Search results for: feeling stressed”

Authors: Rubina Waseem

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The research focuses on the major crises and major effects, largely unforeseen, to counter international security concerns. At the close of 2019, the Covid-19 pandemic broke out in the city of Wuhan in Hubei province, China. The coronavirus was initially seen as an inchoate danger, aimed at striking people randomly. Owing to the extraordinary transmissibility of the virus and the highly knitted nature of the international political world, the Covid-19 soon became a formidable global challenge. The once hustling and bustling avenues, city centers, and market places became deserted. Lockdown, self-isolation, hygiene and safety, social-distancing, and job losses became a new norm. The national economies gradually plunged into crisis. The pandemic has so far caused over 33 million cases and one million deaths. The virus continues to devastate social life, as there is yet no therapeutic available. While the world was preoccupied addressing the human and social toll, the pandemic has exacerbated despair, mistrust, and friction in international relations, diplomacy, and strategy. The research will discuss how the coronavirus has accelerated the trends of transition in the postwar security order constructed by the United States. China, Russia, European Union, and other lesser regional players are now increasingly changing their security orientations to undermine the United States standing and authority in world politics. The systemic level analyses will be adopted as a methodology to broaden the lens of the study, and the research will analyze the prevalent global power distribution, whether vulnerable or exposed. The trends of parochial nationalism and isolationism are increasingly replacing multilateralism and collectivism. Yet worse, military posturing is assuming a greater role in international interactions. Taken together, the pandemic has worsened the prospects of international peace and stability by mounting equal pressure across the channels of international relations, diplomacy, and strategy. It is yet unclear which country or collectivity will face the real brunt. Despite this jaded and pessimistic view, the lingering pandemic has the potential to reinforce cooperation, multilateralism, and collectivism in the realm of international politics. There is a renewed momentum for global efforts against the pandemic. States and societies are coming closer to act as a whole. Equally important, the world leaders are feeling tempted to revisit the traditional conception of national security. In this regard, they are exploring the possibility of according preference to non-traditional security issues. In essence, the research concludes that Covid-19 has put the international political system under a great trial.

Keywords: covid-19, global challenges, international politics, international security

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Authors: Fouzia Khanam, Tridib Chowdhury, Belal Hossain, Sajedur Rahman, Mahfuzar Rahman

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Introduction: Over the last decades, the world has achieved a noticeable success in preventing malaria. Nevertheless, malaria, a vector-borne infectious disease, remains a major public health burden globally as well as in Bangladesh. To achieve the goal of eliminating malaria, BRAC, a leading organization of Bangladesh in collaboration with government, is distributing free LLIN to the 13 endemic districts of the country. The study was conducted with the aim of assessing the gap between coverage, access, and utilization of LLIN among the people of the 13 malaria endemic districts of Bangladesh. Methods: This baseline study employed a community cross-sectional design triangulated with qualitative methods to measure households’ ownership, access and use of 13 endemic districts. A multistage cluster random sampling was employed for the quantitative part and for qualitative part a purposive sampling strategy was done. Thus present analysis included 2640 households encompassing a total of 14475 populations. Data were collected using a pre-tested structured questionnaire through one on one face-to-face interview with respondents. All analyses were performed using STATA (Version 13.0). For the qualitative part participant observation, in-depth interview, focus group discussion, key informant interview and informal interview was done to gather the contextual data. Findings: According to our study, 99.8% of households possessed at least one-bed net in both study areas. 77.4% households possessed at least two LLIN and 43.2% households had access to LLIN for all the members. So the gap between coverage and access is 34%. 91.8% people in the 13 districts and 95.1% in Chittagong Hill Tracts areas reported having had slept under a bed net the night before interviewed. And despite the relatively low access, in 77.8% of households, all the members were used the LLIN the previous night. This higher utilization compared to access might be due to the increased awareness among the community people regarding LLIN uses. However, among those people with sufficient access to LLIN, 6% of them still did not use the LLIN which reflects the behavioral failure that needs to be addressed. The major reasons for not using LLIN, identified by both qualitative and quantitative findings, were insufficient access, sleeping or living outside the home, migration, perceived low efficacy of LLIN, fear of physical side effects or feeling uncomfortable. Conclusion: Given that LLIN access and use was a bit short of the targets, it conveys important messages to the malaria control program. Targeting specific population segments and groups for achieving expected LLIN coverage is very crucial. And also, addressing behavior failure by well-designed behavioral change interventions is mandatory.

Keywords: long lasting insecticide net, malaria, malaria control programme, World Health Organisation

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Authors: John Gaber

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Objectives: Complementary and alternative medicine (CAM) is a medicine or health practice that is used alongside conventional practice. Nowadays, CAM is commonly used in North America and other countries, and there is a need for more scientific study to understand its efficacy in different clinical cases. This retrospective study explores the effectiveness and recovery time of CAMs such as cupping, acupuncture, and sotai to treat cases of non-specific low back pain (ANLBP). Methods: We assessed the effectiveness of acupuncture, cupping, and sotai methods on pain and for the treatment of ANLBP. We have compared the magnitude of pain relief using a pain scale assessment method to compare the efficacy of each treatment. The Face Pain Scale assessment was conducted before and 24 hours post-treatment. This retrospective study analyzed 40 patients and categorized them according to the treatment they received. The study included the control group, and the three intervention groups, each with ten patients. Each of the three intervention groups received one of the intervention methods. The first group received the cupping treatment, where cups were placed on the lower back of both sides on points: BL23, BL25, BL26, BL54, BL37, BL40, and BL57. After vacuuming, the cups will stay for 10-15 minutes under infrared light (IR) heating. IR heating is applied by an infrared heat lamp. The second group received the acupuncture treatment, placing needles on points: BL23, BL25, BL26, BL52BL54, GB30, BL37, BL40, BL57, BL59, BL60, and KI3. The needles will be simulated with IR light. The final group received the sotai treatment, a Japanese form of structural realignment that relieves pain, balance, and mobility -moving the body naturally and spontaneously towards a comfortable direction by focusing on the inner feeling and synchronizing with the patient’s breathing. The SPSS statistical software was used to analyze the data using repeated-measures ANOVA. The data collected demonstrates the change in the FPS assessment method value over the course of treatment. p<0.05 was considered statistically significant. Results: In the cupping, acupuncture, and sotai therapy groups, the mean of the FPS value reduced from 8.7±1.2, 8.8±1.2, 9.0±0.8 before the intervention to 3.5±1.4, 4.3±1.4, 3.3±1.3, 24 hours after the intervention, respectively. The data collected shows that the CAM methods included in this study all show improvements in pain relief 24 hours after treatment. Conclusion: Complementary and alternative medicine were developed to treat injuries and illnesses with the whole body in mind, designed to be used in addition to standard treatments. The data above shows that the use of these treatments can have a pain-relieving effect, but more research should be done on the matter, as finding CAM methods that are efficacious is crucial in the landscape of health sciences.

Keywords: acupuncture, cupping, alternative medicine, rehabilitation, acute injury

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Authors: Cezarina da Conceição Santinho Maurício, José Duque Vicente

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Established in 1987, the Erasmus Programme is a program for the exchange of higher education students. Its purposes are several. The mobility developed has contributed to the promotion of multiple learning, the internalization the feeling of belonging to a community, and the consolidation of cooperation between entities or universities. It also allows the experience of a European experience, considering multilingualism one of the bases of the European project and vehicle to achieve the union in diversity. The program has progressed and introduced changes Erasmus+ currently offers a wide range of opportunities for higher education, vocational education and training, school education, adult education, youth, and sport. These opportunities are open to students and other stakeholders, such as teachers. Portugal was one of the countries that readily adhered to this program, assuming itself as an instrument of internationalization of polytechnic and university higher education. Students and social work teachers have been involved in this mobility of learning and multicultural interactions. The presence and activation of this program was made possible by Portugal's joining the European Union. This event was reflected in the field of portuguese social work and contributes to its approach to the reality of european social work. Historically, the Portuguese social work has built a close connection with the Latin American world and, in particular, with Brazil. There are several examples that can be identified in the different historical stages. This is the case of the post-revolution period of 1974 and the presence of the reconceptualization movement, the struggle for enrollment in the higher education circuit, the process of winning a bachelor's degree, and postgraduate training (the first doctorates of social work were carried out in Brazilian universities). This influence is also found in the scope of the authors and the theoretical references used. This study examines the participation of graduates and students of social work in the Erasmus program. The following specific goals were outlined: to identify the host countries and universities; to investigate the dimension and type of mobility made, understand the learning and experiences acquired, identify the difficulties felt, capture their perspectives on social work and the contribution of this experience in training. In the methodological field, the option fell on a qualitative methodology, with the application of semi-structured interviews to graduates and students of social work with Erasmus mobility experience. Once the graduates agreed, the interviews were recorded and transcribed, analyzed according to the previously defined analysis categories. The findings emphasize the importance of this experience for students and graduates in informal and formal learning. The authors conclude with recommendations to reinforce this mobility, either at the individual level or as a project built for the group or collective.

