Search results for: epistemological access

Authors: Susanne Ferschl, Peter Holzmüller, Elisabeth Wacker

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Ageing populations, advances in medical sciences and digitalization, diversity and social disparities, as well as the increasing need for skilled healthcare professionals, are challenging healthcare systems around the globe. To address these challenges, future healthcare systems need to center on human needs taking into account the living environments that shape individuals’ knowledge of and opportunities to access healthcare. Moreover, health should be considered as a common good and an integral part of securing livelihoods for all people. Therefore, the adoption of a systems approach, as well as inter-disciplinary and inter-sectoral cooperation among healthcare providers, are essential. Additionally, the active engagement of target groups in the planning and design of healthcare structures is indispensable to understand and respect individuals’ health and livelihood needs. We will present the research project b4 – identifying needs | building bridges | developing health care in the social space, which is situated within this reasoning and accompanies the cross-sectoral cooperation project Brückenschlag (building bridges) in a Bavarian district. Brückenschlag seeks to explore effective ways of health care linking university medicine (Maximalversorgung | maximum care) with regional inpatient, outpatient, rehabilitative, and preventive care structures (Regionalversorgung | regional care). To create advantages for both (potential) patients and the involved cooperation partners, project b4 qualitatively assesses needs and motivations among professionals, population groups, and political stakeholders at individual and collective levels. Besides providing an overview of the project structure as well as of regional population and healthcare characteristics, the first results of qualitative interviews conducted with different health experts will be presented. Interviewed experts include managers of participating hospitals, nurses, medical specialists working in the hospital and registered doctors operating in practices in rural areas. At the end of the project life and based on the identified factors relevant to the success -and also for failure- of participatory cooperation in health care, the project aims at informing other districts embarking on similar systems-oriented and human-centered healthcare projects. Individuals’ health care needs in dependence on the social space in which they live will guide the development of recommendations.

Keywords: cross-sectoral collaboration in health care, human-centered health care, regional health care, individual and structural health conditions

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Authors: Inga Žukovaitė

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This work aims to present postdoc research on remote criminal proceedings in court in order to streamline the proceedings and, at the same time, ensure the effective participation of the parties in criminal proceedings and the court's obligation to administer substantive and procedural justice. This study tests the hypothesis that remote criminal proceedings do not in themselves violate the fundamental principles of criminal procedure; however, their implementation must ensure the right of the parties to effective legal remedies and a fair trial and, only then, must address the issues of procedural economy, speed and flexibility/functionality of the application of technologies. In order to ensure that changes in the regulation of criminal proceedings are in line with fair trial standards, this research will provide answers to the questions of what conditions -first of all, legal and only then organisational- are required for remote criminal proceedings to ensure respect for the parties and enable their effective participation in public proceedings, to create conditions for quality legal defence and its accessibility, to give a correct impression to the party that they are heard and that the court is impartial and fair. It also seeks to present the results of empirical research in the courts of Lithuania that was made by using the interview method. The research will serve as a basis for developing a theoretical model for remote criminal proceedings in the EU to ensure a balance between the intention to have innovative, cost-effective, and flexible criminal proceedings and the positive obligation of the State to ensure the rights of participants in proceedings to just and fair criminal proceedings. Moreover, developments in criminal proceedings also keep changing the image of the court itself; therefore, in the paper will create preconditions for future research on the impact of remote criminal proceedings on the trust in courts. The study aims at laying down the fundamentals for theoretical models of a remote hearing in criminal proceedings and at making recommendations for the safeguarding of human rights, in particular the rights of the accused, in such proceedings. The following criteria are relevant for the remote form of criminal proceedings: the purpose of judicial instance, the legal position of participants in proceedings, their vulnerability, and the nature of required legal protection. The content of the study consists of: 1. Identification of the factual and legal prerequisites for a decision to organise the entire criminal proceedings by remote means or to carry out one or several procedural actions by remote means 2. After analysing the legal regulation and practice concerning the application of the elements of remote criminal proceedings, distinguish the main legal safeguards for protection of the rights of the accused to ensure: (a) the right of effective participation in a court hearing; (b) the right of confidential consultation with the defence counsel; (c) the right of participation in the examination of evidence, in particular material evidence, as well as the right to question witnesses; and (d) the right to a public trial.

Keywords: remote criminal proceedings, fair trial, right to defence, technology progress

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Authors: Lorenza Sganzetta, Nunzia Borrelli

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The research intends to reflect on the current mapping of the Food Strategies, on the reasons why in the planning objectives panorama, such sustainability priorities are located in those geographic areas and on the evolutions of these priorities of the Mediterranean planning dispositions. The whirling population growth that is affecting global cities is causing an enormous challenge to conventional resource-intensive food production and supply and the urgent need to face food safety, food security and sustainability concerns. Urban or Territorial Food Strategies can provide an interesting path for the development of this new agenda within the imperative principle of sustainability. In the specific, it is relevant to explore what ‘sustainability’ means within these policies. Most of these plans include actions related to four main components and interpretations of sustainability that are food security and safety, food equity, environmental sustainability itself and cultural identity and, at the designing phase, they differ slightly from each other according to the degree of approximation to one of these dimensions. Moving from these assumptions, the article would analyze some practices and policies representatives of different Food Strategies of the world and focus on the Mediterranean ones, on the problems and negative externalities from which they start, on the first interventions that are implementing and on their main objectives. We will mainly use qualitative data from primary and secondary collections. So far, an essential observation could have been made about the relationship between these sustainability dimensions and geography. In statistical terms, the US and Canadian policies tended to devote a large research space to health issues and access to food; those northern European showed a special attention to the environmental issues and the shortening of the chain; and finally the policies that, even in limited numbers, were being developed in the Mediterranean basin, were characterized by a strong territorial and cultural imprint and their major aim was to preserve local production and the contact between the productive land and the end consumer. Recently, though, Mediterranean food planning strategies are focusing more on health related and food accessibility issues and analyzing our diets not just as a matter of culture and territorial branding but as tools for reducing public health costs and accessibility to fresh food for everyone. The article would reflect then on how Food Safety, Food Security and Health are entering the new agenda of the Mediterranean Food Strategies. The research hypothesis suggests that the economic crisis that in the last years invested both producers and consumers had a significant impact on the nutrition habits and on the redefinition of food poverty, even in the fatherland of the healthy Mediterranean diet. This trend and other variables influenced the orientation and the objectives of the food strategies.

Keywords: food security, food strategy, health, sustainability

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Authors: Fangliang Chen, Yihe Huang, Tejav Deganyar, Anselm Boehm, Hamid Batoul

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With growing population density and further urbanization, the average noise level in cities is increasing. Excessive noise is not only annoying but also leads to a negative impact on human health. To deal with the increasing city noise, environmental regulations bring up higher standards on acoustic comfort in buildings by mitigating the noise transmission from building envelope exterior to interior. Framed window, door and façade systems are the leading choice for modern fenestration construction, which provides demonstrated quality of weathering reliability, environmental efficiency, and installation ease. The overall sound insulation of such systems depends both on glasses and frames, where glass usually covers the majority of the exposed surfaces, thus it is the main source of sound energy transmission. While frames in modern façade systems become slimmer for aesthetic appearance, which contribute to a minimal percentage of exposed surfaces. Nevertheless, frames might provide substantial transmission paths for sound travels through because of much less mass crossing the path, thus becoming more critical in limiting the acoustic performance of the whole system. There are various methodologies and numerical programs that can accurately predict the acoustic performance of either glasses or frames. However, due to the vast variance of size and dimension between frame and glass in the same system, there is no satisfactory theoretical approach or affordable simulation tool in current practice to access the over acoustic performance of a whole façade system. For this reason, laboratory test turns out to be the only reliable source. However, laboratory test is very time consuming and high costly, moreover different lab might provide slightly different test results because of varieties of test chambers, sample mounting, and test operations, which significantly constrains the early phase design of framed façade systems. To address this dilemma, this study provides an effective analytical methodology to predict the acoustic performance of framed façade systems, based on vast amount of acoustic test results on glass, frame and the whole façade system consist of both. Further test results validate the current model is able to accurately predict the overall sound transmission loss of a framed system as long as the acoustic behavior of the frame is available. Though the presented methodology is mainly developed from façade systems with aluminum frames, it can be easily extended to systems with frames of other materials such as steel, PVC or wood.

