Search results for: guide presentation

Authors: Babulayi B. Wilson

Abstract:

Unsatisfactory performance of construction projects in both the industrialised and developing countries indicate that there could be several defects in construction projects phases. Notwithstanding the fact that some project defects are often conceived at the initiation phase of construction projects, insufficient knowledge of contract procedures has been identified as one of the major sources of construction disputes. Contract procedures are a set of rules that outlines the primary obligations and liabilities of parties involved in the implementation of a construction project. Engineering professional bodies often codify contract procedures into standard forms of contract such as the Institution of Civil Engineers (ICE, UK) and Association of Consulting Engineers (ACE, UK) and keep them under constant review by updating any clause to reflect any change in case law or relevant piece of legislation. Even so, it is the responsibility of a professional body or conditions of contract draftsperson to introduce contract-specific clauses that may be necessary for business efficacy but not covered in the chosen standard conditions of contract. In Botswana, the use of clients’ drafted and/or un-adapted for environment of use international forms of contract in conjunction with client-drafted pricing schedules is common. The product of the latter often impact negatively upon contractors’ claims and payments, in that, tender rates and prices can only be deemed to be sufficient if the chosen conditions of contract compliment the pricing schedule (use of standardised procurement documents). In addition, client drafted and the use of borrowed forms of contract such as FIDIC often conflict with domicile law resulting in costly disputes on the part of the client. It is upon the preceding text that the object of the research is to measure the level of knowledge of contract procedures amongst key stakeholders in the Botswana construction industry by requesting a representative sample from the industry and academia to respond to tutorial questions prepared from two commonly used forms of contract for civil works, that is, FIDIC (International Form of Contract) and ICE (UK). The questions were prepared under the following captions: (a) preparation of tender documents (b) obligations of the parties (c) contract administration; and (d) claims, variations, and valuation of variations. After ascertaining that the level of knowledge of contract procedures is insufficient among most practitioners in the Botswana construction industry, major procurement entities, and engineering institutions of learning; a guide to drafting a condition of a construction contract was developed and then validated through seminars and workshops. In the present, the effectiveness of the guide is not yet measured but feedback from seminars and workshops conducted indicates an appreciation of the guide by the majority of major construction industry stakeholders.

Keywords: contract procedures, conditions of contract, professional practice, construction law, forms of contract

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Authors: Abraham J. Rizkalla, Joanne F. Irons, Christopher Q. Cao

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Purpose: Lobectomy was considered the standard of care for early-stage non-small lung cancer (NSCLC) after the Lung Cancer Study Group trial demonstrated increased locoregional recurrence for sublobar resections. However, there has been heightened interest in segmentectomies for selected patients with peripheral lesions ≤2cm, as investigated by the JCOG0802 and CALGB140503 trials. Minimally invasive robotic surgery facilitates segmentectomies with improved maneuverability and visualization of intersegmental planes using indocyanine green. We hereby present a patient who underwent robotic lingulectomy for an undiagnosed ground-glass opacity. Methodology: This video demonstrates a robotic portal lingulectomy using three 8mm ports and a 12mm port. Stereoscopic direct vision facilitated the identification of the lingula artery and vein, and intra-operative bronchoscopy was performed to confirm the lingula bronchus. The intersegmental plane was identified by indocyanine green and a near-infrared camera. Thorough lymph node sampling was performed in accordance with international standards. Results: The 18mm lesion was successfully excised with clear margins to achieve R0 resection with no evidence of malignancy in the 8 lymph nodes sampled. Histopathological examination revealed lepidic predominant adenocarcinoma, pathological stage IA. Conclusion: This video presentation exemplifies the standard approach for robotic portal lingulectomy in appropriately selected patients.

Keywords: lung cancer, robotic segmentectomy, indocyanine green, lingulectomy

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Authors: Arezoo Fallahi

Abstract:

Introduction: Exposure to second-hand smoke is an important global health problem and threatens the health of people, especially children and women. The aim of this study was to determine the effect of education based on the Health Belief Model on preventive behaviors of exposure to secondhand smoke in women. Materials and Methods: This experimental study was performed in 2023in Sanandaj, west of Iran. Seventy-four people were selected by simple random sampling and divided into an intervention group (37 people) and a control group (37 people). Data collection tools included demographic characteristics and a second-hand smoke exposure questionnaire based on the Health Beliefs Model. The training in the intervention group was conducted in three one-hour sessions in the comprehensive health service centers in the form of lectures, pamphlets, and group discussions. Data were analyzed using SPSS software version 21 and statistical tests such as correlation, paired t-test, and independent t-test. Results: The intervention and control groups were homogeneous before education. They were similar in terms of mean scores of the Health Belief Model. However, after an educational intervention, some of the scores increased, including the mean perceived sensitivity score (from 17.62±2.86 to 19.75±1.23), perceived severity score (28.40±4.45 to 31.64±2), perceived benefits score (27.27±4.89 to 31.94±2.17), practice score (32.64±4.68 to 36.91±2.32) perceived barriers from 26.62±5.16 to 31.29±3.34, guide for external action (from 17.70±3.99 to 22/89 ±1.67), guide for internal action from (16.59±2.95 to 1.03±18.75), and self-efficacy (from 19.83 ±3.99 to 23.37±1.43) (P <0.05). Conclusion: The educational intervention designed based on the Health Belief Model in women was effective in performing preventive behaviors against exposure to secondhand smoke.

