Search results for: Lydia W. Y. Fung

Authors: Taylor Kolody, Farkhund Iqbal, Rabia Batool, Benjamin Fung, Mohammed Hussaeni, Saiqa Aleem

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The rising threat of climate change has led to an increase in public awareness and care about our collective and individual environmental impact. A key component of this impact is our use of cars and other polluting forms of transportation, but it is often difficult for an individual to know how severe this impact is. While there are applications that offer this feedback, they require manual entry of what transportation mode was used for a given trip, which can be burdensome. In order to alleviate this shortcoming, a data from the 2016 TRIPlab datasets has been used to train a variety of machine learning models to automatically recognize the mode of transportation. The accuracy of 89.6% is achieved using single deep neural network model with Gated Recurrent Unit (GRU) architecture applied directly to trip data points over 4 primary classes, namely walking, public transit, car, and bike. These results are comparable in accuracy to results achieved by others using ensemble methods and require far less computation when classifying new trips. The lack of trip context data, e.g., bus routes, bike paths, etc., and the need for only a single set of weights make this an appropriate methodology for applications hoping to reach a broad demographic and have responsive feedback.

Keywords: classification, gated recurrent unit, recurrent neural network, transportation

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Authors: Pema Choejey, David Murray, Chun Che Fung

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Bhutan is becoming increasingly dependent on Information and Communications Technologies (ICTs), especially the Internet for performing the daily activities of governments, businesses, and individuals. Consequently, information systems and networks are becoming more exposed and vulnerable to cybersecurity threats. This paper highlights the findings of the survey study carried out to understand the perceptions of cybersecurity implementation among government organizations in Bhutan. About 280 ICT personnel were surveyed about the effectiveness of cybersecurity implementation in their organizations. A questionnaire based on a 5 point Likert scale was used to assess the perceptions of respondents. The questions were asked on cybersecurity practices such as cybersecurity policies, awareness and training, and risk management. The survey results show that less than 50% of respondents believe that the cybersecurity implementation is effective: cybersecurity policy (40%), risk management (23%), training and awareness (28%), system development life cycle (34%); incident management (26%), and communications and operational management (40%). The findings suggest that many of the cybersecurity practices are inadequately implemented and therefore, there exist a gap in achieving a required cybersecurity posture. This study recommends government organizations to establish a comprehensive cybersecurity program with emphasis on cybersecurity policy, risk management, and awareness and training. In addition, the research study has practical implications to both government and private organizations for implementing and managing cybersecurity.

Keywords: awareness and training, cybersecurity policy, risk management, security risks

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Authors: Sze Wai Veera Fung, Peter W. Ferretto

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Similar to most ethnic groups in China, men of the Dong minority hold the primary position in policymaking, moral authority, social values, and the control of the property. As the spatial embodiment of the patriarchal ideals, the house plays a significant role in producing and reproducing the distinctive gender status within the Dong society. Nevertheless, Dong women do not see their home as a cage of confinement, nor do they see themselves as a victim of oppression. For these women with reference to their productive identity, a house is a dwelling place with manifold meanings, including a proof of identity, an economic instrument, and a public resource operating on the community level. This paper examines the role of the house as a central site for identity construction and maintenance for the southern dialect Dong minority women in Hunan, China. Drawing on recent interviews with the Dong women, this study argues that women as productive individuals have a strong influence on the form of their house and the immediate environment, regardless of the male-dominated social construct of the Dong society. The aim of this study is not to produce a definitive relationship between women, house, and identity. Rather, it seeks to offer an alternative lens into the complexity and diversity of gender dynamics operating in and beyond the boundary of the house in the context of contemporary rural China.

Keywords: conception of home, Dong minority, house, rural China, woman’s identity

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Authors: Y. N. Fung, R. Liu, T. M. Choi

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Over the past decades, previous studies have explored different consumers’ attitudes towards sustainable fashion and how these attitudes affect consumer behaviors. Researchers have attempted to provide solutions for product suppliers (e.g., retailers, designers, developers, and manufacturers) through studying consumers’ attitudes towards sustainable fashion. However, based on the studies of consumer attitudes, investigations on the sales and market share of sustainable sportswear products remain under-explored. Gaps may exist between the consumers’ expectations and the developed sustainable sportswear products. In this study, a novel study has been carried out to examine the attitude gaps existing between the sustainable sportswear suppliers’ (SSSs) and the sustainable sportswear consumers (SSCs). This study firstly identifies the key attitudes towards sustainable sportswear product development. It analyses how sustainable attitudes affect the products being developed, as well as the effects of the attitude’s difference between the SSSs and the SSCs on the consumers’ satisfaction towards sportswear product consumption. A gap analysis research framework is adopted with the use of collected questionnaire survey data. The results indicate that a significant difference exists between SSSs and SSCs’ attitudes towards sustainable design, manufacture, product features, and branding. Based on in-depth interviews, the major causes of the difference in attitudes are studied to provide managerial insights for sustainable sportswear product management and business development.

Keywords: sustainability, sportswear, attitude, gap analysis, suppliers, consumers

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Authors: Lydia Foucan, Christine Rambhojan, Rachel Billy, Christophe Armand, Carl-Thony Michel, Jean-Marc Lacorte, Laurent Larifla

