a well-controlled stimulus set of Canadian houses. A methodical modelling of design features will be performed to extract both high and low level image properties, in addition to segmentation of layout-related features. 300 participants from Canada, Denmark, and Germany will rate the images on twelve psychological dimensions representing appealing aspects of a house. Subjective ratings are expected to correlate with specific architectural elements while controlling for typicality and familiarity, and other individual differences. With the lack of relevant studies, this research aims to identify architectural elements of beneficial qualities that can inform design strategies for optimized residential spaces.

Keywords: architectural elements, emotions, psychological response, residential facades.

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1699 Memorizing Music and Learning Strategies

Authors: Elisabeth Eder

Abstract:

Memorizing music plays an important role for instrumentalists and has been researched very little so far. Almost every musician is confronted with memorizing music in the course of their musical career. For numerous competitions, examinations (e.g., at universities, music schools), solo performances, and the like, memorization is a requirement. Learners are often required to learn a piece by heart but are rarely given guidance on how to proceed. This was also confirmed by Eder's preliminary study to examine the topicality and relevance of the topic, in which 111 instrumentalists took part. The preliminary study revealed a great desire for more knowledge or information about learning strategies as well as a greater sense of security when performing by heart on stage through the use of learning strategies by those musicians who use learning strategies. Eder’s research focuses on learning strategies for memorizing music. As part of a large-scale empirical study – an online questionnaire translated into 10 languages was used to conduct the study – 1091 musicians from 64 different countries described how they memorize. The participants in the study also evaluated their learning strategies and justified their choice in terms of their degree of effectiveness. Based on the study and pedagogical literature, 100 learning strategies were identified and categorized; the strategies were examined with regard to their effectiveness, and instrument-specific, age-specific, country-specific, gender-specific, and education-related differences and similarities concerning the choice of learning strategies were investigated. Her research also deals with forms and models of memory and how music-related information can be stored and retrieved and also forgotten again. A further part is devoted to the possibilities that teachers and learners have to support the process of memorization independently of learning strategies. The findings resulting from Elisabeth Eder's research should enable musicians and instrumental students to memorize faster and more confidently.

Keywords: memorizing music, learning strategies, empirical study, effectiveness of strategies

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1698 Atomic Layer Deposition of Metal Oxides on Si/C Materials for the Improved Cycling Stability of High-Capacity Lithium-Ion Batteries

Authors: Philipp Stehle, Dragoljub Vrankovic, Montaha Anjass

Abstract:

Due to its high availability and extremely high specific capacity, silicon (Si) is the most promising anode material for next generation lithium-ion batteries (LIBs). However, Si anodes are suffering from high volume changes during cycling causing unstable solid-electrolyte interface (SEI). One approach for mitigation of these effects is to embed Si particles into a carbon matrix to create silicon/carbon composites (Si/C). These typically show more stable electrochemical performance than bare silicon materials. Nevertheless, the same failure mechanisms mentioned earlier appear in a less pronounced form. In this work, we further improved the cycling performance of two commercially available Si/C materials by coating thin metal oxide films of different thicknesses on the powders via Atomic Layer Deposition (ALD). The coated powders were analyzed via ICP-OES and AFM measurements. Si/C-graphite anodes with automotive-relevant loadings (~3.5 mAh/cm2) were processed out of the materials and tested in half coin cells (HCCs) and full pouch cells (FPCs). During long-term cycling in FPCs, a significant improvement was observed for some of the ALD-coated materials. After 500 cycles, the capacity retention was already up to 10% higher compared to the pristine materials. Cycling of the FPCs continued until they reached a state of health (SOH) of 80%. By this point, up to the triple number of cycles were achieved by ALD-coated compared to pristine anodes. Post-mortem analysis via various methods was carried out to evaluate the differences in SEI formation and thicknesses.