Keywords: women, health behaviour, smoke, belive

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Authors: Zerrin Orbak, Busra Demir

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Osteopetrosis is a rare genetic disease characterized by impaired bone resorption and increased bone sclerosis. Clinical presentation is very different in osteopetrosis. It can be asymptomatic or can be seen with typical symptoms. Here, a case of osteopetrosis was presented when evaluated for nystagmus. She was 10 months old. Parents were second-degree relatives. On physical examination, pigeon chest deformity and horizontal nystagmus were observed. There was a failure of thrive but no fracture. The cardiovascular examination was normal. Cranial, vertebral and long bone roentgenograms revealed characteristic deformities of osteopetrosis and diffuse sclerosis. The diagnosis was confirmed by genetic testing. A Homozygous mutation was detected in the TNFRSF11A gene (c.508A>G p.(Arg170Gly)). RANKL is encoded by the tumor necrosis factor ligand superfamily member 11 (TNFSF11) gene, and the binding to its receptor RANK, encoded by the TNFRSF11A gene, determines the activation of the downstream pathway that drives osteoclast differentiation and activation (51). The complete absence of osteoclasts is the key feature of the osteoclast-poor form of osteopetrosis (46). Patients are characterized by the absence of TRAP-positive osteoclasts in bone biopsies. The osteoclast-poor subtype of osteopetrosis caused by mutations in TNFSF11 gene is ultra-rare in humans. Clinical presentation is usually severe, with onset in early infancy or in fetal life. But here, a case was presented with horizontal nystagmus. A case presented with horizontal nystagmus, which was evaluated by neurology and diagnosed incidentally, was shared.

Keywords: osteopetrosis, nystagmus, bone, osteoclast-poor

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Authors: Eva de Mingo-Fernández, Lourdes Rubio Rico, Carmen Ortega-Segura, Montserrat Querol-García, Raúl González-Jauregui

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Today, one of the great challenges that the university faces is to get closer to society and transfer knowledge. The competency-based training approach favours a continuous interaction between practice and theory, which is why it is essential to establish real experiences with reflection and debate and to contrast them with personal and professional knowledge. Service-learning (SL) consists of an integration of academic learning with service in the community, which enables teachers to transfer knowledge with social value and students to be trained on the basis of experience of real needs and problems with the aim of solving them. SLE combines research, teaching, and social value knowledge transfer with the real social needs and problems of a community. Goal: The objective of this study was to design, implement, and evaluate a service-learning program in the subject of adult nursing for second-year nursing students. Methodology: After establishing collaboration with eight associations of people with different pathologies, the students were divided into eight groups, and each group was assigned an association. The groups were made up of 10-12 students. The associations willing to participate were for the following conditions: diabetes, multiple sclerosis, cancer, inflammatory bowel disease, fibromyalgia, heart, lung, and kidney diseases. The methodological design consisting of 5 activities was then applied. Three activities address personal and individual reflections, where the student initially describes what they think it is like to live with a certain disease. They then express their reflections resulting from an interview conducted by peers, in person or online, with a person living with this particular condition, and after sharing the results of their reflections with the rest of the group, they make an oral presentation in which they present their findings to the other students. This is followed by a service task in which the students collaborate in different activities of the association, and finally, a third individual reflection is carried out in which the students express their experience of collaboration. The evaluation of this activity is carried out by means of a rubric for both the reflections and the presentation. It should be noted that the oral presentation is evaluated both by the rest of the classmates and by the teachers. Results: The evaluation of the activity, given by the students, is 7.80/10, commenting that the experience is positive and brings them closer to the reality of the people and the area.

Keywords: academic learning integration, knowledge transfer, service-learning, teaching methodology

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Authors: Anthony Townsend, Robyn Fasser

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While complete objectivity is a desirable scientific position from which to conduct a care and contact evaluation (CCE), it is precisely the recognition that we are inherently incapable of operating objectively that is the foundation of ethical practice and skilled assessment. Drawing upon recent research from Daniel Kahneman (2021) on the differences between noise and bias, as well as different inherent biases collectively termed “The Elephant in the Brain” by Kevin Simler and Robin Hanson (2019) from Oxford University, this presentation addresses both the various ways in which our judgments, perceptions and even procedures can be distorted and contaminated while conducting a CCE, but also considers the value of second order cybernetics and the psychodynamic concept of ‘ambivalence’ as a conceptual basis to inform our assessment methodologies to limit such errors or at least better identify them. Both a conceptual framework for ambivalence, our higher-order capacity to allow for the convergence and consideration of multiple emotional experiences and cognitive perceptions to inform our reasoning, and a practical methodology for assessment relying on data triangulation, Bayesian inference and hypothesis testing is presented as a means of promoting ethical practice for health care professionals conducting CCEs. An emphasis on widening awareness and perspective, limiting ‘splitting’, is demonstrated both in how this form of emotional processing plays out in alienating dynamics in families as well as the assessment thereof. In addressing this concept, this presentation aims to illuminate the value of ambivalence as foundational to ethical practice for assessors.