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Leptin, an adipocyte-derived hormone, modulates insulin secretion and action via the leptin receptor (LEPR) that is expressed in pancreatic beta cells, adipose tissue, and muscle. Several polymorphisms have been described in the human LEPR gene including p.K109R (rs1137100), p.Q223R (rs1137101) and p.K656N (rs1805094) polymorphisms. The role of these polymorphisms is not yet studied in Guadeloupian population. Our aim was to explore the association of LEPR polymorphisms (K109R, Q223R and K656N) with leptin levels and obesity in non-diabetic Afro-Caribbean subjects. Genotypic analysis of the three polymorphisms was performed in 425 subjects using TaqMan and KASPar Assays. Serum leptin was measured with ELISA kits Biovendor® (RD191001100). Logistic regressions were used for assessment of statistical associations. Mean age was 47.6 ± 12.7 years. Among the participants, 238 (56 %) were women, 124 (30%) were obese and 155 (36.5%) had abdominal obesity. Carriers of LEPR K656N rs1805094 rare allele had significant higher frequencies of obesity (P = 0.007), abdominal obesity (P = 0.004) and metabolic syndrome (P = 0.021) but mean leptin level was not significantly different between both groups (P = 0.075). Odds ratios, adjusted for age and sex associated with presence of rs1805094 rare allele were 1.8 (1.1-2.9), P = 0.012 for obesity, 2.0 (1.2-3.3), P = 0.008 for abdominal obesity and 1.8 (1.1-3.0), P = 0.031 for MetS. No significant association was found with K109R, Q223R. These findings suggest that the K656N polymorphism (but not the K109R or Q223R polymorphism) of LEPR is associated with obesity, abdominal obesity and metabolic syndrome in this Afro-Caribbean non-diabetic population.

Keywords: Afro-Caribbean, leptin levels, leptin receptor gene polymorphisms, obesity

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Authors: Yi-Fung Lin, Yuan-Mei Liao

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Background: Pain is common among patients with cancer and is also one of the most disturbing symptoms. As this suffering is subjective, if patients proactively participate in their pain self-management, pain could be alleviated effectively. However, not everyone can carry out self-management very well because human behavior is a product of the cognition process. In this process, we can see that "self-efficacy" plays an essential role in affecting human behaviors. Methods: We used the eight steps of concept analysis proposed by Walker and Avant to clarify the concept of “self-efficacy for cancer pain management.” A comprehensive literature review was conducted for relevant publications that were published during the period of 1977 to 2021. We used several keywords, including self-efficacy, self-management, concept analysis, conceptual framework, and cancer pain, to search the following databases: PubMed, CINAHL, Web of Science, and Embase. Results: We identified three defining attributes for the concept of self-efficacy for cancer pain management, including pain management abilities, confidence, and continuous pain monitoring, and recognized six skills related to pain management abilities: problem-solving, decision-making, resource utilization, forming partnerships between medical professionals and patients, planning actions, and self-regulation. Five antecedents for the concept of self-efficacy for cancer pain management were identified: pain experience, existing cancer pain, pain-related knowledge, a belief in pain management, and physical/mental state. Consequences related to self-efficacy for cancer pain management were achievement of pain self-management, well pain control, satisfying quality of life, and containing motivation. Conclusions: This analysis provides researchers with a clearer understanding of the concept of “self-efficacy for cancer pain management.” The findings presented here provide a foundation for future research and nursing interventions to enhance self-efficacy for cancer pain management.

Keywords: cancer pain, concept analysis, self-efficacy, self-management

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Authors: Yi-Fung Lin, Pei-Chen Tsai

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Background: The hospital healthcare team provides 24-hour patient care, and therefore shift-work is inevitable in the nursing field. There is an increased awareness that shift-work affecting circadian rhythms may cause various health problems, especially in poor sleep quality, which may harm the quality of life. Purposes: The purpose of this study was to investigate the influences of demographic characteristics on nurses’ sleep quality and quality of life and the relationship between these predictors of nurses’ quality of life. Methods: A cross-sectional, descriptive correlational study was conducted with purposive sampling of 520 female nurses in a medical center in north Taiwan from July to September 2014. Data were collected with structured questionnaires using Psychometric Evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and the World Health Organization Quality of Life (WHOQOL-BREF). Outcomes: The main results include: 1) Irregular menstruation, non-regular exercisers, and more daily caffeine consumption have negative impacts on sleep quality. 2) Younger age, fewer children, low education level, low annual income, irregular menstruation, pain during menstrual cycles, non-regular exercisers, constipation, and poor sleep quality all contribute negative impacts on the quality of life. 3) The odds ratio of sleep disturbance between 12-hour shifts and 8-hour shifts was 2.26, but there was no significant difference regarding their quality of life scores. Conclusion: This study showed that there is a strong correlation between oncology nurses’ sleep quality and quality of life. Sleep quality is a significant predictor of quality of life in oncology nurses.

Keywords: oncology nurses, sleep quality, quality of life, shift-work

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Authors: Taufik Hidayat, Yudha Nurhantari, Bambang U. D. Rianto

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Introduction: The examination of the Short Tandem Repeats (STR) locus on nuclear DNA is very useful in solving the paternity cases. The purpose of this study is to know the description of paternity cases and paternity index/probability of paternity analysis based on Indonesian allele frequency at Sardjito Hospital Yogyakarta. Method: This was an observational study with cross-sectional analytic method. Population and sample were all cases of disputed paternity from January 2011 to June 2015 that fulfill the inclusion and exclusion criteria and were examined at Forensic Medicine Unit of Sardjito Hospital, Medical Faculty of Gadjah Mada University. The paternity index was calculated with EasyDNA Program by Fung (2013). Analysis of the study was conducted by comparing the results through unpaired categorical test using Kolmogorov-Smirnov test. This study was designed with 95% confidence interval (CI) with α = 5% and significance level is p < 0,05. Results: From 42 disputed paternity cases we obtained trio paternity cases were 32 cases (76.2%) and duo without a mother was 10 cases (23.8%). The majority of the fathers' estimated ages were 21-30 years (33.3%) and the mother's age was 31-40 years (38.1%). The majority of the ages of children examined for paternity were under 12 months (47.6%). The majority of ethnic clients are Javanese. Conclusion of inclusion was 57.1%, and exclusion was 42.9%. The Kolmogorov-Smirnov test obtained p-value = 0.673. Conclusion: There is no significant difference between paternity index/probability of paternity based on Indonesian allele frequency between trio and duo of paternity.

