Search results for: cultural training

Authors: Merav Alush Levron, Sivan Rajuan Shtang

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From as early as their emergence in Europe and the US, postmodern and post-colonial paradigm have formed the backbone of the visual culture field of study. The self-representation project of political minorities is studied, described and explained within the premises and perspectives drawn from these paradigms, addressing the key issues they had raised: modernism’s crisis of representation. The struggle for self-representation, agency and multicultural visibility sought to challenge the liberal pretense of universality and equality, hitting at its different blind spots, on issues such as class, gender, race, sex, and nationality. This struggle yielded subversive identity and hybrid performances, including reclaiming, mimicry and masquerading. These performances sought to defy the uniform, universal self, which forms the basis for the liberal, rational, enlightened subject. The argument of this research runs that this politics of representation itself is confined within liberal thought. Alongside post-colonialism and multiculturalism’s contribution in undermining oppressive structures of power, generating diversity in cultural visibility, and exposing the failure of liberal colorblindness, this subversion is constituted in the visual field by way of confrontation, flying in the face of the universal law and relying on its ongoing comparison and attribution to this law. Relying on Deleuze and Guattari, this research set out to draw theoretic and empiric attention to an alternative, post-liberal occurrence which has been taking place in the visual field in parallel to the contra-hegemonic phase and as a product of political reality in the aftermath of the crisis of representation. It is no longer a counter-representation; rather, it is a motion of organic minor desire, progressing in the form of flows and generating what Deleuze and Guattari termed deterritorialization of social structures. This discussion shall have its focus on current post-liberal performances of ‘Mizrahim’ (Jewish Israelis of Arab and Muslim extraction) in the visual field in Israel. In television, video art and photography, these performances challenge the issue of representation and generate concrete peripheral Mizrahiness, realized in the visual organization of the photographic frame. Mizrahiness then transforms from ‘confrontational’ representation into a 'presence', flooding the visual sphere in our plain sight, in a process of 'becoming'. The Mizrahi desire is exerted on the plains of sound, spoken language, the body and the space where they appear. It removes from these plains the coding and stratification engendered by European dominance and rational, liberal enlightenment. This stratification, adhering to the hegemonic surface, is flooded not by way of resisting false consciousness or employing hybridity, but by way of the Mizrahi identity’s own productive, material immanent yearning. The Mizrahi desire reverberates with Mizrahi peripheral 'worlds of meaning', where post-colonial interpretation almost invariably identifies a product of internalized oppression, and a recurrence thereof, rather than a source in itself - an ‘offshoot, never a wellspring’, as Nissim Mizrachi clarifies in his recent pioneering work. The peripheral Mizrahi performance ‘unhook itself’, in Deleuze and Guattari words, from the point of subjectification and interpretation and does not correspond with the partialness, absence, and split that mark post-colonial identities.

Keywords: desire, minority, Mizrahi Jews, post-colonialism, post-liberalism, visibility, Deleuze and Guattari

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Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

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Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

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Authors: Nahid Nariman

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The prosperity of any nation depends on its ability to use human potential, in particular, to offer an education that builds learners' competencies to become effective workforce participants and true citizens of the world. Ever since the Second World War, the United States has been a dominant player in the world politically, economically, socially, and culturally. The rapid rise of technological advancement and consumer technologies have made it clear that science, technology, engineering, and math (STEM) play a crucial role in today’s world economy. Exploring the top qualities demanded from new hires in the industry—i.e., problem-solving skills, teamwork, dependability, adaptability, technical and communication skills— sheds light on the kind of path that is needed for a successful educational system to effectively support STEM. The focus of 21st century education has been to build student competencies by preparing them to acquire and apply knowledge, to think critically and creatively, to competently use information, be able to work in teams, to demonstrate intellectual and moral values as well as cultural awareness, and to be able to communicate. Many educational reforms pinpoint various 'ideal' pathways toward STEM that educators, policy makers, and business leaders have identified for educating the workforce of tomorrow. This study will explore how problem-based learning (PBL), an instructional strategy developed in the medical field and adopted with many successful results in K-12 through higher education, is the proper approach to stimulate underrepresented high school students' interest in pursuing STEM careers. In the current study, the effect of a problem-based STEM model on students' attitudes and career interests was investigated using qualitative and quantitative methods. The participants were 71 low-income, native Hawaiian high school students who would be first-generation college students. They were attending a summer STEM camp developed as the result of a collaboration between the University of Hawaii and the Upward Bound Program. The project, funded by the National Science Foundation's Innovative Technology Experiences for Students and Teachers (ITEST) program, used PBL as an approach in challenging students to engage in solving hands-on, real-world problems in their communities. Pre-surveys were used before camp and post-surveys on the last day of the program to learn about the implementation of the PBL STEM model. A Career Interest Questionnaire provided a way to investigate students’ career interests. After the summer camp, a representative selection of students participated in focus group interviews to discuss their opinions about the PBL STEM camp. The findings revealed a significantly positive increase in students' attitudes towards STEM disciplines and STEM careers. The students' interview results also revealed that students identified PBL to be an effective form of instruction in their learning and in the development of their 21st-century skills. PBL was acknowledged for making the class more enjoyable and for raising students' interest in STEM careers, while also helping them develop teamwork and communication skills in addition to scientific knowledge. As a result, the integration of PBL and a STEM learning experience was shown to positively affect students’ interest in STEM careers.

Keywords: problem-based learning, science education, STEM, underrepresented students

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Authors: Chia-Jung Chen, Yu-Chi Hsu, June-Dong Lin, Kun-Chen Chan, Chieh-Tien Wang, Li-Ching Wu, Chung-Feng Liu

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With fast advances in healthcare technology, various total laboratory automation (TLA) processes have been proposed. However, adopting TLA needs quite high funding. This study explores an early adoption experience by Taiwan’s large-scale hospital group, the Chimei Hospital Group (CMG), which owns three branch hospitals (Yongkang, Liouying and Chiali, in order by service scale), based on the five stages of Everett Rogers’ Diffusion Decision Process. 1.Knowledge stage: Over the years, two weaknesses exists in laboratory department of CMG: 1) only a few examination categories (e.g., sugar testing and HbA1c) can now be completed and reported within a day during an outpatient clinical visit; 2) the Yongkang Hospital laboratory space is dispersed across three buildings, resulting in duplicated investment in analysis instruments and inconvenient artificial specimen transportation. Thus, the senior management of the department raised a crucial question, was it time to process the redesign of the laboratory department? 2.Persuasion stage: At the end of 2013, Yongkang Hospital’s new building and restructuring project created a great opportunity for the redesign of the laboratory department. However, not all laboratory colleagues had the consensus for change. Thus, the top managers arranged a series of benchmark visits to stimulate colleagues into being aware of and accepting TLA. Later, the director of the department proposed a formal report to the top management of CMG with the results of the benchmark visits, preliminary feasibility analysis, potential benefits and so on. 3.Decision stage: This TLA suggestion was well-supported by the top management of CMG and, finally, they made a decision to carry out the project with an instrument-leasing strategy. After the announcement of a request for proposal and several vendor briefings, CMG confirmed their laboratory automation architecture and finally completed the contracts. At the same time, a cross-department project team was formed and the laboratory department assigned a section leader to the National Taiwan University Hospital for one month of relevant training. 4.Implementation stage: During the implementation, the project team called for regular meetings to review the results of the operations and to offer an immediate response to the adjustment. The main project tasks included: 1) completion of the preparatory work for beginning the automation procedures; 2) ensuring information security and privacy protection; 3) formulating automated examination process protocols; 4) evaluating the performance of new instruments and the instrument connectivity; 5)ensuring good integration with hospital information systems (HIS)/laboratory information systems (LIS); and 6) ensuring continued compliance with ISO 15189 certification. 5.Confirmation stage: In short, the core process changes include: 1) cancellation of signature seals on the specimen tubes; 2) transfer of daily examination reports to a data warehouse; 3) routine pre-admission blood drawing and formal inpatient morning blood drawing can be incorporated into an automatically-prepared tube mechanism. The study summarizes below the continuous improvement orientations: (1) Flexible reference range set-up for new instruments in LIS. (2) Restructure of the specimen category. (3) Continuous review and improvements to the examination process. (4) Whether installing the tube (specimen) delivery tracks need further evaluation.

Keywords: innovation decision process, total laboratory automation, health care

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Authors: Adriana De Serio, Adrian Korek

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Aims: This experiential research work presents a Group-MusicTherapy-Theatre-Plan (MusThePlan) the authors have carried out to support the actors. The MusicTherapy gives rise to individual psychophysical feedback and influences the emotional centres of the brain and the subconsciousness. Therefore, the authors underline the effectiveness of the preventive, educational, and training goals of the MusThePlan to lead theatre students and actors to deal with anxiety and to overcome psychophysical weaknesses, shyness, emotional stress in stage performances, to increase flexibility, awareness of one's identity and resources for a positive self-development and psychophysical health, to develop and strengthen social bonds, increasing a network of subjects working for social inclusion and reduction of stigma. Materials-Methods: Thirty students from the University Theatre Faculty participated in weekly music therapy sessions for two months; each session lasted 120 minutes. MusThePlan: Each session began with a free group rhythmic-sonorous-musical-production by body-percussion, voice-canto, instruments, to stimulate communication. Then, a synchronized-structured bodily-rhythmic-sonorous-musical production also involved acting, dances, movements of hands and arms, hearing, and more sensorial perceptions and speech to balance motor skills and the muscular tone. Each student could be the director-leader of the group indicating a story to inspire the group's musical production. The third step involved the students in rhythmic speech and singing drills and in vocal exercises focusing on the musical pitch to improve the intonation and on the diction to improve the articulation and lead up it to an increased intelligibility. At the end of each musictherapy session and of the two months, the Musictherapy Assessment Document was drawn up by analysis of observation protocols and two Indices by the authors: Patient-Environment-Music-Index (time to - tn) to estimate the behavior evolution, Somatic Pattern Index to monitor subject’s eye and mouth and limb motility, perspiration, before, during and after musictherapy sessions. Results: After the first month, the students (non musicians) learned to play percussion instruments and formed a musical band that played classical/modern music on the percussion instruments with the musictherapist/pianist/conductor in a public concert. At the end of the second month, the students performed a public musical theatre show, acting, dancing, singing, and playing percussion instruments. The students highlighted the importance of the playful aspects of the group musical production in order to achieve emotional contact and harmony within the group. The students said they had improved kinetic and vocal and all the skills useful for acting activity and the nourishment of the bodily and emotional balance. Conclusions: The MusThePlan makes use of some specific MusicTherapy methodological models, techniques, and strategies useful for the actors. The MusThePlan can destroy the individual "mask" and can be useful when the verbal language is unable to undermine the defense mechanisms of the subject. The MusThePlan improves actor’s psychophysical activation, motivation, gratification, knowledge of one's own possibilities, and the quality of life. Therefore, the MusThePlan could be useful to carry out targeted interventions for the actors with characteristics of repeatability, objectivity, and predictability of results. Furthermore, it would be useful to plan a University course/master in “MusicTherapy for the Theatre”.