Keywords: erasmus programme, graduates and students of social work, participation, social work

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Authors: Franck kem Acho

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This is a chronic metabolic disorder which is a fast-growing global problem with a huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Diabetes mellitus is a chronic heterogeneous metabolic disorder with a complex pathogenesis. It is characterized by elevated blood glucose levels or hyperglycemia, which results from abnormalities in either insulin secretion or insulin action or both. Hyperglycemia manifests in various forms with a varied presentation and results in carbohydrate, fat, and protein metabolic dysfunctions. Long-term hyperglycemia often leads to various microvascular and macrovascular diabetic complications, which are mainly responsible for diabetes-associated morbidity and mortality. Hyperglycemia serves as the primary biomarker for the diagnosis of diabetes as well. Furthermore, it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This study was conducted in a locality to access the level of knowledge, awareness and risk factors associated with people leaving with diabetes mellitus. A month before the screening was to be conducted, a health screening in some selected churches and on the local community radio as well as on relevant WhatsApp groups were advertised. A general health talk was delivered by the head of the screening unit to all attendees who were all educated on the procedure to be carried out with benefits and any possible discomforts after which the attendee’s consent was obtained. Evaluation of the participants for any leads to the diabetes selected for the screening was done by taking adequate history and physical examinations such as excessive thirst, increased urination, tiredness, hunger, unexplained weight loss, feeling irritable or having other mood changes, having blurry vision, having slow-healing sores, getting a lot of infections, such as gum, skin and vaginal infections. Out of the 94 participants the finding show that 78 were females and 16 were males, 70.21% of participants with diabetes were between the ages of 60-69yrs.The study found that only 10.63% of respondents declared a good level of knowledge of diabetes. Out of 3 symptoms of diabetes analyzed in this study, high blood sugar (58.5%) and chronic fatigue (36.17%) were the most recognized. Out of 4 diabetes risk factors analyzed in this study, obesity (21.27%) and unhealthy diet (60.63%) were the most recognized diabetes risk factors, while only 10.6% of respondents indicated tobacco use. The diabetic foot was the most recognized diabetes complication (50.57%), but some the participants indicated vision problems (30.8%),or cardiovascular diseases (20.21%) as diabetes complications.

Keywords: diabetes mellitus, non comunicable disease, general health talk, hyperglycemia

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Authors: Indujeeva Keerthila Peiris

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The secular view of mindfulness has some connotation to the original meaning of mindfulness mentioned in the Theravada Buddhist texts (Pāli Canon), but there is a substantial difference in the meaning of the two. Secular Mindfulness Based Interventions (MBI) focus on stilling the mind, which may provide short-term benefits and help individuals to deal with physical pain, grief, and distress. However, as with many popular educational innovations, the foundational values of mindfulness strategies have been distorted and subverted in a number of instances in which ‘McMindfulness’ programmes have been implemented with a view to reducing mindfulness mediation as a self-help technique that is easily misappropriated for the exclusive pursuit of corporate objectives, employee pacification, and commercial profit. The intention of this paper is not to critique the misappropriations of mindfulness. Instead, to go back to the root source and bring insights from the Buddhist Pāli Canon and its associated teachings on mindfulness in its own terms. In the Buddha’s discourses, as preserved in the Pāli Canon, there is nothing more significant than the understanding and practice of ‘Satipatthãna’. The Satipatthāna Sutta , the ‘Discourse on the Establishment of Mindfulness,’ opens with a proclamation highlighting both the purpose of this training and its methodology. The right practice of mindfulness is the gateway to understanding the Buddha’s teaching. However, although this concept is widely discussed among the Dhamma practitioners, it is the least understood one of them all. The purpose of this paper is to understand deeper meaning of mindfulness as it was originally intended by the Teacher. The natural state of mind is that it wanders. It wanders into the past, the present, and the future. One’s ability to hold attention to a mind object (emotion, thought, feeling, sensation, sense impression) called ‘concentration’. The intentional concentration process does not lead to wisdom. However, the development of wisdom starts when the mind is calm, concentrated, and unified. The practice of insight contemplation aims at gaining a direct understanding of the real nature of phenomena. According to the Buddha’s teaching, there are three basic facts of all existence: 1) impermanence (anicca in Pāli) ; 2) fabrication (also commonly known as suffering, unsatisfactoriness, sankhara or dukka in Pāli); 3) not-self (insubstantiality or impersonality, annatta in Pāli ). The entire Buddhist doctrine is based on these three facts. The problem is our ignorance covers reality. It is not that a person sees the emptiness of them or that we try to see the emptiness of our experience by conceptually thinking that they are empty. It is an experiential outcome that happens when the cause-and- effect overrides the self-view (sakkaya dhitti), and ignorance is known as ignorance and eradicated once and for all. Therefore, the right view (samma dhitti) is the starting point of the path, not ethical conduct (sila) or samadhi (jhana). In order to develop the right view, we need to first listen to the correct Dhamma and possess Yoniso manasikara (right comprehension) to know the five aggregates as five aggregates.

Keywords: mindfulness, spirituality, buddhism, pali canon

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Authors: Meirav Eshkol, Miri Blaufeld, Rinat Basal

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Aim: The working environment in rural clinics is often isolated and distant from major health centers. In these circumstances, rural health care faces numerous challenges. The hope is that, in the immediate future and in the medium and long range, the rural nursing staff will realize their full professional and personal potential to their own satisfaction and to the health and welfare of their patients. Background: Rural nurses work mostly alone or with very few colleagues, and have the authority to make professional decisions, a fact which often requires them to make critical decisions in pressure situations. In addition, the expectations set for these nurses are extremely high, a fact which requires them to be extremely skilled and to fulfill their professional potential. They are required to provide high-quality and comprehensive care to the individual, the family, and the community and to maintain close interaction with the community. Work in a rural setting requires the flexibility to perform multiple tasks in an isolated setting, often far removed from major health centers. In order to maintain professional satisfaction for the rural nurse, expanded direction and training are required in professional know-how, and in the development of new and existing skills, toward the goal of treating a diverse population and to obtain a comprehensive view of the components of a diagnosis for treatment and to develop an understanding appropriate to the presented reality. Objective: To provide knowledge and to expand and develop professional skills in the prevention and advancement of health in the care of a diverse patient population. The development of strategies and skills for work under pressure alone instills expertise in performing multiple tasks in diverse disciplines. To reduce feelings of stress and burnout. Methodology: This course is the first and one of a kind in Clalit - the biggest health organisation in Israel. Observing and identifying the needs of the nurses in the field relating to the development of professional and personal skills defining goals and objectives, and determining the content of a course designed for rural nurses and kibbutz nurses who are not Clalit employees. Results: 43 nurses participated and 30 answered the feedback questionnaire. The rating of their experience was 4.33 (on a scale of 1-5, with 5 being the highest ranking). 92% indicated the importance of meeting with additional nurses to teach their colleagues. 83% of the nurses indicated an increased sense of organizational belonging. 60% indicated that the course helped to reduce feelings of stress and burnout in becoming a better rural nurse. 80% indicated that the course helped them establish intra-organizational professional cooperation and initiating processes. Conclusion: The course is an instrument which aids in increasing the feeling of organizational belonging, reducing feelings of stress and burnout, creation of relationships and cooperation both within and outside of the organization, increased the realization of the potential of the village nurse.

Keywords: rural nurse, alone, burnout, multiple tasks

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Authors: Hande Burcu Deniz

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People in the U.S. spend a considerable portion of their time indoors. This makes it crucial to provide environments that support the well-being of people. Restorative environments aim to help people recover their cognitive resources that were spent due to intensive use of directed attention. Spending time in nature and taking a nap are two of the best ways to restore these resources. However, they are not possible to do most of the time. The problem is that many studies have revealed how nature and spending time in natural contexts can help boost restoration, but there are fewer studies conducted to understand how cognitive resources can be restored in interior settings. This study aims to explore the answer to this question: which qualities of interiors increase the restorativeness of an interior setting and how do they mediate restorativeness of an interior. To do this, a phenomenological qualitative study was conducted. The study was interested in the definition of attention restoration and the experiences of the phenomena. As the themes emerged, they were analyzed to match with Attention Restoration Theory components (being away, extent, fascination, compatibility) to examine how interior design elements mediate the restorativeness of an interior. The data was gathered from semi-structured interviews with international residents of Minnesota. The interviewees represent young professionals who work in Minnesota and often experience mental fatigue. Also, they have less emotional connections with places in Minnesota, which enabled data to be based on the physical qualities of a space rather than emotional connections. In the interviews, participants were asked about where they prefer to be when they experience mental fatigue. Next, they were asked to describe the physical qualities of the places they prefer to be with reasons. Four themes were derived from the analysis of interviews. The themes are in order according to their frequency. The first, and most common, the theme was “connection to outside”. The analysis showed that people need to be either physically or visually connected to recover from mental fatigue. Direct connection to nature was reported as preferable, whereas urban settings were the secondary preference along with interiors. The second theme emerged from the analysis was “the presence of the artwork,” which was experienced differently by the interviewees. The third theme was “amenities”. Interviews pointed out that people prefer to have the amenities that support desired activity during recovery from mental fatigue. The last theme was “aesthetics.” Interviewees stated that they prefer places that are pleasing to their eyes. Additionally, they could not get rid of the feeling of being worn out in places that are not well-designed. When we matched the themes with the four art components (being away, extent, fascination, compatibility), some of the interior qualities showed overlapping since they were experienced differently by the interviewees. In conclusion, this study showed that interior settings have restorative potential, and they are multidimensional in their experience.