Keywords: city noise, building facades, sound mitigation, sound transmission loss, framed façade system

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Authors: Anusha Vaddiraj Pallapu

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Across the globe, there is a steady increase in people residing in urban areas. Due to this increase in urban population, urban health is affecting. The major issues identified like overcrowding, air pollution, unhealthy diet, inadequate infrastructure, poor solid waste management systems and insufficient access to health facilities, these issues are gradually clearly observed in health statistics of diseases and deaths rapidly increase in urban areas. Therefore, the present study aims to assess the health statistics and infrastructure services at urban areas to know the cause and effect between Infrastructure, its management and diseases (water borne). Most of the Indian cities have the municipal boundaries, which authorized by their respective municipal corporations and development authorities. Generally, cities have various zones under which municipal wards exist. The paper focuses on the city Ahmedabad, at Gujarat state. Ahmedabad Municipal Corporation (AMC) is divided into six zones namely Central zone, West zone, New-West zone, East zone, North zone, and South zone. Each zone includes various wards within it. Incidence of diseases in Ahmadabad which are linked to infrastructure was identified such as water-borne diseases. Later on, the occurrence of water-borne diseases at urban area was examined at each zone level. The study methodology follows four steps i.e. 1) Pre-Field literature study: Study on Sewerage system in urban areas and its best practices and public health status globally and Indian scenario; 2) Field study: Data collection and interviews of stakeholders regarding heal status and issues at each zone and ward level; 3) Post field: Data analysis with qualitative description of each ward of zones, followed by correlation coefficient analysis between sewerage coverage, diseases and density of each ward using geographic information system mapping (GIS); 4) Identification of reasons: Affected health on each of zone and wards followed by correlation analysis on each reason. The results reveal that the health conditions in Ahmedabad municipal zones or boundaries are effected due to the slums created by the migrated people from various rural and urban areas. It is also observed that due to increase in population water supply and sewerage management is affecting. The overall effect on infrastructure is creating the health diseases which detailed in the paper using geographical information system in Indian city.

Keywords: infrastructure, municipal wards, GIS, water supply, sewerage, medical facilities, water borne diseases

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Authors: Temmuz Gönç Şavran

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Migration is a multidimensional and health-related concept that has important consequences for both migrants and the host society. Due to past conflicts and poor living conditions that lead to migration, the dangerous and difficult journey, and the problems they face upon arrival in the destination country, migrants are at higher risk for poor health. Health is a human right, and all societies and communities, including migrant groups, must receive adequate health care. In addition, the health of migrants must be improved to protect the health of the host society and ensure social integration. The main determinants of health are employment, income, education, good housing, and adequate nutrition. It can be said that migrants are among the most vulnerable groups in society in these respects, and migrant health is negatively affected by this situation. Rigid immigration policies or financial constraints in destination countries, the complexity and bureaucracy of health systems, the low health literacy of migrant groups, and the inadequate provision of translation services in health facilities are among the other main factors affecting migrant health. Migrants are also at risk of stigma, exclusion, detection, and deportation when seeking medical care. Based on data from a qualitative study with a descriptive case study design, this paper aims to highlight and sociologically assess the health-related problems of international migrants in Eskisehir, Turkey. The sample consists of 30 international migrants living in Eskisehir, two-thirds of whom are from Syria, Iraq, Afghanistan, and Pakistan. Those who are citizens of the Republic of Turkey are excluded from the study; otherwise, the legal status of the participants is not considered in the selection of the sample. This makes it possible to distinguish the different needs and problems of subgroups and to consider migrant health as a comprehensive concept. The research is supported by Anadolu University in Eskisehir, and data will be collected through semi-structured interviews between November 2022 and February 2023. With holistic sociology of health approach, this study considers migrant health as a comprehensive sociological concept. It aims to reveal the health-related resources and needs of the international migrant groups living in the center of Eskisehir, the problems they encounter in meeting these needs, and the strategies they use to solve these problems. The results are expected to show that the health of migrants is not only influenced by legislation but is shaped by many processes, from housing conditions to cultural habits. It is expected that the results will also raise awareness of discrimination, exclusion, marginalization, and hate speech in migrants’ access to health services.

Keywords: migrant health, sociology of health, sociology of migration, Turkey, refugees

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Authors: Meshal M. Abdullah, Rusty A. Feagin, Layla Musawi

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When humans mismanage arid landscapes, soil erosion can become a primary mechanism that leads to desertification. This study focuses on applying soil erosion models to a disturbed landscape in Umm Nigga, Kuwait, and identifying its predicted change under restoration plans, The northern portion of Umm Nigga, containing both coastal and desert ecosystems, falls within the boundaries of the Demilitarized Zone (DMZ) adjacent to Iraq, and has been fenced off to restrict public access since 1994. The central objective of this project was to utilize GIS and remote sensing to compare the MPSIAC (Modified Pacific South West Inter Agency Committee), EMP (Erosion Potential Method), and USLE (Universal Soil Loss Equation) soil erosion models and determine their applicability for arid regions such as Kuwait. Spatial analysis was used to develop the necessary datasets for factors such as soil characteristics, vegetation cover, runoff, climate, and topography. Results showed that the MPSIAC and EMP models produced a similar spatial distribution of erosion, though the MPSIAC had more variability. For the MPSIAC model, approximately 45% of the land surface ranged from moderate to high soil loss, while 35% ranged from moderate to high for the EMP model. The USLE model had contrasting results and a different spatial distribution of the soil loss, with 25% of area ranging from moderate to high erosion, and 75% ranging from low to very low. We concluded that MPSIAC and EMP were the most suitable models for arid regions in general, with the MPSIAC model best. We then applied the MPSIAC model to identify the amount of soil loss between coastal and desert areas, and fenced and unfenced sites. In the desert area, soil loss was different between fenced and unfenced sites. In these desert fenced sites, 88% of the surface was covered with vegetation and soil loss was very low, while at the desert unfenced sites it was 3% and correspondingly higher. In the coastal areas, the amount of soil loss was nearly similar between fenced and unfenced sites. These results implied that vegetation cover played an important role in reducing soil erosion, and that fencing is much more important in the desert ecosystems to protect against overgrazing. When applying the MPSIAC model predictively, we found that vegetation cover could be increased from 3% to 37% in unfenced areas, and soil erosion could then decrease by 39%. We conclude that the MPSIAC model is best to predict soil erosion for arid regions such as Kuwait.