Keywords: musictherapy, sonorous-musical energy, quality of life, theatre

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Authors: Jerome Dalphinis, Vishal Patel

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The Bailiwick of Jersey is an island British crown dependency situated off the coast of France. Jersey General Hospital’s emergency department sees approximately 40,000 patients a year. It’s outside the NHS, with secondary care being free at the point of care. Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. Procedural sedation produces a minimally depressed level of consciousness in which the patient retains the ability to maintain an airway, and they respond appropriately to physical stimulation. The goals of it are to improve patient comfort and tolerance of the procedure and alleviate associated anxiety. Indications can be stratified by acuity, emergency (cardioversion for life-threatening dysrhythmia), and urgency (joint reduction). In the emergency department, this is most often achieved using a combination of opioids and benzodiazepines. Some departments also use ketamine to produce dissociative sedation, a cataleptic state of profound analgesia and amnesia. The response to pharmacological agents is highly individual, and the drugs used occasionally have unpredictable pharmacokinetics and pharmacodynamics, which can always result in progression between levels of sedation irrespective of the intention. Therefore, practitioners must be able to ‘rescue’ patients from deeper sedation. These practitioners need to be senior clinicians with advanced airway skills (AAS) training. It can lead to adverse effects such as dangerous hypoxia and unintended loss of consciousness if incorrectly undertaken; studies by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have reported avoidable deaths. The Royal College of Emergency Medicine, UK (RCEM) released an updated ‘Safe Sedation of Adults in the Emergency Department’ guidance in 2017 detailing a series of standards for staff competencies, and the required environment and equipment, which are required for each target sedation depth. The emergency department in Jersey undertook audit research in 2018 to assess their current practice. It showed gaps in clinical competency, the need for uniform care, and improved documentation. This spurred the development of a checklist incorporating the above RCEM standards, including contraindication for procedural sedation and difficult airway assessment. This was approved following discussion with the relevant heads of departments and the patient safety directorates. Following this, a second audit research was carried out in 2019 with 17 completed checklists (11 relocation of joints, 6 cardioversions). Data was obtained from looking at the controlled resuscitation drugs book containing documented use of ketamine, alfentanil, and fentanyl. TrakCare, which is the patient electronic record system, was then referenced to obtain further information. The results showed dramatic improvement compared to 2018, and they have been subdivided into six categories; pre-procedure assessment recording of significant medical history and ASA grade (2 fold increase), informed consent (100% documentation), pre-oxygenation (88%), staff (90% were AAS practitioners) and monitoring (92% use of non-invasive blood pressure, pulse oximetry, capnography, and cardiac rhythm monitoring) during procedure, and discharge instructions including the documented return of normal vitals and consciousness (82%). This procedural sedation checklist is a safe intervention that identifies pertinent information about the patient and provides a standardised checklist for the delivery of gold standard of care.

Keywords: advanced airway skills, checklist, procedural sedation, resuscitation

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Authors: Edward Shizha, Edward Makwarimba

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Newcomer and refugee youth feel excluded in the education system in Canada, and the formal education environment does not fully cater for their learning needs. The objective of this study was to build knowledge and understanding of the educational needs and experiences of these youth in Canada and how available afterschool programs can most effectively support their learning needs and academic outcomes. The Employment and Social Development Canada (ESDC), which funded this research, enables and empowers students to advance their educational experience through targeted investments in services that are delivered by youth-serving organizations outside the formal education system through afterschool initiatives. A literature review and a provincial/territorial internet scan were conducted to determine the availability of services and programs that serve the educational needs and academic outcomes of newcomer youth in 10 provinces and 3 territories in Canada. The goal was to identify intersectional factors (e.g., gender, sexuality, culture, social class, race, etc.) that influence educational outcomes of newcomer/refugee students and to recommend ways the ESDC could complement settlement services to enhance students’ educational success. First, data was collected through a literature search of various databases, including PubMed, Web of Science, Scopus, Google docs, ACADEMIA, and grey literature, including government documents, to inform our analysis. Second, a provincial/territorial internet scan was conducted using a template that was created by ESDC staff with the input of the researchers. The objective of the web-search scan was to identify afterschool programs, projects, and initiatives offered to newcomer/refugee youth by service provider organizations. The method for the scan included both qualitative and quantitative data gathering. Both the literature review and the provincial/territorial scan revealed that there are gender disparities in educational outcomes of newcomer and refugee youth. High school completion rates by gender show that boys are at higher risk of not graduating than girls and that girls are more likely than boys to have at least a high school diploma and more likely to proceed to postsecondary education. Findings from literature reveal that afterschool programs are required for refugee youth who experience mental health challenges and miss out on significant periods of schooling, which affect attendance, participation, and graduation from high school. However, some refugee youth use their resilience and ambition to succeed in their educational outcomes. Another finding showed that some immigrant/refugee students, through ethnic organizations and familial affiliation, maintain aspects of their cultural values, parental expectations and ambitious expectations for their own careers to succeed in both high school and postsecondary education. The study found a significant combination of afterschool programs that include academic support, scholarships, bursaries, homework support, career readiness, internships, mentorship, tutoring, non-clinical counselling, mental health and social well-being support, language skills, volunteering opportunities, community connections, peer networking, culturally relevant services etc. These programs assist newcomer youth to develop self-confidence and prepare for academic success and future career development. The study concluded that advantages of afterschool programs are greatest for youth at risk for poor educational outcomes, such as Latino and Black youth, including 2SLGBTQI+ immigrant youth.

Keywords: afterschool programs, educational outcomes, newcomer youth, refugee youth, youth-serving organizations

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Authors: Susana Barreto

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This paper explores a pedagogical exercise that employs family photos as catalysts for teaching visual analysis and inspiring academic writing among MA students. The study aimed to achieve two primary objectives: to impart students with the skills of analyzing images or artifacts and to ignite their writing for research purposes. Conducted at Viana Polytechnic in Portugal, the exercise involved two classes on Arts Management and Art Education Master course comprising approximately twenty students from diverse academic backgrounds, including Economics, Design, Fine Arts, and Sociology, among others. The exploratory exercise involved selecting an old family photo, analyzing its content and context, and deconstructing the chosen images in an intuitive and systematic manner. Students were encouraged to engage in photo elicitation, seeking insights from family/friends to gain multigenerational perspectives on the images. The feedback received from this exercise was consistently positive, largely due to the personal connection students felt with the objects of analysis. Family photos, with their emotional significance, fostered deeper engagement and motivation in the learning process. Furthermore, visual analysing family photos stimulated critical thinking as students interpreted the composition, subject matter, and potential meanings embedded in the images. This practice enhanced their ability to comprehend complex visual representations and construct compelling visual narratives, thereby facilitating the writing process. The exercise also facilitated the identification of patterns, similarities, and differences by comparing different family photos, leading to a more comprehensive analysis of visual elements and themes. Throughout the exercise, students found analyzing their own photographs both enjoyable and insightful. They progressed through preliminary analysis, explored content and context, and artfully interwove these components. Additionally, students experimented with various techniques such as converting photos to black and white, altering framing angles, and adjusting sizes to unveil hidden meanings.The methodology employed included observation, documental analysis of written reports, and student interviews. By including students from diverse academic backgrounds, the study enhanced its external validity, enabling a broader range of perspectives and insights during the exercise. Furthermore, encouraging students to seek multigenerational perspectives from family and friends added depth to the analysis, enriching the learning experience and broadening the understanding of the cultural and historical context associated with the family photos Highlighting the emotional significance of these family photos and the personal connection students felt with the objects of analysis fosters a deeper connection to the subject matter. Moreover, the emphasis on stimulating critical thinking through the analysis of composition, subject matter, and potential meanings in family photos suggests a targeted approach to developing analytical skills. This improvement focuses specifically on critical thinking and visual analysis, enhancing the overall quality of the exercise. Additionally, the inclusion of a step where students compare different family photos to identify patterns, similarities, and differences further enhances the depth of the analysis. This comparative approach adds a layer of complexity to the exercise, ultimately leading to a more comprehensive understanding of visual elements and themes. The expected results of this study will culminate in a set of practical recommendations for implementing this exercise in academic settings.