Keywords: ambivalence, forensic, psychology, noise, bias, ethics

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Authors: Natalie M. Khazaal

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The effects of the civil war on Lebanese women have been challenging to conceptualize. For some, war is a liberating and empowering force for women, while for others it is one that subjugates women and disempowers them in new ways. Scholars have explored the impact on the Lebanese civil war (1975-1990) on women in the fields of labor history, political activism and literary production. In all these arenas, women’s role and visibility were contested and negotiated in diverse ways. But probably the most visible arena where this contestation took place was television. Dramatized entertainment series were crucial sites where fictional women battled out the gender question, and which reflected and participated in the negotiations of gender politics. Even more stunningly, actual television stations became part of this battle through the plots and portrayals of women that they created. The state-backed Tele-Liban (TL) peddled patriarchal articulations of gender that directly competed with the edgy vision of liberated, independent women on the pirate Lebanese Broadcasting Corporation (LBC). This presentation explores how LBC used gender to distinguish its brand against the retrograde TL programing. Television series are an important medium for creating, testing and reenacting gender politics. They are even more consequential in another way. They are the sites where a dramatic shift in the relationship between Arab television and Arab publics—from benign neglect of public concerns towards engagement with audiences—took place for the first time. As this shift is at the heart of why Arab media was seen as a participant in the Arab uprisings, it is important to explore the roots of the shift in the dramas and comedy series of the mid-1980s Lebanese television. This presentation argues that television battles over gender were consequential and need serious consideration as sites of unexpected meaning.

Keywords: gender, Lebanon, television, war, women

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Authors: Chuang Bing-Kai, Shih Hsiang-Ju

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Previous studies showed that emergent adults used dating applications the most since it would satisfy their needs for intimacy. It's also found that those emergent adults were mostly non-heterosexual. What’s more, in this digital era, more and more bisexuals and homosexuals choose to establish connections with others through Internet to seek a sense of belonging. However, studies rarely focused on gay men in their emergent adulthood to explore their experiences of dating applications. The purpose of this study was to explore the experience of gay men using dating applications in their emerging adulthood and to understand their self-presentations and the process of it among different relationships while interacting with others upon using dating applications. The semi-structured interview was conducted with those gay men who aged from 18 to 29, felt attracted to people with same gender physically and mentally, considered themselves homosexual from their subjective understanding and had been using dating applications for more than half a year. Research invitations were distributed with the assistance of social media platforms and LGBTQ+ friends in the community. This study adopted a qualitative research approach and applied hermeneutic phenomenology as the method to analyze the transcripts transcribed from the recorded audio, and to explore their using experiences and self-presentations while interacting with others while using dating apps. It’s expected to find out that there are four stages in the self-presentation process including establishing personal identity, self-exploration and experimentation, exploring shared interest and values, developing and maintaining connections. Plus, gay men’s motives to use dating apps play an important role in this process and thus influence how they position the apps in their life. Through this study, professional workers can better understand gay men’s considerations and strategies in their self-presentation process as well as the impact of using motives.

Keywords: dating applications, emerging adulthood, gay men, hermeneutic phenomenology

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Authors: Eugenija Strazdiene, Violeta Bytautaite, Daivute Krisciuniene

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The object of the investigation is the suit for chemical protection, which totally covers human body together with breathing apparatus, breathing mask and helmet (JSC Ansell Protective Solutions Lithuania). The end users of such clothing are the members of rescue team – firefighters. During the presentation, the results of 3D scanning with stationary Human Solutions scanner and portable Artec Eva scanner will be compared on the basis of the efficiency of scanning procedure and scanning accuracy. Also, the possibilities to exporting scanned bodies into specialized CAD systems for suit design development and material consumption calculation will be analyzed. The necessity to understand and to implement corresponding clothing material properties during 3D visualization of garment on CAD systems will be presented. During the presentation, the outcomes of the project ‘Smart and Safe Work Wear Clothing SWW’ will be discussed. The project is carried out under the Interreg Baltic Sea Region Program as 2014-2020 European territorial cooperation objective. Thematic priority is Capacity for Innovation. The main goal of the project is to improve competitiveness and to increase business possibilities for work wear enterprises in the Baltic Sea Region. The project focuses on mass customization of products for various end users. It engages textile and clothing manufacturing technology researchers, work wear producers, end users, as well as national textile and clothing branch organizations in Finland, Lithuania, Latvia, Estonia and Poland.

