Search results for: London knife crime
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 607

Search results for: London knife crime

37 The Relationship between the Social Entrepreneur and the Social Dimension of Sustainability: A Bibliometric Survey of the Last Twelve Years

Authors: Leticia Lengler, Jefferson Oliveira, Vania Estivalete, Jordana Marques Kneipp, Lucia Regina Da Rosa Gama Madruga

Abstract:

The way social entrepreneurs act and can positively impact on our society engages the interest of academics, companies and governments, who seek solutions to solve or alleviate issues related to the abuse of natural resources, as well as the increase of poverty (social aspects). Studies on social entrepreneurship have been characterized by diverse ramifications and their transdisciplinary character, permeating various disciplines and approaches. Different bibliometric studies were conducted within the theme of social entrepreneurship. In this context, because it is a topic in development and multifaceted, the aim of this article is to present the main interfaces of the studies on the Social Entrepreneur figure in relation to the social concern of sustainability, highlighting the relevant researches and their trends, as well as their relationship with the organizations. Aiming to achieve this purpose, the specific goals are: to identify the most cited authors and articles, to verify the authors and journals with the greatest number of publications and their approaches and to point out their affiliations, countries, and languages of publications. It is still a secondary objective to identify the emerging trends in relation to the social entrepreneur and his social concern stemming from the discussions on sustainability. This way, we analyzed articles from two international databases (Scopus and Web of Science), from 2004 to 2016. The main results were the increase in the number of publications, with most of them in English language, coming mainly from the United States institutions (such as Indiana University and Harvard University) and the United Kingdom (whose main institutions are University of London and Robert Gordon University). Although publications in Spanish and Portuguese are the least expressive in quantity, some tendencies point to publications that discuss the social entrepreneur in terms of gender (that relates to female entrepreneurship) and social class (that relates to the need of building communities that contemplate the Social entrepreneur at the base of the pyramid). It should be noted that the trends of the themes emerged from the analysis of the publication titles only in Portuguese, since this is the native language of the authors who carry out their studies mainly in Brazil. When considering articles in Portuguese (57 indicated by WOS and 9 by Scopus), a previous analysis of the titles was carried out to identify how researchers were approaching the theme social entrepreneur in a joint way to the social dimension of sustainability. However, the analysis of the titles themselves brought a limitation to our study, since it was felt a need to carry out a qualitative study, in which it could be possible to consider the abstracts of the available articles.

Keywords: base of pyramid, social dimension, social entrepreneur, sustainability

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36 Between the House and the City: An Investigation of the Structure of the Family/Society and the Role of the Public Housing in Tokyo and Berlin

Authors: Abudjana Babiker

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The middle of twenty century witnessed an explosion in public housing. After the great depression, some of the capitalists and communist countries have launched policies and programs to produce public housing in the urban areas. Concurrently, modernity was the leading architecture style at the time excessively supported the production, and principally was the instrument for the success of the public housing program due to the modernism manifesto for manufactured architecture as an international style that serves the society and parallelly connect it to the other design industries which allowed for the production of the architecture elements. After the second world war, public housing flourished, especially in communist’s countries. The idea of public housing was conceived as living spaces at the time, while the Workplaces performed as the place for production and labor. Michel Foucault - At the end of the twenty century- the introduction of biopolitics has had highlighted the alteration in the production and labor inter-function. The house does not precisely perform as the sanctuary, from the production, for the family, it opens the house to be -part of the city as- a space for production, not only to produce objects but to reproduce the family as a total part of the production mechanism in the city. While the public housing kept altering from one country to another after the failure of the modernist’s public housing in the late 1970s, the society continued changing parallelly with the socio-economic condition in each political-economical system, and the public housing thus followed. The family structure in the major cities has been dramatically changing, single parenting and the long working hours, for instance, have been escalating the loneliness in the major cities such as London, Berlin, and Tokyo and the public housing for the families is no longer suits the single lifestyle for the individuals. This Paper investigates the performance of both the single/individual lifestyle and the family/society structure in Tokyo and Berlin in a relation to the utilization of public housing under economical policies and the socio-political environment that produced the individuals and the collective. The study is carried through the study of the undercurrent individual/society and case studies to examine the performance of the utilization of the housing. The major finding is that the individual/collective are revolving around the city; the city identified and acts as a system that magnetized and blurred the line between production and reproduction lifestyle. The mass public housing for families is shifting to be a combination between neo-liberalism and socialism housing.

Keywords: loneliness, production reproduction, work live, publichousing

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35 Audit Examining Maternity Assessment Suite Triage Compliance with Birmingham Symptom Specific Obstetric Triage System in a London Teaching Hospital

Authors: Sarah Atalla, Shubham Gupta, Kim Alipio, Tanya Maric

Abstract:

Background: Chelsea and Westminster Hospital have introduced the Birmingham Symptom Specific Obstetric Triage System (BSOTS) for patients who present acutely to the Maternity Assessment Suite (MAS) to prioritise care by urgency. The primary objective was to evaluate whether BSOTS was used appropriately to assess patients (defined as a 90% threshold). The secondary objective was to assess whether patients were seen within their designated triaged timeframe (defined as a 90% threshold). Methodology: MAS records were retrospectively reviewed for a randomly selected one-week period of data from 2020 (21/09/2020 - 27/09/2020). 189 patients presented to MAS during this time. Data were collected on the presenting complaint, time of attendance (divided into four time categories), and triage colour code for the urgency of a review by a doctor (red: immediately, orange: within 15 minutes, yellow: within 1 hour, green: within 4 hours). The number of triage waiting times that were breached and the outcome of the attendance was noted. Results: 49% of patients presenting to MAS during this time period were triaged, which therefore did not meet the 90% target. 67% of patients who were triaged were seen within their allocated timeframe as designated by their triage colour code, which therefore did not meet the 90% target. The most frequent reason for patient attendance was reduced fetal movements (30.5% of attendances). The busiest time of day (when most patients presented) was between 06:01-12:00, and this was also when the highest number of patients were not triaged (26 patients or 54% of patients presenting in this time category). The most used triage category (59%) was the green colour code (to be seen by a doctor within 4 hours), followed by orange (24%), yellow (14%), and red (3%). 45% of triaged patients were admitted, whilst 55% were discharged. 62% of patients allocated to the green triage category were discharged, as compared to 56% of yellow category patients, 27% of orange category patients, and 50% of red category patients. The time of patient presentation to the hospital was also associated with the level of urgency and outcome. Patients presenting from 12:01 to 18:00 were more likely to be discharged (72% discharged) compared to 00:01-06:00 where only 12.5% of patients were discharged. Conclusion: The triage system for assessing the urgency of acutely presenting obstetric patients is only being effectively utilised for 49% of patients. There is potential for enhancing the employment of the triage system to enable further efficiency and boost the promotion of patient safety. It is noted that MAS was busiest at 06:01 - 12:00 when there was also the highest number of non-triaged patients – this highlights some areas where we can improve, including higher levels of staffing, better use of BSOTS to triage patients, and patient education.

Keywords: birmingham, BSOTS, maternal, obstetric, pregnancy, specific, symptom, triage

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34 Dynamic Building Simulation Based Study to Understand Thermal Behavior of High-Rise Structural Timber Buildings

Authors: Timothy O. Adekunle, Sigridur Bjarnadottir

Abstract:

Several studies have investigated thermal behavior of buildings with limited studies focusing on high-rise buildings. Of the limited investigations that have considered thermal performance of high-rise buildings, only a few studies have considered thermal behavior of high-rise structural sustainable buildings. As a result, this study investigates the thermal behavior of a high-rise structural timber building. The study aims to understand the thermal environment of a high-rise structural timber block of apartments located in East London, UK by comparing the indoor environmental conditions at different floors (ground and upper floors) of the building. The environmental variables (temperature and relative humidity) were measured at 15-minute intervals for a few weeks in the summer of 2012 to generate data that was considered for calibration and validation of the simulated results. The study employed mainly dynamic thermal building simulation using DesignBuilder by EnergyPlus and supplemented with environmental monitoring as major techniques for data collection and analysis. The weather file (Test Reference Years- TRYs) for the 2000s from the weather generator carried out by the Prometheus Group was considered for the simulation since the study focuses on investigating thermal behavior of high-rise structural timber buildings in the summertime and not in extreme summertime. In this study, the simulated results (May-September of the 2000s) will be the focus of discussion, but the results will be briefly compared with the environmental monitoring results. The simulated results followed a similar trend with the findings obtained from the short period of the environmental monitoring at the building. The results revealed lower temperatures are often predicted (at least 1.1°C lower) at the ground floor than the predicted temperatures at the upper floors. The simulated results also showed that higher temperatures are predicted in spaces at southeast facing (at least 0.5°C higher) than spaces in other orientations across the floors considered. There is, however, a noticeable difference between the thermal environment of spaces when the results obtained from the environmental monitoring are compared with the simulated results. The field survey revealed higher temperatures were recorded in the living areas (at least 1.0°C higher) while higher temperatures are predicted in bedrooms (at least 0.9°C) than living areas for the simulation. In addition, the simulated results showed spaces on lower floors of high-rise structural timber buildings are predicted to provide more comfortable thermal environment than spaces on upper floors in summer, but this may not be the same in wintertime due to high upward movement of hot air to spaces on upper floors.