Keywords: attention restoration, fatigue, interior design, qualitative study, restorative environments

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Authors: Amar Ghelani

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People with auditory verbal hallucinations (AVH) who seek support from mental health services commonly report feeling unheard and invalidated in their interactions with social workers and psychiatric professionals. Current mental health training and clinical approaches have proven to be inadequate in addressing the complex nature of voice hearing. Childhood trauma is a key factor in the development of AVH and can render people more vulnerable to hearing both supportive and/or disturbing voices. Lived experiences of racism, poverty, and immigration are also associated with development of what is broadly classified as psychosis. Despite evidence affirming the influence of environmental factors on voice hearing, the Western biomedical system typically conceptualizes this experience as a symptom of genetically-based mental illnesses which requires diagnosis and treatment. Overemphasis on psychiatric medications, referrals, and directive approaches to people’s problems has shifted clinical interventions away from assessing and addressing problems directly related to AVH. The Maastricht approach offers voice hearers and mental health workers an alternative and respectful starting point for understanding and coping with voices. The approach was developed by voice hearers in partnership with mental health professionals and entails an innovative method to assess and create meaning from voice hearing and related life stressors. The objectives of the approach are to help people who hear voices: (1) understand the problems and/or people the voices may represent in their history, and (2) cope with distress and find solutions to related problems. The Maastricht approach has also been found to help voice hearers integrate emotional conflicts, reduce avoidance or fear associated with AVH, improve therapeutic relationships, and increase a sense of control over internal experiences. The proposed oral presentation will be guided by a recovery-oriented theoretical framework which suggests healing from psychological wounds occurs through social connections and community support systems. The presentation will start with a brainstorming exercise to identify participants pre-existing knowledge of the subject matter. This will lead into a literature review on the relations between trauma, intersectionality, and AVH. An overview of the Maastricht approach and review of research related to its therapeutic risks and benefits will follow. Participants will learn trauma-informed coping skills and questions which can help voice hearers make meaning from their experiences. The presentation will conclude with a review of resources and learning opportunities where participants can expand their knowledge of the Hearing Voices Movement and Maastricht approach.

Keywords: Maastricht interview, recovery, therapeutic assessment, voice hearing

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Authors: John W. Travis

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There is an epidemic of couples separating after a child is born into a family, generally with the father leaving emotionally or physically in the first few years after birth. This separation creates high levels of stress for both parents, especially the primary parent, leaving her (or him) less available to the infant for healthy attachment and nurturing. The deterioration of the couple’s bond leaves parents increasingly under-resourced, and the dependent child in a compromised environment, with an increased likelihood of developing an attachment disorder. Objectives: To understand the dynamics of a couple, once the additional and extensive demands of a newborn are added to a nuclear family structure, and to identify effective ways to support all members of the family to thrive. Qualitative studies interviewed men, women, and couples after pregnancy and the early years as a family, regarding key destructive factors, as well as effective tools for the couple to retain a strong bond. In-depth analysis of a few cases, including the author’s own experience, reveal deeper insights about subtle factors, replicated in wider studies. Using a self-assessment survey, many fathers report feeling abandoned, due to the close bond of the mother-baby unit, and in turn, withdrawing themselves, leaving the mother without support and closeness to resource her for the baby. Fathers report various types of abandonment, from his partner to his mother, with whom he did not experience adequate connection as a child. The study identified a key destructive factor to be unrecognized wounding from childhood that was carried into the relationship. The study culminated in the naming of Male Postpartum Abandonment Syndrome (MPAS), describing the epidemic in industrialized cultures with the nuclear family as the primary configuration. A growing family system often collapses without a minimum number of adult caregivers per infant, approximately four per infant (3.87), which allows for proper healing and caretaking. In cases with no additional family or community beyond one or two parents, the layers of abandonment and trauma result in the deterioration of a couple’s relationship and ultimately the family structure. The solution includes engaging community in support of new families. The study identified (and recommends) specific resources to assist couples in recognizing and healing trauma and disconnection at multiple levels. Recommendations include wider awareness and availability of resources for healing childhood wounds and greater community-building efforts to support couples for the whole family to thrive.

Keywords: abandonment, attachment, community building, family and marital functioning, healing childhood wounds, infant wellness, intimacy, marital satisfaction, relationship quality, relationship satisfaction

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Authors: Bill D. Geis

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Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

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Authors: Faith Abdul Rasak Asharaf

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Every city has a threshold known as urban carrying capacity based on which it can withstand a particular density of people, above which the city might need to resort to measures like expanding its boundaries or growing vertically. As a result of this circumstance, the number of squatter communities is growing, as is the claustrophobic feeling of being confined inside a "concrete jungle." The expansion of suburbs, commercial areas, and industrial real estate in the areas surrounding medium-sized cities has resulted in changes to their landscapes and urban forms, as well as a systematic shift in their role in the urban hierarchy when functional endowment and connections to other territories are considered. The urban carrying capacity idea provides crucial guidance for city administrators and planners in better managing, designing, planning, constructing, and distributing urban resources to satisfy the huge demands of an evergrowing urban population. An ecological footprint is a criterion of urban carrying capacity, which is the amount of land required to provide humanity with renewable resources and absorb its trash. However, as each piece of land has its unique carrying capacity, including ecological, social, and economic considerations, these metropolitan areas begin to reach a saturation point over time. Various city models have been tried throughout the years to meet the increasing urban population density by moving the zones of work, life, and leisure to achieve maximum sustainable growth. The current scenario is that of a vertical city and compact city concept, in which the maximum density of people is attempted to fit into a definite area using efficient land use and a variety of other strategies, but this has proven to be a very unsustainable method of growth, as evidenced by the COVID-19 period. Due to a shortage of housing and basic infrastructure, densely populated cities gave rise to massive squatter communities, unable to accommodate the overflowing migrants. To achieve optimum carrying capacity, planning measures such as polycentric city and diffuse city concepts can be implemented, which will help to relieve the congested city core by relocating certain sectors of the town to the city periphery, which will help to create newer spaces for design in terms of public space, transportation, and housing, which is a major concern in the current scenario. The study's goal is focused on suggesting design options and solutions in terms of placemaking for better urban quality and urban life for the citizens once city centres have been de-densified based on urban carrying capacity and ecological footprint, taking the case of Kochi as an apt example of a highly densified city core, focusing on Edappally, which is an agglomeration of many urban factors.

Keywords: urban carrying capacity, urbanization, urban sprawl, ecological footprint

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Authors: Hoora Dehghani, Meisam Shahbazi, Reza Zare

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During the previous decade, a significant evolution has occurred in the number of private educational centers and, accordingly, the increase in the number of providers and students of these centers around the world. The number of language teaching institutes in Iran that are considered private educational sectors is also growing exponentially as the request for learning foreign languages has extremely increased in recent years. This fact caused competition among the institutions in improving better services tailored to the students’ demands to win the competition. Along with the growth in the industry of education, higher education institutes should apply the marketing-related concepts and view students as customers because students’ outlooks are similar to consumers with education. Studying the influential factors in the selection of an institute has multiple benefits. Firstly, it acknowledges the institutions of the students’ choice factors. Secondly, the institutions use the obtained information to improve their marketing methods. It also helps institutions know students’ outlooks that can be applied to expand the student know-how. Moreover, it provides practical evidence for educational centers to plan useful amenities and programs, and use efficient policies to cater to the market, and also helps them execute the methods that increase students’ feeling of contentment and assurance. Thus, this study explored the influencing factors in the selection of a language learning institute by language learners and examined and compared the importance among the varying age groups and genders. In the first phase of the study, the researchers selected 15 language learners as representative cases within the specified age ranges and genders purposefully and interviewed them to explore the comprising elements in their language institute selection process and analyzed the results qualitatively. In the second phase, the researchers identified elements as specified items of a questionnaire, and 1000 English learners across varying educational contexts rated them. The TOPSIS method was used to analyze the data quantitatively by representing the level of importance of the items for the participants generally and specifically in each subcategory; genders and age groups. The results indicated that the educational quality, teaching method, duration of training course, establishing need-oriented courses, and easy access were the most important elements. On the other hand, offering training in different languages, the specialized education of only one language, the uniform and appropriate appearance of office staff, having native professors to the language of instruction, applying Computer or online tests instead of the usual paper tests respectively as the least important choice factors in selecting a language institute. Besides, some comparisons among different groups’ ratings of choice factors were made, which revealed the differences among different groups' priorities in choosing a language institute.