Keywords: disputed paternity, paternity index, probability of paternity, short tandem

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Authors: Y. N. Fung, R. Liu, T. M. Choi

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The life cycle assessment (LCA) is widely applied in the study of the sustainable fashion industry. Through the LCA, the social, environmental, and economic performances of the fashion industry can be assessed, which helps sustainable product developers (designers, retailers, and manufacturers) to address problems in product development. In prior studies, environmental impact, economic performance, and social responsibility are commonly considered separately. Inter-relations between dimensions of sustainability and LCA are rarely reported. The development process of sustainable sportswear products is complicated. Changes in the product components (e.g., materials, manufacturing methods, and product design) of sportswear will correspondingly influence supply chain activities and meanwhile affect environmental, economic, and social performances. In this study, the interrelations between different LCAs and how the interrelated LCAs can help product developers to strike a balance among environmental, economic, and social performances are explored. Based on the findings, a three-dimensional assessment framework on the sustainability life cycle is introduced. To examine the applicability of the developed framework, proof-of-concept sportswear legging products were developed. The developed sportswear legging products were assessed in terms of the interrelated dimensions of environmental, economic, and social performances. The results demonstrate the effects of shifting in desig¬n details and product functions on the environmental, social, and economic performances of sportswear products. The outcome of this study provides insights on the approach to balance sustainability and the development of cost-effective and sustainable sportswear products for sportswear developers.

Keywords: sustainable development, sports fashion, life cycle assessment, indicators for sustainability, sustainability impacts

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Authors: Siew Ming Thang, Wong Hoo Keat, Chee Hao Sue, Fung Lan Loo, Ahju Rosalind

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There are numerous studies that explored young learners’ literacy skills in Malaysia but none that uses the eye-tracking device to track their cognitive processes when reading picture storybooks. This study used this method to investigate two groups of prereaders’ cognitive processes in four conditions. (1) A congruent picture was presented, and a matching narration was read aloud by a recorder; (2) Children heard a narration telling about the same characters in the picture but involves a different scene; (3) Only a picture with matching text was present; (4) Students only heard the reading aloud of the text on the screen. The two main objectives of this project are to test which content of pictures helps the prereaders (i.e., young children who have not received any formal reading instruction) understand the narration and whether children try to create a coherent mental representation from the oral narration and the pictures. The study compares two groups of children from two different kindergartens. Group1: 15 Chinese children; Group2: 17 Malay children. The medium of instruction was English. An eye-tracker were used to identify Areas of Interest (AOI) of each picture and the five target elements and calculate number of fixations and total time spent on fixation of pictures and written texts. Two mixed factorial ANOVAs with the storytelling performance (good, average, or weak) and vocabulary level (low, medium, high) as between-subject variables, and the Areas of Interests (AOIs) and display conditions as the within-subject variables were performedon the variables.

Keywords: eye-tracking, cognitive processes, literacy skills, prereaders, visual attention

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Authors: Nazira B. Bekenova, Lydia A. Mukovozova, Andrej M. Grjibovski, Alma Z. Tokayeva, Yerbol M. Smail, Nurlan E. Aukenov

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Erysipelas is an infectious disease with socio-economic significance and prone to prolonged recurrent course (30%). Contribution of genetic factors, in particular the gene polymorphism of cytokines, can be essential in disease etiology and pathogenesis. Interleukin – 17 A are produced by T helpers of 17 type and plays a key role in development of local inflammation process. Local inflammatory process is a dominant in the clinic of erysipelas. Established that the skin and mucosas are primary areas of migration (homing) Th17-cell and their cytokines are stimulate the barrier function of the epithelium. We studied associations between gene polymorphism of IL-17A (C737T) rs 8193036 and IL-17A level in patients with erysipelas Kazakh population. Altogether, 90 cases with erysipelas and 90 healthy controls from an ethnic Kazakh population comprised the sample. Cases were identified at Clinical Infectious Diseases Hospital of Semey (Kazakhstan). The IL-17A (rs8193036) polymorphism was analyzed by a real time polymerase chain reaction. Plasma levels of IL-17 A were assessed by immuneenzyme analysis method using ‘Vector-Best’ test-system (Russia). Differences in levels of IL-17 A between CC, TT, CT groups were studied using Kruskal — Wallis test. Pairwise comparisons were performed using Mann-Whitney tests with Bonferroni correction (New significance level was set to 0.025). We found, that in patients with erysipelas with CC genotype the level of IL-17 A was higher (p= 0, 010) compared to the carriers of CT genotype. When compared the level of IL – 17 A between the patients with TT genotype and patients with CC genotype, also between the patients with CT genotype and patients with TT genotype statistically significant differences are not revealed (p = 0.374 and p = 0.043, respectively). Comparisons of IL-17 A plasma levels between the CC and CT genotypes, between the CC and TT genotypes, and between the TT and CT in healthy patients did not reveal significant differences (p = 0, 291). Therefore, we are determined the associations of gene polymorphism of IL-17 A (C737T) with its level in patients erysipelas carriers CC genotype.

Keywords: erysipelas, interleukin – 17 A, Kazakh, polymorphism

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Authors: Wei Zhang, Chye Kiang Heng, John Chye Fung

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Background: The world’s demographics is currently undergoing the largest wave of both rapid ageing and dramatic urbanisation in human history. As one of the most rapidly ageing countries, Singapore will see about one in four residents aged 65 years and above by 2030 in its high-rise and high-density urban environment. Research questions: To support urban seniors ageing in place and interdependence among senior residents and their informal caregivers, this study argues a community-based care model with bottom-up mutual help networks and asks how neighbourhood built-environment influences the formulation and facilitation of bottom-up mutual help networks in Singapore. Methods: Two public housing communities with different physical environment and rich age-friendly neighbourhood initiatives were chosen as the case studies. The categories, participants and places of bottom-up mutual help activities will be obtained via field observation, non-structural interviews of participants, service providers and managers of care facilities, and documents. Mapping and content analysis will be used to explore the influences of neighbourhood built-environment on the formulation and facilitation of bottom-up mutual help networks. Results and conclusions: The results showed that neighbourhood design, place programming, and place governance have a confluence on the bottom-up mutual help networks for senior residents. Significance: The outcomes of this study will provide fresh evidence for paradigm shifts of community-based care for the elderly and neighbourhood planning. In addition, the research findings will shed light on meaningful implications of urban planners and policy makers as they tackle with the issues arising from the ageing society.