Keywords: building simulation, high-rise, structural timber buildings, sustainable, temperatures, thermal behavior

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33 British Female Muslim Converts: An Investigation into Their De-Conversions from Islam

Authors: Mona Alyedreessy

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This study, which is based on a qualitative study sample of thirty-four British converts from different ages, ethnicities, social classes, areas and religious backgrounds in London, investigates the common challenges, problems and abuse in the name of Islam that many British female Muslim converts experienced during their time as Muslims, which caused them to leave the faith. It is an important study, as it creates an awareness of the weaknesses found in western Muslim societies and in various Islamic educational programs that causes people to leave Islam and contribute towards its negative reputation in the media. The women in this study shared common problems regarding gender and racial discrimination, identity development, feminism, marriage, parenting, Muslim culture, isolation, extremism, belonging and practising Islam in both Muslim and non-Muslim societies with differing sacrifices and consequences that caused them to de-convert. The study argues that many of the personal, religious and social problems female Muslim converts experience are due to a lack of knowledge about Islam and their rights as Muslim women, which often results in them being vulnerable and influenced by the opinions, attitudes and actions of uneducated, abusive, non-practising and extremist Muslims. For example, it was found that young female converts in particular were often taken advantage of and manipulated into believing that many negative actions displayed by patriarchal Muslim husbands were a part of Islam. This created much confusion, especially when their husbands used specific Quran texts and Hadiths to justify their abuse, authority and attitudes that made them miserable. As a result and based on the positive experiences of some converts, the study found that obtaining a broad Islamic education that started with an intimate study of the Prophet Muhammad’s biography alongside being guided by the teachings of western Muslim scholars contributed greatly towards a more enjoyable conversion journey, as women were able to identify and avoid problematic Muslims and abuse in the name of Islam. This in turn helped to create a healthier family unit and Muslim society. Those who enjoyed being Muslims were able to create a balanced western Muslim identity by negotiating and applying their own morals and western values to their understanding of The Prophet’s biography and The Quran and integrated Islamic values into their own secular western environments that were free from foreign cultural practices. The outcomes of the study also highlight some effective modern approaches to da’wah based on the teachings of The Prophet Mohammad and other prophets for young Arab and Asian Muslims who marry, study and live among non-Muslims and converts.

Keywords: abuse, apostasy, converts, Muslims

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32 Implementation of Learning Disability Annual Review Clinics to Ensure Good Patient Care, Safety, and Equality in Covid-19: A Two Pass Audit in General Practice

Authors: Liam Martin, Martha Watson

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Patients with learning disabilities (LD) are at increased risk of physical and mental illness due to health inequality. To address this, NICE recommends that people from the age of 14 with a learning disability should have an annual LD health check. This consultation should include a holistic review of the patient’s physical, mental and social health needs with a view of creating an action plan to support the patient’s care. The expected standard set by the Quality and Outcomes Framework (QOF) is that each general practice should review at least 75% of their LD patients annually. During COVID-19, there have been barriers to primary care, including health anxiety, the shift to online general practice and the increase in GP workloads. A surgery in North London wanted to assess whether they were falling short of the expected standard for LD patient annual reviews in order to optimize care post Covid-19. A baseline audit was completed to assess how many LD patients were receiving their annual reviews over the period of 29th September 2020 to 29th September 2021. This information was accessed using EMIS Web Health Care System (EMIS). Patients included were aged 14 and over as per QOF standards. Doctors were not notified of this audit taking place. Following the results of this audit, the creation of learning disability clinics was recommended. These clinics were recommended to be on the ground floor and should be a dedicated time for LD reviews. A re-audit was performed via the same process 6 months later in March 2022. At the time of the baseline audit, there were 71 patients aged 14 and over that were on the LD register. 54% of these LD patients were found to have documentation of an annual LD review within the last 12 months. None of the LD patients between the ages of 14-18 years old had received their annual review. The results were discussed with the practice, and dedicated clinics were set up to review their LD patients. A second pass of the audit was completed 6 months later. This showed an improvement, with 84% of the LD patients registered at the surgery now having a documented annual review within the last 12 months. 78% of the patients between the ages of 14-18 years old had now been reviewed. The baseline audit revealed that the practice was not meeting the expected standard for LD patient’s annual health checks as outlined by QOF, with the most neglected patients being between the ages of 14-18. Identification and awareness of this vulnerable cohort is important to ensure measures can be put into place to support their physical, mental and social wellbeing. Other practices could consider an audit of their annual LD health checks to make sure they are practicing within QOF standards, and if there is a shortfall, they could consider implementing similar actions as used here; dedicated clinics for LD patient reviews.

Keywords: COVID-19, learning disability, learning disability health review, quality and outcomes framework

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31 Analysis of Environmental Sustainability in Post- Earthquake Reconstruction : A Case of Barpak, Nepal

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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30 Explore and Reduce the Performance Gap between Building Modelling Simulations and the Real World: Case Study

Authors: B. Salehi, D. Andrews, I. Chaer, A. Gillich, A. Chalk, D. Bush

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With the rapid increase of energy consumption in buildings in recent years, especially with the rise in population and growing economies, the importance of energy savings in buildings becomes more critical. One of the key factors in ensuring energy consumption is controlled and kept at a minimum is to utilise building energy modelling at the very early stages of the design. So, building modelling and simulation is a growing discipline. During the design phase of construction, modelling software can be used to estimate a building’s projected energy consumption, as well as building performance. The growth in the use of building modelling software packages opens the door for improvements in the design and also in the modelling itself by introducing novel methods such as building information modelling-based software packages which promote conventional building energy modelling into the digital building design process. To understand the most effective implementation tools, research projects undertaken should include elements of real-world experiments and not just rely on theoretical and simulated approaches. Upon review of the related studies undertaken, it’s evident that they are mostly based on modelling and simulation, which can be due to various reasons such as the more expensive and time-consuming nature of real-time data-based studies. Taking in to account the recent rise of building energy software modelling packages and the increasing number of studies utilising these methods in their projects and research, the accuracy and reliability of these modelling software packages has become even more crucial and critical. This Energy Performance Gap refers to the discrepancy between the predicted energy savings and the realised actual savings, especially after buildings implement energy-efficient technologies. There are many different software packages available which are either free or have commercial versions. In this study, IES VE (Integrated Environmental Solutions Virtual Environment) is used as it is a common Building Energy Modeling and Simulation software in the UK. This paper describes a study that compares real time results with those in a virtual model to illustrate this gap. The subject of the study is a north west facing north-west (345°) facing, naturally ventilated, conservatory within a domestic building in London is monitored during summer to capture real-time data. Then these results are compared to the virtual results of IES VE, which is a commonly used building energy modelling and simulation software in the UK. In this project, the effect of the wrong position of blinds on overheating is studied as well as providing new evidence of Performance Gap. Furthermore, the challenges of drawing the input of solar shading products in IES VE will be considered.