Keywords: CAD systems, mass customization, 3D scanning, safe work wear

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Authors: Peter Ferguson

Abstract:

In 2018, Japan’s Ministry of Education revised the public elementary school curriculum. As part of widespread reforms, the recent Course of Study established English as an academic subject in Grades 5 and 6 plus lowered the starting age of 'foreign language activities' to Grade 3. These changes were implemented in April 2020. This presentation will examine the process and effects that policy implementation had on schools and teachers. A critical analysis of the 2018 Course of Study policy documents revealed several discourses were expressed concerning not only English education and foreign language acquisition, but that larger political and socioeconomic ideological beliefs on globalization, language, nation, culture, and identity were also articulated. Using excerpts from document analysis, the presenter will demonstrate how competing discourses were expressed in policy texts. Data from interviews with national policymakers also exposed several challenges policymakers faced as they tried to balance competing discourses and articulate important pedagogical concepts while having their voices heard. Findings show that some stakeholders were marginalized during the processes of policy creation, transmission, and implementation. This presentation is part of a larger multiple case study that utilized ethnography of language policy and critical analysis of discourse to examine how English education language policy was implemented into the national elementary school curriculum in Japan, and how stakeholders at the various educational levels contended with the creation, interpretation, and appropriation of the language policy.

Keywords: ethnography of language policy, elementary school EFL, language ideologies, discourse analysis

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Authors: Arezoo Fallahi

Abstract:

Introduction: Exposure to second-hand smoke is an important global health problem and threatens the health of people, especially children and women. The aim of this study was to determine the effect of education based on the Health Belief Model on preventive behaviors of exposure to second-hand smoke in women. Materials and Methods: This experimental study was performed in 2022 in Sanandaj, west of Iran. Seventy-four people were selected by simple random sampling and divided into an intervention group (37 people) and a control group (37 people). Data collection tools included demographic characteristics and a second-hand smoke exposure questionnaire based on the Health Beliefs Model. The training in the intervention group was conducted in three one-hour sessions in the comprehensive health service centers in the form of lectures, pamphlets, and group discussions. Data were analyzed using SPSS software version 21 and statistical tests such as correlation, paired t-test, and independent t-test. Results: The intervention and control groups were homogeneous before education. They were similar in terms of mean scores of the Health Belief Model. However, after an educational intervention, some of the scores increased, including the mean perceived sensitivity score (from 17.62±2.86 to 19.75±1.23), perceived severity score (28.40±4.45 to 31.64±2), perceived benefits score (27.27±4.89 to 31.94±2.17), practice score (32.64±4.68 to 36.91±2.32) perceived barriers from 26.62±5.16 to 31.29±3.34, guide for external action (from 17.70±3.99 to 22/89 ±1.67), guide for internal action from (16.59±2.95 to 1.03±18.75), and self-efficacy (from 19.83 ±3.99 to 23.37±1.43) (P <0.05). Conclusion: The educational intervention designed based on the Health Belief Model in women was effective in performing preventive behaviors against exposure to second-hand smoke.

Keywords: education, women, exposure to secondhand smoke, health belief model

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Authors: Sawsan Al-Saaidi, Ghayth K. Shaker Al-Shaibani

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This paper investigates certain linguistics properties of four selected speeches by Al-Qaeda’s former leader Osama bin Laden who legitimated the use of jihad by Muslims in various countries when he was alive. The researchers adopt van Dijk’s (2009; 1998) Socio-Cognitive approach and Ideological Square theory respectively. Socio-Cognitive approach revolves around various cognitive, socio-political, and discursive aspects that can be found in political discourse as in Osama bin Laden’s one. The political discourse can be defined in terms of textual properties and contextual models. Pertaining to the ideological square, it refers to positive self-presentation and negative other-presentation which help to enhance the textual and contextual analyses. Therefore, among the most significant properties in Osama bin Laden’s discourse are the use of presuppositions and implicatures which are based on background knowledge and contextual models as well. Thus, the paper concludes that Osama bin Laden used a number of manipulative strategies which augmented and embellished the use of ‘jihad’ in order to develop a more effective discourse for his audience. In addition, the findings have revealed that bin Laden used different implicit and embedded interpretations of different topics which have been accepted as taken-for-granted truths for him to legitimate Jihad against his enemies. There are many presuppositions in the speeches analysed that result in particular common-sense assumptions and a world-view about the selected speeches. More importantly, the assumptions in the analysed speeches help consolidate the ideological analysis in terms of in-group and out-group members.