Keywords: Built environment, Mutual help, Neighbourhood, Senior residents, Singapore

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Authors: Lydia Murugi Mugendi

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The promotion of tree growing as a lucrative enterprise is the focus of this paper as management practices have shifted focus from protection of natural forest resources to community/government partnerships with the aim of resource conservation, management and increase of on-farm tree growing. Using KEFRI as (the source) of information pertaining Melia volkensii (the medium or message) being transferred, this paper investigates the current perception towards forestry and the behavioural attitudes of recipients of forest intervention activities. The two objectives explored in this paper are to find out the level of adoption of Mukau in Kitui, Kibwezi and Samburu/Taru and secondly, to find out the characteristics of the adoption process between Kitui, Kibwezi and Samburu/Taru. The methodologies used during data collection were participatory rural appraisal tools in conjunction with the social survey questionnaires. Simple random sampling and snowball sampling were used to identify respondents within the three target sites and analysis was done using SPSS. Results of the study of indicating that adoption rates of the Mukau in Samburu/Taru, where forestry-related activities were introduced within the past one decade had significantly increase despite initial resistance. The other areas, which had benefited from numerous decades of intense forestry extension projects and activities, indicated a decline in re-adoption rates of Mukau as an enterprise. This study has brought out the reality of adoption trends and state of Mukau population within the three counties while providing a glimpse towards the communities’ perception in regards to adoption of forestry and other environmental innovations. The outcome of the study is to provide a guideline for extension/ dissemination officers in KEFRI and related stakeholders to promote seamless cohesive interaction between the recipient communities of the proposed interventions.

Keywords: adoption, innovation, enterprise, extension, DOI Theory

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Authors: Lydia Novozhilova, Vladimir Urazhdin

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An optimization problem for reinforced thin-walled vessels under uniform external pressure is considered. The conventional approaches to optimization generally start with pre-defined geometric parameters of the vessels, and then employ analytic or numeric calculations and/or experimental testing to verify functionality, such as stability under the projected conditions. The proposed approach consists of two steps. First, the feasibility domain will be identified in the multidimensional parameter space. Every point in the feasibility domain defines a design satisfying both geometric and functional constraints. Second, an objective function defined in this domain is formulated and optimized. The broader applicability of the suggested methodology is maximized by implementing the Support Vector Machines (SVM) classification algorithm of machine learning for identification of the feasible design region. Training data for SVM classifier is obtained using the Simulation package of SOLIDWORKS®. Based on the data, the SVM algorithm produces a curvilinear boundary separating admissible and not admissible sets of design parameters with maximal margins. Then optimization of the vessel parameters in the feasibility domain is performed using the standard algorithms for the constrained optimization. As an example, optimization of a ring-stiffened closed cylindrical thin-walled vessel with semi-spherical caps under high external pressure is implemented. As a functional constraint, von Mises stress criterion is used but any other stability constraint admitting mathematical formulation can be incorporated into the proposed approach. Suggested methodology has a good potential for reducing design time for finding optimal parameters of thin-walled vessels under uniform external pressure.

Keywords: design parameters, feasibility domain, von Mises stress criterion, Support Vector Machine (SVM) classifier

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Authors: Lydia Foucan, Laurent Larifla, Emmanuelle Durand, Christine Rambhojan, Veronique Dhennin, Jean-Marc Lacorte, Philippe Froguel, Amelie Bonnefond

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In the population of Guadeloupe Island (472,124 inhabitants and 80% of subjects of African descent), overweight and obesity were estimated at 23% and 9% respectively among children. High prevalence of diabetes has been reported (~10%) in the adult population. Nevertheless, no study has investigated the contribution of gene mutations to childhood obesity in this population. We aimed to investigate rare genetic mutations in genes involved in monogenic obesity or diabetes in obese Afro-Caribbean children from Guadeloupe Island using next-generation sequencing. The present investigation included unrelated obese children, from a previous study on overweight conducted in Guadeloupe Island in 2013. We sequenced coding regions of 59 genes involved in monogenic obesity or diabetes. A total of 25 obese schoolchildren (with Z-score of body mass index [BMI]: 2.0 to 2.8) were screened for rare mutations (non-synonymous, splice-site, or insertion/deletion) in 59 genes. Mean age of the study population was 12.4 ± 1.1 years. Seventeen children (68%) had insulin-resistance (HOMA-IR > 3.16). A family history of obesity (mother or father) was observed in eight children and three of the accompanying parent presented with type 2 diabetes. None of the children had gonadotrophic abnormality or mental retardation. We detected five rare heterozygous mutations, in four genes involved in monogenic obesity, in five different obese children: MC4R p.Ile301Thr and SIM1 p.Val326Thrfs*43 mutations which were pathogenic; SIM1 p.Ser343Pro and SH2B1 p.Pro90His mutations which were likely pathogenic; and NTRK2 p.Leu140Phe that was of uncertain significance. In parallel, we identified seven carriers of mutation in ABCC8 or KCNJ11 (involved in monogenic diabetes), which were of uncertain significance (KCNJ11 p.Val13Met, KCNJ11 p.Val151Met, ABCC8 p.Lys1521Asn and ABCC8 p.Ala625Val). Rare pathogenic or likely pathogenic mutations, linked to severe obesity were detected in more than 15% of this Afro-Caribbean population at high risk of obesity and type 2 diabetes.