Keywords: choice factors, EFL institute selection, english learning, need analysis, TOPSIS

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Authors: Nasreen Abdulmannan

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Fetal abnormalities are categorized as a structural abnormality, non-structural abnormality, or a combination of both. Fetal structural abnormalities (FSA) include, but are not limited, to Down syndrome, congenital diaphragmatic hernia, and cleft lip and palate. These abnormalities can be detected in the first weeks of pregnancy, which is almost around 9 - 20 weeks gestational. Etiological factors for FSA are unknown; however, transmitted genetic risk can be one of these factors. Consanguineous marriage often referred to as inbreeding, represents a significant risk factor for FSA due to the increased likelihood of deleterious genetic traits shared by both biological parents. In a country such as the Kingdom of Saudi Arabia (KSA), consanguineous marriage is high, which creates a significant risk of children being born with congenital abnormalities. Historically, the practice of consanguinity occurred commonly among European royalty. For example, Great Britain’s Queen Victoria married her German first cousin, Prince Albert of Coburg. Although a distant blood relationship, the United Kingdom’s Queen Elizabeth II married her cousin, Prince Philip of Greece and Denmark—both of them direct descendants of Queen Victoria. In Middle Eastern countries, a high incidence of consanguineous unions still exists, including in the KSA. Previous studies indicated that a significant gap exists in understanding the lived experiences of Saudi women dealing with an FSA-complicated pregnancy. Eleven participants were interviewed using a semi-structured interview format for this qualitative phenomenological study investigating the lived experiences of pregnant Saudi women carrying a child with FSA. This study explored the gaps in current literature regarding the lived experiences of pregnant Saudi women whose pregnancies were complicated by FSA. In addition, the researcher acquired knowledge about the available support and resources as well as the Saudi cultural perspective on FSA. This research explored the lived experiences of pregnant Saudi women utilizing Giorgi’s (2009) approach to data collection and data management. Findings for this study cover five major themes: (1) initial maternal reaction to the FSA diagnosis per ultrasound screening; (2) strengthening of the maternal relationship with God; (3) maternal concern for their child’s future; (4) feeling supported by their loved ones; and (5) lack of healthcare provider support and guidance. Future research in the KSA is needed to explore the network support for these mothers. This study recommended further clinical nursing research, nursing education, clinical practice, and healthcare policy/procedures to provide opportunities for improvement in nursing care and increase awareness in KSA society.

Keywords: fetal structural abnormalities, psychological distress, health provider, health care

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Authors: Li Shuping, Shu Huaping, Yi Chaofan, Tao Jiang

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Equestrian practice is often considered having a unique effect on improving symptoms in children with autism. This study evaluated and measured the changes in daily behavior, morphological, physical function, and fitness indexes of two group children with autism by means of 12 weeks of equestrian and basketball exercises. 19 clinically diagnosed children with moderate/mild autism were randomly divided into equestrian group (9 children, age=10.11±1.90y) and basketball group (10 children, age=10.70±2.16y). Both the equestrian and basketball groups practiced twice a week for 45 to 60 minutes each time. Three scales, the Autism Behavior Checklist (ABC), the Childhood Autism Rating Scale (CARS) and the Clancy Autism Behavior Scale (CABS) were used to assess their human behavior and psychology. Four morphological, seven physical function and fitness indicators were measured to evaluate the effects of the two exercises on the children’s body. The evaluations were taken by every four weeks ( pre-exercise, the 4th week, the 8th week and 12th week (post exercise). The result showed that the total scores of ABC, CARS and CABS, the dimension scores of ABC on the somatic motor, language and life self-care obtained after exercise were significantly lower than those obtained before 12 week exercises in both groups. The ABC feeling dimension scores of equestrian group and ABC communication dimension score of basketball group were significantly lower,and The upper arm circumference, sitting forward flexion, 40 second sit-up, 15s lateral jump, vital capacity, and single foot standing of both groups were significantly higher than that of before exercise.. The BMI of equestrian group was significantly reduced. The handgrip strength of basketball group was significantly increased. In conclusion, both types of exercises could improve daily behavior, morphological, physical function, and fitness indexes of the children with autism. However, the behavioral psychological scores, body morphology and function indicators and time points were different in the middle and back of the two interventions.But the indicators and the timing of the improvement were different. To the group of equestrian, the improvement of the flexibility occurred at week 4, the improvement of the sensory perception, control and use their own body, and promote the development of core strength endurance, coordination and cardiopulmonary function occurred at week 8，and the improvement of core strength endurance, coordination and cardiopulmonary function occurred at week 12. To the group of basketball, the improvement of the hand strength, balance, flexibility and cardiopulmonary function occurred at week 4, the improvement of the self-care ability and language expression ability, and core strength endurance and coordination occurred at week 8, the improvement of the control and use of their own body and social interaction ability occurred at week 12. In comparison of the exercise effects, the equestrian exercise improved the physical control and application ability appeared earlier than that of basketball group. Basketball exercise improved the language expression ability, self-care ability, balance ability and cardiopulmonary function of autistic children appeared earlier than that of equestrian group.

Keywords: intervention, children with autism, equestrain, basketball

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Authors: Jemma McGourty, Brid Delahunt, Fiona Hackett, Sharon Courtney, Richard English, Graham Russell, Sinéad O’Connor

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Fundamental Movement Skills (FMS) mastery is considered essential for children’s ongoing, meaningful engagement in Physical Activity (PA). There has been a dearth of Irish research on baseline FMS and their development by means of intervention in young primary school children. In addition, as children’s participation in PA is heavily influenced by both parents and teachers, it is imperative to understand their attitudes and perceptions towards PA participation and its’ promotion in children. The ‘Fun, Move, Play’ Project investigated the effect of a 6-week play based PA intervention on primary school children’s (aged 6-8 years) FMS while also exploring the attitudes and perceptions of their parents and teachers towards PA participation. The FMS intervention utilised a pre-post quasi-experimental design to determine the effect of a 6-week play based PA intervention (devised from the iCoach Kids Programme) on 176 primary school children’s FMS (N = 176: 90 girls and 86 boys; M = 7.2 years; SD = 0.48). Objective measures of 7 FMS (run, skip, vertical jump, static balance, stationary dribble, catch, kick) were made using a combination of the TGMD2 and Get Skilled, Get Active resources. One hundred parents (87 mothers; 13 fathers; M=36 years; SD=5.45) and 90 teachers (67 females; 23 males) completed surveys investigating their attitudes and perceptions towards PA participation. In addition, 19 of these parents and 9 of these teachers participated in semi-structured qualitative interviews to explore, in more depth, their views and perceptions of PA participation. Both the FMS data set and survey responses were analysed using SPSS version 23, using appropriate statistical analysis. A thematic analysis framework was used to analyse the qualitative findings. A significant improvement was observed in the children’s overall FMS score pre-post intervention (t = 16.67; df = 175; p < 0.001), while there were also significant improvements in each of the seven individual FMS measured in the children, pre-post intervention. Findings from the parent surveys and interviews indicated that parents had positive attitudes towards PA, viewed it as important and supported their child’s PA participation. However, a lack of knowledge regarding the amount and intensity of PA that children should participate in emerged as a recurrent finding. Also, there was a significant positive correlation between the PA levels of parents’ and their children (r = .41; n = 100; p < .001). Arising from the teachers’ surveys and interviews was a positive attitude towards PA and the impact that it has on a child’s health and well-being. They also reported feeling more confident teaching certain aspects of the PE curriculum (games and sports) compared to others (gymnastics, dance), where they appreciate working with specialist practitioners. Conclusion: A short-term PA intervention has a positive effect on children’s FMS. While parents are supportive of their child’s PA participation, there is a knowledge gap regarding National PA guidelines for children. Teachers appreciate the importance of PA in children, but face a number of challenges in its implementation and promotion.

Keywords: fundamental movement skills, parents attitudes to physical activity, short-term intervention, teachers attitudes to physical activity

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Authors: Jaspinder Kaur, Jatinder Pal Singh

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Introduction- Delusional parasitosis is a rare psychotic illness characterized by a fixed belief of manifesting a parasite in a body when in reality, it was not. Also known as Ekbom syndrome or delusional infestations, or acarophobia. Although the patient has no primary skin pathology, but all skin findings were secondary to skin manipulation by the patient itself, which is why up to 90% of patients first seek consultation from a dermatologist. Most commonly, it was seen in older people with female to male ratio is 2:1. For treatment, the patient first need to be investigated to rule all other possible causes, as Delusional parasitosis can be caused by Vitamin B12 deficiency, pellagra, hepatic and renal disease, diabetes mellitus, multiple sclerosis, and leprosy. When all possible causes ruled out, psychiatric referral to be done. Rule out other psychiatric comorbidities, and treatment should be done accordingly. Patient with delusional parasitosis responds well to second generation antipsychotics and need to continuous medication over years, and relapse is likely if treatment is stopped. Case Presentation- A 79-year-old female, belonging to lower socio-economic status, presented with complaints of itching sensation with erythematous patches over the scalp and multiple scratch excoriations lesion over the scalp, face and neck from the past 7-8 months. She had a feeling of small insect crawling under her skin and scalp area. To reduce the itching and kill the insect, she would scratch and squeeze her skin repeatedly. When the family tried to give her explanation that there was no insect in her body, she would not get convinced, rather got angry and abuse family members for not believing her. Gradually, her sleep would remain disturbed, she would be seen awake at night, seen to be scratching her skin, pull her scalp hair, even squeeze out her healed lesions. She collected her skin debris, scalp hairs and look out for insect. Because of her continuous illness, the patient started to remain sad and had crying spells. Her appetite decreased. She became socially isolated and stopped doing her activities of daily living. Family member’s first consulted dermatologist, investigated thoroughly with routine investigations, autoimmune and malignancy workup. As all investigations were normal, following which patient was referred for psychiatric evaluation. The patient was started on Tablet Olanzapine 2.5 mg, gradually increased to 7.5 mg. Over 1 month, there was reduction in itching, skin pricking. Lesions were gradually healed, and the patient continued to take other dermatological medications and ointment and was in regular follow up with psychiatric liaison from past 2 months with 70-80 % improvement in her symptoms. Conclusion- Delusional parasitosis is a psychiatric disorder of insidious onset, seen commonly in middle and old age people. Both psychiatric and dermatology consultation liaison will help the patient for an early diagnosis and adequate treatment. If a primary psychiatric diagnosis, the patient respond well to second generation antipsychotics but always require a further evaluation and treatment management if it is secondary to some physical or other psychiatric comorbidity.