Keywords: soil erosion, GIS, modified pacific South west inter agency committee model (MPSIAC), erosion potential method (EMP), Universal soil loss equation (USLE)

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Authors: Fernando Araujo, Sandra Cardoso, Fátima Fonseca, Sandra Cavaca

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A debureaucratization strategy for the Portuguese Health Service was assumed by the Executive Board of the SNS, in deep articulation with the Shared Services of the Ministry of Health. Two of the main dimensions were focused on sick leaves (SL), that transform primary health care (PHC) in administrative institutions, limiting access to patients. The self-declaration of illness (SDI) project, through the National Health Service Contact Centre (SNS24), began on May 1, 2023, and has already resulted in the issuance of more than 300,000 SDI without the need to allocate resources from the National Health Service (NHS). This political decision allows each citizen, in a maximum 2 times/year, and 3 days each time, if ill, through their own responsibility, report their health condition in a dematerialized way, and by this way justified the absence to work, although by Portuguese law in these first three days, there is no payment of salary. Using a digital approach, it is now feasible without the need to go to the PHC and occupy the time of the PHC only to obtain an SL. Through this measure, bureaucracy has been reduced, and the system has been focused on users, improving the lives of citizens and reducing the administrative burden on PHC, which now has more consultation times for users who need it. The second initiative, which began on March 1, 2024, allows the SL to be issued in emergency departments (ED) of public hospitals and in the health institutions of the social and private sectors. This project is intended to allow the user who has suffered a situation of acute urgent illness and who has been observed in an ED of a public hospital or in a private or social entity no longer need to go to PHC only to apply for the respective SL. Since March 1, 54,453 SLs have been issued, 242 in private or social sector institutions and 6,918 in public hospitals, of which 134 were in ED and 47,292 in PHC. This approach has proven to be technically robust, allows immediate resolution of problems and differentiates the performance of doctors. However, it is important to continue to qualify the proper functioning of the ED, preventing non-urgent users from going there only to obtain SL. Thus, in order to make better use of existing resources, it was operationalizing this extension of its issuance in a balanced way, allowing SL to be issued in the ED of hospitals only to critically ill patients or patients referred by INEM, SNS24, or PHC. In both cases, an intense public campaign was implemented to explain the way it works and the benefits for patients. In satisfaction surveys, more than 95% of patients and doctors were satisfied with the solutions, asking for extensions to other areas. The administrative simplification agenda of the NHS continues its effective development. For the success of this debureaucratization agenda, the key factors are effective communication and the ability to reach patients and health professionals in order to increase health literacy and the correct use of NHS.

Keywords: debureaucratization strategy, self-declaration of illness, sick leaves, SNS24

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Authors: Jeremy Jenrette, Z. Y. C. Liu, Pranav Chimote, Edward Fox, Trevor Hastie, Francesco Ferretti

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Suitable shark conservation depends on well-informed population assessments. Direct methods such as scientific surveys and fisheries monitoring are adequate for defining population statuses, but species-specific indices of abundance and distribution coming from these sources are rare for most shark species. We can rapidly fill these information gaps by boosting media-based remote monitoring efforts with machine learning and automation. We created a database of shark images by sourcing 24,546 images covering 219 species of sharks from the web application spark pulse and the social network Instagram. We used object detection to extract shark features and inflate this database to 53,345 images. We packaged object-detection and image classification models into a Shark Detector bundle. We developed the Shark Detector to recognize and classify sharks from videos and images using transfer learning and convolutional neural networks (CNNs). We applied these models to common data-generation approaches of sharks: boosting training datasets, processing baited remote camera footage and online videos, and data-mining Instagram. We examined the accuracy of each model and tested genus and species prediction correctness as a result of training data quantity. The Shark Detector located sharks in baited remote footage and YouTube videos with an average accuracy of 89\%, and classified located subjects to the species level with 69\% accuracy (n =\ eight species). The Shark Detector sorted heterogeneous datasets of images sourced from Instagram with 91\% accuracy and classified species with 70\% accuracy (n =\ 17 species). Data-mining Instagram can inflate training datasets and increase the Shark Detector’s accuracy as well as facilitate archiving of historical and novel shark observations. Base accuracy of genus prediction was 68\% across 25 genera. The average base accuracy of species prediction within each genus class was 85\%. The Shark Detector can classify 45 species. All data-generation methods were processed without manual interaction. As media-based remote monitoring strives to dominate methods for observing sharks in nature, we developed an open-source Shark Detector to facilitate common identification applications. Prediction accuracy of the software pipeline increases as more images are added to the training dataset. We provide public access to the software on our GitHub page.

Keywords: classification, data mining, Instagram, remote monitoring, sharks

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Authors: Mariyan Tomov

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Bulgarian working class immigrants are increasingly concerned with UK’s recent immigration policies in the context of Brexit. The new ID system would exclude many people currently working in Britain and would break the usual immigrant travel patterns. Post-Brexit Britain would aim to repeal seasonal immigrants. Measures for keeping long-term and life-long immigrants have been implemented and migrants that aim to remain in Britain and establish a household there would be more privileged than temporary or seasonal workers. The results of such regulating mechanisms come at the expense of migrants’ longings for a ‘normal’ existence, especially for those coming from Central and Eastern Europe. Based on in-depth interviews with Bulgarian working class immigrants, the study found out that their major concerns following the decision of the UK to leave the EU are related with the freedom to travel, reside and work in the UK. Furthermore, many of the interviewed women are concerned that they could lose some of the EU's fundamental rights, such as maternity and protection of pregnant women from unlawful dismissal. The soar of commodity prices and university fees and the limited access to public services, healthcare and social benefits in the UK, are also subject to discussion in the paper. The most serious problem, according to the interview, is that the attitude towards Bulgarians and other immigrants in the UK is deteriorating. Both traditional and social media in the UK often portray the migrants negatively by claiming that they take British job positions while simultaneously abuse the welfare system. As a result, the Bulgarian migrants often face social exclusion, which might have negative influence on their health and welfare. In this sense, some of the interviewed stress on the fact that the most important changes after Brexit must take place in British society itself. The aim of the proposed study is to provide a better understanding of the Bulgarian migrants’ economic, health and sociocultural experience in the context of Brexit. Methodologically, the proposed paper leans on: 1. Analysing ethnographic materials dedicated to the pre- and post-migratory experiences of Bulgarian working class migrants, using SPSS. 2. Semi-structured interviews are conducted with more than 50 Bulgarian working class migrants [N > 50] in the UK, between 18 and 65 years. The communication with the interviewees was possible via Viber/Skype or face-to-face interaction. 3. The analysis is guided by theoretical frameworks. The paper has been developed within the framework of the research projects of the National Scientific Fund of Bulgaria: DCOST 01/25-20.02.2017 supporting COST Action CA16111 ‘International Ethnic and Immigrant Minorities Survey Data Network’.

Keywords: Bulgarian migrants in UK, economic experiences, sociocultural experiences, Brexit

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Authors: Carmen Rocio Fernandez Diaz

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This paper focuses on the relevance of information and communication technologies (hereinafter referred as ‘ICTs’) as an essential part of the day-to-day life of all societies nowadays, as they offer the scenario where an immense number of behaviors are performed that previously took place in the physical world. In this context, areas of reality that have remained outside the so-called ‘information society’ are hardly imaginable. Nevertheless, it is possible to identify a means that continue to be behind this reality, and it is the penitentiary area regarding inmates rights, as security aspects in prison have already be improved by new technologies. Introducing ICTs in prisons is still a matter subject to great rejections. The study of comparative penitentiary systems worldwide shows that most of them use ICTs only regarding educational aspects of life in prison and that communications with the outside world are generally based on traditional ways. These are only two examples of the huge range of activities where ICTs can carry positive results within the prison. Those positive results have to do with the social reintegration of persons serving a prison sentence. Deprivation of liberty entails contact with the prison subculture and the harmful effects of it, causing in cases of long-term sentences the so-called phenomenon of ‘prisonization’. This negative effect of imprisonment could be reduced if ICTs were used inside prisons in the different areas where they can have an impact, and which are treated in this research, as (1) access to information and culture, (2) basic and advanced training, (3) employment, (4) communication with the outside world, (5) treatment or (6) leisure and entertainment. The content of all of these areas could be improved if ICTs were introduced in prison, as it is shown by the experience of some prisons of Belgium, United Kingdom or The United States. However, rejections to introducing ICTs in prisons obey to the fact that it could carry also risks concerning security and the commission of new offences. Considering these risks, the scope of this paper is to offer a real proposal to introduce ICTs in prison, trying to avoid those risks. This enterprise would be done to take advantage of the possibilities that ICTs offer to all inmates in order to start to build a life outside which is far from delinquency, but mainly to those inmates who are close to release. Reforming prisons in this sense is considered by the author of this paper an opportunity to offer inmates a progressive resettlement to live in freedom with a higher possibility to obey the law and to escape from recidivism. The value that new technologies would add to education, employment, communications or treatment to a person deprived of liberty constitutes a way of humanization of prisons in the 21st century.