Keywords: visual analysis, academic writing, pedagogical exercise, family photos

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Authors: Asma Omri, Iheb Sifaoui, Sofiane Sayahi, Hichem Besbes

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Future vehicle systems demand advanced capabilities, notably in-cabin life detection and driver monitoring systems, with a particular emphasis on drowsiness detection. To meet these requirements, several techniques employ artificial intelligence methods based on real-time vital sign measurements. In parallel, Frequency-Modulated Continuous-Wave (FMCW) radar technology has garnered considerable attention in the domains of healthcare and biomedical engineering for non-invasive vital sign monitoring. FMCW radar offers a multitude of advantages, including its non-intrusive nature, continuous monitoring capacity, and its ability to penetrate through clothing. In this paper, we propose a system utilizing the AWR6843AOP radar from Texas Instruments (TI) to extract precise vital sign information. The radar allows us to estimate Ballistocardiogram (BCG) signals, which capture the mechanical movements of the body, particularly the ballistic forces generated by heartbeats and respiration. These signals are rich sources of information about the cardiac cycle, rendering them suitable for heart rate estimation. The process begins with real-time subject positioning, followed by clutter removal, computation of Doppler phase differences, and the use of various filtering methods to accurately capture subtle physiological movements. To address the challenges associated with FMCW radar-based vital sign monitoring, including motion artifacts due to subjects' movement or radar micro-vibrations, Long Short-Term Memory (LSTM) networks are implemented. LSTM's adaptability to different heart rate patterns and ability to handle real-time data make it suitable for continuous monitoring applications. Several crucial steps were taken, including feature extraction (involving amplitude, time intervals, and signal morphology), sequence modeling, heart rate estimation through the analysis of detected cardiac cycles and their temporal relationships, and performance evaluation using metrics such as Root Mean Square Error (RMSE) and correlation with reference heart rate measurements. For dataset construction and LSTM training, a comprehensive data collection system was established, integrating the AWR6843AOP radar, a Heart Rate Belt, and a smart watch for ground truth measurements. Rigorous synchronization of these devices ensured data accuracy. Twenty participants engaged in various scenarios, encompassing indoor and real-world conditions within a moving vehicle equipped with the radar system. Static and dynamic subject’s conditions were considered. The heart rate estimation through LSTM outperforms traditional signal processing techniques that rely on filtering, Fast Fourier Transform (FFT), and thresholding. It delivers an average accuracy of approximately 91% with an RMSE of 1.01 beat per minute (bpm). In conclusion, this paper underscores the promising potential of FMCW radar technology integrated with artificial intelligence algorithms in the context of automotive applications. This innovation not only enhances road safety but also paves the way for its integration into the automotive ecosystem to improve driver well-being and overall vehicular safety.

Keywords: ballistocardiogram, FMCW Radar, vital sign monitoring, LSTM

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Authors: Wenfan Yan, Yumei Han

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Objectives: Educational inequality persists between China's ethnic minority regions and the mainland. The key to rectifying this disparity lies in enhancing the quality of educators. This paper delves into the Chinese government's innovative policy, "Group Educators Supporting Tibet" (GEST), designed to bridge the shortage of high-quality teachers in Tibet, a representative underprivileged ethnic minority area. GEST aims to foster collective action by networking provincial expert educators with Tibetan counterparts and collaborating between supporting provincial educational entities and Tibetan education entities. Theoretical Framework: The unequal distribution of social capital contributes significantly to the educational gap between ethnic minority areas and other regions in China. Within the framework of social network theory, motivated GEST educators take action to foster resources and relationships. This study captures grassroots perspectives to outline how social networking contributes to the policy objective of enhancing Tibetan teachers' quality and eradicating educational injustice. Methodology: A sequential mixed-methods approach was adopted to scrutinize policy impacts from the vantage point of social networking. Quantitative research involved surveys for GEST and Tibetan teachers, exploring demographics, perceptions of policy significance, motivations, actions, and networking habits. Qualitative research included focus group interviews with GEST educators, local teachers, and students from program schools. The findings were meticulously analyzed to provide comprehensive insights into stakeholders' experiences and the impacts of the GEST policy. Key Findings: The policy empowers individuals to impact Tibetan education significantly. Motivated GEST educators with prior educational support experiences contribute to its success. Supported by a collective -school, city, province, and government- the new social structure fosters higher efficiency. GEST's approach surpasses conventional methods. The individual, backed by educators, realizes the potential of transformative class design. Collective activities -pedagogy research, teaching, mentoring, training, and partnerships- equip Tibetan teachers, enhancing educational quality and equity. This collaborative effort establishes a robust foundation for the policy's success, emphasizing the collective impact on Tibetan education. Contributions: This study contributes to international policy studies focused on educational equity through collective teacher action. Using a mixed-methods approach and guided by social networking theory, it accentuates stakeholders' perspectives, elucidating the genuine impacts of the GEST policy. The study underscores the advancement of social networking, the reinforcement of local teacher quality, and the transformative potential of cultivating a more equitable and adept teaching workforce in Tibet. Limitations of the Study and Suggestions for Future Research Directions: While the study emphasizes the positive impacts of motivated GEST educators, there might be aspects or challenges not fully explored. A more comprehensive understanding of potential drawbacks or obstacles would provide a more balanced view. For future studies, investigating the long-term impact of the GEST policy on educational quality could provide insights into the sustainability of the improvements observed. Also, understanding the perspectives of Tibetan teachers who may not have directly benefited from GEST could reveal potential disparities in policy implementation.

Keywords: teacher development, social networking, teacher quality, mixed research method

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Authors: Thaveesha Dheerasekera, Dileeka Sandamali Alwis

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The escalating prevalence of mental health issues, such as depression and suicidal ideation, is a matter of significant global concern. It is plausible that a variety of factors, such as life events, social isolation, and preexisting physiological or psychological health conditions, could instigate or exacerbate these conditions. Traditional approaches to diagnosing depression entail a considerable amount of time and necessitate the involvement of adept practitioners. This underscores the necessity for automated systems capable of promptly detecting and diagnosing symptoms of depression. The PsyVBot system employs sophisticated natural language processing and machine learning methodologies, including the use of the NLTK toolkit for dataset preprocessing and the utilization of a Long Short-Term Memory (LSTM) model. The PsyVBot exhibits a remarkable ability to diagnose depression with a 94% accuracy rate through the analysis of user input. Consequently, this resource proves to be efficacious for individuals, particularly those enrolled in academic institutions, who may encounter challenges pertaining to their psychological well-being. The PsyVBot employs a Long Short-Term Memory (LSTM) model that comprises a total of three layers, namely an embedding layer, an LSTM layer, and a dense layer. The stratification of these layers facilitates a precise examination of linguistic patterns that are associated with the condition of depression. The PsyVBot has the capability to accurately assess an individual's level of depression through the identification of linguistic and contextual cues. The task is achieved via a rigorous training regimen, which is executed by utilizing a dataset comprising information sourced from the subreddit r/SuicideWatch. The diverse data present in the dataset ensures precise and delicate identification of symptoms linked with depression, thereby guaranteeing accuracy. PsyVBot not only possesses diagnostic capabilities but also enhances the user experience through the utilization of audio outputs. This feature enables users to engage in more captivating and interactive interactions. The PsyVBot platform offers individuals the opportunity to conveniently diagnose mental health challenges through a confidential and user-friendly interface. Regarding the advancement of PsyVBot, maintaining user confidentiality and upholding ethical principles are of paramount significance. It is imperative to note that diligent efforts are undertaken to adhere to ethical standards, thereby safeguarding the confidentiality of user information and ensuring its security. Moreover, the chatbot fosters a conducive atmosphere that is supportive and compassionate, thereby promoting psychological welfare. In brief, PsyVBot is an automated conversational agent that utilizes an LSTM model to assess the level of depression in accordance with the input provided by the user. The demonstrated accuracy rate of 94% serves as a promising indication of the potential efficacy of employing natural language processing and machine learning techniques in tackling challenges associated with mental health. The reliability of PsyVBot is further improved by the fact that it makes use of the Reddit dataset and incorporates Natural Language Toolkit (NLTK) for preprocessing. PsyVBot represents a pioneering and user-centric solution that furnishes an easily accessible and confidential medium for seeking assistance. The present platform is offered as a modality to tackle the pervasive issue of depression and the contemplation of suicide.

Keywords: chatbot, depression diagnosis, LSTM model, natural language process

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Authors: Subhash Nerella, Ziyuan Guan, Azra Bihorac, Parisa Rashidi

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Intensive care units (ICUs) provide care to critically ill patients in severe and life-threatening conditions. However, patient monitoring in the ICU is limited by the time and resource constraints imposed on healthcare providers. Many critical care indices such as mobility are still manually assessed, which can be subjective, prone to human errors, and lack granularity. Other important aspects, such as environmental factors, are not monitored at all. For example, critically ill patients often experience circadian disruptions due to the absence of effective environmental “timekeepers” such as the light/dark cycle and the systemic effect of acute illness on chronobiologic markers. Although the occurrence of delirium is associated with circadian disruption risk factors, these factors are not routinely monitored in the ICU. Hence, there is a critical unmet need to develop systems for precise and real-time assessment through novel enabling technologies. We have developed the mobility and circadian disruption quantification system (Mobi-DiQ) by augmenting biomarker and clinical data with pervasive sensing data to generate mobility and circadian cues related to mobility, nightly disruptions, and light and noise exposure. We hypothesize that Mobi-DiQ can provide accurate mobility and circadian cues that correlate with bedside clinical mobility assessments and circadian biomarkers, ultimately important for delirium risk assessment and prevention. The collected multimodal dataset consists of depth images, Electromyography (EMG) data, patient extremity movement captured by accelerometers, ambient light levels, Sound Pressure Level (SPL), and indoor air quality measured by volatile organic compounds, and the equivalent CO₂ concentration. For delirium risk assessment, the system recognizes mobility cues (axial body movement features and body key points) and circadian cues, including nightly disruptions, ambient SPL, and light intensity, as well as other environmental factors such as indoor air quality. The Mobi-DiQ system consists of three major components: the pervasive sensing system, a data storage and analysis server, and a data annotation system. For data collection, six local pervasive sensing systems were deployed, including a local computer and sensors. A video recording tool with graphical user interface (GUI) developed in python was used to capture depth image frames for analyzing patient mobility. All sensor data is encrypted, then automatically uploaded to the Mobi-DiQ server through a secured VPN connection. Several data pipelines are developed to automate the data transfer, curation, and data preparation for annotation and model training. The data curation and post-processing are performed on the server. A custom secure annotation tool with GUI was developed to annotate depth activity data. The annotation tool is linked to the MongoDB database to record the data annotation and to provide summarization. Docker containers are also utilized to manage services and pipelines running on the server in an isolated manner. The processed clinical data and annotations are used to train and develop real-time pervasive sensing systems to augment clinical decision-making and promote targeted interventions. In the future, we intend to evaluate our system as a clinical implementation trial, as well as to refine and validate it by using other data sources, including neurological data obtained through continuous electroencephalography (EEG).