Keywords: delusional parasitosis, delusional infestations, rare, primary psychiatric diagnosis, antipsychotic agents

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Authors: Juliana Chiarini Balbino Fernandes

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This article aims to investigate the Spanish didactic book, entitled ‘El Calculo y La Medida en El Primer Grado de La Escuela Decroly’, written by Dr. O. Decroly and A. Hamaide, published in Madrid, in the year 1934. In addition to analyzing how mathematical knowledge is present in the proposed Centers of Interest. The textbooks, in addition to pedagogical tools, reflect a certain moment in society and allow the analysis of the theoretical-methodological proposal that can be implemented by the teacher. The study proposed here will be carried out by the lens of Cultural History, supported by Roger Chartier (1991) and by the concepts on textbooks, based on Alain Choppin (2004). The textbook selected for this study exposes a program of ideas associated with the method of Centers of Interest and arithmetic is linked to these interests. In the first courses (six to eight years), most centers can be considered to correspond to occasional calls, as they take advantage of events that arise spontaneously to work with observation, measurement, association and expression exercises. The program of ideas associated with Centers of Interest addresses the biological and social aspects of children, as long as they can express their needs for activities and games, satisfying the natural curiosity. Still, the program of associated ideas offers occasions for problems whose data are taken in observation exercises and concrete expressions (manuals, drawings). In the method applied at the school of L'Ermitage, school created by Decroly in Belgium in 1907, observation, is the basis of each center of interest. It offers the chance to compare and measure. To observe is more than to perceive; it is also to establish relations between the graded aspects of the same object, to seek relations between different intensities; is to verify successions, special and temporary relationships; is to make comparisons, to notice differences and similarities in block or datable (analysis), is to establish a bridge between the world and the thought. To make the observation more precise, it is important to compare, measure, and resort to considered objects as natural units of measure. Measurement and calculation are, therefore, quite naturally subject to observation. Thus, it is possible to make the child enter into the interest in the calculation, linking it to the observation. It was observed that the Centers of Interest, according to Decroly, should respond to the concerns and attend to the motivations of the students and the teaching of arithmetical must obey a logical seriation, considering the interest and the experience of the children. The teaching of arithmetical should not be limited to the schedule, it should cover every quantitative aspect that arises in the other disciplines. The feeling of unity is established in observation, association and expression, which coordinate a whole program of cultural activities, concentrating it around a central idea.

Keywords: didactic book, centers of interest, mathematical knowledge, primary education

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Authors: Maya de Vries Kedem, Abir Jubran, Diana Baron

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Employment in Israel offers Palestinian workers an income double what they can earn in the West Bank. The need to support their families leads many educated Palestinians to forgo finding work in their profession in the Palestinian Authority and instead look for employment in those sectors open to them in Israel, particularly the construction, agriculture, and industry sectors. The International Labor Organization estimated that about 1,200 workers in Israel die every year because of occupational diseases (diseases caused by working conditions). Construction workers in Israel are constantly exposed to dust, noise, chemical materials, and work in awkward postures, which require prolonged bending, repetitive motion, and other risk factors that can lead to illnesses and death. Occupational health is vastly neglected in Israel and construction workers are particularly at risk . As of June 2022, the Israeli quota in the construction sector for Palestinian workers stood at 80,000. Kav LaOved released a new study on the state of occupational health among Palestinian workers employed in construction in Israel. The study Roadmap to Health: Palestinian Workers in Israel's Construction Sector reviews the extent to which the health of Palestinian workers is protected at work in Israel. The report includes analysis of a survey administered to 256 workers as well as interviews with 10 workers and with 5 Israeli occupational health experts. Report highlights: • Among survey respondents, 63.9% stated that safety procedures to protect their health are rarely followed in their workplace (e.g., taking breaks, using protective gear, following restrictions on lifting heavy items, and having inspectors regularly on site to monitor safety). • All 256 Palestinian workers who participated to the survey said that their health has been directly or indirectly harmed by working in Israel and reported suffering from the following problems: orthopedic problems such as joint, hand, leg or knee problems (100%); headaches (75%); back problems (36.3%); eye problems (23.8%); breathing problems (17.6%); chronic pain (14.8%); heart problems (7.8%); and skin problems (3.5%). • Workers who are injured or do not feel well often continue working for fear of losing their payment for that day. About half of the 256 survey respondents reported that they pay brokerage fees to find an employer with a work permit, often paying between 2,000 and 3,000 NIS per month. “I have an obligation—I pay about NIS 120 a day for my permit, [and] I have to pay for it whether I work or not" a worker said. • Most Palestinian construction workers suffer from stress and mental health problems. Workers pointed to several issues that greatly affect their mood and mental state: daily crossings at crowded checkpoints where workers stand for hours; lack of sleep due to leaving home daily at 3:00-3:30 am; commuting two to four hours to work in each direction; and abusive work environments. A worker told KLO that the sight of thousands of workers standing together at the checkpoint causes “high blood pressure and the feeling that you are going to be squeezed.” Another said, “I felt that my bones would break.” In the survey workers reported suffering from insomnia (70.1%), breathing difficulties (35.8%), chest pressure (27.6%), or rapid pulse rate (12.2%).

Keywords: construction sector, palestinian workers, occupational health, Israel, occupation

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Authors: Mariko Hara, Mari Aoki, Takako Ito, Masao Sugita

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Social distancing measures due to the COVID-19 crisis had a severe impact on music and art practices based in community settings. They had to re-think how to connect with their dispersed community using online tools. As the social distancing continues, there is an urgent need to investigate the possibilities of online community music and art practices. Are they sustainable actions that can have positive impacts on the community and the quality of lives of people over time? The Online Lindgren Café (hereafter ‘OLC’) is a monthly online literature event which started in June 2020. In the OLC, up to 14 members meet online to discuss the works of Astrid Lindgren and similar authors. Members come from various places in Japan and Norway, with a variety of expertise from music therapy, music education, psychotherapy, music sociology, storytelling, and theatre, and their family members join them. In these meetings, music and arts activities emerged in response to interests among the members. The resources and experiences of the members helped to develop these activities further. This paper first introduces one of the music and art activities in one specific event, a collaborative picture book-making with music, which was initiated and led by the second author. The third author chose the music, and the activity itself was recorded. This is followed by the description of a reflecting event, where the recording of the collaborative picture book-making activity was shared to facilitate further creations (drawings, haiku, and fabric weaving) as well as group reflections on the trajectories of the Online Lindgren Café. Finally, we will discuss the preliminary findings using the data collected at the reflecting event. Key findings suggest that the resource-driven approach of the OLC leveled the relationships among the intergenerational, multi-cultural, and interdisciplinary members. This enabled the members to set aside their professional and/or predominant identities, which allowed them to discover their own and others’ resources. The relaxed, unstructured, and liminal phenomenon at OLC can be regarded as a form of communitas, where members gain a sense of liberation and belonging in a different way from in-person communications. Participation from one’s home, as well as a video conferencing function that allowed the members to position themselves among the other participants in equal-sized windows, seems to have enabled members to feel safe to express themselves openly at the same time feel a sense of belonging. Furthermore, in the OLC, music and arts activities acted to inclusively connect and re-connect dispersed, intergenerational members with each other. For instance, in a music and drawing activity, music acted as a means for each member to engage in their own ‘drawing space’ while still feeling connected with the others. The positive experiences from these activities inspired the members to use similar approaches outside of the OLC. The finding suggests that, because of its resource-driven approach supported by the music and arts activities, the OLC could be developed further as a permeable and sustainable action even after any current social distancing measures are lifted.