Keywords: deprivation of freedom, information and communication technologies, imprisonment, social reintegration

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Authors: Kristen Emory, Jerry Flores

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Purpose: We explore the unique and underrepresented experiences of Indigenous women living in Toronto, Canada, during the first year of the COVID-19 pandemic. The purpose of this study is to better document the impacts of COVID-19 on the mental health and well-being of Indigenous women in Toronto, Canada, in order to better understand unmet needs, as well as lay the groundwork for more targeted research and potential interventions based on these needs. Background: It has been fairly well documented that the COVID-19 pandemic has increased mental health concerns among various populations globally. There have also been numerous studies indicating increases in substance use and abuse in response to the stress of the pandemic. There is also evidence that the COVID-19 pandemic has disproportionately impacted a variety of historically marginalized populations in Canada, the US, and globally, including Indigenous populations. While these studies provide some insight into how the COVID-19 pandemic is impacting the global population, much less is known about the lived experiences of Indigenous populations during the time of COVID-19. Better understanding these experiences will allow public health professionals, governments, and non-governmental organizations better combat health inequities related to the pandemic. Methods: In-depth qualitative semi-structured virtual (due to COVID-19) interviews with 13 Indigenous women were conducted during the first year of the COVID-19 pandemic (2020). Interviews were recorded, transcribed, and analyzed by team members using Dedoose qualitative analysis software. Findings: COVID-19 negatively affected Indigenous females identifying participants’ mental health and corresponding reported increases in substance use. In addition to the daily stress of the unpredictability of life in the time of the COVID-19 pandemic, participants cited job loss, economic concerns, homeschooling, and lack of access to medical resources as primary factors in increasing their stress and decreasing mental health and wellbeing. In response to these stressors, a majority of participants cited coping mechanisms such as increased substance use to help deal with the uncertainty. In particular, alcohol and tobacco emerged as coping mechanisms to help participants cope with stress related to the pandemic (as well as its social and economic toll on respondents' lives). We will present qualitative data to be presented, including participant direct quotes, explaining their experiences with COVID-19, mental health, and increased substance use, as well as analysis and synthesis with the existing scientific evidence base. Conclusion: This research is among the good studies to our knowledge that scientifically explore the impact of COVID-19 on mental health and well-being and corresponding increases in reported substance use.

Keywords: mental health, covid-19, indigenous, inequity, anxiety, depression, stress

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Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

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Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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Authors: Ambeck Celyne Tebid, Harry S. Rampa

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The South African Education system recognises the need for all learners including those experiencing learning difficulties, to have access to a single unified system of education. For teachers to be pedagogically responsive to an increasingly diverse learner population without appropriate support has been proven to be unrealistic. As such, this has considerably hampered interest amongst teachers, especially those at the foundation phase to work within an Inclusive Education (IE) and training system. This qualitative study aimed at investigating foundation phase teachers’ experiences of school-based support teams (SBSTs) in two Full-Service (inclusive schools) and one Mainstream public primary school in the Gauteng province of South Africa; with particular emphasis on finding ways to supporting them, since teachers claimed they were not empowered in their initial training to teach learners experiencing learning difficulties. Hence, SBSTs were created at school levels to fill this gap thereby, supporting teaching and learning by identifying and addressing learners’, teachers’ and schools’ needs. With the notion that IE may be failing because of systemic reasons, this study uses Bronfenbrenner’s (1979) ecosystemic as well as Piaget’s (1980) maturational theory to examine the nature of support and experiences amongst teachers taking individual and systemic factors into consideration. Data was collected using in-depth, face-to-face interviews, document analysis and observation with 6 foundation phase teachers drawn from 3 different schools, 3 SBST coordinators, and 3 school principals. Data was analysed using the phenomenological data analysis method. Amongst the findings of the study is that South African full- service and mainstream schools have functional SBSTs which render formal and informal support to the teachers; this support varies in quality depending on the socio-economic status of the relevant community where the schools are situated. This paper, however, argues that what foundation phase teachers settled for as ‘support’ is flawed; as well as how they perceive the SBST and its role is problematic. The paper conclude by recommending that, the SBST should consider other approaches at foundation phase teacher support such as, empowering teachers with continuous practical experiences on how to deal with real classroom scenarios, as well as ensuring that all support, be it on academic or non-academic issues should be provided within a learning community framework where the teacher, family, SBST and where necessary, community organisations should harness their skills towards a common goal.

Keywords: foundation phase, full- service schools, inclusive education, learning difficulties, school-based support teams, teacher support

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Authors: Desjardin, Michaels, Martinez, Ulmann

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Copper IUD is one of the most efficient and cost-effective contraception. However, pain at insertion hampers the use of this method. This is especially unfortunate in nulliparous women, often younger, who are excellent candidates for this contraception, including Emergency Contraception. Standard insertion procedure of a copper IUD usually involves measurement of uterine cavity with an hysterometer and the use of a tenaculum in order to facilitate device insertion. Both procedures lead to patient pain which often constitutes a limitation of the method. To overcome these issues, we have developed a modified insertor combined with a copper IUD. The singular design of the inserter includes a flexible inflatable membrane technology allowing an easy access to the uterine cavity even in case of abnormal uterine positions or narrow cervical canal. Moreover, this inserter makes possible a direct IUD insertion with no hysterometry and no need for tenaculum. To assess device effectiveness and patient-reported pain, a study was conducted at two clinics in Fance with 31 individuals who wanted to use a copper IUD as contraceptive method. IUD insertions have been performed by four healthcare providers. Operators completed questionnaire and evaluated effectiveness of the procedure (including IUD correct fundal placement and other usability questions) as their satisfaction. Patient also completed questionnaire and pain during procedure was measured on a 10-cm Visual Analogue Scale (VAS). Analysis of the questionnaires indicates that correct IUD placement took place in more than 93% of women, which is a standard efficacy rate. It also demonstrates that IUD insertion resulted in no, light or moderate pain predominantly in nulliparous women. No insertion resulted in severe pain (none above 6cm on a 10-cm VAS). This translated by a high level of satisfaction from both patients and practitioners. In addition, this modified inserter allowed a simplification of the insertion procedure: correct fundal placement was ensured with no need for hysterometry (100%) prior to insertion nor for cervical tenaculum to pull on the cervix (90%). Avoidance of both procedures contributed to the decrease in pain during insertion. Taken together, the results of the study demonstrate that this device constitutes a significant advance in the use of copper IUDs for any woman. It allows a simplification of the insertion procedure: there is no need for pre-insertion hysterometry and no need for traction on the cervix with tenaculum. Increased comfort during insertion should allow a wider use of the method for nulliparous women and for emergency contraception. In addition, pain is often underestimated by practitioners, but fear of pain is obviously one of the blocking factors as indicated by the analysis of the questionnaire. This evaluation brings interesting information on the use of this modified inserter for standard copper IUD and promising perspectives to set up a changement in the standard of IUD insertion procedure.