Keywords: building energy modelling and simulation, integrated environmental solutions virtual environment, IES VE, performance gap, real time data, solar shading products

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29 Analysis of Distance Travelled by Plastic Consumables Used in the First 24 Hours of an Intensive Care Admission: Impacts and Methods of Mitigation

Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

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28 Integration of Icf Walls as Diurnal Solar Thermal Storage with Microchannel Solar Assisted Heat Pump for Space Heating and Domestic Hot Water Production

Authors: Mohammad Emamjome Kashan, Alan S. Fung

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In Canada, more than 32% of the total energy demand is related to the building sector. Therefore, there is a great opportunity for Greenhouse Gases (GHG) reduction by integrating solar collectors to provide building heating load and domestic hot water (DHW). Despite the cold winter weather, Canada has a good number of sunny and clear days that can be considered for diurnal solar thermal energy storage. Due to the energy mismatch between building heating load and solar irradiation availability, relatively big storage tanks are usually needed to store solar thermal energy during the daytime and then use it at night. On the other hand, water tanks occupy huge space, especially in big cities, space is relatively expensive. This project investigates the possibility of using a specific building construction material (ICF – Insulated Concrete Form) as diurnal solar thermal energy storage that is integrated with a heat pump and microchannel solar thermal collector (MCST). Not much literature has studied the application of building pre-existing walls as active solar thermal energy storage as a feasible and industrialized solution for the solar thermal mismatch. By using ICF walls that are integrated into the building envelope, instead of big storage tanks, excess solar energy can be stored in the concrete of the ICF wall that consists of EPS insulation layers on both sides to store the thermal energy. In this study, two solar-based systems are designed and simulated inTransient Systems Simulation Program(TRNSYS)to compare ICF wall thermal storage benefits over the system without ICF walls. In this study, the heating load and DHW of a Canadian single-family house located in London, Ontario, are provided by solar-based systems. The proposed system integrates the MCST collector, a water-to-water HP, a preheat tank, the main tank, fan coils (to deliver the building heating load), and ICF walls. During the day, excess solar energy is stored in the ICF walls (charging cycle). Thermal energy can be restored from the ICF walls when the preheat tank temperature drops below the ICF wall (discharging process) to increase the COP of the heat pump. The evaporator of the heat pump is taking is coupled with the preheat tank. The provided warm water by the heat pump is stored in the second tank. Fan coil units are in contact with the tank to provide a building heating load. DHW is also delivered is provided from the main tank. It is investigated that the system with ICF walls with an average solar fraction of 82%- 88% can cover the whole heating demand+DHW of nine months and has a 10-15% higher average solar fraction than the system without ICF walls. Sensitivity analysis for different parameters influencing the solar fraction is discussed in detail.

Keywords: net-zero building, renewable energy, solar thermal storage, microchannel solar thermal collector

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27 Troubling Depictions of Gambian Womanhood in Dayo Forster’s Reading the Ceiling

Authors: A. Wolfe

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Dayo Forster’s impressively crafted Reading the Ceiling (2007) enjoys a relatively high profile among Western readers. It is one of only a handful of Gambian novels to be published by an international publisher, Simon and Schuster of London, and was subsequently shortlisted for the Commonwealth Writer’s Best First Book Prize in 2008. It is currently available to US readers in print and as an e-book and has 167 ratings on Goodreads. This paper addresses the possible influence of the book on Western readers’ perception of The Gambia, or Africa in general, through its depiction of the conditions of Gambian women’s lives. Through a close reading of passages and analysis of imagery, intertextuality, and characterization in the book, the paper demonstrates that Forster portrays the culture of The Gambia as oppressively patriarchal and the prospects for young girls who stay in the country as extremely limited. Reading the Ceiling starts on Ayodele’s 18th birthday, the day she has planned to have sex for the first time. Most of the rest of the book is divided into three parts, each following the chain of events that occur after sex with a potential partner. Although Ayodele goes abroad for her education in each of the three scenarios, she ultimately capitulates to the patriarchal politics and demands of marriage and childrearing in The Gambia, settling for relationships with men she does not love, cooking and cleaning for husbands and children, and silencing her own opinions and desires in exchange for the familiar traditions of patriarchal—and, in one case, polygamous—marriage. Each scenario ends with resignation to death, as, after her mother’s funeral, Ayodele admits to herself that she will be next. Forster uses dust and mud imagery throughout the novel to indicate the dinginess of Ayodele’s life as a young woman, and then wife and mother, in The Gambia as well as the inescapability of this life. This depiction of earthen material is also present in the novel’s recounting of an oral tale about a mermaid captured by fishermen, a story that mirrors Ayodele’s ensnarement by traditional marriage customs and gender norms. A review of the fate of other characters in the novel reveals that Ayodele is not the only woman who becomes trapped by the expectations for women in The Gambia, as those who stay in the country end up subservient to their husbands and/or victims of men’s habitual infidelity. It is important to note that Reading the Ceiling is focused on the experiences of a minority—The Gambia’s middle class, Christian urban dwellers with money for education. Regardless of its limited scope, the novel clearly depicts The Gambia as a place where women are simply unable to successfully contend against traditional patriarchal norms. Although this novel evokes vivid imagery of The Gambia through original and compelling descriptions of food preparation, clothing, and scenery, it perhaps does little to challenge stereotypical perceptions of the lives of African women among a Western readership.

Keywords: African literature, commonwealth literature, marriage, stereotypes, women

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26 Using Google Distance Matrix Application Programming Interface to Reveal and Handle Urban Road Congestion Hot Spots: A Case Study from Budapest

Authors: Peter Baji

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In recent years, a growing body of literature emphasizes the increasingly negative impacts of urban road congestion in the everyday life of citizens. Although there are different responses from the public sector to decrease traffic congestion in urban regions, the most effective public intervention is using congestion charges. Because travel is an economic asset, its consumption can be controlled by extra taxes or prices effectively, but this demand-side intervention is often unpopular. Measuring traffic flows with the help of different methods has a long history in transport sciences, but until recently, there was not enough sufficient data for evaluating road traffic flow patterns on the scale of an entire road system of a larger urban area. European cities (e.g., London, Stockholm, Milan), in which congestion charges have already been introduced, designated a particular zone in their downtown for paying, but it protects only the users and inhabitants of the CBD (Central Business District) area. Through the use of Google Maps data as a resource for revealing urban road traffic flow patterns, this paper aims to provide a solution for a fairer and smarter congestion pricing method in cities. The case study area of the research contains three bordering districts of Budapest which are linked by one main road. The first district (5th) is the original downtown that is affected by the congestion charge plans of the city. The second district (13th) lies in the transition zone, and it has recently been transformed into a new CBD containing the biggest office zone in Budapest. The third district (4th) is a mainly residential type of area on the outskirts of the city. The raw data of the research was collected with the help of Google’s Distance Matrix API (Application Programming Interface) which provides future estimated traffic data via travel times between freely fixed coordinate pairs. From the difference of free flow and congested travel time data, the daily congestion patterns and hot spots are detectable in all measured roads within the area. The results suggest that the distribution of congestion peak times and hot spots are uneven in the examined area; however, there are frequently congested areas which lie outside the downtown and their inhabitants also need some protection. The conclusion of this case study is that cities can develop a real-time and place-based congestion charge system that forces car users to avoid frequently congested roads by changing their routes or travel modes. This would be a fairer solution for decreasing the negative environmental effects of the urban road transportation instead of protecting a very limited downtown area.