Keywords: silicon anodes, li-ion batteries, atomic layer deposition, silicon-carbon composites, surface coatings

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1697 Positive Energy Districts in the Swedish Energy System

Authors: Vartan Ahrens Kayayan, Mattias Gustafsson, Erik Dotzauer

Abstract:

The European Union is introducing the positive energy district concept, which has the goal to reduce overall carbon dioxide emissions. Other studies have already mapped the make-up of such districts, and reviewed their definitions and where they are positioned. The Swedish energy system is unique compared to others in Europe, due to the implementation of low-carbon electricity and heat energy sources and high uptake of district heating. The goal for this paper is to start the discussion about how the concept of positive energy districts can best be applied to the Swedish context and meet their mitigation goals. To explore how these differences impact the formation of positive energy districts, two cases were analyzed for their methods and how these integrate into the Swedish energy system: a district in Uppsala with a focus on energy and another in Helsingborg with a focus on climate. The case in Uppsala uses primary energy calculations which can be critisied but take a virtual border that allows for its surrounding system to be considered. The district in Helsingborg has a complex methodology for considering the life cycle emissions of the neighborhood. It is successful in considering the energy balance on a monthly basis, but it can be problematized in terms of creating sub-optimized systems due to setting tight geographical constraints. The discussion of shaping the definitions and methodologies for positive energy districts is taking place in Europe and Sweden. We identify three pitfalls that must be avoided so that positive energy districts meet their mitigation goals in the Swedish context. The goal of pushing out fossil fuels is not relevant in the current energy system, the mismatch between summer electricity production and winter energy demands should be addressed, and further implementations should consider collaboration with the established district heating grid.

Keywords: positive energy districts, energy system, renewable energy, European Union

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1696 Neuroecological Approach for Anthropological Studies in Archaeology

Authors: Kalangi Rodrigo

Abstract:

The term Neuroecology elucidates the study of customizable variation in cognition and the brain. Subject marked the birth since 1980s, when researches began to apply methods of comparative evolutionary biology to cognitive processes and the underlying neural mechanisms of cognition. In Archaeology and Anthropology, we observe behaviors such as social learning skills, innovative feeding and foraging, tool use and social manipulation to determine the cognitive processes of ancient mankind. Depending on the brainstem size was used as a control variable, and phylogeny was controlled using independent contrasts. Both disciplines need to enriched with comparative literature and neurological experimental, behavioral studies among tribal peoples as well as primate groups which will lead the research to a potential end. Neuroecology examines the relations between ecological selection pressure and mankind or sex differences in cognition and the brain. The goal of neuroecology is to understand how natural law acts on perception and its neural apparatus. Furthermore, neuroecology will eventually lead both principal disciplines to Ethology, where human behaviors and social management studies from a biological perspective. It can be either ethnoarchaeological or prehistoric. Archaeology should adopt general approach of neuroecology, phylogenetic comparative methods can be used in the field, and new findings on the cognitive mechanisms and brain structures involved mating systems, social organization, communication and foraging. The contribution of neuroecology to archaeology and anthropology is the information it provides on the selective pressures that have influenced the evolution of cognition and brain structure of the mankind. It will shed a new light to the path of evolutionary studies including behavioral ecology, primate archaeology and cognitive archaeology.

Keywords: Neuroecology, Archaeology, Brain Evolution, Cognitive Archaeology

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1695 Evaluating the Effectiveness of Combined Psychiatric and Psychotherapeutic Care versus Psychotherapy Alone in the Treatment of Depression and Anxiety in Cancer Patients

Authors: Nathen A. Spitz, Dennis Martin Kivlighan III, Arwa Aburizik

Abstract:

Background and Purpose: Presently, there is a paucity of naturalistic studies that directly compare the effectiveness of psychotherapy versus concurrent psychotherapy and psychiatric care for the treatment of depression and anxiety in cancer patients. Informed by previous clinical trials examining the efficacy of concurrent approaches, this study sought to test the hypothesis that a combined approach would result in the greatest reduction of depression and anxiety symptoms. Methods: Data for this study consisted of 433 adult cancer patients, with 252 receiving only psychotherapy and 181 receiving concurrent psychotherapy and psychiatric care at the University of Iowa Hospitals and Clinics. Longitudinal PHQ9 and GAD7 data were analyzed between both groups using latent growth curve analyses. Results: After controlling for treatment length and provider effects, results indicated that concurrent care was more effective than psychotherapy alone for depressive symptoms (γ₁₂ = -0.12, p = .037). Specifically, the simple slope for concurrent care was -0.25 (p = .022), and the simple slope for psychotherapy alone was -0.13 (p = .006), suggesting that patients receiving concurrent care experienced a greater reduction in depressive symptoms compared to patients receiving psychotherapy alone. In contrast, there were no significant differences between psychotherapy alone and concurrent psychotherapy and psychiatric care in the reduction of anxious symptoms. Conclusions: Overall, as both psychotherapy and psychiatric care may address unique aspects of mental health conditions, in addition to potentially providing synergetic support to each other, a combinatorial approach to mental healthcare for cancer patients may improve outcomes.