Keywords: contraceptio, IUD, innovation, pain

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Authors: Peter Robinson, Milka Ivanova

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Despite the growing interest in the Cold War period and heritage, little attention has been paid to the presentation and curatorship of Cold War heritage in eastern or western Europe. In 2021 Leeds Beckett University secured a British Academy Grant to explore visitor experiences, curatorship, emotion, and memory at Cold War-related tourist sites, comparing the perspectives of eastern and western European sites through research carried out in the UK and Bulgaria. The research explores the themes of curatorship, experience, and memory. Many of the sites included in the research in the UK-based part of the project are nuclear bunkers that have been decommissioned and are now open to visitors. The focus of this conference abstract is one of several perspectives drawn from a British Academy Grant-funded project exploring curatorship, visitor experience and nostalgia and memory in former cold war spaces in the UK, bringing together critical comparisons between western and eastern European sites. The project identifies specifically the challenges of ownership, preservation and presentation and discusses the challenges facing those who own, manage, and provide access to cold war museums and sites. The research is underpinned by contested issues of authenticity and ownership, discussing narrative accounts of those involved in caring for and managing these sites. The research project draws from interviews with key stakeholders, site observations, visitor surveys, and content analysis of Trip advisor posts. Key insights from the project include the external challenges owners and managers face from a lack of recognition of and funding for important Cold War sites in the UK that are at odds with interest shown in cold war sites by visitors to Cold War structures and landmarks. The challenges center on the lack of consistent approaches toward cold war heritage conservation, management, and ownership, lack of curatorial expertise and over-reliance on no-expert interpretation and presentation of heritage, the effect of the passage of time on personal connections to cold war heritage sites, the dissipating technological knowledge base, the challenging structure that does not lend themselves easily as visitor attractions or museums, the questionable authenticity of artifacts, the limited archival material, and quite often limited budgets. A particularly interesting insight focusing on nuclear bunkers has been on the difficulties in site reinterpretation because of the impossibility of fully exploring the enormity of nuclear war as a consistent threat of the Cold War. Further insights from the research highlight the secrecy of many of the sites as a key marketing strategy, particularly in relation to the nuclear bunker sites included in the project.

Keywords: cold war, curatorship, heritage, nuclear bunkers.

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Authors: Elidrissi Laila, El Rhaoussi Fatima-Zahra, Haddad Fouad, Tahiri Mohamed, Hliwa Wafaa, Bellabah Ahmed, Badre Wafaa

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Introduction: Metabolic Dysfunction Associated with Non-Alcoholic Fatty Liver Disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is the leading cause of chronic liver disease. The cardiometabolic risk factors associated with MASLD represent common health issues and significant public health challenges. Medical students, being active participants in the healthcare system and a young demographic, are particularly relevant for understanding this entity to prevent its occurrence on a personal and collective level. The objective of our study is to assess the level of knowledge among medical students regarding MASLD, its risk factors, and its long-term consequences. Materials and Methods: We conducted a descriptive cross-sectional study using an anonymous questionnaire distributed through social media over a period of 2 weeks. Medical students from various faculties in Morocco answered 22 questions about MASLD, its etiological factors, diagnosis, complications, and principles of treatment. All responses were analyzed using the Jamovi software. Results: A total of 124 students voluntarily provided complete responses. 59% of our participants were in their 3rd year, with a median age of 21 years. Among the respondents, 27% were overweight, obese, or diabetic. 83% correctly answered more than half of the questions, and 77% believed they knew about MASLD. However, 84% of students were unaware that MASLD is the leading cause of chronic liver disease, and 12% even considered it a rare condition. Regarding etiological factors, overweight and obesity were mentioned in 93% of responses, and type 2 diabetes in 84%. 62% of participants believed that type 1 diabetes could not be implicated in MASLD. For 83 students, MASLD was considered a diagnosis of exclusion, while 41 students believed that a biopsy was mandatory for diagnosis. 12% believed that MASLD did not lead to long-term complications, and 44% were unaware that MASLD could progress to hepatocellular carcinoma. Regarding treatment, 85% included weight loss, and 19% did not consider diabetes management as a therapeutic approach for MASLD. At the end of the questionnaire, 89% of the students expressed a desire to learn more about MASLD and were invited to access an informative sheet through a hyperlink. Conclusion: MASLD represents a significant public health concern due to the prevalence of its risk factors, notably the obesity pandemic, which is widespread among the young population. There is a need for awareness about the seriousness of this emerging and long-underestimated condition among young future physicians.

Keywords: MASLD, medical students, obesity, diabetes

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Authors: Xiangtuo Chen, Paul-Henry Cournéde

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Crop yield prediction is a paramount issue in agriculture. The main idea of this paper is to find out efficient way to predict the yield of corn based meteorological records. The prediction models used in this paper can be classified into model-driven approaches and data-driven approaches, according to the different modeling methodologies. The model-driven approaches are based on crop mechanistic modeling. They describe crop growth in interaction with their environment as dynamical systems. But the calibration process of the dynamic system comes up with much difficulty, because it turns out to be a multidimensional non-convex optimization problem. An original contribution of this paper is to propose a statistical methodology, Multi-Scenarios Parameters Estimation (MSPE), for the parametrization of potentially complex mechanistic models from a new type of datasets (climatic data, final yield in many situations). It is tested with CORNFLO, a crop model for maize growth. On the other hand, the data-driven approach for yield prediction is free of the complex biophysical process. But it has some strict requirements about the dataset. A second contribution of the paper is the comparison of these model-driven methods with classical data-driven methods. For this purpose, we consider two classes of regression methods, methods derived from linear regression (Ridge and Lasso Regression, Principal Components Regression or Partial Least Squares Regression) and machine learning methods (Random Forest, k-Nearest Neighbor, Artificial Neural Network and SVM regression). The dataset consists of 720 records of corn yield at county scale provided by the United States Department of Agriculture (USDA) and the associated climatic data. A 5-folds cross-validation process and two accuracy metrics: root mean square error of prediction(RMSEP), mean absolute error of prediction(MAEP) were used to evaluate the crop prediction capacity. The results show that among the data-driven approaches, Random Forest is the most robust and generally achieves the best prediction error (MAEP 4.27%). It also outperforms our model-driven approach (MAEP 6.11%). However, the method to calibrate the mechanistic model from dataset easy to access offers several side-perspectives. The mechanistic model can potentially help to underline the stresses suffered by the crop or to identify the biological parameters of interest for breeding purposes. For this reason, an interesting perspective is to combine these two types of approaches.