Keywords: deep learning, delirium, healthcare, pervasive sensing

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Authors: Nayer Mofidtabatabaei

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Advancements in artificial intelligence (AI) have transformed various fields, including psychology and behavioral sciences. This paper explores the diverse ways in which AI is applied to enhance research, diagnosis, therapy, and understanding of human behavior and mental health. We discuss the potential benefits and challenges associated with AI in these fields, emphasizing the ethical considerations and the need for collaboration between AI researchers and psychological and behavioral science experts. Artificial Intelligence (AI) has gained prominence in recent years, revolutionizing multiple industries, including healthcare, finance, and entertainment. One area where AI holds significant promise is the field of psychology and behavioral sciences. AI applications in this domain range from improving the accuracy of diagnosis and treatment to understanding complex human behavior patterns. This paper aims to provide an overview of the various AI applications in psychological and behavioral sciences, highlighting their potential impact, challenges, and ethical considerations. Mental Health Diagnosis AI-driven tools, such as natural language processing and sentiment analysis, can analyze large datasets of text and speech to detect signs of mental health issues. For example, chatbots and virtual therapists can provide initial assessments and support to individuals suffering from anxiety or depression. Autism Spectrum Disorder (ASD) Diagnosis AI algorithms can assist in early ASD diagnosis by analyzing video and audio recordings of children's behavior. These tools help identify subtle behavioral markers, enabling earlier intervention and treatment. Personalized Therapy AI-based therapy platforms use personalized algorithms to adapt therapeutic interventions based on an individual's progress and needs. These platforms can provide continuous support and resources for patients, making therapy more accessible and effective. Virtual Reality Therapy Virtual reality (VR) combined with AI can create immersive therapeutic environments for treating phobias, PTSD, and social anxiety. AI algorithms can adapt VR scenarios in real-time to suit the patient's progress and comfort level. Data Analysis AI aids researchers in processing vast amounts of data, including survey responses, brain imaging, and genetic information. Privacy Concerns Collecting and analyzing personal data for AI applications in psychology and behavioral sciences raise significant privacy concerns. Researchers must ensure the ethical use and protection of sensitive information. Bias and Fairness AI algorithms can inherit biases present in training data, potentially leading to biased assessments or recommendations. Efforts to mitigate bias and ensure fairness in AI applications are crucial. Transparency and Accountability AI-driven decisions in psychology and behavioral sciences should be transparent and subject to accountability. Patients and practitioners should understand how AI algorithms operate and make decisions. AI applications in psychological and behavioral sciences have the potential to transform the field by enhancing diagnosis, therapy, and research. However, these advancements come with ethical challenges that require careful consideration. Collaboration between AI researchers and psychological and behavioral science experts is essential to harness AI's full potential while upholding ethical standards and privacy protections. The future of AI in psychology and behavioral sciences holds great promise, but it must be navigated with caution and responsibility.

Keywords: artificial intelligence, psychological sciences, behavioral sciences, diagnosis and therapy, ethical considerations

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Authors: Giuliana Murfet, Heidi Behrens

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Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

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Authors: Harold M. Carag, April Charmaine D. Camacho, Girlie Nora A. Abrigo, Florencia G. Palis, Ma. Larissa Lelu P. Gata

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A technology impact assessment on the use of microbial inoculants in the reforestation and rehabilitation of forest ancestral lands of the Magbukün Aytas in Morong, Bataan was conducted. This two-year rainforestation technology aimed to determine the optimum condition for the improvement of seedling survival rate in the nursery and in the field to hasten the process of forest regeneration of Magbukün Ayta’s ancestral land. A combination of qualitative methods (key informant interviews, focus groups and participant observation), participated by the farmers who were directly involved in the project, community men and women, the council of elders and the project staff, was employed to complete this impact assessment. The recorded data were transcribed, and the accounts were broadly categorized on the following aspects: social (gender, institutional, anthropological), economic and environmental. The Australian Center for International Agricultural Research (ACIAR) framework was primarily used for the impact analysis while the Harvard Analytical Framework was specifically used for the gender impact analysis. Through this technology, a wildling nursery with more than one thousand seedlings was successfully established and served as a good area for the healthy growth of seedlings that would be planted in the forest. Results showed that this technology affected positively and negatively the various gender roles present in the community although household work remained to be the women’s responsibility. The technology introduced directly added up to the workload done by the men and women (preparing and applying fertilizer, making pots etc.) but this, in turn, provided ways to increase their sources of livelihood. The gender roles that were already present were further strengthened after the project and men remained to be in control. The technology or project in turn also benefited from the already present roles since they no longer have to assign things to them, the execution of the various roles was smoothly executed. In the anthropological aspect, their assigned task to manage the nursery was an easy responsibility because of their deep connection to the environment and their fear and beliefs on ‘engkato’ and ‘anito’ was helpful in guarding the forest. As the cultural value of these trees increases, their mindset of safeguarding the forest also heightens. Meanwhile, the welfare of the whole tribe is the ultimate determinant of the swift entry of projects. The past institutions brought ephemeral reliefs on the subsistence of the Magbukün Aytas. These were good ‘conditioning’ factors for the adoption of the technology of the project. As an attempt to turn away from the dependent of harmful chemical, the project’s way of introducing organic inputs was slowly gaining popularity in the community. Economically, the project was able to provide additional income to the farmers. However, the slow mode of payment dismayed other farmers and abandoned their roles. Lastly, major environmental effects weren’t that much observed after the application of the technology. The minor effects concentrated more on the improved conditions of the soil and water in the community. Because of the introduced technology, soil conditions became more favorable specifically for the species that were planted. The organic fertilizers used were in turn not harmful for the residents living in Sitio Kanawan. There were no human diseases caused by the technology. The conservation of the biodiversity of the forest is clearly the most evident long-term result of the project.

Keywords: ancestral lands, impact assessment, microbial inculants, reforestation

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Authors: Daniel Stabler, Anne-Laure Mention, Henri Hakala, Ahmad Alaassar

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In Europe, 2.2 billion tons of waste annually generate severe environmental damage and economic burdens, and negatively impact human health. A stark illustration of the problem is found within the consumer electronics industry, which reflects one of the most complex global waste streams. Of the 5.3 billion globally discarded mobile phones in 2022, only 17% were properly recycled. To address these pressing issues, Europe has made significant strides in developing waste management strategies, Circular Economy initiatives, and Right to Repair policies. These endeavors aim to make product repair and maintenance more accessible, extend product lifespans, reduce waste, and promote sustainable resource use. European countries have introduced Right to Repair policies, often in conjunction with extended producer responsibility legislation, repair subsidies, and consumer repair indices, to varying degrees of regulatory rigor. Changing societal trends emphasizing sustainability and environmental responsibility have driven consumer demand for more sustainable and repairable products, benefiting repair-focused consumer electronics businesses. In academic research, much of the literature in Management studies has examined the European Circular Economy and the Right to Repair from firm-level perspectives. These studies frequently employ a business-model lens, emphasizing innovation and strategy frameworks. However, this study takes an institutional perspective, aiming to understand the adoption of Circular Economy and repair-focused business models within the European consumer electronics market. The concepts of the Circular Economy and the Right to Repair align with institutionalism as they reflect evolving societal norms favoring sustainability and consumer empowerment. Regulatory institutions play a pivotal role in shaping and enforcing these concepts through legislation, influencing the behavior of businesses and individuals. Compliance and enforcement mechanisms are essential for their success, compelling actors to adopt sustainable practices and consider product life extension. Over time, these mechanisms create a path for more sustainable choices, underscoring the influence of institutions and societal values on behavior and decision-making. Institutionalism, particularly 'neo-institutionalism,' provides valuable insights into the factors driving the adoption of Circular and repair-focused business models. Neo-institutional pressures can manifest through coercive regulatory initiatives or normative standards shaped by socio-cultural trends. The Right to Repair movement has emerged as a prominent and influential idea within academic discourse and sustainable development initiatives. Therefore, understanding how macro-level societal shifts toward the Circular Economy and the Right to Repair trigger firm-level responses is imperative. This study aims to answer a crucial question about the impact of European Right to Repair initiatives had on the financial and environmental performance of European consumer electronics companies at the firm level. A quantitative and statistical research design will be employed. The study will encompass an extensive sample of consumer electronics firms in Northern and Western Europe, analyzing their financial and environmental performance in relation to the implementation of Right to Repair mechanisms. The study's findings are expected to provide valuable insights into the broader implications of the Right to Repair and Circular Economy initiatives on the European consumer electronics industry.