Keywords: Budapest, congestion charge, distance matrix API, application programming interface, pilot study

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25 Urban Planning Patterns after (COVID-19): An Assessment toward Resiliency

Authors: Mohammed AL-Hasani

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The Pandemic COVID-19 altered the daily habits and affected the functional performance of the cities after this crisis leaving remarkable impacts on many metropolises worldwide. It is so obvious that having more densification in the city leads to more threats altering this main approach that was called for achieving sustainable development. The main goal to achieve resiliency in the cities, especially in forcing risks, is to deal with a planning system that is able to resist, absorb, accommodate and recover from the impacts that had been affected. Many Cities in London, Wuhan, New York, and others worldwide carried different planning approaches and varied in reaction to safeguard the impacts of the pandemic. The cities globally varied from the radiant pattern predicted by Le Corbusier, or having multi urban centers more like the approach of Frank Lloyd Wright’s Broadacre City, or having linear growth or gridiron expansion that was common by Doxiadis, compact pattern, and many other hygiene patterns. These urban patterns shape the spatial distribution and Identify both open and natural spaces with gentrified and gentrifying areas. This crisis paid attention to reassess many planning approaches and examine the existing urban patterns focusing more on the aim of continuity and resiliency in managing the crises within the rapid transformation and the power of market forces. According to that, this paper hypothesized that those urban planning patterns determine the method of reaction in assuring quarantine for the inhabitance and the performance of public services and need to be updated through carrying out an innovative urban management system and adopt further resilience patterns in prospective urban planning approaches. This paper investigates the adaptivity and resiliency of variant urban planning patterns regarding selected cities worldwide that affected by COVID-19 and their role in applying certain management strategies in controlling the pandemic spread, finding out the main potentials that should be included in prospective planning approaches. The examination encompasses the spatial arrangement, blocks definition, plots arrangement, and urban space typologies. This paper aims to investigate the urban patterns to deliberate also the debate between densification as one of the more sustainable planning approaches and disaggregation tendency that was followed after the pandemic by restructuring and managing its application according to the assessment of the spatial distribution and urban patterns. The biggest long-term threat to dense cities proves the need to shift to online working and telecommuting, creating a mixture between using cyber and urban spaces to remobilize the city. Reassessing spatial design and growth, open spaces, urban population density, and public awareness are the main solutions that should be carried out to face the outbreak in our current cities that should be managed from global to tertiary levels and could develop criteria for designing the prospective cities

Keywords: COVID-19, densification, resiliency, urban patterns

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24 Nurture Early for Optimal Nutrition: A Community-Based Randomized Controlled Trial to Improve Infant Feeding and Care Practices Using Participatory Learning and Actions Approach

Authors: Priyanka Patil, Logan Manikam

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Background: The first 1000 days of life are a critical window and can result in adverse health consequences due to inadequate nutrition. South-Asian (SA) communities face significant health disparities, particularly in maternal and child health. Community-based interventions, often employing Participatory-Learning and Action (PLA) approaches, have effectively addressed health inequalities in lower-income nations. The aim of this study was to assess the feasibility of implementing a PLA intervention to improve infant feeding and care practices in SA communities living in London. Methods: Comprehensive analyses were conducted to assess the feasibility/fidelity of this pilot randomized controlled trial. Summary statistics were computed to compare key metrics, including participant consent rates, attendance, retention, intervention support, and perceived effectiveness, against predefined progression rules guiding toward a definitive trial. Secondary outcomes were analyzed, drawing insights from multiple sources, such as The Children’s-Eating-Behaviour Questionnaire (CEBQ), Parental-Feeding-Style Questionnaires (PFSQ), Food-diary, and the Equality-Impact-Assessment (EIA) tool. A video analysis of children's mealtime behavior trends was conducted. Feedback interviews were collected from study participants. Results: Process-outcome measures met predefined progression rules for a definitive trial, which deemed the intervention as feasible and acceptable. The secondary outcomes analysis revealed no significant changes in children's BMI z-scores. This could be attributed to the abbreviated follow-up period of 6 months, reduced from 12 months, due to COVID-19-related delays. CEBQ analysis showed increased food responsiveness, along with decreased emotional over/undereating. A similar trend was observed in PFSQ. The EIA tool found no potential discrimination areas, and video analysis revealed a decrease in force-feeding practices. Participant feedback revealed improved awareness and knowledge sharing. Conclusion: This study demonstrates that a co-adapted PLA intervention is feasible and well-received in optimizing infant-care practices among South-Asian community members in a high-income country. These findings highlight the potential of community-based interventions to enhance health outcomes, promoting health equity.

Keywords: child health, childhood obesity, community-based, infant nutrition

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23 An Audit of Climate Change and Sustainability Teaching in Medical School

Authors: Karolina Wieczorek, Zofia Przypaśniak

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Climate change is a rapidly growing threat to global health, and part of the responsibility to combat it lies within the healthcare sector itself, including adequate education of future medical professionals. To mitigate the consequences, the General Medical Council (GMC) has equipped medical schools with a list of outcomes regarding sustainability teaching. Students are expected to analyze the impact of the healthcare sector’s emissions on climate change. The delivery of the related teaching content is, however, often inadequate and insufficient time is devoted for exploration of the topics. Teaching curricula lack in-depth exploration of the learning objectives. This study aims to assess the extent and characteristics of climate change and sustainability subjects teaching in the curriculum of a chosen UK medical school (Barts and The London School of Medicine and Dentistry). It compares the data to the national average scores from the Climate Change and Sustainability Teaching (C.A.S.T.) in Medical Education Audit to draw conclusions about teaching on a regional level. This is a single-center audit of the timetabled sessions of teaching in the medical course. The study looked at the academic year 2020/2021 which included a review of all non-elective, core curriculum teaching materials including tutorials, lectures, written resources, and assignments in all five years of the undergraduate and graduate degrees, focusing only on mandatory teaching attended by all students (excluding elective modules). The topics covered were crosschecked with GMC Outcomes for graduates: “Educating for Sustainable Healthcare – Priority Learning Outcomes” as gold standard to look for coverage of the outcomes and gaps in teaching. Quantitative data was collected in form of time allocated for teaching as proxy of time spent per individual outcomes. The data was collected independently by two students (KW and ZP) who have received prior training and assessed two separate data sets to increase interrater reliability. In terms of coverage of learning outcomes, 12 out of 13 were taught (with the national average being 9.7). The school ranked sixth in the UK for time spent per topic and second in terms of overall coverage, meaning the school has a broad range of topics taught with some being explored in more detail than others. For the first outcome 4 out of 4 objectives covered (average 3.5) with 47 minutes spent per outcome (average 84 min), for the second objective 5 out of 5 covered (average 3.5) with 46 minutes spent (average 20), for the third 3 out of 4 (average 2.5) with 10 mins pent (average 19 min). A disproportionately large amount of time is spent delivering teaching regarding air pollution (respiratory illnesses), which resulted in the topic of sustainability in other specialties being excluded from teaching (musculoskeletal, ophthalmology, pediatrics, renal). Conclusions: Currently, there is no coherent strategy on national teaching of climate change topics and as a result an unstandardized amount of time spent on teaching and coverage of objectives can be observed.

Keywords: audit, climate change, sustainability, education

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22 Evaluation of Trabectedin Safety and Effectiveness at a Tertiary Cancer Center at Qatar: A Retrospective Analysis

Authors: Nabil Omar, Farah Jibril, Oraib Amjad

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Purpose: Trabecatine is a is a potent marine-derived antineoplastic drug which binds to the minor groove of the DNA, bending DNA towards the major groove resulting in a changed conformation that interferes with several DNA transcription factors, repair pathways and cell proliferation. Trabectedin was approved by the European Medicines Agency (EMA; London, UK) for the treatment of adult patients with advanced stage soft tissue sarcomas in whom treatment with anthracyclines and ifosfamide has failed, or for those who are not candidates for these therapies. The recommended dosing regimen is 1.5 mg/m2 IV over 24 hours every 3 weeks. The purpose of this study was to comprehensively review available data on the safety and efficacy of trabectedin used as indicated for patients at a Tertiary Cancer Center at Qatar. Methods: A medication administration report generated in the electronic health record identified all patients who received trabectedin between November 1, 2015 and November 1, 2017. This retrospective chart review evaluated the indication of trabectedin use, compliance to administration protocol and the recommended monitoring parameters, number of patients improved on the drug and continued treatment, number of patients discontinued treatment due to side-effects and the reported side effects. Progress and discharged notes were utilized to report experienced side effects during trabectedin therapy. A total of 3 patients were reviewed. Results: Total of 2 out of 3 patients who received trabectedin were receiving it for non-FDA and non-EMA, approved indications; metastatic rhabdomyosarcoma and ovarian cancer stage IV with poor prognosis. And only one patient received it as indicated for leiomyosarcoma of left ureter with metastases to liver, lungs and bone. None of the patients has continued the therapy due to development of serious side effects. One patient had stopped the medication after one cycle due to disease progression and transient hepatic toxicity, the other one had disease progression and developed 12 % reduction in LVEF after 12 cycles of trabectedin, and the third patient deceased, had disease progression on trabectedin after the 10th cycle that was received through peripheral line which resulted in developing extravasation and left arm cellulitis requiring debridement. Regarding monitoring parameters, at baseline the three patients had ECHO, and Creatine Phosphokinase (CPK) but it was not monitored during treatment as recommended. Conclusion: Utilizing this medication as indicated with performing the appropriate monitoring parameters as recommended can benefit patients who are receiving it. It is important to reinforce the intravenous administration via central intravenous line, the re-assessment of left ventricular ejection fraction (LVEF) by echocardiogram or multigated acquisition (MUGA) scan at 2- to 3-month intervals thereafter until therapy is discontinued, and CPK and LFTs levels prior to each administration of trabectedin.