Keywords: Al-Qaeda, cognition, critical discourse analysis, Osama Bin Laden, jihad, implicature, legitimisation, presupposition, political discourse

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Authors: Cui Li, Xu Yuping

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Based on the question of, "Are short video creators who are digital workers controlled by platform rules?" this study discusses the specific ways of platform rules control and the impact on short video creators. Based on the theory of digital labor, this paper adopts the method of in-depth interview and participant observation and chooses 24 producers of short video content of Tiktok to conduct in-depth interview. At the same time, through entering the short video creation field, the author carries on the four-month field investigation, obtains the creation process related data, and analyzes how the short video creator, as the digital labor, is controlled by the platform rule, as well as the creator in this process of compromise and resistance, a more comprehensive presentation of the short video creators of the labor process. It is found that the short video creators are controlled by the platform rules, mainly in the control of traffic rules, and the creators create content, compromise and resist under the guidance of traffic. First, while the platform seems to offer a flexible and autonomous way for creators to monetize, the threshold for participating in the event is actually very high for creators, and the rules for monetizing the event are vague. Under the influence of the flow rule, the creator is faced unstable incomes and high costs. Therefore, creators have to follow the rules of traffic to guide their own creation, began to flow-oriented content production, mainly reflected in the need to keep up-to-date, the pursuit of traffic to ride on the hot spots, in order to flow regardless, set up people "Born for the show", by the label solidified content creation. Secondly, the irregular working hours lead to the extension and overwork of the working hours, which leads to the internal friction of the short video creators at the spiritual level, and finally leads to the Rat Race of video creation. Thirdly, the video creator has completed the internalization and compromise of the platform rules in practice, which promotes the creator to continue to create independently, and forms the intrinsic motive force of the creator. Finally, the rule-controlled short video creators resist and fight in flexible ways, make use of the mechanism and rules of the platform to carry on the second creation, carry on the routine production, purchase the false flow, transfer the creation position to maintain own creation autonomy.

Keywords: short videos, tiktok, production, digital labors

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Authors: Farhat Jabeen, Syed Asfaq Hussain Bukhari

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In the wake of the contemporary period the basic objective of the research paper points out that socio-cultural scenario of Pakistan reveals that gender-based violence is deep rooted in the society irrespective of language and ethnicity. This paper would reconnaissance the possibility reforms in Pakistan for diminishing of violence. Women are not given their due role, rights, and respect. Furthermore, they are treated as chattels. This presentation will cover the socio-customary practices in the context of discrimination, stigmatization, and violence against women. This paper envisages justice in a broader sense of recognition of rights for women, and masculine structure of society, socio-customary practices and discrimination against women are a very serious concern which needs to be understood as a multidimensional problem. The paper will specially focus on understanding the existing obstacles of women in Pakistan in the constitutional scenario. Women stumble across discrimination and human rights manipulations, voluptuous violation and manipulation including domestic viciousness and are disadvantaged by laws, strategies, and programming that do not take their concerns into considerations. This presentation examines the role of honour killings among Pakistani community. This affects their self-assurance and capability to elevation integrity campaign where gender inequalities and discrimination in social, legal domain are to be put right. This paper brings to light the range of practices, laws and legal justice regarding the status of women and also covers attitude towards compensations for murders/killings, domestic violence, rape, adultery, social behavior and recourse to justice.

Keywords: discrimination, cultural, women, violence

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Authors: Amos King'ori Githu

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Water safety is crucial for all ages, but particularly for children. In the past decade, preschool institutions in Sub-Saharan Africa have seen the inclusion of swimming as one of the co-curricular activities. However, these countries face challenges in adopting frameworks, staffing, and resources to heighten water safety, quality, and drowning prevention, hence the focus of this research. It is worth noting that drowning is a leading cause of injury-related deaths among children. Universally, the highest drowning rates occur among children aged 1-4 years and 5-9 years. Preschool children even stand a higher risk of drowning as they are active, eager, and curious to explore their environment. If not supervised closely around or in water, these children can drown quickly in just a few inches of water. Thus, this empirical review focuses on the identification, assessment, and analysis of water safety efforts to curb drowning among children and assess the quality of water to mitigate contamination that may eventually pose infection risks to the children. In addition, it outlines the use of behavioral theories and evaluation frameworks to guide the above. Notably, a search on ten databases was adopted for crucial peer-reviewed articles, and five were selected in the eventual review. This research relied extensively on secondary data to curb water infections and drowning-inflicted deaths among children. It suffices to say that interventions must be supported that adopt an array of strategies, are guided by planning and theory as well as evaluation frameworks, and are vast in intervention design, evaluation, and delivery methodology. Finally, this approach will offer solid evidence that can be shared to guide future practices and policies in preschools on child safety and drowning prevention.

Keywords: water quality and safety, drowning prevention, preschool children, sub-saharan Africa, supervision

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Authors: Joanna Maj

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Body machine interfaces (BMIs) afford users a non-invasive way coordinate movement. Vibrotactile stimulation has been incorporated into BMIs to allow feedback in real-time and guide movement control to benefit patients with cognitive deficits, such as stroke survivors. To advance research in this area, we examined vibrational discrimination thresholds at four body locations to determine suitable application sites for future multi-channel BMIs using vibration cues to guide movement planning and control. Twelve healthy adults had a pair of small vibrators (tactors) affixed to the skin at each location: forearm, shoulders, torso, and knee. A "standard" stimulus (186 Hz; 750 ms) and "probe" stimuli (11 levels ranging from 100 Hz to 235 Hz; 750 ms) were delivered. Probe and test stimulus pairs could occur sequentially or simultaneously (timing). Participants verbally indicated which stimulus felt more intense. Stimulus order was counterbalanced across tactors and body locations. Probabilities that probe stimuli felt more intense than the standard stimulus were computed and fit with a cumulative Gaussian function; the discrimination threshold was defined as one standard deviation of the underlying distribution. Threshold magnitudes depended on stimulus timing and location. Discrimination thresholds were better for stimuli applied sequentially vs. simultaneously at the torso as well as the knee. Thresholds were small (better) and relatively insensitive to timing differences for vibrations applied at the shoulder. BMI applications requiring multiple channels of simultaneous vibrotactile stimulation should therefore consider the shoulder as a deployment site for a vibrotactile BMI interface.