Keywords: circular economy, right to repair, institutionalism, environmental management, european union

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Authors: Zeinab Zaremohzzabieh, Syasya Firzana Azmi, Haslinda Abdullah, Soh Kim Geok, Aini Azeqa Ma'rof, Hayrol Azril Mohammed Shaffril

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The escalating prevalence of doping in sports, casting a shadow over both high-performance and recreational settings, has emerged as a formidable concern, particularly within the realm of young athletes. Doping, characterized by the surreptitious use of prohibited substances to gain a competitive edge, underscores the pressing need for comprehensive and efficacious preventive measures. This study aims to address a crucial void in current research by unraveling the motivations that drive clean adolescent athletes to steadfastly abstain from performance-enhancing substances. In navigating this intricate landscape, the study adopts a positive psychology perspective, investigating into the conditions and processes that contribute to the holistic well-being of individuals and communities. At the heart of this exploration lies the application of the PERMA model, a comprehensive positive psychology framework encapsulating positive emotion, engagement, relationships, meaning, and accomplishments. This model functions as a distinctive lens, dissecting intervention results to offer nuanced insights into the complex dynamics of clean sport behavior. The research is poised to usher in a paradigm shift from conventional anti-doping strategies, predominantly fixated on identifying deficits, towards an innovative approach firmly rooted in positive psychology. The objective of this study is to evaluate the efficacy of a positive education intervention program tailored to promote clean sport behavior among Malaysian adolescent athletes. Representing unexplored terrain within the landscape of anti-doping efforts, this initiative endeavors to reshape the focus from deficiencies to strengths. The meticulously crafted pilot study engages thirty adolescent athletes, divided into a control group of 15 and an experimental group of 15. The pilot study serves as the crucible to assess the effectiveness of the prepared intervention package, providing indispensable insights that will meticulously guide the finalization of an all-encompassing intervention program for the main study. The main study adopts a pioneering two-arm randomized control trial methodology, actively involving adolescent athletes from diverse Malaysian high schools. This approach aims to address critical lacunae in anti-doping strategies, specifically calibrated to resonate with the unique context of Malaysian schools. The study, cognizant of the imperative to develop preventive measures harmonizing with the cultural and educational milieu of Malaysian adolescent athletes, aspires to cultivate a culture of clean sport. In conclusion, this research aspires to contribute unprecedented insights into the efficacy of positive education interventions firmly rooted in the PERMA model. By unraveling the intricacies of clean sport behavior, particularly within the context of Malaysian adolescent athletes, the study seeks to introduce transformative preventive methods. The adoption of positive psychology as an avant-garde anti-doping tool represents an innovative and promising approach, bridging a conspicuous gap in scholarly research and offering potential panaceas for the sporting community. As this study unfurls its chapters, it carries the promise not only to enrich our understanding of clean sport behavior but also to pave the way for positive metamorphosis within the realm of adolescent sports in Malaysia.

Keywords: positive education interventions, a pilot study, clean sport behavior, adolescent athletes, Malaysia

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Authors: Philipp Sommer, Amgad Agoub

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The construction sector significantly impacts global CO₂ emissions, particularly through the energy usage of residential buildings. To address this, various governments, including Germany's, are focusing on reducing emissions via sustainable refurbishment initiatives. This study examines the application of machine learning (ML) to estimate energy demands dynamically in residential buildings and enhance the potential for large-scale sustainable refurbishment. A major challenge in Germany is the lack of extensive publicly labeled datasets for energy performance, as energy performance certificates, which provide critical data on building-specific energy requirements and consumption, are not available for all buildings or require on-site inspections. Conversely, England and other countries in the European Union (EU) have rich public datasets, providing a viable alternative for analysis. This research adapts insights from these English datasets to the German context by developing a comprehensive data schema and calibration dataset capable of predicting building energy demand effectively. The study proposes a minimal feature set, determined through feature importance analysis, to optimize the ML model. Findings indicate that ML significantly improves the scalability and accuracy of energy demand forecasts, supporting more effective emissions reduction strategies in the construction industry. Integrating energy performance certificates into municipal heat planning in Germany highlights the transformative impact of data-driven approaches on environmental sustainability. The goal is to identify and utilize key features from open data sources that significantly influence energy demand, creating an efficient forecasting model. Using Extreme Gradient Boosting (XGB) and data from energy performance certificates, effective features such as building type, year of construction, living space, insulation level, and building materials were incorporated. These were supplemented by data derived from descriptions of roofs, walls, windows, and floors, integrated into three datasets. The emphasis was on features accessible via remote sensing, which, along with other correlated characteristics, greatly improved the model's accuracy. The model was further validated using SHapley Additive exPlanations (SHAP) values and aggregated feature importance, which quantified the effects of individual features on the predictions. The refined model using remote sensing data showed a coefficient of determination (R²) of 0.64 and a mean absolute error (MAE) of 4.12, indicating predictions based on efficiency class 1-100 (G-A) may deviate by 4.12 points. This R² increased to 0.84 with the inclusion of more samples, with wall type emerging as the most predictive feature. After optimizing and incorporating related features like estimated primary energy consumption, the R² score for the training and test set reached 0.94, demonstrating good generalization. The study concludes that ML models significantly improve prediction accuracy over traditional methods, illustrating the potential of ML in enhancing energy efficiency analysis and planning. This supports better decision-making for energy optimization and highlights the benefits of developing and refining data schemas using open data to bolster sustainability in the building sector. The study underscores the importance of supporting open data initiatives to collect similar features and support the creation of comparable models in Germany, enhancing the outlook for environmental sustainability.

Keywords: machine learning, remote sensing, residential building, energy performance certificates, data-driven, heat planning

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Authors: Jennifer Wheeldon, Nick de Viggiani, Nikki Cotterill

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Background: Urinary and fecal incontinence affect a significant proportion of older adults aged 65 and over who permanently reside in residential and nursing home facilities. Incontinence symptoms have been linked to comorbidities, an increased risk of infection and reduced quality of life and mental wellbeing of residents. However, continence care provision can often be poor, further compromising the health and wellbeing of this vulnerable population. Objectives: To identify experiences and perceptions of continence care provision in older adult residential care settings and to identify factors that help or hinder good continence care provision. Settings included both residential care homes and nursing homes for older adults. Methods: A qualitative evidence synthesis using systematic review methodology established the current evidence-base. Data from 20 qualitative and mixed-method studies was appraised and synthesized. Following the review process, 10* qualitative interviews with staff working in older adult residential care settings were conducted across six* sites, which included registered managers, registered nurses and nursing/care assistants/aides. Purposive sampling recruited individuals from across England. Both evidence synthesis and interview data was analyzed thematically, both manually and with NVivo software. Results: The evidence synthesis revealed complex barriers and facilitators for continence care provision at three influencing levels: macro (structural and societal external influences), meso (organizational and institutional influences) and micro (day-to-day actions of individuals impacting service delivery). Macro-level barriers included negative stigmas relating to incontinence, aging and working in the older adult social care sector, restriction of continence care resources such as containment products (i.e. pads), short staffing in care facilities, shortfalls in the professional education and training of care home staff and the complex health and social care needs of older adult residents. Meso-level barriers included task-centered organizational cultures, ageist institutional perspectives regarding old age and incontinence symptoms, inadequate care home management and poor communication and teamwork among care staff. Micro-level barriers included poor knowledge and negative attitudes of care home staff and residents regarding incontinence symptoms and symptom management and treatment. Facilitators at the micro-level included proactive and inclusive leadership skills of individuals in management roles. Conclusions: The findings of the evidence synthesis study help to outline the complexities of continence care provision in older adult care homes facilities. Macro, meso and micro level influences demonstrate problematic and interrelated barriers across international contexts, indicating that improving continence care in this setting is extremely challenging due to the multiple levels at which care provision and services are impacted. Both international and national older adult social care policy-makers, researchers and service providers must recognize this complexity, and any intervention seeking to improve continence care in older adult care home settings must be planned accordingly and appreciatively of the complex and interrelated influences. It is anticipated that the findings of the qualitative interviews will shed further light on the national context of continence care provision specific to England; data collection is ongoing*. * Sample size is envisaged to be between 20-30 participants from multiple sites by Spring 2023.

Keywords: continence care, residential and nursing homes, evidence synthesis, qualitative

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Authors: Divya SY. Ang, Mark B. Tan, Nicholas EM. Yeo, Siti RB. Sudirman, Khong Yik Chew

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Introduction: The importance of the amalgamation of technological and engineering advances with surgical principles of reconstruction cannot be overemphasized. With earlier detection of cancer, consequences of high-speed living and neglect, like traumatic injuries and infection, resulting in increasingly younger patients with bone defects. This may result in malformations and suboptimal function that is more noticeable and palpable in the younger, active demographic. Our team proposes a technique that encapsulates a mesh of multidisciplinary effort, tissue engineering and reconstructive principles. Methods/Materials: Our patient was a young competitive footballer in his early 30s who was diagnosed with submandibular adenoid cystic carcinoma with bony involvement. He was thus counselled for a right hemi mandibulectomy, the floor of mouth resection, right selective neck dissection, tracheostomy, and free fibular flap reconstruction of his mandible and required post-operative radiotherapy. Being young and in his prime sportsman years, he was unable to accept the morbidities associated with using his fibula to reconstruct his mandible despite it being the gold standard reconstructive option. The fibula is an ideal vascularized bone flap because it’s reliable and easily shaped with relatively minimal impact on functional outcomes. The fibula contributes to 30% of weightbearing and is the attachment for the lateral compartment muscles; it is stronger in footballers concerning lateral bending. When harvesting the fibula, the distal 6-8cm and up to 10% of the total length is preserved to maintain the ankle’s stability, thus, minimizing the impact on daily activities. There are studies that have noted gait variability post-operatively. Therefore, returning to a premorbid competitive level may be doubtful. To improve his functional outcomes, the decision was made to try and restore the fibula's form and function. Using the concept of Fused Deposition Modelling (FDM), our team comprising of Plastics, Otolaryngology, Orthopedics and Radiology, worked with Osteopore to design a 3D bioresorbable implant to regenerate the fibula defect (14.5cm). Bone marrow was harvested via reaming the contralateral hip prior to the wide resection. 30mls of his blood was obtained for extracting platelet rich plasma. These were packed into the Osteopore 3D-printed bone scaffold. This was then secured into the fibula defect with titanium plates and screws. The flexor hallucis longus and soleus were anchored along the construct and intraosseous membrane, done in a single setting. Results: He was reviewed closely as an outpatient over 10 months post operatively. He reported no discernable loss or difference in ankle function. He is satisfied and back in training and our team has video and photographs that substantiate his progress. Conclusion: FDM allows regeneration of long bone defects. However, we aimed to also restore his eversion and inversion that is imperative for footballers and hence reattached his previously dissected muscles along the length of the Osteopore implant. We believe that the reattachment of the muscle stabilizes not only the construct but allows optimum muscle tensioning when moving his ankle. This is a simple but effective technique in restoring complete function and form in a young patient whose minute muscle control is imperative to life.