Keywords: crop yield prediction, crop model, sensitivity analysis, paramater estimation, particle swarm optimization, random forest

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Authors: Lorena C. Cintra, Izadora M. De Oliveira, Amanda G. Fernandes, Francieli Colussi, Rosália S. A. Jesuíno, Fabrícia P. Faria, Cirano J. Ulhoa

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Xylan is the main component of hemicellulose and for its complete degradation is required cooperative action of a system consisting of several enzymes including endo-xylanases (XYN), β-xylosidases (XYL) and α-L-arabinofuranosidases (ABF). The recombinant hemicellulolytic enzymes an endoxylanase (HXYN2), β-xylosidase (HXYLA), and an α-L-arabinofuranosidase (ABF3) were used in hydrolysis tests. These three enzymes are produced by filamentous fungi and were expressed heterologously and produced in Pichia pastoris previously. The aim of this work was to evaluate the effect of recombinant hemicellulolytic enzymes on the enzymatic hydrolysis of sugarcane bagasse (SCB). The interaction between the three recombinant enzymes during SCB pre-treated by steam explosion hydrolysis was performed with different concentrations of HXYN2, HXYLA and ABF3 in different ratios in according to a central composite rotational design (CCRD) 23, including six axial points and six central points, totaling 20 assays. The influence of the factors was assessed by analyzing the main effects and interaction between the factors, calculated using Statistica 8.0 software (StatSoft Inc. Tulsa, OK, USA). The Pareto chart was constructed with this software and showed the values of the Student’s t test for each recombinant enzyme. It was considered as response variable the quantification of reducing sugars by DNS (mg/mL). The Pareto chart showed that the recombinant enzyme ABF3 exerted more significant effect during SCB hydrolysis, with higher concentrations and with the lowest concentration of this enzyme. It was performed analysis of variance according to Fisher method (ANOVA). In ANOVA for the release of reducing sugars (mg/ml) as the variable response, the concentration of ABF3 showed significance during hydrolysis SCB. The result obtained by ANOVA, is in accordance with those presented in the analysis method based on the statistical Student's t (Pareto chart). The degradation of the central chain of xylan by HXYN2 and HXYLA was more strongly influenced by ABF3 action. A model was obtained, and it describes the performance of the interaction of all three enzymes for the release of reducing sugars, and can be used to better explain the results of the statistical analysis. The formulation capable of releasing the higher levels of reducing sugars had the following concentrations: HXYN2 with 600 U/g of substrate, HXYLA with 11.5 U.g-1 and ABF3 with 0.32 U.g-1. In conclusion, the recombinant enzyme that has a more significant effect during SCB hydrolysis was ABF3. It is noteworthy that the xylan present in the SCB is arabinoglucoronoxylan, due to this fact debranching enzymes are important to allow access of enzymes that act on the central chain.

Keywords: experimental design, hydrolysis, recombinant enzymes, sugar cane bagasse

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Authors: E. V. Fakhrutdinova, Y. S. Kolesnikova, E. A. Karasik, V. M. Zagidullina

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Poverty as the social and economic phenomenon exists in any society and represents a many-sided problem. In this sense it is universal and for many centuries serves as a research objects for scientists. Special attention to a problem of poverty in Russia is caused, first of all, by the critical growth of inequality and by scales of expansion of poverty, considerable decrease in the level and quality of life of the population, decrease in availability of education during the period of reforming. The expansion of poverty on the working members of society, youth, which has to provide reproduction of the population is alarming. As poverty is the reason of weakening of national security of the country, degradation of the population, decline in the quality of the human capital, complication of a demographic situation, strengthening of social contradictions in society, so far as the reduction of poverty, so, the increase in production. Poverty: the characteristic of an economic situation of the individual or social group at which they can't satisfy certain minimum requirements necessary for life, preservations of working capacity and reproduction. Poverty became one of the critical factors expelling people from the system of the institutional interactions reducing social space in which their relations were building breaking their social identity. Complication of the problem of poverty in modern society happened due to penetration of the related relations into many spheres of life. It is known that negative consequences of poverty display not only at the personal level of the poor person, but also at the level of interpersonal social interactions, decline in the quality and level of development of the human capital, and also at social and economic system in general. We conducted a research on the influence of education on the change of poverty level of the population. We consider education as a resource for an increase of the income and social mobility. Dependence of the income of the population on the level of education, availability of education (level of education and quality of education) on the level of income of families is found. Differentiation of quality and number of educational services for children depending on the level of the income of families is revealed. Influence of a factor of poverty on the availability of education is also studied. We consider expenses on education as the limiter of access to education. We consider education as a factor of fixation and aggravation of a property inequality. In the solution of problems of poverty the defining condition is the state regulation of social and economic development by means of creation of the effective institutional environment. The state has to develop measures for an increase of availability of various services to all categories of citizens, in particular services of health care and education, especially for poor citizens enters. The special attention regarding an increase of availability of education services has to be paid to creation of system of social elevators.

Keywords: poverty, education, human capital, quality of life

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Authors: Usman Asif, Klaus Schmidt

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In recent years, the development of alternate fuel vehicles has helped to reduce carbon emissions worldwide. As the number of vehicles will continue to increase in the future, the energy demand will also increase. Therefore, we must consider automotive technologies that are efficient and less harmful to the environment in the long run. Battery Electric Vehicles (BEVs) have gained popularity in recent years because of their lower maintenance, lower fuel costs, and lower carbon emissions. Nevertheless, BEVs show several disadvantages, such as slow charging times and lower range than traditional combustion-powered vehicles. These factors keep many people from switching to BEVs. The authors of this research believe that these limitations can be overcome by using fuel cell technology. Fuel cell technology converts chemical energy into electrical energy from hydrogen power and therefore serves as fuel to power the motor and thus replacing heavy lithium batteries that are expensive and hard to recycle. Also, in contrast to battery-powered electric vehicle technology, Fuel Cell Electric Vehicles (FCEVs) offer higher ranges and lower fuel-up times and therefore are more competitive with electric vehicles. However, FCEVs have not gained the same popularity as electric vehicles due to stringent legal frameworks, underdeveloped infrastructure, high fuel transport, and storage costs plus the expense of fuel cell technology itself. This research will focus on the legal frameworks for hydrogen-powered vehicles, and how a change in these policies may affect and improve hydrogen fueling infrastructure and lower hydrogen transport and storage costs. These policies may also facilitate reductions in fuel cell technology costs. In order to attain a better framework, a number of countries have developed conceptual roadmaps. These roadmaps have set out a series of objectives to increase the access of FCEVs to their respective markets. This research will specifically focus on policies in Japan, Europe, and the USA in their attempt to shape the automotive industry of the future. The researchers also suggest additional policies that may help to accelerate the advancement of FCEVs to mass-markets. The approach was to provide a solid literature review using resources from around the globe. After a subsequent analysis and synthesis of this review, the authors concluded that in spite of existing legal challenges that have hindered the advancement of fuel-cell technology in the automobile industry in the past, new initiatives that enhance and advance the very same technology in the future are underway.

Keywords: fuel cell electric vehicles, fuel cell technology, legal frameworks, policies and regulations

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Authors: Hugo Ribadeau Dumas

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In India, cities represent intense battlefields where patriarchal norms are simultaneously defied and reinforced. While Indian metropolises have witnessed numerous initiatives where women boldly claimed their right to the city, urban spaces still remain disproportionately unfriendly to female city-dwellers. As a result, the presence of strees (women, in Hindi) in the streets remains a socially and politically potent phenomenon. This paper explores how, in India, women engage with the city as compared to men. Borrowing analytical tools from urban geography, it uses Hindi cinema as a medium to map the extent to which activities, attitudes and experiences in urban spaces are highly gendered. The sample consists of 30 movies, both mainstream and independent, which were released between 2010 and 2020, were set in an urban environment and comprised at least one pivotal female character. The paper adopts a quantitative approach, consisting of the scrutiny of close to 3,000 minutes of footage, the labeling and time count of every scene, and the computation of regressions to identify statistical relationships between characters and the way they navigate the city. According to the analysis, female characters spend half less time in the public space than their male counterparts. When they do step out, women do it mostly for utilitarian reasons; inversely, in private spaces or in pseudo-public commercial places – like malls – they indulge in fun activities. For male characters, the pattern is the exact opposite: fun takes place in public and serious work in private. The characters’ attitudes in the streets are also greatly gendered: men spend a significant amount of time immobile, loitering, while women are usually on the move, displaying some sense of purpose. Likewise, body language and emotional expressiveness betray differentiated gender scripts: while women wander in the streets either smiling – in a charming role – or with a hostile face – in a defensive mode – men are more likely to adopt neutral facial expressions. These trends were observed across all movies, although some nuances were identified depending on the character's age group, social background, and city, highlighting that the urban experience is not the same for all women. The empirical pieces of evidence presented in this study are helpful to reflect on the meaning of public space in the context of contemporary Indian cities. The paper ends with a discussion on the link between universal access to public spaces and women's empowerment.