Keywords: trabectedin, drug-use evaluation, safety, effectiveness, adverse drug reaction, monitoring

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21 Assessing the Outcomes of Collaboration with Students on Curriculum Development and Design on an Undergraduate Art History Module

Authors: Helen Potkin

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This paper presents a practice-based case study of a project in which the student group designed and planned the curriculum content, classroom activities and assessment briefs in collaboration with the tutor. It focuses on the co-creation of the curriculum within a history and theory module, Researching the Contemporary, which runs for BA (Hons) Fine Art and Art History and for BA (Hons) Art Design History Practice at Kingston University, London. The paper analyses the potential of collaborative approaches to engender students’ investment in their own learning and to encourage reflective and self-conscious understandings of themselves as learners. It also addresses some of the challenges of working in this way, attending to the risks involved and feelings of uncertainty produced in experimental, fluid and open situations of learning. Alongside this, it acknowledges the tensions inherent in adopting such practices within the framework of the institution and within the wider of context of the commodification of higher education in the United Kingdom. The concept underpinning the initiative was to test out co-creation as a creative process and to explore the possibilities of altering the traditional hierarchical relationship between teacher and student in a more active, participatory environment. In other words, the project asked about: what kind of learning could be imagined if we were all in it together? It considered co-creation as producing different ways of being, or becoming, as learners, involving us reconfiguring multiple relationships: to learning, to each other, to research, to the institution and to our emotions. The project provided the opportunity for students to bring their own research and wider interests into the classroom, take ownership of sessions, collaborate with each other and to define the criteria against which they would be assessed. Drawing on students’ reflections on their experience of co-creation alongside theoretical considerations engaging with the processual nature of learning, concepts of equality and the generative qualities of the interrelationships in the classroom, the paper suggests that the dynamic nature of collaborative and participatory modes of engagement have the potential to foster relevant and significant learning experiences. The findings as a result of the project could be quantified in terms of the high level of student engagement in the project, specifically investment in the assessment, alongside the ambition and high quality of the student work produced. However, reflection on the outcomes of the experiment prompts a further set of questions about the nature of positionality in connection to learning, the ways our identities as learners are formed in and through our relationships in the classroom and the potential and productive nature of creative practice in education. Overall, the paper interrogates questions of what it means to work with students to invent and assemble the curriculum and it assesses the benefits and challenges of co-creation. Underpinning it is the argument that, particularly in the current climate of higher education, it is increasingly important to ask what it means to teach and to envisage what kinds of learning can be possible.

Keywords: co-creation, collaboration, learning, participation, risk

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20 Conservation Detection Dogs to Protect Europe's Native Biodiversity from Invasive Species

Authors: Helga Heylen

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With dogs saving wildlife in New Zealand since 1890 and governments in Africa, Australia and Canada trusting them to give the best results, Conservation Dogs Ireland want to introduce more detection dogs to protect Europe's native wildlife. Conservation detection dogs are fast, portable and endlessly trainable. They are a cost-effective, highly sensitive and non-invasive way to detect protected and invasive species and wildlife disease. Conservation dogs find targets up to 40 times faster than any other method. They give results instantly, with near-perfect accuracy. They can search for multiple targets simultaneously, with no reduction in efficacy The European Red List indicates the decline in biodiversity has been most rapid in the past 50 years, and the risk of extinction never higher. Just two examples of major threats dogs are trained to tackle are: (I)Japanese Knotweed (Fallopia Japonica), not only a serious threat to ecosystems, crops, structures like bridges and roads - it can wipe out the entire value of a house. The property industry and homeowners are only just waking up to the full extent of the nightmare. When those working in construction on the roads move topsoil with a trace of Japanese Knotweed, it suffices to start a new colony. Japanese Knotweed grows up to 7cm a day. It can stay dormant and resprout after 20 years. In the UK, the cost of removing Japanese Knotweed from the London Olympic site in 2012 was around £70m (€83m). UK banks already no longer lend on a house that has Japanese Knotweed on-site. Legally, landowners are now obliged to excavate Japanese Knotweed and have it removed to a landfill. More and more, we see Japanese Knotweed grow where a new house has been constructed, and topsoil has been brought in. Conservation dogs are trained to detect small fragments of any part of the plant on sites and in topsoil. (II)Zebra mussels (Dreissena Polymorpha) are a threat to many waterways in the world. They colonize rivers, canals, docks, lakes, reservoirs, water pipes and cooling systems. They live up to 3 years and will release up to one million eggs each year. Zebra mussels attach to surfaces like rocks, anchors, boat hulls, intake pipes and boat engines. They cause changes in nutrient cycles, reduction of plankton and increased plant growth around lake edges, leading to the decline of Europe's native mussel and fish populations. There is no solution, only costly measures to keep it at bay. With many interconnected networks of waterways, they have spread uncontrollably. Conservation detection dogs detect the Zebra mussel from its early larvae stage, which is still invisible to the human eye. Detection dogs are more thorough and cost-effective than any other conservation method, and will greatly complement and speed up the work of biologists, surveyors, developers, ecologists and researchers.

Keywords: native biodiversity, conservation detection dogs, invasive species, Japanese Knotweed, zebra mussel

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19 Intermodal Strategies for Redistribution of Agrifood Products in the EU: The Case of Vegetable Supply Chain from Southeast of Spain

Authors: Juan C. Pérez-Mesa, Emilio Galdeano-Gómez, Jerónimo De Burgos-Jiménez, José F. Bienvenido-Bárcena, José F. Jiménez-Guerrero

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Environmental cost and transport congestion on roads resulting from product distribution in Europe have to lead to the creation of various programs and studies seeking to reduce these negative impacts. In this regard, apart from other institutions, the European Commission (EC) has designed plans in recent years promoting a more sustainable transportation model in an attempt to ultimately shift traffic from the road to the sea by using intermodality to achieve a model rebalancing. This issue proves especially relevant in supply chains from peripheral areas of the continent, where the supply of certain agrifood products is high. In such cases, the most difficult challenge is managing perishable goods. This study focuses on new approaches that strengthen the modal shift, as well as the reduction of externalities. This problem is analyzed by attempting to promote intermodal system (truck and short sea shipping) for transport, taking as point of reference highly perishable products (vegetables) exported from southeast Spain, which is the leading supplier to Europe. Methodologically, this paper seeks to contribute to the literature by proposing a different and complementary approach to establish a comparison between intermodal and the “only road” alternative. For this purpose, the multicriteria decision is utilized in a p-median model (P-M) adapted to the transport of perishables and to a means of shipping selection problem, which must consider different variables: transit cost, including externalities, time, and frequency (including agile response time). This scheme avoids bias in decision-making processes. By observing the results, it can be seen that the influence of the externalities as drivers of the modal shift is reduced when transit time is introduced as a decision variable. These findings confirm that the general strategies, those of the EC, based on environmental benefits lose their capacity for implementation when they are applied to complex circumstances. In general, the different estimations reveal that, in the case of perishables, intermodality would be a secondary and viable option only for very specific destinations (for example, Hamburg and nearby locations, the area of influence of London, Paris, and the Netherlands). Based on this framework, the general outlook on this subject should be modified. Perhaps the government should promote specific business strategies based on new trends in the supply chain, not only on the reduction of externalities, and find new approaches that strengthen the modal shift. A possible option is to redefine ports, conceptualizing them as digitalized redistribution and coordination centers and not only as areas of cargo exchange.