Keywords: fused deposition modelling, functional reconstruction, lower limb bony defects, regenerative surgery, 3D printing, tissue engineering

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Authors: Hao Huang

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INTRODUCTION: The Association of American Colleges and Universities (AACU) recommends the development of ‘high-impact practices,’ in an effort to increase rates of student retention and student engagement at undergraduate institutions. To achieve these goals, the Scripps College Humanities Institute and HI Fellows Seminar not only featured distinguished academics presenting their scholarship about current immigration policy and its consequences in the USA and around the world but integrated socially significant community leaders and creative activists/artivists in public talks, student workshops and collaborative art events. Students participated in experiential learning that involved guest personal presentations and discussions, oral history interviews that applied standard oral history methodologies, detailed cultural documentation, collaborative artistic interventions, and weekly posts in Internet Digital Learning Environment Sakai collaborative course forums and regular responses to other students’ comments. Our teaching pedagogies addressed the four learning styles outlined in Kolb’s Learning Style Inventory. PROJECT DESCRIPTION: Over the academic year 2017-18, the Scripps College Humanities Institute and HI Fellows Seminar presented a Fall 2017 topic, ‘The World at Our Doorsteps: Immigration and Deportation in Los Angeles’. Our purpose was to address how current federal government anti-immigration measures have affected many students of color, some of whom are immigrants, many of whom are related to and are friends with people who are impacted by the attitudes as well as the practices of the U.S. Citizenship and Immigration Services. In Spring 2018, we followed with the topic, ‘Exclusive Nationalisms: Global Migration and Immigration’. This addresses the rise of white supremacists who have ascended to position of power worldwide, in America, Europe, Russia, and xenophobic nationalisms in China, Myanmar and the Philippines. Recent scholarship has suggested the existence of categories of refugees beyond the political or social, who fit into the more inclusive category of migrants. ASSESSMENT METHODOLOGIES: Assessment methodologies not only included qualitative student interviews and quantitative student evaluations in standard rubric format, but also Outcome Assessments, Formative Evaluations, and Outside Guest Teacher feedback. These indicated that the most effective educational practices involved collaborative inquiry in undergraduate research, community-based learning, and capstone projects. Assessments of E-portfolios, written and oral coursework, and final creative projects with associated 10-12 page analytic paper revealed that students developed their understanding of how government and social organizations work; they developed communication skills that enhanced working with others from different backgrounds; they developed their ability to thoughtfully evaluate their course performance by adopting reflective practices; they gained analytic and interpretive skills that encouraged self-confidence and self- initiative not only academically, but also with regards to independent projects. CONCLUSION: Most importantly, the Scripps Humanities Institute experiential learning project spurred on real-world actions by our students, such as a public symposium on how to cope with bigots, a student tutoring program for immigrant staff children, student negotiations with the administration to establish meaningful, sustainable diversity and inclusion programs on-campus. Activism is not only to be taught to and for our students– it has to be enacted by our students.

Keywords: immigration, migration, human rights, learning assessment

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Authors: Nathan Garcia

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The polarizing dialogue of contemporary political America results from core philosophical differences. But these differences are beyond ideological and reach metaphysical distinction. Good intellectual historians have theorized that fundamental concepts such as freedom, God, and nature have been sterilized of their intellectual vigor. They are partially correct. 19th-century pragmatist Charles Sanders Peirce offers a penetrating philosophy which can yield greater insight into the contemporary political divide. Peirce argues that metaphysical and ethical issues are derivative of operational logic. His triadic logical structure and ensuing metaphysical principles constructed therefrom is contemporaneously applicable for three reasons. First, Peirce’s logic aptly scrutinizes the logical processes of liberal and conservative mindsets. Each group arrives at a cosmological root metaphor (abduction), resulting in a contemporary assessment (deduction), ultimately prompting attempts to verify the original abduction (induction). Peirce’s system demonstrates that liberal citizens develop a cosmological root metaphor in the concept of fairness (abduction), resulting in a contemporary assessment of, for example, underrepresented communities being unfairly preyed upon (deduction), thereby inciting anger toward traditional socio-political structures suspected of purposefully destabilizing minority communities (induction). Similarly, conservative citizens develop a cosmological root metaphor in the concept of freedom (abduction), resulting in a contemporary assessment of, for example, liberal citizens advocating an expansion of governmental powers (deduction), thereby inciting anger towards liberal communities suspected of attacking freedoms of ordinary Americans in a bid to empower their interests through the government (induction). The value of this triadic assessment is the categorization of distinct types of inferential logic by their purpose and boundaries. Only deductive claims can be concretely proven, while abductive claims are merely preliminary hypotheses, and inductive claims are accountable to interdisciplinary oversight. Liberals and conservative logical processes preclude constructive dialogue because of (a) an unshared abductive framework, and (b) misunderstanding the rules and responsibilities of their types of claims. Second, Peircean metaphysical principles offer a greater summary of the contemporaneously divisive political climate. His insights can weed through the partisan theorizing to unravel the underlying philosophical problems. Corrosive nominalistic and essentialistic presuppositions weaken the ability to share experiences and communicate effectively, both requisite for any promising constructive dialogue. Peirce’s pragmatist system can expose and evade fallacious thinking in pursuit of a refreshing alternative framework. Finally, Peirce’s metaphysical foundation enables a logically coherent, scientifically informed orthopraxis well-suited for American dialogue. His logical structure necessitates radically different anthropology conducive to shared experiences and dialogue within a dynamic, cultural continuum. Pierce’s fallibilism and sensitivity to religious sentiment successfully navigate between liberal and conservative values. In sum, he provides a normative paradigm for intranational dialogue that privileges individual experience and values morally defensible notions of freedom, God, and nature. Utilizing Peirce’s thought will yield fruitful analysis and offers a promising philosophical alternative for framing and engaging in contemporary American political discourse.

Keywords: Charles s. Peirce, american politics, logic, pragmatism

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Authors: Brandy Yee, Dianne Yee

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Through the exploration of the lived experiences, beliefs and values of instructional leaders, teachers and students in Finland, Germany and Canada, we investigated the factors which contribute to developmentally responsive, intellectually engaging middle-level learning environments for early adolescents. Student-centred leadership dimensions, effective instructional practices and student agency were examined through the lens of current policy and research on middle-level learning environments emerging from the Canadian province of Manitoba. Consideration of these three research perspectives in the context of early adolescent learning, placed against an international backdrop, provided a previously undocumented perspective on leading, teaching and learning in the middle years. Aligning with a social constructivist, qualitative research paradigm, the study incorporated collective case study methodology, along with constructivist grounded theory methods of data analysis. Data were collected through semi-structured individual and focus group interviews and document review, as well as direct and participant observation. Three case study narratives were developed to share the rich stories of study participants, who had been selected using maximum variation and intensity sampling techniques. Interview transcript data were coded using processes from constructivist grounded theory. A cross-case analysis yielded a conceptual framework highlighting key factors that were found to be significant in the establishment of developmentally responsive, intellectually engaging middle-level learning environments. Seven core categories emerged from the cross-case analysis as common to all three countries. Within the visual conceptual framework (which depicts the interconnected nature of leading, teaching and learning in middle-level learning environments), these seven core categories were grouped into Essential Factors (student agency, voice and choice), Contextual Factors (instructional practices; school culture; engaging families and the community), Synergistic Factors (instructional leadership) and Cornerstone Factors (education as a fundamental cultural value; preservice, in-service and ongoing teacher development). In addition, sub-factors emerged from recurring codes in the data and identified specific characteristics and actions found in developmentally responsive, intellectually engaging middle-level learning environments. Although this study focused on 12 schools in Finland, Germany and Canada, it informs the practice of educators working with early adolescent learners in middle-level learning environments internationally. The authentic voices of early adolescent learners are the most important resource educators have to gauge if they are creating effective learning environments for their students. Ongoing professional dialogue and learning is essential to ensure teachers are supported in their work and develop the pedagogical practices needed to meet the needs of early adolescent learners. It is critical to balance consistency, coherence and dependability in the school environment with the necessary flexibility in order to support the unique learning needs of early adolescents. Educators must intentionally create a school culture that unites teachers, students and their families in support of a common purpose, as well as nurture positive relationships between the school and its community. A large, urban school district in Canada has implemented a school cohort-based model to begin to bring developmentally responsive, intellectually engaging middle-level learning environments to scale.

Keywords: developmentally responsive learning environments, early adolescents, middle level learning, middle years, instructional leadership, instructional practices, intellectually engaging learning environments, leadership dimensions, student agency

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Authors: Paul J. McKay

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Large-scale genome-wide association studies (GWAS) investigating genetic contributions to sexual orientation and gender identity are largely lacking and may reduce stigma experienced in the LGBTQ+ community by providing an underlying biological explanation for queerness. While there is a growing consensus within the scientific community that genetic makeup contributes – at least in part – to sexual orientation and gender identity, there is a marked lack of genomics research exploring polygenic contributions to queerness. Based on recent (2019) findings from a large-scale GWAS investigating the genetic architecture of same-sex sexual behavior, and various additional peer-reviewed publications detailing novel insights into the molecular mechanisms of sexual orientation and gender identity, we hypothesize that sexual orientation and gender identity are complex, multifactorial, and polygenic; meaning that many genetic factors contribute to these phenomena, and environmental factors play a possible role through epigenetic modulation. In recent years, large-scale GWAS studies have been paramount to our modern understanding of many other complex human traits, such as in the case of autism spectrum disorder (ASD). Despite possible benefits of such research, including reduced stigma towards queer people, improved outcomes for LGBTQ+ in familial, socio-cultural, and political contexts, and improved access to healthcare (particularly for trans populations); important risks and considerations remain surrounding this type of research. To mitigate possibilities such as invalidation of the queer identities of existing LGBTQ+ individuals, genetic discrimination, or the possibility of euthanasia of embryos with a genetic predisposition to queerness (through reproductive technologies like IVF and/or gene-editing in utero), we propose a community-engaged research (CER) framework which emphasizes the privacy and confidentiality of research participants. Importantly, the historical legacy of scientific research attempting to pathologize queerness (in particular, falsely equating gender variance to mental illness) must be acknowledged to ensure any future research conducted in this realm does not propagate notions of homophobia, transphobia or stigma against queer people. Ultimately, in a world where same-sex sexual activity is criminalized in 69 UN member states, with 67 of these states imposing imprisonment, 8 imposing public flogging, 6 (Brunei, Iran, Mauritania, Nigeria, Saudi Arabia, Yemen) invoking the death penalty, and another 5 (Afghanistan, Pakistan, Qatar, Somalia, United Arab Emirates) possibly invoking the death penalty, the importance of this research cannot be understated, as finding a biological basis for queerness would directly oppose the harmful rhetoric that “being LGBTQ+ is a choice.” Anti-trans legislation is similarly widespread: In the United States in 2022 alone (as of Oct. 13), 155 anti-trans bills have been introduced preventing trans girls and women from playing on female sports teams, barring trans youth from using bathrooms and locker rooms that align with their gender identity, banning access to gender affirming medical care (e.g., hormone-replacement therapy, gender-affirming surgeries), and imposing legal restrictions on name changes. Understanding that a general lack of knowledge about the biological basis of queerness may be a contributing factor to the societal stigma faced by gender and sexual orientation minorities, we propose the initiation of large-scale GWAS studies investigating the genetic basis of gender identity and sexual orientation.