Keywords: psychiatry, psychology, psycho-oncology, combined care, psychotherapy, behavioral psychology

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1694 Relationship Between Muscle Mass and Insulin Resistance in Cirrhotic Patients with Hepatitis B

Authors: Eyüp S. Akbas, Betul Ayaz, Beyza S. Haksever, Sema Basat

Abstract:

We aimed to evaluate the relationship between insulin resistance, muscle mass and muscle strength in patients with Hepatitis B virus-related cirrhosis. In our study, there were 65 patients with hepatitis B virus-related cirrhosis in Child A and B group and 65 healthy control individual. Control group was chosen between patients who admitted to the internal medicine clinic and had no pathological values in a routine examination. Muscle mass index was calculated with bioimpedance analysis for both groups to determine muscle strength and muscle mass. Handgrip strength, arm, and calf circumference were measured. In both groups, HOMA-IR was calculated to determine insulin resistance. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) value was detected 3,47±3,80 in the study group and 1,83±1,20 in control group. There were significant differences between the two groups in arm circumference, fasting insulin, fasting glucose, HOMA-IR, High-density lipoprotein (HDL) and total cholesterol parameters. The correlation coefficient between muscle mass and insulin resistance was statistically insignificant, especially in the study group. In healthy individuals group and all the groups, there wasn’t a correlation between muscle mass and insulin resistance. The upper limit for HOMA-IR was determined as 3,2. In control group, %78,9 of individuals were in HOMA-IR ( < 3.2) group and %21,1 of them were in ( ≥ 3,2) group. In study group, %68,3 of individuals were in HOMA-IR ( < 3,2) group and %31.7 were in HOMA-IR ( ≥ 3,2) group. In our study, we did not find a relationship between muscle mass and insulin resistance in patients with liver cirrhosis. In the study group, we detected a positive relationship between muscle mass, handgrip strength, and calf circumference. We did not find a relationship between insulin resistance and handgrip strength in our study.

Keywords: cirrhosis, hepatitis B, Insulin resistance, muscle mass

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1693 Psychological Nano-Therapy: A New Method in Family Therapy

Authors: Siamak Samani, Nadereh Sohrabi

Abstract:

Psychological nano-therapy is a new method based on systems theory. According to the theory, systems with severe dysfunctions are resistant to changes. Psychological nano-therapy helps the therapists to break this ice. Two key concepts in psychological nano-therapy are nano-functions and nano-behaviors. The most important step in psychological nano-therapy in family therapy is selecting the most effective nano-function and nano-behavior. The aim of this study was to check the effectiveness of psychological nano-therapy for family therapy. One group pre-test-post-test design (quasi-experimental Design) was applied for research. The sample consisted of ten families with severe marital conflict. The important character of these families was resistance for participating in family therapy. In this study, sending respectful (nano-function) text massages (nano-behavior) with cell phone were applied as a treatment. Cohesion/respect sub scale from self-report family processes scale and family readiness for therapy scale were used to assess all family members in pre-test and post-test. In this study, one of family members was asked to send a respectful text massage to other family members every day for a week. The content of the text massages were selected and checked by therapist. To compare the scores of families in pre-test and post-test paired sample t-test was used. The results of the test showed significant differences in both cohesion/respect score and family readiness for therapy between per-test and post-test. The results revealed that these families have found a better atmosphere for participation in a complete family therapy program. Indeed, this study showed that psychological nano-therapy is an effective method to make family readiness for therapy.