Keywords: electromyography, electromyogram, neuromuscular disorders, biomedical instrumentation, controls engineering

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Authors: Tamphasana Wairokpam

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Inflammatory myopathies (IMs) have long been recognised as a heterogenous family of myopathies with acute, subacute, and sometimes chronic presentation and are potentially treatable. Necrotizing autoimmune myopathies (NAM) are a relatively new subset of myopathies. Patients generally present with subacute onset of proximal myopathy and significantly elevated creatinine kinase (CK) levels. It is being increasingly recognised that there are limitations to the independent diagnostic utility of muscle biopsy. Immunohistochemistry tests may reveal important information in these cases. The traditional classification of IMs failed to recognise NAM as a separate entity and did not adequately emphasize the diversity of IMs. This review and case report on NAM aims to highlight the heterogeneity of this entity and focus on the distinct clinical presentation, biopsy findings, specific auto-antibodies implicated, and available treatment options with prognosis. This article is a meta-analysis of literatures on NAM and a case report illustrating the clinical course, investigation and biopsy findings, antibodies implicated, and management of a patient with NAM. The main databases used for the search were Pubmed, Google Scholar, and Cochrane Library. Altogether, 67 publications have been taken as references. Two biomarkers, anti-signal recognition protein (SRP) and anti- hydroxyl methylglutaryl-coenzyme A reductase (HMGCR) Abs, have been found to have an association with NAM in about 2/3rd of cases. Interestingly, anti-SRP associated NAM appears to be more aggressive in its clinical course when compared to its anti-HMGCR associated counterpart. Biopsy shows muscle fibre necrosis without inflammation. There are reports of statin-induced NAM where progression of myopathy has been seen even after discontinuation of statins, pointing towards an underlying immune mechanism. Diagnosisng NAM is essential as it requires more aggressive immunotherapy than other types of IMs. Most cases are refractory to corticosteroid monotherapy. Immunosuppressive therapy with other immunotherapeutic agents such as IVIg, rituximab, mycophenolate mofetil, azathioprine has been explored and found to have a role in the treatment of NAM. In conclusion,given the heterogeneity of NAM, it appears that NAM is not just a single entity but consists of many different forms, despite the similarities in presentation and its classification remains an evolving field. A thorough understanding of underlying mechanism and the clinical correlation with antibodies associated with NAM is essential for efficacious management and disease prognostication.

Keywords: inflammatory myopathies, necrotising autoimmune myopathies, anti-SRP antibody, anti-HMGCR antibody, statin induced myopathy

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Authors: Denise C. I. Maior-Barron

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This conference presentation proposes to discuss the Japanese tourist perception of Marie Antoinette, at the heritage site which represents the home par excellence of the last Queen of France: Petit Trianon, Versailles. The underpinning analysis has a two-fold aim of firstly identifying the elements that contributed at the said perception and secondly of placing this in the wider context of tabi (travel) culture. The contribution of the presentation lies in its relevance to the analysis of postmodern trends of Japanese travel culture in relation to the consumption of European cultural heritage, through an insight into Japanese contemporary perception of heritage sites and their associated historical figures subject to controversy. Based upon the author’s doctoral studies field research at Petit Trianon - survey led in situ between 2010-2012, applied with the questionnaire method on a total of 307 respondents out of which 53 Japanese nationals - the media sources that were revealed to have had a direct influence on these nationals’ perception of Marie Antoinette, were Riyoko Ikeda’s shōjo manga La Rose de Versailles (1972) and Sofia Coppola’s film Marie-Antoinette (2006). The interpretation of the survey results through an assessment of visitor discourse determined the research methodology to be qualitative as opposed to quantitative, thus what confirmed the empirical hypothesis of the survey was a pattern of perception instead of percentages. Consequently, the interpretation focused on the answers to the questions relating to the image of Marie Antoinette in relation to historical knowledge, cultural background and last but not least media influences.