Keywords: cinema, Indian cities, public space, women empowerment

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Authors: Sudikshya Bhandari, Jonathan K. London

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Barpak in northern Nepal represents a unique identity expressed through the local rituals, values, lifeways and the styles of vernacular architecture. The traditional residential buildings and construction practices adopted by the dominant ethnic groups: Ghales and Gurungs, reflect environmental, social, cultural and economic concerns. However, most of these buildings did not survive the Gorkha earthquake in 2015 that made many residents skeptical about their strength to resist future disasters. This led Barpak residents to prefer modern housing designs primarily for the strength but additionally for convenience and access to earthquake relief funds. Post-earthquake reconstruction has transformed the cohesive community, developed over hundreds of years into a haphazard settlement with the imposition of externally-driven building models. Housing guidelines provided for the community reconstruction and earthquake resilience have been used as a singular template, similar to other communities on different geographical locations. The design and construction of these buildings do not take into account the local, historical, environmental, social, cultural and economic context of Barpak. In addition to the physical transformation of houses and the settlement, the consequences continue to develop challenges to sustainability. This paper identifies the major challenges for environmental sustainability with the construction of new houses in post-earthquake Barpak. Mixed methods such as interviews, focus groups, site observation, and documentation, and analysis of housing and neighborhood design have been used for data collection. The discernible changing situation of this settlement due to the new housing has included reduced climatic adaptation and thermal comfort, increased consumption of agricultural land and water, minimized use of local building materials, and an increase in energy demand. The research has identified that reconstruction housing practices happening in Barpak, while responding to crucial needs for disaster recovery and resilience, are also leading this community towards an unsustainable future. This study has also integrated environmental, social, cultural and economic parameters into an assessment framework that could be used to develop place-based design guidelines in the context of other post-earthquake reconstruction efforts. This framework seeks to minimize the unintended repercussions of unsustainable reconstruction interventions, support the vitality of vernacular architecture and traditional lifeways and respond to context-based needs in coordination with residents.

Keywords: earthquake, environment, reconstruction, sustainability

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Authors: Ruchirat Patanathabutr

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This applied research has adopted descriptive social science research methodology to interpret, analyze and assess the data and used descriptive analysis to present the research results. The objective of this research is to investigate the behaviors and opinions on the service and construction of cable car system at the Upper Esaan Wild Animal Adventure Park (Khon Kaen – Udon Thani) in Khao Suan Kwang District, Khon Kaen Province (Khon Kaen Zoo) of people in the local and distant communities as well as the service users. The research results have revealed that the main target group is the residents in the upper northeastern region of Thailand, especially those who have resided in the immediate vicinity of the cable car project and in nearby districts for more than 10 years. They are men and women at the age of 20-60 with high school diploma and higher levels of education, working as traders/entrepreneurs, government officers/state enterprise employees, and freelancers/self-employed, with the average monthly income of no more than 30,000 baht. Khon Kaen Zoo should improve its 4 organizational images as a tourist attraction, an animal display enclosure, an educational institution and as a provincial symbol; however, the zoo should mainly be presented as an important tourist attraction. The service should focus on maintaining the service standards in both the animal display area and the ocean park. The attention should also be directed at the types and numbers of animals, service quality, service fee, convenient access and transportation, promotions and the standards of other services. Regarding the community involvement in the cable car system construction project, it is strongly agreed that there should be a cable car service between the animal display area and the ocean park and a round-trip ticket should cost 20 baht, 50 baht or 100 baht, respectively. Khon Kaen Zoo or responsible entity must provide related groups of people, such as people in the local and distant communities as well as the service users, with accurate information about the community management guidelines. This is because the community opinions have showed the uncertainty about the cable car system construction at Khon Kaen Zoo and the 4 principles of management, including planning, organizing, leading and controlling, are indicated as uncertain as there is no statistically significant difference at 0.05. In addition, the social, economic, and environmental impacts of the cable car system construction at Khon Kaen Zoo on the communities must be considered carefully.

Keywords: community opinion, cable car system, Khon Kaen Zoo, Thailand

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Authors: Sophie Oakes-Rogers, Di Bailey, Karen Slade

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Female offenders are a uniquely vulnerable group, who are at high risk of suicide. Whilst the prevention of self-harm and suicide remains a key global priority, we need to better understand the relationship between these challenging behaviours that constitute a pressing problem, particularly in environments designed to prioritise safety and security. Method choice is unlikely to be random, and is instead influenced by a range of cultural, social, psychological and environmental factors, which change over time and between countries. A key aspect of self-harm and suicide in women receiving forensic care is the lack of free access to methods. At a time where self-harm and suicide rates continue to rise internationally, understanding the role of these influencing factors and the impact of current suicide prevention strategies on the use of near-lethal methods is crucial. This poster presentation will present findings from 25 interviews and 3 focus groups, which enlisted a Participatory Action Research approach to explore the differences between self-harming and suicidal behavior. A key element of this research was using the lived experiences of women receiving forensic care from one forensic pathway in the UK, and the staffs who care for them, to discuss the role of near-lethal self-harm (NLSH). The findings and suggestions from the lived accounts of the women and staff will inform a draft assessment tool, which better assesses the risk of suicide based on the lethality of methods. This tool will be the first of its kind, which specifically captures the needs of women receiving forensic services. Preliminary findings indicate women engage in NLSH for two key reasons and is determined by their history of self-harm. Women who have a history of superficial non-life threatening self-harm appear to engage in NLSH in response to a significant life event such as family bereavement or sentencing. For these women, suicide appears to be a realistic option to overcome their distress. This, however, differs from women who appear to have a lifetime history of NLSH, who engage in such behavior in a bid to overcome the grief and shame associated with historical abuse. NLSH in these women reflects a lifetime of suicidality and indicates they pose the greatest risk of completed suicide. Findings also indicate differences in method selection between forensic provisions. Restriction of means appears to play a role in method selection, and findings suggest it causes method substitution. Implications will be discussed relating to the screening of female forensic patients and improvements to the current suicide prevention strategies.