Keywords: family therapy, family conflicts, nano-therapy, family readiness

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1692 Effects of Intracerebroventricular Injection of Spexin and Its Interaction with Nitric Oxide, Serotonin, and Corticotropin Receptors on Central Food Intake Regulation in Chicken

Authors: Mohaya Farzin, Shahin Hassanpour, Morteza Zendehdel, Bita Vazir, Ahmad Asghari

Abstract:

Aim: There are several differences between birds and mammals in terms of food intake regulation. Therefore, this study aimed to investigate the effects of the intracerebroventricular (ICV) injection of spexin and its interaction with nitric oxide, serotonin, and corticotropin receptors on central food intake regulation in broiler chickens. Materials and Methods: In experiment 1, chickens received ICV injection of saline, PCPA (p-chlorophenyl alanine,1.25 µg), spexin, and PCPA+spexin. In experiments 2-7, 8-OH-DPAT (5-HT1A agonist, 15.25 nmol), SB-242084 (5-HT2C receptor antagonist, 1.5µg), L-arginine (Precursor of nitric oxide, 200 nmol), L-NAME (nitric oxide synthetase inhibitor, 100 nmol), Astressin-B (CRF1/CRF2 receptor antagonist, 30 µg) and Astressin2-B (CRF2 receptor antagonist, 30 µg) were injected to chickens instead of the PCPA. Then, food intake was measured until 120 minutes after the injection. Results: Spexin significantly decreased food consumption (P<0.05). Concomitant injection of SB-242084+spexin attenuated spexin-induced hypophagia (P<0.05). Co-injection of L-arginine+spexin enhanced spexin-induced hypophagia, and this effect was reversed by L-NAME (P<0.05). Also, concomitant injection of Astressin-B + spexin or Astressin2-B + spexin enhanced spexin-induced hypophagia (P<0.05). Conclusions: Based on these observations, spexin-induced hypophagia may be mediated by nitric oxide and 5-HT2C, CRF1, and CRF2 receptors in neonatal broiler chickens.

Keywords: spexin, serotonin, corticotropin, nitric oxide, food intake, chicken

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1691 Body Mass Components in Young Soccer Players

Authors: Elizabeta Sivevska, Sunchica Petrovska, Vaska Antevska, Lidija Todorovska, Sanja Manchevska, Beti Dejanova, Ivanka Karagjozova, Jasmina Pluncevic Gligoroska

Abstract:

Introduction: Body composition plays an important role in the selection of young soccer players and it is associated with their successful performance. The most commonly used model of body composition divides the body into two compartments: fat components and fat-free mass (muscular and bone components). The aims of the study were to determine the body composition parameters of young male soccer players and to show the differences in age groups. Material and methods: A sample of 52 young male soccer players, with an age span from 9 to 14 years were divided into two groups according to the age (group 1 aged 9 to 12 years and group 2 aged 12 to 14 years). Anthropometric measurements were taken according to the method of Mateigka. The following measurements were made: body weight, body height, circumferences (arm, forearm, thigh and calf), diameters (elbow, knee, wrist, ankle) and skinfold thickness (biceps, triceps, thigh, leg, chest, abdomen). The measurements were used in Mateigka’s equations. Results: Body mass components were analyzed as absolute values (in kilograms) and as percentage values: the muscular component (MC kg and MC%), the bone component (BCkg and BC%) and the body fat (BFkg and BF%). The group up to 12 years showed the following mean values of the analyzed parameters: MM=21.5kg; MM%=46.3%; BC=8.1kg; BC%=19.1%; BF= 6.3kg; BF%= 15.7%. The second group aged 12-14 year had mean values of body composition parameters as follows: MM=25.6 kg; MM%=48.2%; BC = 11.4 kg; BC%=21.6%; BF= 8.5 kg; BF%= 14. 7%. Conclusions: The young soccer players aged 12 up to 14 years who are in the pre-pubertal phase of growth and development had higher bone component (p<0.05) compared to younger players. There is no significant difference in muscular and fat body component between the two groups of young soccer players.