Keywords: childhood obesity, MC4R, monogenic obesity, SIM1

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Authors: Lydia Booney Jyrwa, Rabindra Nath Bhuyan

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Chocolate Mahseer (Neolissochilus hexagonolepis) is one of the Mahseer species inhabiting the North-eastern region of India and is a native species to the state of Meghalaya since it can adapt and grow well under the agro climatic conditions of the region. The natural population of this fish has been declining over the years from this part of the country. The natural population of this fish has been declining over the years from this part of the country. The fish is considered as one of the endangered species of the Mahseer group, which is having tremendous scope for culture, sports and tourism. But non-availability of quality seed is a hindrance for the culture of this fish. Thus induced breeding of the fish by hormonal administration with pituitary gland and synthetic hormones is the only reliable method to procure the pure seed of the fish. Chocolate Mahseer was successfully bred at the Hatchery Complex, St. Anthony’s College, Shillong, Meghalaya by using pituitary extract and synthetic hormone viz. ovaprim, ovatide and gonopro-FH. The dose standardized is @ 4mg/kg body weight to both male and female as 1st dose and @ 7.9 mg/kg body weight only to female as 2nd dose for pituitary extract and single dose @ 0.8 ml/kg body weight to female and @ 0.3 ml/kg body weight to male of both ovaprim and ovatide, while a single dose @ 0.9 ml/kg body weight to female and @ 0.3 ml/kg body weight to male of gonopro-FH. The doses are standardized after a series of trial and error experiment performed. The fecundity of the fish was 3500 eggs/ kg body weight. The final hatching percentage achieved was 60%. The survival rate of hatchling was 50% up to fry stage. The use of synthetic hormone and positive response of the fish to the hormone will go in long way for production of quality seed of the fish which in turn help in culture of the species as the fish can be a very good candidate species for the culture in the state. This study will also help in the ranching of the fish in the natural habitat leading to conservation of the species. However, the study should be continued further for the large scale production of seeds.

Keywords: chocolate mahseer, induced breeding, pituitary extract, synthetic hormone

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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Authors: Amirhossein Eisapour, Mohammad Emamjome Kashan, Alan S. Fung

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This research addresses the pressing global challenges of clean energy and water supplies, emphasizing the need for sustainable solutions for the building sector. The research centers on integrating Reverse Osmosis (RO) systems with building energy systems, incorporating Solar Thermal Collectors (STC)/Photovoltaic Thermal (PVT), water-to-water heat pumps, and an Insulated Concrete Form (ICF) based building foundation wall thermal energy storage. The study explores an innovative configuration’s effectiveness in addressing water and heating demands through clean energy sources while addressing ICF-based thermal storage challenges, which could overheat in the cooling season. Analyzing four configurations—STC-ICF, STC-ICF-RO, PVT-ICF, and PVT-ICF-RO, the study conducts a sensitivity analysis on collector area (25% and 50% increase) and weather data (evaluating five Canadian cities, Winnipeg, Toronto, Edmonton, Halifax and Vancouver). Key outcomes highlight the benefits of integrated RO scenarios, showcasing reduced ICF wall temperature, diminished unwanted heat in the cooling season, reduced RO pump consumption and enhanced solar energy production. The STC-ICF-RO and PVT-ICF-RO systems achieved energy savings of 653 kWh and 131 kWh, respectively, in comparison to their non-integrated RO counterparts. Additionally, both systems successfully contributed to lowering the CO2 production level of the energy system. The calculated payback period of STC-ICF-RO (2 years) affirms the proposed systems’ economic viability. Compared to the base system, which does not benefit from the ICF and RO integration with the building energy system, the STC-ICF-RO and PVT-ICF-RO demonstrate a dramatic energy consumption reduction of 20% and 32%, respectively. The sensitivity analysis suggests potential system improvements under specific conditions, especially when implementing the introduced energy system in communities of buildings.

Keywords: insulated concrete form, thermal energy storage, reverse osmosis, building energy systems, solar thermal collector, photovoltaic thermal, heat pump

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Authors: Yu Fang Chen, Jeng Fung Hung

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This study aimed to develop a circular economy scale to assess the level of recognition among high-level executives in businesses regarding the circular economy. The circular economy is crucial for global ESG sustainable development and poses a challenge for corporate social responsibility. The aim of promoting the circular economy is to reduce resource consumption, move towards sustainable development, reduce environmental impact, maintain ecological balance, increase economic value, and promote employment. This study developed a 23-item Circular Economy Scale, which includes three subscales: "Understanding of Circular Economy by Enterprises" (8 items), "Attitudes" (9 items), and "Behaviors" (6 items). The Likert 5-point scale was used to measure responses, with higher scores indicating higher levels of agreement among senior executives with regard to the circular economy. The study tested 105 senior executives and used a structural equation model (SEM) as a measurement indicator to determine the extent to which potential variables were measured. The standard factor loading of the measurement indicator needs to be higher than 0.7, and the average variance explained (AVE) represents the index of convergent validity, which should be greater than 0.5 or at least 0.45 to be acceptable. Out of the 23 items, 12 did not meet the standard, so they were removed, leaving 5 items, 3 items, and 3 items for each of the three subscales, respectively, all with a factor loading greater than 0.7. The AVE for all three subscales was greater than 0.45, indicating good construct validity. The Cronbach's α reliability values for the three subscales were 0.887, 0.787, and 0.734, respectively, and the total scale was 0.860, all of which were higher than 0.7, indicating good reliability. The Circular Economy Scale developed in this study measures three conceptual components that align with the theoretical framework of the literature review and demonstrate good reliability and validity. It can serve as a measurement tool for evaluating the degree of acceptance of the circular economy among senior executives in enterprises. In the future, this scale can be used by senior executives in enterprises as an evaluation tool to further explore its impact on sustainable development and to promote circular economy and sustainable development based on the reference provided.