Keywords: communitas, COVID-19, musical affordances, online community of practices, resource-driven approach

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Authors: Elieder P. Romanzini, Lutti M. Delevatti, Rhaony G. Leite, Ricardo A. Reis, Euclides B. Malheiros

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Brazilian beef cattle production systems are an important profitability source for the national gross domestic product. The main characteristic of these systems is forage utilization as the exclusive feed source. Forage utilization had been causing on owners the false feeling of low production costs. However, this low cost is followed to low profit causing a lot times worst animal index what can result in activities changes or until land sold. Aiming to evaluate economic impacts into Brazilian beef cattle systems were evaluated four nitrogen fertilizer (N) application levels (0, 90, 180 and 270 kg per hectare [kg.ha-1]). Research was developed during 2015 into Forage Crops and Grasslands section of São Paulo State University, “Júlio de Mesquita Filho” (Unesp) (Jaboticabal, São Paulo, Brazil). Pastures were seeded with Brachiaria brizantha Stapf. ‘Marandu’ (Palisade grass) handled using continuous grazing system, with variable stocking rate, sward height maintained at 25 cm. The economic evaluation was developed in rearing e finishing phases. We evaluated the cash flows inside each phase on different N levels. Economic valuations were considering: cost-effective operating (CEO), cost-total operating (CTO), gross revenue (GR), operating profit (OP) and net income (NI), every measured in US$. Complementary analyses were developed, profitability was calculated by [OP/GR]. Pay back (measured in years) was calculated considering average capital stocktaking pondered by area in use (ACS) divided by [GR-CEO]. And the internal rate of return (IRR) was calculated by 100/(pay back). Input prices were prices during 2015 and were obtained from Anuário Brasileiro da Pecuária, Centro de Estudos Avançados em Economia Aplicada and quotation in the same region of animal production (northeast São Paulo State) during the period above mentioned. Values were calculated in US$ according exchange rate US$1.00 equal R$3.34. The CEO, CTO, GR, OP and NI per hectare for each N level were respectively US$1,919.66; US$2,048.47; US$2,905.72; US$857.25 and US$986.06 to 0 kg.ha-1; US$2,403.20; US$2,551.80; US$3,530.19; US$978.39 and US$1,126.99 to 90 kg.ha-1; US$3,180.42; US$3,364.81; US$4,985.03; US$1,620.23 and US$1,804.62 to 180 kg.ha-1andUS$3,709.14; US$3,915.15; US$5,554.95; US$1,639.80 and US$1,845.81 to 270 kg.ha-1. Relationship to another economic indexes, profitability, pay back and IRR, the results were respectively 29.50%, 6.44 and 15.54% to 0 kg.ha-1; 27.72%, 6.88 and 14.54% to 90 kg.ha-1; 32.50%, 4.08 and 24.50% to 180 kg.ha-1 and 29.52%, 3.42 and 29.27% to 270 kg.ha-1. Values previously presented in this evaluation allowing to affirm that the best result was obtained to N level 270 kg.ha-1. These results among all N levels evaluated could be explained by improve occurred on stocking rate caused by increase on N level. However, a crucial information about high N level application into pastures is the efficiency of N utilization (associated to environmental impacts) that normally decrease with the increase on N level. Hence, considering all situations (efficiency of N utilization and economic results) into tropical pastures used to beef cattle production could be recommended N level equal to 180kg.ha-1, which had better profitability and cause lesser environmental impacts, proved by other studies developed in the same area.

Keywords: Brachiaria brizantha, cost-total operating, gross revenue, profitability

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Authors: Nirit Gavish, Rotem Halutz, Liad Neta

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Nowadays, chatbots are gaining more and more attention due to the advent of large language models. One of the important considerations in chatbot design is how to create an interface to achieve high user satisfaction, trust, and acceptance. Since WhatsApp conversations sometimes substitute for face-to-face communication, we studied whether WhatsAppization of the chatbot -making the conversation resemble a WhatsApp conversation more- will improve user satisfaction, trust, and acceptance, or whether the opposite will occur due to the Uncanny Valley (UV) effect. The task was a drive-sharing task, in which participants communicated with a textual chatbot via WhatsApp and could decide whether to participate in a ride to college with a driver suggested by the chatbot. WhatsAppization of the chatbot was done in two ways: By a dialog-style conversation (Dialog versus No Dialog), and by adding WhatsApp indicators – “Last Seen”, “Connected”, “Read Receipts”, and “Typing…” (Indicators versus No Indicators). Our 120 participants were randomly assigned to one of the four 2 by 2 design groups, with 30 participants in each. They interacted with the WhatsApp chatbot and then filled out a questionnaire. The results demonstrated that, as expected from the manipulation, the interaction with the chatbot was longer for the dialog condition compared to the no dialog. This extra interaction, however, did not lead to higher acceptance -quite the opposite, since participants in the dialog condition were less willing to implement the decision made at the end of the conversation with the chatbot and continue the interaction with the driver they chose. The results are even more striking when considering the Indicators condition. Both for the satisfaction measures and the trust measures, participants’ ratings were lower in the Indicators condition compared to the No Indicators. Participants in the Indicators condition felt that the ride search process was harder to operate, and slower (even though the actual interaction time was similar). They were less convinced that the chatbot suggested real trips and they trusted the person offering the ride and referred to them by the chatbot less. These effects were more evident for participants who preferred to share their rides using WhatsApp compared to participants who preferred chatbots for that purpose. Considering our findings, we can say that the WhatsAppization of the chatbot was detrimental. This is true for the both chatbot WhatsAppization methods – by making the conversation more a dialog and adding WhatsApp indicators. For the chosen drive-sharing task, the results were, in addition to lower satisfaction, less trust in the chatbot’s suggestion and even in the driver suggested by the chatbot, and lower willingness to actually undertake the suggested ride. In addition, it seems that the most problematic WhatsAppization method was using WhatsApp’s indicators during the interaction with the chatbot. The current study suggests that a conversation with an artificial agent should also not imitate a WhatsApp conversation very closely. With the proliferation of WhatsApp use, the emotional and social aspect of face-to face commination are moving to WhatsApp communication. Based on the current study’s findings, it is possible that the UV effect also occurs in WhatsAppization, and not only in humanization, of the chatbot, with a similar feeling of eeriness, and is more pronounced for people who prefer to use WhatsApp over chatbots. The current research can serve as a starting point to study the very interesting and important topic of chatbots WhatsAppization. More methods of WhatsAppization and other tasks could be the focus of further studies.

Keywords: chatbot, WhatsApp, humanization, Uncanny Valley, drive sharing

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Authors: N. Uaphongsathorn, C. Worawong, S. Thaewpia

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Background and significance: The population is aging in Thai society, the elderly dependent is at great risk of various functional, psychological, and socio-economic problems as well as less access to health care. They may require long term care at home to maximize their functional abilities and activities of daily living and to improve their quality of life during their own age. Therefore, there is a need to develop a home-based long term care to meet the long term care needs of elders dependent. Methods: The research purpose was to develop long term care model among the elderly dependent in Chaiyaphum province in Northeast region of Thailand. Action Research which is composing of planning, action, observation, and reflection phases was used. Research was carried out for 12 months in all sub-districts of 6 districts in Chaiyaphum province. Participants (N = 1,010) participating in the processes of model development were comprised of 3 groups: a) a total of 110 health care professionals, b) a total of 600 health volunteers and family caregivers and c) a total of 300 the elderly dependent with chronically medical illnesses or disabilities. Descriptive statistics and content analysis were used to analyze data. Findings: Results have shown that the most common health problems among elders dependent with physical disabilities to function independently were cardiovascular disease, dementia, and traffic injuries. The development of home-based long term care model among elders dependent in Chaiyaphum province was composed of six key steps. They are: a) initiating policies supporting formal and informal caregivers for the elder dependent in all sub-districts, b) building network and multidisciplinary team, c) developing 3-day care manager training program and 3-day care provider training program d) training case managers and care providers for the elderly dependent through team and action learning, e) assessing, planning and providing care based on care individual’s needs of the elderly dependent, and f) sharing experiences for good practice and innovation for long term care at homes in district urban and rural areas. Among all care managers and care providers, the satisfaction level for training programs was high with a mean score of 3.98 out of 5. The elders dependent and family caregivers addressed that long term care at home could contribute to improving life’s daily activities, family relationship, health status, and quality of life. Family caregivers and volunteers have feeling a sense of personal satisfaction and experiencing providing meaningful care and support for elders dependent. Conclusion: In conclusion, a home-based long term care is important to Thai elders dependent. Care managers and care providers play a large role and responsibility to provide appropriate care to meet the elders’ needs in both urban and rural areas in Thai society. Further research could be rigorously studied with a larger group of populations in similar socio-economic and cultural contexts.