Keywords: body composition, young soccer players, body fat, fat-free mass

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1690 Poverty Eradication Program in Malaysia

Authors: Ibrahim Mamat, Wan Mohd Zaifurin Wan Nawang

Abstract:

Malaysia's poverty eradication program is a long-term plan that was initially implemented by the government after the riots of the races on May 13, 1969. The incident broke out due to the huge economic gap between the majority of Malaysians,Malays and non-Malays minorities. As a result of the event, the government drafted the New Economic Policy(NEP) in 1970 to reduce the differences in economic status among races in Malaysia. At the end of this policy period (NEP) in 1990, the incidence of poverty in Malaysia was around 6.5 per cent. The incidence of poverty in Malaysia continued to decline to 0.6 per cent (2014) through some other policy after the NEP. The decline in poverty has been the result of the government's efforts to implement the New Economic Policy (1970-1990), National Development Policy (1991-2000), NationalVision Policy (2001-2010), and National Transformation Policy (2011-2020).This article also explains the meaning, concepts and measurements of poverty in order to identify the Poverty Level and measure the Poverty Index using various dimensions. This explanation is very important for a country like Malaysia who has some people living below the poverty line. In such a context, an effective poverty eradication policy can benefit the poor.Consequently, this article examines the continuing involvement of the government and non-governmental organizations through the empowerment program of the hardcore poor to change their lifestyle and culture as well as the vicious circle of poverty is indispensable to ensure that poverty eradication programs are in line with current economic and social changes. In addition, the involvement of non-governmental organizations and the State Islamic Religious Council to provide assistance to the poor is appropriate as the institution has its own distinctive interpretation of poverty to determine the type of assistance, criteria and so on to enable the rights of the poor to be ensured and protected.

Keywords: economic policy, poor, poverty eradication, poverty program

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1689 Commercial Management vs. Quantity Surveying: Hoax or Harmonization

Authors: Zelda Jansen Van Rensburg

Abstract:

Purpose: This study investigates the perceived disparities between Quantity Surveying and Commercial Management in the construction industry, questioning if these differences are substantive or merely semantic. It aims to challenge the conventional notion of Commercial Managers’ superiority by critically evaluating QS and CM roles, exploring CM integration possibilities, examining qualifications for aspiring Commercial Managers, assessing regulatory frameworks, and considering terminology redefinition for global QS professional enhancement. Design: Utilizing mixed methods like literature reviews, surveys, interviews, and document analyses, this research examines the QS-CM relationship. Insights from industry professionals, academics, and regulatory bodies inform the investigation into changing QS roles. Findings: Empirical data highlight evolving roles, showcasing areas of convergence and divergence between QSs and CM. Potential CM integration into QS practice and qualifications for aspiring Commercial Managers are identified. Limitations/Implications: Limitations include potential bias in self-reported data and findings. Nevertheless, the research informs future practices and educational approaches in QS and CM, reflecting the changing roles and responsibilities of Quantity Surveyors. Practical Implications: Findings inform industry practitioners, educators, and regulators, stressing the need to adapt to changing QS roles and integrate CM principles where applicable. Value to the Conference Theme: Aligned with ‘Evolving roles and responsibilities of Quantity Surveyors,’ this research offers insights crucial for understanding the changing dynamics within the QS profession and informs strategies to navigate these shifts effectively.

Keywords: quantity surveying, commercial management, cost engineering, quantity survey

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1688 Kinetic Study of Physical Quality Changes on Jumbo Squid (Dosidicus gigas) Slices during Application High-Pressure Impregnation

Authors: Mario Perez-Won, Roberto Lemus-Mondaca, Fernanda Marin, Constanza Olivares

Abstract:

This study presents the simultaneous application of high hydrostatic pressure (HHP) and osmotic dehydration of jumbo squid (Dosidicus gigas) slice. Diffusion coefficients for both components water and solids were improved by the process pressure, being influenced by pressure level. The working conditions were different pressures such as 100, 250, 400 MPa and pressure atmospheric (0.1 MPa) for time intervals from 30 to 300 seconds and a 15% NaCl concentration. The mathematical expressions used for mass transfer simulations both water and salt were those corresponding to Newton, Henderson and Pabis, Page and Weibull models, where the Weibull and Henderson-Pabis models presented the best fitted to the water and salt experimental data, respectively. The values for water diffusivity coefficients varied from 1.62 to 8.10x10⁻⁹ m²/s whereas that for salt varied among 14.18 to 36.07x10⁻⁹ m²/s for selected conditions. Finally, as to quality parameters studied under the range of experimental conditions studied, the treatment at 250 MPa yielded on the samples a minimum hardness, whereas springiness, cohesiveness and chewiness at 100, 250 and 400 MPa treatments presented statistical differences regarding to unpressurized samples. The colour parameters L* (lightness) increased, however, but b* (yellowish) and a* (reddish) parameters decreased when increasing pressure level. This way, samples presented a brighter aspect and a mildly cooked appearance. The results presented in this study can support the enormous potential of hydrostatic pressure application as a technique important for compounds impregnation under high pressure.

Keywords: colour, diffusivity, high pressure, jumbo squid, modelling, texture

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1687 The Yak of Thailand: Folk Icons Transcending Culture, Religion, and Media

Authors: David M. Lucas, Charles W. Jarrett

Abstract:

In the culture of Thailand, the Yak serve as a mediated icon representing strength, power, and mystical protection not only for the Buddha, but for population of worshipers. Originating from the forests of China, the Yak continue to stand guard at the gates of Buddhist temples. The Yak represents Thai culture in the hearts of Thai people. This paper presents a qualitative study regarding the curious mix of media, culture, and religion that projects the Yak of Thailand as a larger than life message throughout the political, cultural, and religious spheres. The gate guardians, or gods as they are sometimes called, appear throughout the religious temples of Asian cultures. However, the Asian cultures demonstrate differences in artistic renditions (or presentations) of such sentinels. Thailand gate guards (the Yak) stand in front of many Buddhist temples, and these iconic figures display unique features with varied symbolic significance. The temple (or wat), plays a vital role in every community; and, for many people, Thailand’s temples are the country’s most endearing sights. The authors applied folk-nography as a methodology to illustrate the importance of the Thai Yak in serving as meaningful icons that transcend not only time, but the culture, religion, and mass media. The Yak represent mythical, religious, artistic, cultural, and militaristic significance for the Thai people. Data collection included interviews, focus groups, and natural observations. This paper summarizes the perceptions of the Thai people concerning their gate sentries and the relationship, communication, connection, and the enduring respect that Thai people hold for their guardians of the gates.

Keywords: communication, culture, folknography, icon, image, media, protection, religion, yak

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1686 Body Composition Response to Lower Body Positive Pressure Training in Obese Children

Authors: Basant H. El-Refay, Nabeel T. Faiad

Abstract:

Background: The high prevalence of obesity in Egypt has a great impact on the health care system, economic and social situation. Evidence suggests that even a moderate amount of weight loss can be useful. Aim of the study: To analyze the effects of lower body positive pressure supported treadmill training, conducted with hypocaloric diet, on body composition of obese children. Methods: Thirty children aged between 8 and 14 years, were randomly assigned into two groups: intervention group (15 children) and control group (15 children). All of them were evaluated using body composition analysis through bioelectric impedance. The following parameters were measured before and after the intervention: body mass, body fat mass, muscle mass, body mass index (BMI), percentage of body fat and basal metabolic rate (BMR). The study group exercised with antigravity treadmill three times a week during 2 months, and participated in a hypocaloric diet program. The control group participated in a hypocaloric diet program only. Results: Both groups showed significant reduction in body mass, body fat mass and BMI. Only study group showed significant reduction in percentage of body fat (p = 0.0.043). Changes in muscle mass and BMR didn't reach statistical significance in both groups. No significant differences were observed between groups except for muscle mass (p = 0.049) and BMR (p = 0.042) favoring study group. Conclusion: Both programs proved effective in the reduction of obesity indicators, but lower body positive pressure supported treadmill training was more effective in improving muscle mass and BMR.