Keywords: circular economy, corporate social responsibility, scale development, structural equation model

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Authors: Lydia Ouma Radoli

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The paradox of documenting history through visuals that objectify gruesome images to depict the prominence of stories intrigues media researchers. In East Africa, the topic has been captured in a variety of media frames, but scantly in scholarly work. This paper adopts Visual Rhetoric and Framing Theories to tease out the drivers behind the criteria for the selection of violent visuals. The paper projects that quantitative and qualitative literature regarding journalists’ personal and work-related exposure to PSTD will give insights into the concept of trauma journalism - reporting of horrific events, e.g., violent crime and terror. The data will be collected through methods such as document analysis (photographs and videos) and in-depth interviews to summarize the informational contents with respect to the research objectives and questions. The study is hinged on the background that the criterion for news production is constructed from the idea that ‘if there’s violence, conflict, and death involved, the story gets top priority.’ The anticipated outcome is to establish trauma experiences of visual rhetors, suggest mitigations, and address gaps in academic research. The findings of the study will sustain the critical role of visual rhetors. Further, media practitioners may find the study useful in assessing the effects and values of visual witnessing. Historically, the criterion for visual news production has been that if there’s violence, conflict, and death involved, the story gets top priority. To capture the goriness of the images, media theorists and sociologists have used the expression: “If it bleeds, it leads.” The statement assumes that audiences are attracted to pictures that show violent images. Further, research on visual aspects of Television news has shown its ability to hold viewers’ attention and cause aggression. This paper samples images and narratives from Journalists who have covered trauma-related events. The samples are indicative of the problem under study, which depicts journalists exposed to traumatic events as not receiving any Psycho-social support within newsrooms. It is hoped that the study could inform policy and practice within developing countries through the interpretations of theoretical and empirical explanations of existing trauma phenomena among journalists.

Keywords: visual-witnessing, media culture, visual rhetoric, imaging violence in East Africa

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Authors: Yi-Fung Lin, Shiow-Ching Shun, Wen-Yu Hu

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Background: A skill mix model is regarded as one of the most effective methods of reducing nursing shortages, as well as easing nursing staff workloads and labor costs. Although this model shows several benefits for the health workforce, the relationship between the optimal model of skill mix and the patient mortality rate remains to be discovered. Objectives: This review aimed to explore the relationship between the skill mix model and patient mortality rate in acute care hospitals. Data Sources: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases and researchers retrieved studies published between January 1986 and March 2022. Review methods: Two independent reviewers screened the titles and abstracts based on selection criteria, extracted the data, and performed critical appraisals using the STROBE checklist of each included study. The studies focused on adult patients in acute care hospitals, and the skill mix model and patient mortality rate were included in the analysis. Results: Six included studies were conducted in the USA, Canada, Italy, Taiwan, and European countries (Belgium, England, Finland, Ireland, Spain, and Switzerland), including patients in medical, surgical, and intensive care units. There were both nurses and nursing assistants in their skill mix team. This main finding is that three studies (324,592 participants) show evidence of fewer mortality rates associated with hospitals with a higher percentage of registered nurse staff (range percentage of registered nurse staff 36.1%-100%), but three articles (1,122,270 participants) did not find the same result (range of percentage of registered nurse staff 46%-96%). However, based on appraisal findings, those showing a significant association all meet good quality standards, but only one-third of their counterparts. Conclusions: In light of the limited amount and quality of published research in this review, it is prudent to treat the findings with caution. Although the evidence is not insufficient certainty to draw conclusions about the relationship between nurse staffing level and patients' mortality, this review lights the direction of relevant studies in the future. The limitation of this article is the variation in skill mix models among countries and institutions, making it impossible to do a meta-analysis to compare them further.

Keywords: nurse staffing level, nursing assistants, mortality, skill mix

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Authors: Zenah Gheblawi, Susan Armijo-Olivo, Elisa B. Pelai, Vaishali Sharma, Musa Tashfeen, Angela Fung, Francisca Claveria

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Due to physiological differences between men and women, pain is experienced differently between the two sexes. Chronic pain disorders, notably temporomandibular disorders (TMDs), disproportionately affect women in diagnosis, and pain severity in opposition of their male counterparts. TMDs are a type of musculoskeletal disorder that target the masticatory muscles, temporalis muscle, and temporomandibular joints, causing considerable orofacial pain which can usually be referred to the neck and back. Therapeutic methods are scarce, and are not TMD-centered, with the latest research suggesting that subjects with chronic musculoskeletal pain disorders have abnormal alterations in the grey matter of their brains which can be remedied with exercise, and thus, decreasing the pain experienced. The aim of the study is to investigate the effects of exercise therapy in TMD female patients experiencing chronic jaw pain and to assess the consequential effects on brain activity. In a randomized controlled trial, the effectiveness of an exercise program to improve brain alterations and clinical outcomes in women with TMD pain will be tested. Women with chronic TMD pain will be randomized to either an intervention arm or a placebo control group. Women in the intervention arm will receive 8 weeks of progressive exercise of motor control training using visual feedback (MCTF) of the cervical muscles, twice per week. Women in the placebo arm will receive innocuous transcutaneous electrical nerve stimulation during 8 weeks as well. The primary outcomes will be changes in 1) pain, measured with the Visual Analogue Scale, 2) brain structure and networks, measured by fractional anisotropy (brain structure) and the blood-oxygen level dependent signal (brain networks). Outcomes will be measured at baseline, after 8 weeks of treatment, and 4 months after treatment ends and will determine effectiveness of MCTF in managing TMD, through improved clinical outcomes. Results will directly inform and guide clinicians in prescribing more effective interventions for women with TMD. This study is underway, and no results are available at this point. The results of this study will have substantial implications on the advancement in understanding the scope of plasticity the brain has in regards with pain, and how it can be used to improve the treatment and pain of women with TMD, and more generally, other musculoskeletal disorders.