Keywords: environmental externalities, intermodal transport, perishable food, transit time

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18 Socio-Economic Transformation of Barpak Post-Earthquake Reconstruction

Authors: Sudikshya Bhandari, Jonathan K. London

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The earthquake of April 2015 was one of the biggest disasters in the history of Nepal. The epicenter was located near Barpak, north of the Gorkha district. Before the disaster, this settlement was a compact and homogeneous settlement manifesting its uniqueness through the social and cultural activities, and a distinct vernacular architecture. Narrow alleys with stone paved streets, buildings with slate roofs, and common spaces between the houses made this settlement socially, culturally, and environmentally cohesive. With the presence of micro hydro power plants, local economic activities enabled the local community to exist and thrive. Agriculture and animal rearing are the sources of livelihood for the majority of families, along with the booming homestays (where local people welcome guests to their home, as a business) and local shops. Most of these activities are difficult to find as the houses have been destroyed with the earthquake and the process of reconstruction has been transforming the outlook of the settlement. This study characterized the drastic transformation in Barpak post-earthquake, and analyzed the consequences of the reconstruction process. In addition, it contributes to comprehending a broader representation about unsustainability created by the lack of contextual post-disaster development. Since the research is based in a specific area, a case study approach was used. Sample houses were selected on the basis of ethnicity and house typology. Mixed methods such as key informant and semi structured interviews, focus groups, observations and photographs are used for the collection of data. The research focus is predominantly on the physical change of the house typology from vernacular to externally adopted designs. This transformation of the house entails socio-cultural changes such as social fragmentation with differences among the rich and the poor and decreases in the social connectivity within families and neighborhood. Families have found that new houses require more maintenance and resources that have increased their economic expenses. The study also found that the reconstructed houses are not thermally comfortable in the cold climate of Barpak, leading to the increased use of different sources of heating like electric heaters and more firewood. Lack of storage spaces for crops and livestock have discouraged them to pursue traditional means of livelihood and depend more on buying food from stores, ultimately making it less economical for most of the families. The transformation of space leading to the economic, social and cultural changes demonstrates the unsustainability of Barpak. Conclusions from the study suggest place based and inclusive planning and policy formations that include locals as partners, identifying the possible ways to minimize the impact and implement these recommendations into the future policy and planning scenarios.

Keywords: earthquake, Nepal, reconstruction, settlement, transformation

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17 Introduction of Acute Paediatric Services in Primary Care: Evaluating the Impact on GP Education

Authors: Salman Imran, Chris Healey

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Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.

Keywords: clinics, education, paediatricians, primary care

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16 Higher Education in India Strength, Weakness, Opportunities and Threats

Authors: Renu Satish Nair

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Indian higher education system is the third largest in the world next to United States and China. India is experiencing a rapid growth in higher education in terms of student enrollment as well as establishment of new universities, colleges and institutes of national importance. Presently about 22 million students are being enrolled in higher education and more than 46 thousand institutions’ are functioning as centers of higher education. Indian government plays a 'command and control' role in higher education. The main governing body is University Grants Commission, which enforces its standards, advises the government, and helps coordinate between the centre and the state. Accreditation of higher learning is over seen by 12 autonomous institutions established by the University Grants Commission. The present paper is an effort to analyze the strength, weakness, opportunities and threat (SWOT Analysis) of Indian Higher education system. The higher education in India is progressing ahead by virtue of its strength which is being recognized at global level. Several institutions of India, such as Indian Institutes of Technology (IITs), Indian Institutes of Management (IIMs) and National Institutes of Technology (NITs) have been globally acclaimed for their standard of education. Three Indian universities were listed in the Times Higher Education list of the world’s top 200 universities i.e. Indian Institutes of Technology, Indian Institute of Management and Jawahar Lal Nehru University in 2005 and 2006. Six Indian Institutes of Technology and the Birla Institute of Technology and Science - Pilani were listed among the top 20 science and technology schools in Asia by the Asia Week. The school of Business situated in Hyderabad was ranked number 12 in Globe MBA ranking by the Financial Times of London in 2010 while the All India Institute of Medical Sciences has been recognized as a global leader in medical research and treatment. But at the same time, because of vast expansion, the system bears several weaknesses. The Indian higher education system in many parts of the country is in the state of disrepair. In almost half the districts in the country higher education enrollment are very low. Almost two third of total universities and 90% of colleges are rated below average on quality parameters. This can be attributed to the under prepared faculty, unwieldy governance and other obstacles to innovation and improvement that could prohibit India from meeting its national education goals. The opportunities in Indian higher education system are widely ranged. The national institutions are training their products to compete at global level and make them capable to grab opportunities worldwide. The state universities and colleges with their limited resources are giving the products that are capable enough to secure career opportunities and hold responsible positions in various government and private sectors with in the country. This is further creating opportunities for the weaker section of the society to join the main stream. There are several factors which can be defined as threats to Indian higher education system. It is a matter of great concern and needs proper attention. Some important factors are -Conservative society, particularly for women education; -Lack of transparency, -Taking higher education as a means of business

Keywords: Indian higher education system, SWOT analysis, university grants commission, Indian institutes of technology

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15 Feasibility of Washing/Extraction Treatment for the Remediation of Deep-Sea Mining Trailings

Authors: Kyoungrean Kim

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Importance of deep-sea mineral resources is dramatically increasing due to the depletion of land mineral resources corresponding to increasing human’s economic activities. Korea has acquired exclusive exploration licenses at four areas which are the Clarion-Clipperton Fracture Zone in the Pacific Ocean (2002), Tonga (2008), Fiji (2011) and Indian Ocean (2014). The preparation for commercial mining of Nautilus minerals (Canada) and Lockheed martin minerals (USA) is expected by 2020. The London Protocol 1996 (LP) under International Maritime Organization (IMO) and International Seabed Authority (ISA) will set environmental guidelines for deep-sea mining until 2020, to protect marine environment. In this research, the applicability of washing/extraction treatment for the remediation of deep-sea mining tailings was mainly evaluated in order to present preliminary data to develop practical remediation technology in near future. Polymetallic nodule samples were collected at the Clarion-Clipperton Fracture Zone in the Pacific Ocean, then stored at room temperature. Samples were pulverized by using jaw crusher and ball mill then, classified into 3 particle sizes (> 63 µm, 63-20 µm, < 20 µm) by using vibratory sieve shakers (Analysette 3 Pro, Fritsch, Germany) with 63 µm and 20 µm sieve. Only the particle size 63-20 µm was used as the samples for investigation considering the lower limit of ore dressing process which is tens to 100 µm. Rhamnolipid and sodium alginate as biosurfactant and aluminum sulfate which are mainly used as flocculant were used as environmentally friendly additives. Samples were adjusted to 2% liquid with deionized water then mixed with various concentrations of additives. The mixture was stirred with a magnetic bar during specific reaction times and then the liquid phase was separated by a centrifugal separator (Thermo Fisher Scientific, USA) under 4,000 rpm for 1 h. The separated liquid was filtered with a syringe and acrylic-based filter (0.45 µm). The extracted heavy metals in the filtered liquid were then determined using a UV-Vis spectrometer (DR-5000, Hach, USA) and a heat block (DBR 200, Hach, USA) followed by US EPA methods (8506, 8009, 10217 and 10220). Polymetallic nodule was mainly composed of manganese (27%), iron (8%), nickel (1.4%), cupper (1.3 %), cobalt (1.3%) and molybdenum (0.04%). Based on remediation standards of various countries, Nickel (Ni), Copper (Cu), Cadmium (Cd) and Zinc (Zn) were selected as primary target materials. Throughout this research, the use of rhamnolipid was shown to be an effective approach for removing heavy metals in samples originated from manganese nodules. Sodium alginate might also be one of the effective additives for the remediation of deep-sea mining tailings such as polymetallic nodules. Compare to the use of rhamnolipid and sodium alginate, aluminum sulfate was more effective additive at short reaction time within 4 h. Based on these results, sequencing particle separation, selective extraction/washing, advanced filtration of liquid phase, water treatment without dewatering and solidification/stabilization may be considered as candidate technologies for the remediation of deep-sea mining tailings.