Keywords: elderly people, care manager, care provider, long term care

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Authors: Zahra Mohajer, Afsaneh Soltani

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Doping is a major issue in competitive sports and is favored by vast groups of athletes. The feeling of being higher-ranking than others and gaining fame has caused many athletes to misuse drugs. The definition of doping is to use prohibited substances and/or methods that help physical or mental performances or both. Doping counts as the illegal use of chemical substances or drugs, excessive amounts of physiological substances to increase the performance at or out of competition or even the use of inappropriate medications to treat an injury to gain the ability to participate in a competition. The International Olympic Committee (IOC) and World Anti-Doping Agency (WADA) have forbidden these substances to ensure fair and equal competition and also the health of the competitors. As of 2004 WADA has published an international list of illegal substances used for doping, which is updated annually. In the process of the Genome Project scientists have gained the ability to treat numerous diseases by gene therapy, which may result in bodily performance increase and therefore a potential opportunity to misuse by some athletes. Gene doping is defined as the non-therapeutic direct and indirect genetic modifications using genetic materials that can improve the performances in sports events. Biosynthetic drugs are a form of indirect genetic engineering. The method can be performed in three ways such as injecting the DNA directly into the muscle, inserting the genetically engineered cells, or transferring the DNA using a virus as a vector. Erythropoietin is a hormone majorly released by the kidney and in small amounts by the liver. Its function is to stimulate the erythropoiesis and therefore the more production of red blood cells (RBC) which causes an increase in Hemoglobin (Hb). During this process, the oxygen delivery to muscles will increase, which will improve athletic performance and postpone exhaustion. There are ways to increase the oxygen transferred to muscles such as blood transfusion, stimulating the production of red blood cells by using Erythropoietin (EPO), and also using allosteric effectors of Hemoglobin. EPO can either be injected as a protein or can be inserted into the cells as the gene which encodes EPO. Adeno-associated viruses have been employed to deliver the EPO gene to the cells. Employing the genes that naturally exist in the human body such as the EPO gene can reduce the risk of detecting gene doping. The first research about blood doping was conducted in 1947. The study has shown that an increase in hematocrit (HCT) up to 55% following homologous transfusion makes it more unchallenging for the body to perform the exercise at the altitude. Thereafter athletes’ attraction to blood infusion escalated. Also, a study has demonstrated that by reinfusing their own blood 4 weeks after being drawn, three men have shown a rise in Hb level which improved the oxygen uptake, and a delay in exhaustion. The list of performance-enhancing drugs is published by WADA annually and includes the following drugs: anabolic agents, hormones, Beta-2 agonists, Beta-blockers, Diuretics, Stimulants, narcotics, cannabinoids, and corticosteroids.

Keywords: doping, PEDs, sports, WADA

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Authors: Majdah Alnefaie

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The ‘netnographic study’ and data mining have been used to monitor the public interaction on Social Media Sites (SMSs) to understand what the motivational factors influence the Saudi intentions regarding allowing women driving in Saudi Arabia in 2018. The netnographic study monitored the publics’ textual and visual communications in Twitter, Snapchat, and YouTube. SMSs users’ communications method is also known as electronic word of mouth (eWOM). Netnography methodology is still in its initial stages as it depends on manual extraction, reading and classification of SMSs users text. On the other hand, data mining is come from the computer and physical sciences background, therefore it is much harder to extract meaning from unstructured qualitative data. In addition, the new development in data mining software does not support the Arabic text, especially local slang in Saudi Arabia. Therefore, collaborations between social and computer scientists such as ‘netnographic study’ and data mining will enhance the efficiency of this study methodology leading to comprehensive research outcome. The eWOM communications between individuals on SMSs can promote a sense that sharing their preferences and experiences regarding politics and social government regulations is a part of their daily life, highlighting the importance of using SMSs as assistance in promoting participation in political and social. Therefore, public interactions on SMSs are important tools to comprehend people’s intentions regarding the new government regulations in the country. This study aims to answer this question, "What factors influence the Saudi Arabians' intentions of Saudi female's car-driving in 2018". The study utilized qualitative method known as netnographic study. The study used R studio to collect and analyses 27000 Saudi users’ comments from 25th May until 25th June 2018. The study has developed data collection model that support importing and analysing the Arabic text in the local slang. The data collection model in this study has been clustered based on different type of social networks, gender and the study main factors. The social network analysis was employed to collect comments from SMSs owned by governments’ originations, celebrities, vloggers, social activist and news SMSs accounts. The comments were collected from both males and females SMSs users. The sentiment analysis shows that the total number of positive comments Saudi females car driving was higher than negative comments. The data have provided the most important factors influenced the Saudi Arabians’ intention of Saudi females car driving including, culture and environment, freedom of choice, equal opportunities, security and safety. The most interesting finding indicted that women driving would play a role in increasing the individual freedom of choice. Saudi female will be able to drive cars to fulfill her daily life and family needs without being stressed due to the lack of transportation. The study outcome will help Saudi government to improve woman quality of life by increasing the ability to find more jobs and studies, increasing income through decreasing the spending on transport means such as taxi and having more freedom of choice in woman daily life needs. The study enhances the importance of using use marketing research to measure the public opinions on the new government regulations in the country. The study has explained the limitations and suggestions for future research.

Keywords: netnographic study, data mining, social media, Saudi Arabia, female driving

Procedia PDF Downloads 128

Authors: Shawndra Bowers, Allie Brandriet, Betsy Gilbertson

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This paper will highlight how Auburn Online’s instructional designers leveraged student and faculty data to update and improve online course design and instructional materials. When designing and revising online courses, it can be difficult for faculty to know what strategies are most likely to engage learners and improve educational outcomes in a specific discipline. It can also be difficult to identify which metrics are most useful for understanding and improving teaching, learning, and course design. At Auburn Online, the instructional designers use a suite of data based student’s performance, participation, satisfaction, and engagement, as well as faculty perceptions, to inform sound learning and design principles that guide growth-mindset consultations with faculty. The consultations allow the instructional designer, along with the faculty member, to co-create an actionable course improvement plan. Auburn Online gathers learning analytics from a variety of sources that any instructor or instructional design team may have access to at their own institutions. Participation and performance data, such as page: views, assignment submissions, and aggregate grade distributions, are collected from the learning management system. Engagement data is pulled from the video hosting platform, which includes unique viewers, views and downloads, the minutes delivered, and the average duration each video is viewed. Student satisfaction is also obtained through a short survey that is embedded at the end of each instructional module. This survey is included in each course every time it is taught. The survey data is then analyzed by an instructional designer for trends and pain points in order to identify areas that can be modified, such as course content and instructional strategies, to better support student learning. This analysis, along with the instructional designer’s recommendations, is presented in a comprehensive report to instructors in an hour-long consultation where instructional designers collaborate with the faculty member on how and when to implement improvements. Auburn Online has developed a triage strategy of priority 1 or 2 level changes that will be implemented in future course iterations. This data-informed decision-making process helps instructors focus on what will best work in their teaching environment while addressing which areas need additional attention. As a student-centered process, it has created improved learning environments for students and has been well received by faculty. It has also shown to be effective in addressing the need for improvement while removing the feeling the faculty’s teaching is being personally attacked. The process that Auburn Online uses is laid out, along with the three-tier maintenance and revision guide that will be used over a three-year implementation plan. This information can help others determine what components of the maintenance and revision plan they want to utilize, as well as guide them on how to create a similar approach. The data will be used to analyze, revise, and improve courses by providing recommendations and models of good practices through determining and disseminating best practices that demonstrate an impact on student success.

Keywords: data-driven, improvement, online courses, faculty development, analytics, course design

Procedia PDF Downloads 33

Authors: Rashed Shah, Jeanne Koepsell, Dixmer Rivera, Eric Swedberg, David Marsh

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Success of primary health care goals of health promotion and disease prevention may well be determined by community based health workers’ overall job satisfaction. It is also important to understand the ways community health workers perceive their jobs and the importance they give to the various factors influencing their job satisfaction, which is critical before making a decision for task-shifting and for expanding their scope of work. Although brigadistas are unpaid volunteers, they are formally recognized and receive support and supervision from the Ministry of Health in Nicaragua. Brigadistas are responsible for classifying and diagnosing illnesses, administering treatment, counseling mothers and care givers within the community, encouraging referral in case of serious illness and making follow-up visits at home. Some brigadistas provide more technically advanced services, including treatment for pneumonia, diarrhea, malaria and tuberculosis and/or distribution of contraceptives. Expanding brigadistas’ duties could threaten their heretofore ‘job satisfaction’. This study primarily aims to report on job satisfaction of brigadistas in Nicaragua before expanding the scope of their work by adding more responsibilities. The study was guided by the following research questions: 1) What aspects of their job made the brigadistas satisfied or dissatisfied? 2) What is the job satisfaction level of brigadistas in Nicaragua? This cross-sectional study was conducted during March – July 2014, to assess brigadistas’ job satisfaction, prior to deciding on inclusion of care for sick newborns and young infants (<2 months of age) to brigadistas’ existing service package of community case management for children of 2-59 months of age. Following stratified random sampling strategy, 15 brigadistas were randomly selected from each of the following four strata: [(1) females under 25 years of age, (2) females over 30 years of age, (3) males under 25 years of age, and (4) males over 30 years of age. Out of 45 completed in-person interview with eligible and available brigadistas, 20 (44.4%) were with female and 25 (55.6%) were with male respondents; the mean age (±sd) was found as 32.0 (±3.2) years. About 53% (24/45) brigadista mentioned “Training” as the most helpful for performing their job. Another 31% (14/45) mentioned that “feeling of doing good, supporting community, women and children” was helpful to perform their job well. When asked about difficulty, about 35.5% (16/45) brigadistas mentioned about “Lack of time” due to their responsibilities in family, farm, other work places, study and such time constraint made their job performance difficult. Measured on a 0-5 scale, estimated average job satisfaction was 4.2. Current trends in task-shifting and integrated program delivery require community health workers (like the brigadistas) to deliver several essential services, including maternal, newborn and child health, and family planning, and thereby increasing their responsibilities. Given the reported level of job satisfaction among brigadistas (4.2 out of 5), and the mentioned difficulty in performing their current job (as ‘Lack of Time’) in this study results, the policy makers and program managers in MOH should be cautious enough before making a decision to expand current scope of work for brigadistas in Nicaragua.