Keywords: exercise therapy, musculoskeletal disorders, physical therapy, rehabilitation, tempomandibular disorders

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Authors: Man Fung Ho, Lap So, Jiaqi Zhang, Yuheng Zhao, Huiyang Lu, Tat Shing Choi, K. Y. Michael Wong

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Nowadays, a tremendous amount of data is available in the transportation system, enabling the development of various machine learning approaches to make short-term latency predictions. A natural question is then the choice of relevant information to enable accurate predictions. Using traffic data collected from the Taiwan Freeway System, we consider the prediction of short-term latency of a freeway segment with a length of 17 km covering 5 measurement points, each collecting vehicle-by-vehicle data through the electronic toll collection system. The processed data include the past latencies of the freeway segment with different time lags, the traffic conditions of the individual segments (the accumulations, the traffic fluxes, the entrance and exit rates), the total accumulations, and the weekday latency profiles obtained by Gaussian process regression of past data. We arrive at several important conclusions about how data should be refined to obtain accurate predictions, which have implications for future system-wide latency predictions. (1) We find that the prediction of median latency is much more accurate and meaningful than the prediction of average latency, as the latter is plagued by outliers. This is verified by machine-learning prediction using XGBoost that yields a 35% improvement in the mean square error of the 5-minute averaged latencies. (2) We find that the median latency of the segment 15 minutes ago is a very good baseline for performance comparison, and we have evidence that further improvement is achieved by machine learning approaches such as XGBoost and Long Short-Term Memory (LSTM). (3) By analyzing the feature importance score in XGBoost and calculating the mutual information between the inputs and the latencies to be predicted, we identify a sequence of inputs ranked in importance. It confirms that the past latencies are most informative of the predicted latencies, followed by the total accumulation, whereas inputs such as the entrance and exit rates are uninformative. It also confirms that the inputs are much less informative of the average latencies than the median latencies. (4) For predicting the latencies of segments composed of two or three sub-segments, summing up the predicted latencies of each sub-segment is more accurate than the one-step prediction of the whole segment, especially with the latency prediction of the downstream sub-segments trained to anticipate latencies several minutes ahead. The duration of the anticipation time is an increasing function of the traveling time of the upstream segment. The above findings have important implications to predicting the full set of latencies among the various locations in the freeway system.

Keywords: data refinement, machine learning, mutual information, short-term latency prediction

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Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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Authors: Susanna Graziano, Lydia Krstic Ward

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The purpose of this presentation is to demonstrate the steps of using multimedia and collaborative platforms in project-based learning. The presentation will demonstrate the stages of the learning project with various components of independent and collaborative learning, where students research the topic, share information, prepare a survey, use social media (Facebook, Instagram, WhasApp) and collaborative platforms (wikispaces.com and Google docs) to collect, analyze and process data, then produce reports and logos to be displayed as a final product. At the beginning of the presentation participants will answer a questionnaire about project based learning and share their experience on using social media, real–world project work and collaborative learning. Using a PPP, the presentation will walk participants through the steps of a completed project where tertiary education students are involved in putting together a multimedia campaign for safe driving in Kuwait. The research component of the project entails taking a holistic view on the problem of the high death rate in traffic accidents. The final goal of the project is to lead students to raise public awareness about the importance of safe driving. The project steps involve using the social media and collaborative platforms for collecting data and sharing the required materials to be used in the final product – a display of written reports, slogans and videos, as well as oral presentations. The same structure can be used to organize a multimedia campaign focusing on other issues, whilst scaffolding on students’ ability to brainstorm, retrieve information, organize it and engage in collaborative/ cooperative learning whilst being immersed in content-based learning as well as in authentic tasks. More specifically, the project we carried out at Box Hill College was a real-world one and involved a multimedia Campaign for Safe Driving since reckless driving is one of the major problems in the country. The idea for the whole project started by a presentation given by a board member of the Kuwaiti Society for Traffic Safety who was invited to college and spoke about: • Driving laws in the country, • What causes car accidents, • Driving safety tips. The principal goal of this project was to let students consider problems of traffic in Kuwait from different points of view. They also had to address the number and causes of accidents, evaluate the effectiveness of the local traffic law in order to send a warning about the importance of safe driving and, finally, suggest ways of its improvement. Benefits included: • Engagement, • Autonomy, • Motivation, • Content knowledge, • Language mastery, • Enhanced critical thinking, • Increased metacognitive awareness, • Improved social skills, • Authentic experience.

Keywords: social media, online learning platforms, collaborative platforms, project based learning

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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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Authors: Lydia Tan, Philippe Lemey, Lieselot Houspie, Marco Viveen, Darren Martin, Frank Coenjaerts

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Introduction: Human respiratory syncytial virus (hRSV) is the leading cause of severe respiratory tract infections in infants under the age of two. Genomic substitutions and related evolutionary dynamics of hRSV are of great influence on virus transmission behavior. The evolutionary patterns formed are due to a precarious interplay between the host immune response and RSV, thereby selecting the most viable and less immunogenic strains. Studying genomic profiles can teach us which genes and consequent proteins play an important role in RSV survival and transmission dynamics. Study design: In this study, genetic diversity and evolutionary rate analysis were conducted on 36 RSV subgroup B whole genome sequences and 37 subgroup A genome sequences. Clinical RSV isolates were obtained from nasopharyngeal aspirates and swabs of children between 2 weeks and 5 years old of age. These strains, collected during epidemic seasons from 2001 to 2011 in the Netherlands and Belgium by either conventional or 454-sequencing. Sequences were analyzed for genetic diversity, recombination events, synonymous/non-synonymous substitution ratios, epistasis, and translational consequences of mutations were mapped to known 3D protein structures. We used Bayesian statistical inference to estimate the rate of RSV genome evolution and the rate of variability across the genome. Results: The A and B profiles were described in detail and compared to each other. Overall, the majority of the whole RSV genome is highly conserved among all strains. The attachment protein G was the most variable protein and its gene had, similar to the non-coding regions in RSV, more elevated (two-fold) substitution rates than other genes. In addition, the G gene has been identified as the major target for diversifying selection. Overall, less gene and protein variability was found within RSV-B compared to RSV-A and most protein variation between the subgroups was found in the F, G, SH and M2-2 proteins. For the F protein mutations and correlated amino acid changes are largely located in the F2 ligand-binding domain. The small hydrophobic phosphoprotein and nucleoprotein are the most conserved proteins. The evolutionary rates were similar in both subgroups (A: 6.47E-04, B: 7.76E-04 substitution/site/yr), but estimates of the time to the most recent common ancestor were much lower for RSV-B (B: 19, A: 46.8 yrs), indicating that there is more turnover in this subgroup. Conclusion: This study provides a detailed description of whole RSV genome mutations, the effect on translation products and the first estimate of the RSV genome evolution tempo. The immunogenic G protein seems to require high substitution rates in order to select less immunogenic strains and other conserved proteins are most likely essential to preserve RSV viability. The resulting G gene variability makes its protein a less interesting target for RSV intervention methods. The more conserved RSV F protein with less antigenic epitope shedding is, therefore, more suitable for developing therapeutic strategies or vaccines.