Keywords: deep-sea mining tailings, heavy metals, remediation, extraction, additives

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14 An Alternative to Problem-Based Learning in a Post-Graduate Healthcare Professional Programme

Authors: Brogan Guest, Amy Donaldson-Perrott

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The Master’s of Physician Associate Studies (MPAS) programme at St George’s, University of London (SGUL), is an intensive two-year course that trains students to become physician associates (PAs). PAs are generalized healthcare providers who work in primary and secondary care across the UK. PA programmes face the difficult task of preparing students to become safe medical providers in two short years. Our goal is to teach students to develop clinical reasoning early on in their studies and historically, this has been done predominantly though problem-based learning (PBL). We have had an increase concern about student engagement in PBL and difficulty recruiting facilitators to maintain the low student to facilitator ratio required in PBL. To address this issue, we created ‘Clinical Application of Anatomy and Physiology (CAAP)’. These peer-led, interactive, problem-based, small group sessions were designed to facilitate students’ clinical reasoning skills. The sessions were designed using the concept of Team-Based Learning (TBL). Students were divided into small groups and each completed a pre-session quiz consisting of difficult questions devised to assess students’ application of medical knowledge. The quiz was completed in small groups and they were not permitted access of external resources. After the quiz, students worked through a series of openended, clinical tasks using all available resources. They worked at their own pace and the session was peer-led, rather than facilitator-driven. For a group of 35 students, there were two facilitators who observed the sessions. The sessions utilised an infinite space whiteboard software. Each group member was encouraged to actively participate and work together to complete the 15-20 tasks. The session ran for 2 hours and concluded with a post-session quiz, identical to the pre-session quiz. We obtained subjective feedback from students on their experience with CAAP and evaluated the objective benefit of the sessions through the quiz results. Qualitative feedback from students was generally positive with students feeling the sessions increased engagement, clinical understanding, and confidence. They found the small group aspect beneficial and the technology easy to use and intuitive. They also liked the benefit of building a resource for their future revision, something unique to CAAP compared to PBL, which out students participate in weekly. Preliminary quiz results showed improvement from pre- and post- session; however, further statistical analysis will occur once all sessions are complete (final session to run December 2022) to determine significance. As a post-graduate healthcare professional programme, we have a strong focus on self-directed learning. Whilst PBL has been a mainstay in our curriculum since its inception, there are limitations and concerns about its future in view of student engagement and facilitator availability. Whilst CAAP is not TBL, it draws on the benefits of peer-led, small group work with pre- and post- team-based quizzes. The pilot of these sessions has shown that students are engaged by CAAP, and they can make significant progress in clinical reasoning in a short amount of time. This can be achieved with a high student to facilitator ratio.

Keywords: problem based learning, team based learning, active learning, peer-to-peer teaching, engagement

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13 The Importance of School Culture in Supporting Student Mental Health Following the COVID-19 Pandemic: Insights from a Qualitative Study

Authors: Rhiannon Barker, Gregory Hartwell, Matt Egan, Karen Lock

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Background: Evidence suggests that mental health (MH) issues in children and young people (CYP) in the UK are on the rise. Of particular concern is data that indicates that the pandemic, together with the impact of school closures, have accentuated already pronounced inequalities; children from families on low incomes or from black and minority ethnic groups are reportedly more likely to have been adversely impacted. This study aimed to help identify specific support which may facilitate the building of a positive school climate and protect student mental health, particularly in the wake of school closures following the pandemic. It has important implications for integrated working between schools and statutory health services. Methods: The research comprised of three parts; scoping, case studies, and a stakeholder workshop to explore and consolidate results. The scoping phase included a literature review alongside interviews with a range of stakeholders from government, academia, and the third sector. Case studies were then conducted in two London state schools. Results: Our research identified how student MH was being impacted by a range of factors located at different system levels, both internal to the school and in the wider community. School climate, relating both to a shared system of beliefs and values, as well as broader factors including style of leadership, teaching, discipline, safety, and relationships -all played a role in the experience of school life and, consequently, the MH of both students and staff. Participants highlighted the importance of a whole school approach and ensuring that support for student MH was not separated from academic achievement, as well as the importance of identifying and applying universal measuring systems to establish levels of MH need. Our findings suggest that a school’s climate is influenced by the style and strength of its leadership, while this school climate - together with mechanisms put in place to respond to MH needs (both statutory and non-statutory) - plays a key role in supporting student MH. Implications: Schools in England have a responsibility to decide on the nature of MH support provided for their students, and there is no requirement for them to report centrally on the form this provision takes. The reality on the ground, as our study suggests, is that MH provision varies significantly between schools, particularly in relation to ‘lower’ levels of need which are not covered by statutory requirements. A valid concern may be that in the huge raft of possible options schools have to support CYP wellbeing, too much is left to chance. Work to support schools in rebuilding their cultures post-lockdowns must include the means to identify and promote appropriate tools and techniques to facilitate regular measurement of student MH. This will help establish both the scale of the problem and monitor the effectiveness of the response. A strong vision from a school’s leadership team that emphasises the importance of student wellbeing, running alongside (but not overshadowed by) academic attainment, should help shape a school climate to promote beneficial MH outcomes. The sector should also be provided with support to improve the consistency and efficacy of MH provision in schools across the country.

Keywords: mental health, schools, young people, whole-school culture

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12 Application of 3D Apparel CAD for Costume Reproduction

Authors: Zi Y. Kang, Tracy D. Cassidy, Tom Cassidy

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3D apparel CAD is one of the remarkable products in advanced technology which enables intuitive design, visualisation and evaluation of garments through stereoscopic drape simulation. The progressive improvements of 3D apparel CAD have led to the creation of more realistic clothing simulation which is used not only in design development but also in presentation, promotion and communication for fashion as well as other industries such as film, game and social network services. As a result, 3D clothing technology is becoming more ubiquitous in human culture and lives today. This study considers that such phenomenon implies that the technology has reached maturity and it is time to inspect the status of current technology and to explore its potential uses in ways to create cultural values to further move forward. For this reason, this study aims to generate virtual costumes as culturally significant objects using 3D apparel CAD and to assess its capability, applicability and attitudes of the audience towards clothing simulation through comparison with physical counterparts. Since the access to costume collection is often limited due to the conservative issues, the technology may make valuable contribution by democratization of culture and knowledge for museums and its audience. This study is expected to provide foundation knowledge for development of clothing technology and for expanding its boundary of practical uses. To prevent any potential damage, two replicas of the costumes in the 1860s and 1920s at the Museum of London were chosen as samples. Their structural, visual and physical characteristics were measured and collected using patterns, scanned images of fabrics and objective fabric measurements with scale, KES-F (Kawabata Evaluation System of Fabrics) and Titan. Commercial software, DC Suite 5.0 was utilised to create virtual costumes applying collected data and the following outcomes were produced for the evaluation: Images of virtual costumes and video clips showing static and dynamic simulation. Focus groups were arranged with fashion design students and the public for evaluation which exposed the outcomes together with physical samples, fabrics swatches and photographs. The similarities, application and acceptance of virtual costumes were estimated through discussion and a questionnaire. The findings show that the technology has the capability to produce realistic or plausible simulation but expression of some factors such as details and capability of light material requires improvements. While the use of virtual costumes was viewed as more interesting and futuristic replacements to physical objects by the public group, the fashion student group noted more differences in detail and preferred physical garments highlighting the absence of tangibility. However, the advantages and potential of virtual costumes as effective and useful visual references for educational and exhibitory purposes were underlined by both groups. Although 3D apparel CAD has sufficient capacity to assist garment design process, it has limits in identical replication and more study on accurate reproduction of details and drape is needed for its technical improvements. Nevertheless, the virtual costumes in this study demonstrated the possibility of the technology to contribute to cultural and knowledgeable value creation through its applicability and as an interesting way to offer 3D visual information.