Keywords: cultural heritage, manga, film, tabi

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Authors: Tracy Smith-Carrier

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In 1995, the World Health Organization declared that poverty was the biggest killer and the greatest cause of suffering in the world. Income is certainly a key social determinant of health, the lack of which causes innumerable health and mental health conditions. In seeking to provide relief from financial hardship for residents within their populace, states in the Global North have largely turned to the non-profit and charitable sector. The stigma and shame of accessing charity is a significant barrier for many, but what is more problematic is that the embrace of the charitable model has let governments off the hook from responding to their international human rights obligations. Although states are signatories to various human rights treaties and conventions internationally, many of these laws have not been implemented domestically. This presentation explores the limits of the charitable model in addressing poverty in countries of the Global North. Unlike in the ages passed, when poverty was thought to be an individual problem, we now know that poverty is largely systemic in nature. In this presentation, we will identify the structural determinants of poverty, outline why people are reticent to access charitable programs and services and how income security is reproduced through the charitable model, and discuss evidence-informed solutions, such as a basic income guarantee, to move beyond the charitable model in favour of a rights-based justice model. To move beyond charity, we must demand that governments recognize our fundamental human rights and address poverty and hunger using a justice model based on substantive human rights.

Keywords: basic income, charity, poverty, income security, hunger, food security, social justice, human rights

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Authors: Sheam-Chyun Lin, Wei-Kai Chen, Hung-Cheng Yen, Yung-Jen Cheng, Yu-Cheng Chen

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Result from the constant dwindle in natural resources, the alternative way to reduce the costs in our daily life would be urgent to be found in the near future. As the ancient technique based on the theory of solar chimney since roman times, the double-skin façade are simply composed of two large glass panels in purpose of daylighting and also natural ventilation in the daytime. Double-skin façade is generally installed on the exterior side of buildings as function as the window, so there’s always a huge amount of passive solar energy the façade would receive to induce the airflow every sunny day. Therefore this article imposes a domestic double-skin window for residential usage and attempts to improve the volume flow rate inside the cavity between the panels by the frame geometry design, the installation of outlet guide plate and the solar energy collection system. Note that the numerical analyses are applied to investigate the characteristics of flow field, and the boundary conditions in the simulation are totally based on the practical experiment of the original prototype. Then we redesign the prototype from the knowledge of the numerical results and fluid dynamic theory, and later the experiments of modified prototype will be conducted to verify the simulation results. The velocities at the inlet of each case are increase by 5%, 45% and 15% from the experimental data, and also the numerical simulation results reported 20% improvement in volume flow rate both for the frame geometry design and installation of outlet guide plate.

Keywords: solar energy, double-skin façades, thermal buoyancy, fluid machinery

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Authors: Raj Chavan

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At present, the United States is home to more than 14,000 Water Resource Recovery Facilities (WRRFs), of which approximately 35% have implemented nutrient limits of some kind. These WRRFs contribute 10 to 15% of the total nutrient burden to surface rivers in the United States and account for approximately 1% of total power demand and 2% of total greenhouse gas emissions (GHG). There are several factors that have influenced the development of densification technologies in the direction of more compact and energy-efficient nutrient removal processes. Prior to surface water discharge, existing facilities that necessitate capacity expansion or biomass densification for greater treatability within the same footprint are being subjected to stricter nutrient removal requirements. Densification of activated sludge as a method for nutrient removal and process intensification at WRRFs has garnered considerable attention in recent times. The biological processes take place within the aerobic sediment granules, which form the basis of the technology. The possibility of generating granular sludge through continuous (or conventional) activated sludge processes (CAS) or densification of biomass through the transfer of activated sludge flocs to a denser biomass aggregate as an exceptionally efficient intensification technique has generated considerable interest. This presentation aims to furnish attendees with a foundational comprehension of densification through the illustration of practical concerns and insights. The subsequent subjects will be deliberated upon. What are some potential techniques for producing and preserving densified granules? What processes are responsible for the densification of biological flocs? How do physical selectors contribute to the process of biological flocs becoming denser? What viable strategies exist for the management of densified biological flocs, and which design parameters of physical selection influence the retention of densified biological flocs? determining operational solutions for floc and granule customization in order to meet capacity and performance objectives? The answers to these pivotal questions will be derived from existing full-scale treatment facilities, bench-scale and pilot-scale investigations, and existing literature data. By the conclusion of the presentation, the audience will possess a fundamental comprehension of the densification concept and its significance in attaining effective effluent treatment. Additionally, case studies pertaining to the design and operation of densification procedures will be incorporated into the presentation.