Keywords: drug target selection, epidemiology, respiratory syncytial virus, RSV

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

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Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

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

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Authors: Elizabeth R. LaFave, Grayson Sink, Anna Vassallo, Samantha Mills, Eli G. Hvastkovs

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Throughout history and into modern times, the continuation of male influence over female healthcare has created inadequacies in availability and access to treatments, often further limited in rural communities. The historical plight of women in healthcare can be understood by studying the advancements made by women in the field, both through their career arcs and by delving into the treatments they offer. An early example is the case of Martha Ballard (1735-1812), a midwife in New York who practiced when female practitioners were dismissed in favor of less educated male physicians, which was a well-accepted practice into the twentieth century. In order to overcome these setbacks, a strategy used by some female practitioners was to develop and market their own remedies in an attempt to better serve female patients. By highlighting the compromises and social manipulation of female entrepreneurs, in comparison with the medicines they developed and used, we can map their ability to carve a specific niche for themselves and their targeted customers. The application of modern chemical approaches in a historical context serves to enhance a variety of perspectives within the museum sphere necessary for the comprehension and understanding of the female plight in both medical care and service. In order to further examine the overall bias and scrutiny for women in the medical field, specifically those undertaking entrepreneurial roles, examples of alternative remedies from female founders will be analyzed utilizing these approaches. Modern analytical chemistry techniques, specifically mass spectrometry (MS), have been successful in offering compositional analyses for both labeled and unlabeled ingredients in old medicines. Previously, we have analyzed two forms of alternative treatment options created by male medical professionals to address lingering historical questions of purity and validity. Although primarily sugar based, both Humphreys’ Specifics and Boericke & Tafel remedies also contained unique ingredients, albeit in small quantities, with medicinal properties. Here, we applied the same methodology to study another highly politicized 19th-century debate surrounding the contribution and role of women in the medical profession through analyzing three remedies, each from a different female-led manufacturing company; Mrs. Joe Persons, Lydia Pinkham, and Winslow’s Syrups. Following MS analyses for both labeled and unlabeled ingredients, both Winslow’s and Pinkham’s remedies were similar to their male counterparts in advertisement strategy, targeted customer base, and overall composition of remedy (primarily sugar-based with small amounts of unique ingredients). In effect, these unbiased chemical assessments are used to dissect the rationality of both market and physician criticism for each individual manufacturer through assessment of authenticity, benefaction, and comparison among female entrepreneurs and their aims to enter the medical community (i.e., geographic location, market size). Our work aims to increase collaboration between STEM (Science, Technology, Engineering, Mathematics)-based fields and historical museum studies on a larger scale while also answering questions of potential bias towards females in the medical community as means of comparison to their male counterparts and in-depth historical analyses to unravel individual strategies to overcome the setback.

Keywords: nineteenth-century medicine, alternative remedies, female healthcare, chemical analyses, mass spectrometry

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Authors: Annis Lai Chu Fung

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While aggression had high stability throughout developmental stages and across generations, it should be the top priority of researchers and frontline helping professionals to develop prevention and intervention programme for aggressive children and children at risk of developing aggressive behaviours. Although there is a substantial amount of anti-bullying programmes, they gave disappointingly small effect sizes. The neglectful practical significance could be attributed to the overly simplistic categorisation of individuals involved as bullies or victims. In the past three decades, the distinction between reactive and proactive aggression has been well-proved. As children displaying reactively aggressive behaviours have distinct social-information processing pattern with those showing proactively aggressive behaviours, it is critical to identify the unique needs of the two subtypes accordingly when designing an intervention. The onset of reactive aggression and proactive aggression was observed at earliest in 4.4 and 6.8 years old respectively. Such findings called for a differential early intervention targeting these high-risk children. However, to the best of the author’s knowledge, the author was the first to establish an evidence-based intervention programme against reactive and proactive aggression. With the largest samples in the world, the author, in the past 10 years, explored three different approaches and their effectiveness against aggression quantitatively and qualitatively with longitudinal design. The three approaches presented are (a) cognitive-behavioral approach, (b) moral education, with Chinese marital arts and ethics as the medium, and (c) bioneurological measures (omega-3 supplementation). The studies adopted a multi-informant approach with repeated measures before and after the intervention, and follow-up assessment. Participants were recruited from primary and secondary schools in Hong Kong. In the cognitive-behavioral approach, 66 reactive aggressors and 63 proactive aggressors, aged from 11 to 17, were identified from 10,096 secondary-school children with questionnaire and subsequent structured interview. Participants underwent 10 group sessions specifically designed for each subtype of aggressor. Results revealed significant declines in aggression levels from the baseline to the follow-up assessment after 1 year. In moral education through the Chinese martial arts, 315 high-risk aggressive children, aged 6 to 12 years, were selected from 3,511 primary-school children and randomly assigned into four types of 10-session intervention group, namely martial-skills-only, martial-ethics-only, both martial-skills-and-ethics, and physical fitness (placebo). Results showed only the martial-skills-and-ethics group had a significant reduction in aggression after treatment and 6 months after treatment comparing with the placebo group. In the bioneurological approach, 218 children, aged from 8 to 17, were randomly assigned to the omega-3 supplement group and the placebo group. Results revealed that compared with the placebo group, the omega-3 supplement group had significant declines in aggression levels at the 6-month follow-up assessment. All three approaches were effective in reducing proactive and reactive aggression. Traditionally, intervention programmes against aggressive behaviour often adapted the cognitive and/or behavioural approach. However, cognitive-behavioural approach for children was recently challenged by its demanding requirement of cognitive ability. Traditional cognitive interventions may not be as beneficial to an older population as in young children. The present study offered an insightful perspective in aggression reduction measures.

Keywords: intervention, outcome effectiveness, proactive aggression, reactive aggression

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