Keywords: digital clothing technology, garment simulation, 3D Apparel CAD, virtual costume

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11 Organisational Mindfulness Case Study: A 6-Week Corporate Mindfulness Programme Significantly Enhances Organisational Well-Being

Authors: Dana Zelicha

Abstract:

A 6-week mindfulness programme was launched to improve the well being and performance of 20 managers (including the supervisor) of an international corporation in London. A unique assessment methodology was customised to the organisation’s needs, measuring four parameters: prioritising skills, listening skills, mindfulness levels and happiness levels. All parameters showed significant improvements (p < 0.01) post intervention, with a remarkable increase in listening skills and mindfulness levels. Although corporate mindfulness programmes have proven to be effective, the challenge remains the low engagement levels at home and the implementation of these tools beyond the scope of the intervention. This study has offered an innovative approach to enforce home engagement levels, which yielded promising results. The programme launched with a 2-day introduction intervention, which was followed by a 6-week training course (1 day a week; 2 hours each). Participants learned all basic principles of mindfulness such as mindfulness meditations, Mindfulness Based Stress Reduction (MBSR) techniques and Mindfulness Based Cognitive Therapy (MBCT) practices to incorporate into their professional and personal lives. The programme contained experiential mindfulness meditations and innovative mindfulness tools (OWBA-MT) created by OWBA - The Well Being Agency. Exercises included Mindful Meetings, Unitasking and Mindful Feedback. All sessions concluded with guided discussions and group reflections. One fundamental element of this programme was engagement level outside of the workshop. In the office, participants connected with a mindfulness buddy - a team member in the group with whom they could find support throughout the programme. At home, participants completed online daily mindfulness forms that varied according to weekly themes. These customised forms gave participants the opportunity to reflect on whether they made time for daily mindfulness practice, and to facilitate a sense of continuity and responsibility. At the end of the programme, the most engaged team member was crowned the ‘mindful maven’ and received a special gift. The four parameters were measured using online self-reported questionnaires, including the Listening Skills Inventory (LSI), Mindfulness Attention Awareness Scale (MAAS), Time Management Behaviour Scale (TMBS) and a modified version of the Oxford Happiness Questionnaire (OHQ). Pre-intervention questionnaires were collected at the start of the programme, and post-intervention data was collected 4-weeks following completion. Quantitative analysis using paired T-tests of means showed significant improvements, with a 23% increase in listening skills, a 22% improvement in mindfulness levels, a 12% increase in prioritising skills, and an 11% improvement in happiness levels. Participant testimonials exhibited high levels of satisfaction and the overall results indicate that the mindfulness programme substantially impacted the team. These results suggest that 6-week mindfulness programmes can improve employees’ capacities to listen and work well with others, to effectively manage time and to experience enhanced satisfaction both at work and in life. Limitations noteworthy to consider include the afterglow effect and lack of generalisability, as this study was conducted on a small and fairly homogenous sample.

Keywords: corporate mindfulness, listening skills, organisational well being, prioritising skills, mindful leadership

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10 A Cluster Randomised Controlled Trial Investigating the Impact of Integrating Mass Drug Administration Treating Soil Transmitted Helminths with Mass Dog Rabies Vaccination in Remote Communities in Tanzania

Authors: Felix Lankester, Alicia Davis, Safari Kinung'hi, Catherine Bunga, Shayo Alkara, Imam Mzimbiri, Jonathan Yoder, Sarah Cleaveland, Guy H. Palmer

Abstract:

Achieving the London Declaration goal of a 90% reduction in neglected tropical diseases (NTDs) by 2030 requires cost-effective strategies that attain high and comprehensive coverage. The first objective of this trial was to assess the impact on cost and coverage of employing a novel integrative One Health approach linking two NTD control programs: mass drug administration (MDA) for soil-transmitted helminths in humans (STH) and mass dog rabies vaccination (MDRV). The second objective was to compare the coverage achieved by the MDA, a community-wide deworming intervention, with that of the existing national primary school-based deworming program (NSDP), with particular focus on the proportion of primary school-age children reached and their school enrolment status. Our approach was unconventional because, in line with the One Health approach to disease control, it coupled the responsibilities and resources of the Ministries responsible for human and animal health into one program with the shared aim of preventing multiple NTDs. The trial was carried out in hard-to-reach pastoral communities comprising 24 villages of the Ngorongoro District, Tanzania, randomly allocated to either Arm A (MDA and MDRV), Arm B (MDA only) or Arm C (MDRV only). Objective one: The percentage of people in each target village that received treatment through MDA in Arms A and B was 63% and 65%, respectively (χ2 = 1, p = 0.32). The percentage of dogs vaccinated in Arm A and C was 70% and 81%, respectively (χ2 =9, p = 0.003). It took 33% less time for a single person and a dog to attend the integrated delivery than two separate events. Cost per dose (including delivery) was lower under the integrated strategy, with delivery of deworming and rabies vaccination reduced by $0.13 (54%) and $0.85 (19%) per dose, respectively. Despite a slight reduction in the proportion of village dogs vaccinated in the integrated event, both the integrated and non-integrated strategies achieved the target threshold of 70% required to eliminate rabies. Objective two: The percentages of primary school age children enrolled in school that was reached by this trial (73%) and the existing NSDP (80%) were not significantly different (F = 0.9, p = 0.36). However, of the primary school age children treated in this trial, 46% were not enrolled in school. Furthermore, 86% of the people treated would have been outside the reach of the NSDP because they were not primary school age or were primary school age children not enrolled in school. The comparable reach, the substantial reductions in cost per dose delivered and the decrease in participants’ time support this integrated One Health approach to control multiple NTDs. Further, the recorded level of non-enrolment at primary school suggests that, in remote areas, school-based delivery strategies could miss a large fraction of school-age children and that programs that focus delivery solely at the level of the primary school will miss a substantial proportion of both primary school age children as well as other individuals from the community. We have shown that these populations can be effectively reached through extramural programs.

Keywords: canine mediated human rabies, integrated health interventions, mass drug administration, neglected tropical disease, One Health, soil-transmitted helminths

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9 Stroke Prevention in Patients with Atrial Fibrillation and Co-Morbid Physical and Mental Health Problems

Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

Abstract:

Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

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8 A Case for Strategic Landscape Infrastructure: South Essex Estuary Park

Authors: Alexandra Steed

Abstract:

Alexandra Steed URBAN was commissioned to undertake the South Essex Green and Blue Infrastructure Study (SEGBI) on behalf of the Association of South Essex Local Authorities (ASELA): a partnership of seven neighboring councils within the Thames Estuary. Located on London’s doorstep, the 70,000-hectare region is under extraordinary pressure for regeneration, further development, and economic expansion, yet faces extreme challenges: sea-level rise and inadequate flood defenses, stormwater flooding and threatened infrastructure, loss of internationally important habitats, significant existing community deprivation, and lack of connectivity and access to green space. The brief was to embrace these challenges in the creation of a document that would form a key part of ASELA’s Joint Strategic Framework and feed into local plans and master plans. Thus, helping to tackle climate change, ecological collapse, and social inequity at a regional scale whilst creating a relationship and awareness between urban communities and the surrounding landscapes and nature. The SEGBI project applied a ‘land-based’ methodology, combined with a co-design approach involving numerous stakeholders, to explore how living infrastructure can address these significant issues, reshape future planning and development, and create thriving places for the whole community of life. It comprised three key stages, including Baseline Review; Green and Blue Infrastructure Assessment; and the final Green and Blue Infrastructure Report. The resulting proposals frame an ambitious vision for the delivery of a new regional South Essex Estuary (SEE) Park – 24,000 hectares of protected and connected landscapes. This unified parkland system will drive effective place-shaping and “leveling up” for the most deprived communities while providing large-scale nature recovery and biodiversity net gain. Comprehensive analysis and policy recommendations ensure best practices will be embedded within planning documents and decisions guiding future development. Furthermore, a Natural Capital Account was undertaken as part of the strategy showing the tremendous economic value of the natural assets. This strategy sets a pioneering precedent that demonstrates how the prioritisation of living infrastructure has the capacity to address climate change and ecological collapse, while also supporting sustainable housing, healthier communities, and resilient infrastructures. It was only achievable through a collaborative and cross-boundary approach to strategic planning and growth, with a shared vision of place, and a strong commitment to delivery. With joined-up thinking and a joined-up region, a more impactful plan for South Essex was developed that will lead to numerous environmental, social, and economic benefits across the region, and enhancing the landscape and natural environs on the periphery of one of the largest cities in the world.

Keywords: climate change, green and blue infrastructure, landscape architecture, master planning, regional planning, social equity

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