Keywords: genome-wide association studies (GWAS), sexual and gender minorities (SGM), polygenicity, community-engaged research (CER)

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Authors: Ali R. Alshawawreh, Francisco Liébana-Cabanillas, Francisco J. Blanco-Encomienda

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Collaboration between marketing and business intelligence (BI) is crucial in today's ever-evolving business landscape. These two domains play pivotal roles in molding customers' experiential knowledge. Marketing insights offer valuable information regarding customer needs, preferences, and behaviors, thus refining marketing strategies and enhancing overall customer experiences. Conversely, BI facilitates data-driven decision-making, leading to heightened operational efficiency, product quality, and customer satisfaction. The analysis of customer data through BI unveils patterns and trends, informing product development, marketing campaigns, and customer service initiatives aimed at enriching experiences and knowledge. Customer experiential knowledge (CEK) encompasses customers' implicit comprehension of consumption experiences influenced by diverse factors, including social and cultural influences. This study primarily focuses on telecommunications companies in Jordan, scrutinizing how experiential customer knowledge mediates the relationship between marketing intelligence, business intelligence, and innovation in product and service offerings. Drawing on theoretical frameworks such as the resource-based view (RBV) and service-dominant logic (SDL), the research aims to comprehend how organizations utilize their resources, particularly knowledge, to foster innovation. Employing a quantitative research approach, the study collected and analyzed primary data to explore hypotheses. The chosen method was justified for its efficacy in handling large sample sizes. Structural equation modeling (SEM) facilitated by Smart PLS software evaluated the relationships between the constructs, followed by mediation analysis to assess the indirect associations in the model. The study findings offer insights into the intricate dynamics of organizational innovation, uncovering the interconnected relationships between business intelligence, customer experiential knowledge-based innovation (CEK-DI), marketing intelligence (MI), and product and service innovation (PSI), underscoring the pivotal role of advanced intelligence capabilities in developing innovative practices rooted in a profound understanding of customer experiences. Organizations equipped with cutting-edge BI tools are better positioned to devise strategies informed by precise insights into customer needs and behaviors. Furthermore, the positive impact of BI on PSI reaffirms the significance of data-driven decision-making in shaping the innovation landscape. Companies leveraging BI demonstrate adeptness in identifying market opportunities guiding the development of novel products and services. The substantial impact of CEK-DI on PSI highlights the crucial role of customer experiences in driving organizational innovation. Firms actively integrating customer insights into their innovation processes are more likely to create offerings aligned with customer expectations, fostering higher levels of product and service innovation. Additionally, the positive and significant effect of MI on CEK-DI underscores the critical role of market insights in shaping innovative strategies. While the relationship between MI and PSI is positive, a slightly weaker significance level indicates a nuanced association, suggesting that while MI contributes to innovation, other factors may also influence the innovation landscape, warranting further exploration. In conclusion, the study underscores the essential role of intelligence capabilities, particularly artificial intelligence, in driving innovation, emphasizing the necessity for organizations to leverage market and customer intelligence for effective and competitive innovation practices. Collaborative efforts between marketing and business intelligence serve as pivotal drivers of innovation, influencing experiential customer knowledge and shaping organizational strategies and practices, ultimately enhancing overall customer experiences and organizational performance.

Keywords: marketing intelligence, business intelligence, product, customer experiential knowledge-driven innovation

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Authors: Roven Tumaneng, Angelica Kristina Monzon, Ralph Sedricke Lapuz, Jose Don De Alban, Jennica Paula Masigan, Joanne Rae Pales, Laila Monera Pornel, Dennis Tablazon, Rizza Karen Veridiano, Jackie Lou Wenceslao, Edmund Leo Rico, Neil Aldrin Mallari

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Most protected area management plans in the Philippines, particularly the smaller and more remote islands suffer from insufficient baseline data, which should provide the bases for formulating measureable conservation targets and appropriate management interventions for these protected areas. Attempts to synthesize available data particularly on cultural and socio-economic characteristic of local peoples within and outside protected areas also suffer from the lack of comprehensive and detailed inventories, which should be considered in designing adaptive management interventions to be used for those protected areas. Mt Guiting-guiting Natural Park (MGGNP) located in Sibuyan Island is one of the poorly studied protected areas in the Philippines. In this study, we determined the highly biologically important areas of the protected area using Maximum Entropy approach (MaxEnt) from environmental predictors (i.e., topographic, bioclimatic,land cover, and soil image layers) derived from global remotely sensed data and point occurrence data of species of birds and trees recorded during field surveys on the island. A total of 23 trigger species of birds and trees was modeled and stacked to generate species richness maps for biological high conservation value areas (HCVAs). Forest habitat change was delineated using dual-polarised L-band ALOS-PALSAR mosaic data at 25 meter spatial resolution, taken at two acquisition years 2007 and 2009 to provide information on forest cover ad habitat change in the island between year 2007 and 2009. Determining the livelihood guilds were also conducted using the data gathered from171 household interviews, from which demographic and livelihood variables were extracted (i.e., age, gender, number of household members, educational attainment, years of residency, distance from forest edge, main occupation, alternative sources of food and resources during scarcity months, and sources of these alternative resources).Using Principal Component Analysis (PCA) and Kruskal-Wallis test, the diversity and patterns of forest resource use by people in the island were determined with particular focus on the economic activities that directly and indirectly affect the population of key species as well as to identify levels of forest resource use by people in different areas of the park.Results showed that there are gaps in the area occupied by the natural park, as evidenced by the mismatch of the proposed HCVAs and the existing perimeters of the park. We found out that subsistence forest gathering was the possible main driver for forest degradation out of the eight livelihood guilds that were identified in the park. Determining the high conservation areas and identifyingthe anthropogenic factors that influence the species richness and abundance of key species in the different management zone of MGGNP would provide guidance for the design of a protected area management plan and future monitoring programs. However, through intensive communication and consultation with government stakeholders and local communities our results led to setting conservation targets in local development plans and serve as a basis for the reposition of the boundaries and reconfiguration of the management zones of MGGNP.

Keywords: conservation gaps, livelihood guilds, MaxEnt, protected area

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Authors: Ghidey Ghebreyohanes, Eltahir Awad Gasim Khalil, Zemenfes Tsighe, Faiza Ali

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Background: reproductive health (RH) is a state of physical, mental and social well-being in all matters relating to the reproductive system at all stages of life. In East Africa including Eritrea, adolescents comprise more than a quarter of the population. The region holds the highest rates of sexually transmitted diseases, HIV, unwanted pregnancy and unsafe abortion with its complications. Young girls carry the highest burden of reproductive health problems due to their risk taking behavior, lack of knowledge, peer pressure, physiologic immaturity and low socioeconomic status. Design: this was a Community-based, randomized, case-controlled and pre-test-post-test intervention study. Setting: Zoba Debub was randomly selected out of the six zobas in Eritrea. The four high schools out of the 26 in Zoba Debub were randomly selected as study target schools. Over three quarter of the people live on farming. The target population was female students attending grade nine with majority of these girls live in the distant villages and walk to school. The study participants were randomly selected (n=165) from each school. Furthermore, the 1 intervention and 3 controls for the study arms were assigned randomly. Objectives: this study aimed to assess the effectiveness of peer reproductive health education in improving knowledge, attitude, and health service use of high school adolescent girls in Eritrea Methods: the protocol was reviewed and approved by the Scientific and Ethics Committees of Faculty of Nursing Sciences, University of Khartoum. Data was collected using pre-designed and pretested questionnaire emphasizing on reproductive health knowledge, attitude and practice. Sample size was calculated using proportion formula (α 0.01; power of 95%). Measures used were scores and proportions. Descriptive and inferential statistics, t-test and chi square at (α .01), 99% confidence interval were used to compare changes of pre and post-intervention scores using SPSS soft ware. Seventeen students were selected for peer educators by the school principals and other teachers based on inclusion criteria that include: good academic performance and acceptable behavior. One peer educator educated one group composed of 8-10 students for two months. One faculty member was selected to supervise peer educators. The principal investigator conducted the training of trainers and provided supervision and discussion to peer educators every two weeks until the end of intervention. Results: following informed consent, 627 students [164 in intervention and 463 in the control group] with a ratio of 1 to 3, were enrolled in the study. The mean age for the total study population was 15.4±1.0 years. The intervention group mean age was 15.3±1.0 year; while the control group had a mean age of 15.4±1.0. The mean ages for the study arms were similar (p= 0.4). The majority (96 %) of the study participants are from Tigrigna ethnic group. Reproductive knowledge scores which was calculated out of a total 61 grade points: intervention group (pretest 6.7 %, post-test 33.6 %; p= 0.0001); control group (pretest 7.3 %, posttest 7.3 %, p= 0.92). Proportion difference in attitude calculated out of 100%: intervention group (pretest 42.3 % post test 54.7% p= 0.001); controls group (pretest 45%, post test 44.8 p= 0.7). Proportion difference in Practice calculated out of 100 %: intervention group (pretest 15.4%, post test 80.4 % p= 0.0001); control group (pretest 16.8%, posttest 16.9 % p= 0.8). Mothers were quoted as major (> 90 %) source of reproductive health information. All focus group discussants and most of survey participants agreed on the urgent need of reproductive health information and services for adolescent girls. Conclusion: reproductive health knowledge and use of facilities is poor among adolescent girls in sub-urban Eretria. School-based peer reproductive health education is effective and is the best strategy to improve reproductive health knowledge and attitudes.