Keywords: forensic mental health, method substitution, restriction of means, suicide

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Authors: Haiyan Huang, Jan Blommaert, Ellen Van Praet

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The embrace of neoliberal economic system in China has engendered the entry of global commodity capitalism into domestic Chinese market and ushered in the post-feminism that is closely associated with consumerism from western culture. Chinese women are instilled and thus hold the belief of empowering themselves and expressing their individualism through consumption. To unravel the consumerist ideologies embedded in Li’s discursive practices, we rely on critical discourse analysis (CDA) as our research framework. The data analyses suggest that cosmopolitanism and class are two repeating themes when Li engages in persuading consumerist behaviors from the female audience. Through hints and cues such as “going on business trips”, “traveling abroad”, “international brands” and among others, Li provides the access to and possibility of imagining cosmopolitan and middle class identity for his audience. Such yearning for western culture and global citizen identity also implicates the aspiration for a well-off socioeconomic status, proving that post-feminism in China not only embodies western consumerism but also implicates the struggle of class movement. These defining elements of choice and freedom are well-situated in contemporary Chinese society where women are enjoying more educational and economic independence than before. However a closer examination reveals conflicts between hegemonic discourse of post-feminism and the status quo. First, propagating women’s power through consumption obscure the entrenched gender inequality in China. Philosophies such as employment discrimination, equal payment, education right, etc., the cornerstones of feminism did not exist in China, leading to historical gender issues unsolved. Second, the lengthy broadcastings (which normally last more than 2 hours) featured with big discounts on products beg the question who are the real audience of ecommerce livestreaming. Seemingly addressing to young well-off Chinese females, Li’s discursive practice can be targeting at young but not wealthy girls who aspire to mimic the lifestyle of middle class women. By selling the idea of empowering and constructing identity through consuming beauty products (e.g., lipsticks), capitalists are endeavoring to create the post-feminism illusion and cause anxieties among Chinese females. Through in-depth analyses of hegemonic discourse on ecommerce livestreaming of lipsticks, the paper contributes to a better understanding of post-feminism in contemporary China and meanwhile illustrates the problems Chinese women face in securing power and equality.

Keywords: Chinese women, critical discourse analysis, ecommerce livestreaming, post-feminism

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Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

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Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

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Authors: Jami Wang, Brian Kao, Davin Agustines

Abstract:

COVID-19 highlighted the active discrimination against the Asian American population easily seen through media, social tension, and increased crimes against the specific population. It is well known that long-term racism can also have a large impact on both emotional and psychological well-being. However, the healthcare disparity during this time also revealed how the Asian American community lacked the research data, political support, and medical infrastructure for this particular population. During a time when Asian American fear for safety with decreasing mental health, telepsychiatry is particularly promising. COVID-19 demonstrated how well psychiatry could integrate with telemedicine, with psychiatry being the second most utilized telemedicine visits. However, the Asian American community did not utilize the telepsychiatry resources as much as other groups. Because of this, we wanted to understand why the patient population who was affected the most by COVID-19 mentally did not seek out care. To do this, we decided to study the top top telepsychiatry platforms. The current top telepsychiatry companies in the United States include Teladoc and BetterHelp. In the Teladoc mental health sector, they only had 4 available languages (English, Spanish, French, and Danis,) with none of them being an Asian language. In a similar manner, Teladoc’s top competitor in the telepsychiatry space, BetterHelp, only listed a total of 3 Asian languages, including Mandarin, Japanese, and Malaysian. However, this is still a short list considering they have over 20 languages available. The shortage of available physicians that speak multiple languages is concerning, as it could be difficult for the Asian American community to relate with. There are limited mental health resources that cater to their likely cultural needs, further exacerbating the structural racism and institutional barriers to appropriate care. It is important to note that these companies do provide interpreters to comply with the nondiscrimination and language assistance federal law. However, interactions with an interpreter are not only more time-consuming but also less personal than talking directly with a physician. Psychiatry is the field that emphasizes interpersonal relationships. The trust between a physician and the patient is critical in developing patient rapport to guide in better understanding the clinical picture and treating the patient appropriately. The language barrier creates an additional barrier between the physician and patient. Because Asian Americans are one of the largest growing patient population bases, these telehealth companies have much to gain by catering to the Asian American market. Without providing adequate access to bilingual and bicultural physicians, the current system will only further exacerbate the growing disparity. The healthcare community and telehealth companies need to recognize that the Asian American population is a severely underserved population in mental health and has much to gain from telepsychiatry. The lack of language is one of many reasons why there is a disparity for Asian Americans in the mental health space.

Keywords: telemedicine, psychiatry, Asian American, disparity

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Authors: Anastasia Constantinou, Panayiotis Laouris, Stephen Morris

Abstract:

Background: Climate change has been reported as one of the worst threats to healthcare. The healthcare sector is a significant contributor to greenhouse gas emissions with primary care being responsible for 23% of the NHS’ total carbon footprint. Digital interventions, primarily focusing on telemedicine, offer a route to change. This systematic review aims to quantify and characterize the carbon footprint savings associated with the implementation of digital interventions in the setting of primary care. Methods: A systematic review of published literature was conducted according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, PubMed, and Scopus databases as well as Google scholar were searched using key terms relating to “carbon footprint,” “environmental impact,” “sustainability”, “green care”, “primary care,”, and “general practice,” using citation tracking to identify additional articles. Data was extracted and analyzed in Microsoft Excel. Results: Eight studies were identified conducted in four different countries between 2010 and 2023. Four studies used interventions to address primary care services, three studies focused on the interface between primary and specialist care, and one study addressed both. Digital interventions included the use of mobile applications, online portals, access to electronic medical records, electronic referrals, electronic prescribing, video-consultations and use of autonomous artificial intelligence. Only one study carried out a complete life cycle assessment to determine the carbon footprint of the intervention. It estimate that digital interventions reduced the carbon footprint at primary care level by 5.1 kgCO2/visit, and at the interface with specialist care by 13.4 kg CO₂/visit. When assessing the relationship between travel-distance saved and savings in emissions, we identified a strong correlation, suggesting that most of the carbon footprint reduction is attributed to reduced travel. However, two studies also commented on environmental savings associated with reduced use of paper. Patient savings in the form of reduced fuel cost and reduced travel time were also identified. Conclusion: All studies identified significant reductions in carbon footprint following implementation of digital interventions. In the future, controlled, prospective studies incorporating complete life cycle assessments and accounting for double-consulting effects, use of additional resources, technical failures, quality of care and cost-effectiveness are needed to fully appreciate the sustainable benefit of these interventions

Keywords: carbon footprint, environmental impact, primary care, sustainable healthcare

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Authors: Tania Lisboa, Angela Voyajolu, Adam Ockelford

Abstract:

The positive impact of music on the development of children with autism is widely acknowledged: music offers a unique channel for communication, wellbeing and self-regulation, as well as access to culture and a means of creative engagement. Yet, no coherent program exists for parents, carers and teachers to follow with their children in the early years, when the need for interventions is often most acute. Hence, research and the development of resources is urgently required. Autism is a project with children on the autism spectrum. The project aims at promoting the participants’ engagement with music through involvement in specially-designed musical activities with parents and carers. The main goal of the research is to verify the effectiveness of newly designed resources and strategies, which are based on the Sounds of Intent in the Early Years (SoI-EY) framework of musical development. This is a pilot study, comprising case studies of five children with autism in the early years. The data comprises semi-structured interviews, observations of videos, and feedback from parents on resources. Interpretative Phenomenological Analysis was chosen to analyze the interviews. The video data was coded in relation to the SoI-EY framework. The feedback from parents was used to evaluate the resources (i.e. musical activity cards). The participants’ wider development was also assessed through selected elements of the Early Years Foundation Stage (EYFS), a national assessment framework used in England: specifically, communication, language and social-emotional development. Five families of children on the autism spectrum (aged between 4-8 years) participated in the pilot. The research team visited each family 4 times over a 3-month period, during which the children were observed, and musical activities were suggested based on the child’s assessed level of musical development. Parents then trialed the activities, providing feedback and gathering further video observations of their child’s musical engagement between visits. The results of one case study will be featured in this paper, in which the evidence suggests that specifically tailored musical activity may promote communication and social engagement for a child with language difficulties on the autism spectrum. The resources were appropriate for the children’s involvement in musical activities. Findings suggest that non-specialist musical engagement with family and carers can be a powerful means to foster communication. The case study featured in this paper illustrates this with a child of limited verbal ability. There is a need for further research and development of resources that can be made available to all those working with children on the autism spectrum.

Keywords: autism, development, music education, resources

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