Keywords: Brigadisata, job satisfaction, Nicaragua, task-shifting

Procedia PDF Downloads 204

Authors: Nuno Biga

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Continuous processes’ improvement is a permanent challenge for managers of any organization. Lean management means that efficiency gains can be obtained through a systematic framework able to explore synergies between processes, eliminate waste of time, and other resources. Leaderships in organizations determine the efficiency of the teams through their influence on collaborators, their motivation, and consolidation of ownership (group) feeling. The “organization health” depends on the leadership style, which is directly influenced by the intrinsic characteristics of each personality and leadership ability (leadership competencies). Therefore, it’s important that managers can correct in advance any deviation from expected leadership exercises. Top management teams must assume themselves as regulatory agents of leadership within the organization, ensuring monitoring of actions and the alignment of managers in accordance with the humanist standards anchored in a visible Code of Ethics and Conduct. This article is built around an innovative model of “Business Interactive Games” (BI GAMES) that simulates a real-life management environment. It shows that the strategic management of operations depends on a complex set of endogenous and exogenous variables to the intervening agents that require specific skills and a set of critical processes to monitor. BI GAMES are designed for each management reality and have already been applied successfully in several contexts over the last five years comprising the educational and enterprise ones. Results from these experiences are used to demonstrate how serious games in working living labs contributed to improve the organizational environment by focusing on the evaluation of players’ (agents’) skills, empower its capabilities, and the critical factors that create value in each context. The implementation of the BI GAMES simulator highlights that leadership skills are decisive for the performance of teams, regardless of the sector of activity and the specificities of each organization whose operation is intended to simulate. The players in the BI GAMES can be managers or employees of different roles in the organization or students in the learning context. They interact with each other and are asked to decide/make choices in the presence of several options for the follow-up operation, for example, when the costs and benefits are not fully known but depend on the actions of external parties (e.g., subcontracted enterprises and actions of regulatory bodies). Each team must evaluate resources used/needed in each operation, identify bottlenecks in the system of operations, assess the performance of the system through a set of key performance indicators, and set a coherent strategy to improve efficiency. Through the gamification and the serious games approach, organizational managers will be able to confront the scientific approach in strategic decision-making versus their real-life approach based on experiences undertaken. Considering that each BI GAME’s team has a leader (chosen by draw), the performance of this player has a direct impact on the results obtained. Leadership skills are thus put to the test during the simulation of the functioning of each organization, allowing conclusions to be drawn at the end of the simulation, including its discussion amongst participants.

Keywords: business interactive games, gamification, management empowerment skills, simulation living labs

Procedia PDF Downloads 84

Authors: Jatziri Y. Moreno-Martínez, Arturo Galván, Israel Enrique Herrera Díaz, José Ramón Gasca Tirado

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In recent years, for the elevated viaducts in Mexico City, a construction system based on precast/pre-stressed concrete elements has been used, in which the bridge girders are divided in two parts by imposing a hinged support in sections where the bending moments that are originated by the gravity loads in a continuous beam are minimal. Precast concrete girders with dapped ends are a representative sample of a behavior that has complex configurations of stresses that make them more vulnerable to cracking due to flexure–shear interaction. The design procedures for ends of the dapped girders are well established and are based primarily on experimental tests performed for different configurations of reinforcement. The critical failure modes that can govern the design have been identified, and for each of them, the methods for computing the reinforcing steel that is needed to achieve adequate safety against failure have been proposed. Nevertheless, the design recommendations do not include procedures for controlling diagonal cracking at the entrant corner under service loading. These cracks could cause water penetration and degradation because of the corrosion of the steel reinforcement. The lack of visual access to the area makes it difficult to detect this damage and take timely corrective actions. Three-dimensional non-linear numerical models based on Finite Element Method to study the cracking at the entrant corner of dapped-end beams were performed using the software package ANSYS v. 11.0. The cracking was numerically simulated by using the smeared crack approach. The concrete structure was modeled using three-dimensional solid elements SOLID65 capable of cracking in tension and crushing in compression. Drucker-Prager yield surface was used to include the plastic deformations. The longitudinal post-tension was modeled using LINK8 elements with multilinear isotropic hardening behavior using von Misses plasticity. The reinforcement was introduced with smeared approach. The numerical models were calibrated using experimental tests carried out in “Instituto de Ingeniería, Universidad Nacional Autónoma de México”. In these numerical models the characteristics of the specimens were considered: typical solution based on vertical stirrups (hangers) and on vertical and horizontal hoops with a post-tensioned steel which contributed to a 74% of the flexural resistance. The post-tension is given by four steel wires with a 5/8’’ (16 mm) diameter. Each wire was tensioned to 147 kN and induced an average compressive stress of 4.90 MPa on the concrete section of the dapped end. The loading protocol consisted on applying symmetrical loading to reach the service load (180 kN). Due to the good correlation between experimental and numerical models some additional numerical models were proposed by considering different percentages of post-tension in order to find out how much it influences in the appearance of the cracking in the reentrant corner of the dapped-end beams. It was concluded that the increasing of percentage of post-tension decreases the displacements and the cracking in the reentrant corner takes longer to appear. The authors acknowledge at “Universidad de Guanajuato, Campus Celaya-Salvatierra” and the financial support of PRODEP-SEP (UGTO-PTC-460) of the Mexican government. The first author acknowledges at “Instituto de Ingeniería, Universidad Nacional Autónoma de México”.

Keywords: concrete dapped-end beams, cracking control, finite element analysis, postension

Procedia PDF Downloads 195

Authors: Virginia Chika Okafor

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The pastoral letter, an open letter addressed by a bishop to members of his diocese for the purpose of promoting faith and good Christian living, constitutes a persuasive religious discourse characterized by numerous rhetorical devices. Previous studies on Christian religious language have concentrated mainly on sermons, liturgy, prayers, theology, scriptures, hymns, and songs to the exclusion of the persuasive power of pastoral letters. This study, therefore, examined major rhetorical devices in selected Roman Catholic bishops’ Lenten pastoral letters in the Ecclesiastical Province of Onitsha, with a view to determining their persuasive discourse functions. Aristotelian Rhetoric was adopted as the framework because of its emphasis on persuasion through three main rhetorical appeals: logos, pathos, and ethos. Data were drawn from 10 pastoral letters of five Roman Catholic bishops in five dioceses (two letters from each) out of the seven in the Ecclesiastical of Onitsha. The five dioceses (Onitsha arch-diocese, Nnewi, Awka, Enugu, and Awgu dioceses) were chosen because pastoral letters are regularly published there. The 10 pastoral letters were published between 2000 and 2010 and range between 20 and 104 pages. They were selected, through purposive sampling, based on consistency in the publication and rhetorical content. Data were subjected to discourse analysis. Three categories of rhetorical devices were identified: those relating to logos (logical devices), those relating to pathos (pathetical devices), and those relating to ethos (ethical devices). Major logical devices deployed were: testimonial reference functioning as authority to validate messages; logical arguments appealing to the rationality of the audience; nominalization and passivation objectifying the validity of ideas; and modals of obligation/necessity appealing to the audience’s sense of responsibility and moral duty. Prominent among the pathetical devices deployed were: use of Igbo language to express solidarity with the audience; inclusive pronoun (we) to create a feeling of belonging, collectivism and oneness with them; prayers to inspire them; and positive emotion-laden words to refer to the Roman Catholic Church (RCC) to keep the audience emotionally attached to it. Finally, major ethical devices deployed were: use of first-person singular pronoun (I) and imperatives to invoke the authority of the bishops’ office; Latinisms to show learnedness; greetings and appreciation to express goodwill; and exemplary Biblical characters as models of faith, repentance, and love. The rhetorical devices were used in relation to the bishops’ messages of faith, repentance, love and loyalty to the Roman Catholic Church. Roman Catholic bishops’ pastoral letters in the Ecclesiastical Province of Onitsha are thus characterized by logos-, pathos-, and ethos-related rhetorical devices designed to persuade the audience to live according to the bishops’ messages of faith, love, repentance, and loyalty to the Roman Catholic Church. The rhetorical devices, therefore, establish the pastoral letters as a significant form of persuasive religious discourse.

Keywords: ecclesiastical province of Onitsha, pastoral letters, persuasive discourse functions, rhetorical devices, Roman Catholic bishops

Procedia PDF Downloads 407