Keywords: children, hypocaloric diet, lower body positive pressure supported treadmill, obesity

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1685 Forest Soil Greenhouse Gas Real-Time Analysis Using Quadrupole Mass Spectrometry

Authors: Timothy L. Porter, T. Randy Dillingham

Abstract:

Vegetation growth and decomposition, along with soil microbial activity play a complex role in the production of greenhouse gases originating in forest soils. The absorption or emission (respiration) of these gases is a function of many factors relating to the soils themselves, the plants, and the environment in which the plants are growing. For this study, we have constructed a battery-powered, portable field mass spectrometer for use in analyzing gases in the soils surrounding trees, plants, and other areas. We have used the instrument to sample in real-time the greenhouse gases carbon dioxide and methane in soils where plant life may be contributing to the production of gases such as methane. Gases such as isoprene, which may help correlate gas respiration to microbial activity have also been measured. The instrument is composed of a quadrupole mass spectrometer with part per billion or better sensitivity, coupled to battery-powered turbo and diaphragm pumps. A unique ambient air pressure differentially pumped intake apparatus allows for the real-time sampling of gases in the soils from the surface to several inches below the surface. Results show that this instrument is capable of instant, part-per-billion sensitivity measurement of carbon dioxide and methane in the near surface region of various forest soils. We have measured differences in soil respiration resulting from forest thinning, forest burning, and forest logging as compared to pristine, untouched forests. Further studies will include measurements of greenhouse gas respiration as a function of temperature, microbial activity as measured by isoprene production, and forest restoration after fire.

Keywords: forest, soil, greenhouse, quadrupole

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1684 Quality Analysis of Lake Malawi's Diplotaxodon Fish Species Processed in Solar Tent Dryer versus Open Sun Drying

Authors: James Banda, Jupiter Simbeye, Essau Chisale, Geoffrey Kanyerere, Kings Kamtambe

Abstract:

Improved solar tent dryers for processing small fish species were designed to reduce post-harvest fish losses and improve supply of quality fish products in the southern part of Lake Malawi under CultiAF project. A comparative analysis of the quality of Diplotaxodon (Ndunduma) from Lake Malawi processed in solar tent dryer and open sun drying was conducted using proximate analysis, microbial analysis and sensory evaluation. Proximates for solar tent dried fish and open sun dried fish in terms of proteins, fats, moisture and ash were 63.3±0.15% and 63.3±0.34%, 19.6±0.09% and 19.9±0.25%, 8.3±0.12% and 17.0±0.01%, and 15.6±0.61% and 21.9±0.91% respectively. Crude protein and crude fat showed non-significant differences (p = 0.05), while moisture and ash content were significantly different (p = 001). Open sun dried fish had significantly higher numbers of viable bacteria counts (5.2×10⁶ CFU) than solar tent dried fish (3.9×10² CFU). Most isolated bacteria from solar tent dried and open sun dried fish were 1.0×10¹ and 7.2×10³ for Total coliform, 0 and 4.5 × 10³ for Escherishia coli, 0 and 7.5 × 10³ for Salmonella, 0 and 5.7×10² for shigella, 4.0×10¹ and 6.1×10³ for Staphylococcus, 1.0×10¹ and 7.0×10² for vibrio. Qualitative evaluation of sensory properties showed higher acceptability of 3.8 for solar tent dried fish than 1.7 for open sun dried fish. It is concluded that promotion of solar tent drying in processing small fish species in Malawi would support small-scale fish processors to produce quality fish in terms of nutritive value, reduced microbial contamination, sensory acceptability and reduced moisture content.

Keywords: diplotaxodon, Malawi, open sun drying, solar tent drying

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1683 An Evaluative Study of Services Provided in Community Based Rehabilitation Centres in Jordan

Authors: Wesam Darawsheh

Abstract:

Purpose: There is an absence of studies directed to evaluate the effectiveness of Community Based Rehabilitation (CBR) programs in Jordan. This research study is aimed at investigating the effectiveness of the services of CBR programmes in Jordan. Method: A questionnaire anonymized survey was carried out with forty-seven participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised eighteen questions that collected both qualitative and quantitative data with both closed- and open-ended questions. The survey assessed participants’ knowledge of CBR and perception of the effectiveness of services provided. The quantitative data were analyzed using SPSS Version 22.0 (2016, IBM Corporation New York). Qualitative data were analyzed through thematic content and analysis and open coding to identify emergent themes. Results: The ROC curve revealed that the AUC for questions of the survey to be (AUC=0.846) which indicated a good specificity and sensitivity of the questions of the survey. The MANOVA revealed insignificant results in the effect of the CBR site (p= 0.157), and the level of education of participants (p=0.549), on the perception of the effectiveness of CBR services. There were insignificant differences between the scores of PWDs and volunteers (p=0.781). 40.4% evaluated the effectiveness of CBR services to be low. This mainly stemmed out from the lack of efforts of the CBR programmes to raise the knowledge of the local community about CBR, disability and the role toward PWDs. Conclusions: A speculation for priorities of CBR programmes in Jordan was offered where efforts need to be directed at promoting livelihood and the empowerment components, in order to actualize the main three principles of CBR mainly by promoting multispectral collaboration as a way of operation.

Keywords: community based rehabilitation (CBR), people with disabilities (PWDS), CBR centres, rehabilitation services, Jordan, mixed-methods, evaluative study

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1682 Water Resources Green Efficiency in China: Evaluation, Spatial Association Network Structure Analysis, and Influencing Factors

Authors: Tingyu Zhang

Abstract:

This paper utilizes the Super-SBM model to assess water resources green efficiency (WRGE) among provinces in China and investigate its spatial and temporal features, based on the characteristic framework of “economy-environment-society.” The social network analysis is employed to examine the network pattern and spatial interaction of WRGE. Further, the quadratic assignment procedure method is utilized for examining the influencing factors of the spatial association of WRGE regarding “relationship.” The study reveals that: (1) the spatial distribution of WRGE demonstrates a distribution pattern of Eastern>Western>Central; (2) a remarkable spatial association exists among provinces; however, no strict hierarchical structure is observed. The internal structure of the WRGE network is characterized by the feature of "Eastern strong and Western weak". The block model analysis discovers that the members of the “net spillover” and “two-way spillover” blocks are mostly in the eastern and central provinces; “broker” block, which plays an intermediary role, is mostly in the central provinces; and members of the “net beneficiary” block are mostly in the western region. (3) Differences in economic development, degree of urbanization, water use environment, and water management have significant impacts on the spatial connection of WRGE. This study is dedicated to the realization of regional linkages and synergistic enhancement of WRGE, which provides a meaningful basis for building a harmonious society of human and water coexistence.

Keywords: water resources green efficiency, super-SBM model, social network analysis, quadratic assignment procedure

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1681 Influence of Loudness Compression on Hearing with Bone Anchored Hearing Implants

Authors: Anja Kurz, Marc Flynn, Tobias Good, Marco Caversaccio, Martin Kompis

Abstract:

Bone Anchored Hearing Implants (BAHI) are routinely used in patients with conductive or mixed hearing loss, e.g. if conventional air conduction hearing aids cannot be used. New sound processors and new fitting software now allow the adjustment of parameters such as loudness compression ratios or maximum power output separately. Today it is unclear, how the choice of these parameters influences aided speech understanding in BAHI users. In this prospective experimental study, the effect of varying the compression ratio and lowering the maximum power output in a BAHI were investigated. Twelve experienced adult subjects with a mixed hearing loss participated in this study. Four different compression ratios (1.0; 1.3; 1.6; 2.0) were tested along with two different maximum power output settings, resulting in a total of eight different programs. Each participant tested each program during two weeks. A blinded Latin square design was used to minimize bias. For each of the eight programs, speech understanding in quiet and in noise was assessed. For speech in quiet, the Freiburg number test and the Freiburg monosyllabic word test at 50, 65, and 80 dB SPL were used. For speech in noise, the Oldenburg sentence test was administered. Speech understanding in quiet and in noise was improved significantly in the aided condition in any program, when compared to the unaided condition. However, no significant differences were found between any of the eight programs. In contrast, on a subjective level there was a significant preference for medium compression ratios of 1.3 to 1.6 and higher maximum power output.

Keywords: Bone Anchored Hearing Implant, baha, compression, maximum power output, speech understanding

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