Keywords: reproductive health, adolescent girls, eretria, health education

Procedia PDF Downloads 331

Authors: Waqas Abrar

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Background: Pakistan is confronted with a formidable challenge to increase uptake of modern contraceptive methods. USAID, through its flagship Maternal and Child Survival Program (MCSP), in Pakistan is determined to support provincial Departments of Health and Population Welfare to increase the country's contraceptive prevalence rates (CPR) in Sindh, Punjab and Balochistan to achieve FP2020 goals. To inform program design and planning, a Rapid Situation Assessment (RSA) of family planning was carried out in Rawalpindi and Lahore districts in Punjab and Karachi district in Sindh. Methodology: The methodology consisted of comprehensive desk review of available literature and used a qualitative approach comprising of in-depth interviews (IDIs) and focus group discussions (FGDs). FGDs were conducted with community women, men, and mothers-in-law whereas IDIs were conducted with health facility in-charges/chiefs, healthcare providers, and community health workers. Results: Some of the oft-quoted reasons captured during desk review included poor quality of care at public sector facilities, affordability and accessibility in rural communities and providers' technical incompetence. Moreover, providers had inadequate knowledge of contraceptive methods and lacked counseling techniques; thereby, leading to dissatisfied clients and hence, discontinuation of contraceptive methods. These dissatisfied clients spread the myths and misconceptions about contraceptives in their respective communities which seriously damages community-level family planning efforts. Private providers were found reluctant to insert Intrauterine Contraceptive Devices (IUCDs) due to inadequate knowledge vis-à-vis post insertion issues/side effects. FGDs and IDIs unveiled multi-faceted reasons for poor contraceptives uptake. It was found that low education and socio-economic levels lead to low contraceptives uptake and mostly uneducated women rely on condoms provided by Lady Health Workers (LHWs). Providers had little or no knowledge about postpartum family planning or lactational amenorrhea. At community level family planning counseling sessions organized by LHWs and Male Mobilizers do not sensitize community men on permissibility of contraception in Islam. Many women attributed their physical ailments to the use of contraceptives. Lack of in-service training, job-aids and Information, Education and Communications (IEC) materials at facilities seriously comprise the quality of care in effective family planning service delivery. This is further compounded by frequent stock-outs of contraceptives at public healthcare facilities, poor data quality, false reporting, lack of data verification systems and follow-up. Conclusions: Some key conclusions from this assessment included capacity building of healthcare providers on long acting reversible contraceptives (LARCs) which give women contraception for a longer period. Secondly, capacity building of healthcare providers on postpartum family planning is an enormous challenge that can be best addressed through institutionalization. Thirdly, Providers should be equipped with counseling skills and techniques including inculcation of pros and cons of all contraceptive methods. Fourthly, printed materials such as job-aids and Information, Education and Communications (IEC) materials should be disseminated among healthcare providers and clients. These concluding statements helped MCSP to make informed decisions with regard to setting broad objectives of project and were duly approved by USAID.

Keywords: capacity building, contraceptive prevalence rate, family planning, Institutionalization, Pakistan, postpartum care, postpartum family planning services

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Authors: Yu-Lin Chen, Kimberly Koester, Marissa Raymond-Flesh, Anika Thapar, Jay Thapar

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Purpose: Effectively communicating adolescent health topics to teens and their parents is crucial. This study emphasizes critically evaluating the optimal use of artificial intelligence tools (AI), which are increasingly prevalent in disseminating health information. By fostering a deeper understanding of AI voice preference in the context of health, the research aspires to have a ripple effect, enhancing the collective health literacy and decision-making capabilities of both teenagers and their parents. This study explores AI voices' potential within health learning modules for annual well-child visits. We aim to identify preferred voice characteristics and understand factors influencing perceived trustworthiness, ultimately aiming to improve health literacy and decision-making in both demographics. Methods: A cross-sectional study assessed preferences and trust perceptions of AI voices in learning modules among teens (11-18) and their parents/guardians in Northern California. The study involved the development of four distinct learning modules covering various adolescent health-related topics, including general communication, sexual and reproductive health communication, parental monitoring, and well-child check-ups. Participants were asked to evaluate eight AI voices across the modules, considering a set of six factors such as intelligibility, naturalness, prosody, social impression, trustworthiness, and overall appeal, using Likert scales ranging from 1 to 10 (the higher, the better). They were also asked to select their preferred choice of voice for each module. Descriptive statistics summarized participant demographics. Chi-square/t-tests explored differences in voice preferences between groups. Regression models identified factors impacting the perceived trustworthiness of the top-selected voice per module. Results: Data from 104 participants (teen=63; adult guardian = 41) were included in the analysis. The mean age is 14.9 for teens (54% male) and 41.9 for the parent/guardian (12% male). At the same time, similar voice quality ratings were observed across groups, and preferences varied by topic. For instance, in general communication, teens leaned towards young female voices, while parents preferred mature female tones. Interestingly, this trend reversed for parental monitoring, with teens favoring mature male voices and parents opting for mature female ones. Both groups, however, converged on mature female voices for sexual and reproductive health topics. Beyond preferences, the study delved into factors influencing perceived trustworthiness. Interestingly, social impression and sound appeal emerged as the most significant contributors across all modules, jointly explaining 71-75% of the variance in trustworthiness ratings. Conclusion: The study emphasizes the importance of catering AI voices to specific audiences and topics. Social impression and sound appeal emerged as critical factors influencing perceived trustworthiness across all modules. These findings highlight the need to tailor AI voices by age and the specific health information being delivered. Ensuring AI voices resonate with both teens and their parents can foster their engagement and trust, ultimately leading to improved health literacy and decision-making for both groups. Limitations and future research: This study lays the groundwork for understanding AI voice preferences for teenagers and their parents in healthcare settings. However, limitations exist. The sample represents a specific geographic location, and cultural variations might influence preferences. Additionally, the modules focused on topics related to well-child visits, and preferences might differ for more sensitive health topics. Future research should explore these limitations and investigate the long-term impact of AI voice on user engagement, health outcomes, and health behaviors.

Keywords: artificial intelligence, trustworthiness, voice, adolescent

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Authors: Volker Wannack

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Regional, national, and international strategies focusing on hydrogen (H₂) and blockchain are driving significant advancements in hydrogen and blockchain technology worldwide. These strategies lay the foundation for the groundbreaking "Blockchain Based Hydrogen Market (BBH₂)" project. The primary goal of this project is to develop a functional Blockchain Minimum Viable Product (B-MVP) for the hydrogen market. The B-MVP will leverage blockchain as an enabling technology with a common database and platform, facilitating secure and automated transactions through smart contracts. This innovation will revolutionize logistics, trading, and transactions within the hydrogen market. The B-MVP has transformative potential across various sectors. It benefits renewable energy producers, surplus energy-based hydrogen producers, hydrogen transport and distribution grid operators, and hydrogen consumers. By implementing standardized, automated, and tamper-proof processes, the B-MVP enhances cost efficiency and enables transparent and traceable transactions. Its key objective is to establish the verifiable integrity of climate-friendly "green" hydrogen by tracing its supply chain from renewable energy producers to end users. This emphasis on transparency and accountability promotes economic, ecological, and social sustainability while fostering a secure and transparent market environment. A notable feature of the B-MVP is its cross-border operability, eliminating the need for country-specific data storage and expanding its global applicability. This flexibility not only broadens its reach but also creates opportunities for long-term job creation through the establishment of a dedicated blockchain operating company. By attracting skilled workers and supporting their training, the B-MVP strengthens the workforce in the growing hydrogen sector. Moreover, it drives the emergence of innovative business models that attract additional company establishments and startups and contributes to long-term job creation. For instance, data evaluation can be utilized to develop customized tariffs and provide demand-oriented network capacities to producers and network operators, benefitting redistributors and end customers with tamper-proof pricing options. The B-MVP not only brings technological and economic advancements but also enhances the visibility of national and international standard-setting efforts. Regions implementing the B-MVP become pioneers in climate-friendly, sustainable, and forward-thinking practices, generating interest beyond their geographic boundaries. Additionally, the B-MVP serves as a catalyst for research and development, facilitating knowledge transfer between universities and companies. This collaborative environment fosters scientific progress, aligns with strategic innovation management, and cultivates an innovation culture within the hydrogen market. Through the integration of blockchain and hydrogen technologies, the B-MVP promotes holistic innovation and contributes to a sustainable future in the hydrogen industry. The implementation process involves evaluating and mapping suitable blockchain technology and architecture, developing and implementing the blockchain, smart contracts, and depositing certificates of origin. It also includes creating interfaces to existing systems such as nomination, portfolio management, trading, and billing systems, testing the scalability of the B-MVP to other markets and user groups, developing data formats for process-relevant data exchange, and conducting field studies to validate the B-MVP. BBH₂ is part of the "Technology Offensive Hydrogen" funding call within the research funding of the Federal Ministry of Economics and Climate Protection in the 7th Energy Research Programme of the Federal Government.

Keywords: hydrogen, blockchain, sustainability, innovation, structural change

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