Keywords: densification, intensification, nutrient removal, granular sludge

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Authors: Ayami Umemura

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Without exception, all the bodies dissected in the gross anatomical practices are bodies that have lived irreplaceable lives, laughing and talking with family and friends. While medical education aims to cultivate medical knowledge that is universally applicable to all human bodies, it relies on a unique, irreplaceable, and singular entity. In this presentation, we will explore the ``irreplaceable relationship'' that is cultivated between medical students and anonymous cadavers during gross anatomical practices, drawing on Emmanuel Levinas's ``ethics of the face'' and Martin Buber's discussion of “I-Thou.'' Through this, we aim to present ``a different ethic'' that emerges only in the context of face-to-face relationships, which differs from the generalized, institutionalized, mass-produced ethics like seen in so-called ``ethics codes.'' Since the 1990s, there has been a movement around the world to use gross anatomical practices as an "educational tool" for medical professionalism and medical ethics, and some educational institutions have started disclosing the actual names, occupations, and places of birth of corpses to medical students. These efforts have also been criticized because they lack medical calmness. In any case, the issue here is that this information is all about the past that medical students never know directly. The critical fact that medical students are building relationships from scratch and spending precious time together without any information about the corpses before death is overlooked. Amid gross anatomical practices, a medical student is exposed to anonymous cadavers with faces and touching and feeling them. In this presentation, we will examine a collection of essays written by medical students on gross anatomical practices collected by the Japanese Association for Volunteer Body Donation from medical students across the country since 1978. There, we see the students calling out to the corpse, being called out to, being encouraged, superimposing the carcasses on their own immediate family, regretting parting, and shedding tears. Then, medical students can be seen addressing the dead body in the second person singular, “you.” These behaviors reveal an irreplaceable relationship between the anonymous cadavers and the medical students. The moment they become involved in an irreplaceable relationship between “I and you,” an accidental and anonymous encounter becomes inevitable. When medical students notice being the inevitable takers of voluntary and addressless gifts, they pledge to become “Good Doctors” owing the anonymous persons. This presentation aims to present “a different ethic” based on uniqueness and irreplaceability that comes from the faces of the others embedded in each context, which is different from “routine” and “institutionalized” ethics. That can only be realized ``because of anonymity''.

Keywords: anonymity, irreplaceability, uniqueness, singularlity, emanuel levinas, martin buber, alain badiou, medical education

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Authors: Kathleen Seers, Rachel Hogg

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Diagnosis of Autism Spectrum Disorder (ASD) in women is increasing, prompting research into the presentation of female ASD and exploring why females are failing to meet the diagnostic threshold. One explanation is the use of masking behaviors, where traits of ASD are suppressed and gender-appropriate behaviors are mimicked to reduce the visibility and victimization of ASD girls. Current research explores ASD presentation and the lived experiences of ASD girls and adolescents; however, there is a paucity of literature in relation to the intra- and inter- psychic experiences of ASD women. Through a social constructionist framework, this qualitative study sought to understand how the construction of gender and the medicalisation of ASD influences women’s experiences of ASD. This study also explored the use and consequence of masking strategies and the impact this has on well-being. Eight women were interviewed, and three major themes were identified. The themes outline the influence of gender expectations and social norms on the women’s experiences, the significance of diagnosis to their identity, and the influence of the medicalization of ASD. Participants shared experiences of feeling different and internalizing blame for this difference. The feeling of difference was a major contributor to the women’s positive or negative mental well-being. The process of diagnosis allowed participants to create and confirm their identity. Diagnosis also led to improvements in well-being, however, the findings also explore the complexity of labeling individuals with a disorder and the difficulties that arise from the construct of ‘functionality’ for those with Autism. The study also explores the temporal nature of ASD and the changing experiences of women as they mature. It is hoped this study promotes discussion and provides clinicians and those connected to ASD women with insights into the support ASD women require to live authentic lives.

Keywords: female autism, gender, masking, social constructionism

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Authors: Josie Gardner

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The overall intention of this research is to reimagine peacebuilding in both in theory and practical application in light of the shortcomings and unsustainability of the current peacebuilding paradigm. These limitations are identified here as an overly rational-material approach to peacebuilding that neglects the inner dimension of peace for a fragmented rather than holistic model, and that espouses a conflict and violence-centric approach to peacebuilding. In counter, this presentation is purposed to investigate the dynamics of inner and outer peace as a holistic, complex system towards ‘inner-outer’ peacebuilding. This paper draws from primary research in the protracted conflict context of north-western India (Jammu, Kashmir & Ladakh) as a case study. This presentation has two central aims. First, to introduce the process of inner (psycho-spiritual) peacebuilding, which has thus far been neglected by mainstream and orthodox literature. Second, to examine why inner peacebuilding is essential for realising sustainable peace on a broader scale as outer (socio-political) peace and to better understand how the inner and outer dynamics of peace relate and affect one another. To these ends, Josephine (the researcher/author/presenter) partnered with Yakjah Reconciliation and Development Network to implement a series of action-oriented workshops and retreats centred around healing, reconciliation, leadership, and personal development for the dual purpose of collaboratively generating data, theory, and insights, as well as providing the youth leaders with an experiential, transformative experience. The research team created and used a novel methodological approach called Mapping Ritual Ecologies, which draws from Participatory Action Research and Digital Ethnography to form a collaborative research model with a group of 20 youth co-researchers who are emerging youth peace leaders in Kashmir, Jammu, and Ladakh. This research found significant intra- and inter-personal shifts towards an experience of inner peace through inner peacebuilding activities. Moreover, this process of inner peacebuilding affected their families and communities through interpersonal healing and peace leadership in an inside-out process of change. These insights have generated rich insights and have supported emerging theories about the dynamics between inner and outer peace, power, justice, and collective healing. This presentation argues that the largely neglected dimension of inner (psycho-spiritual) peacebuilding is imperative for broader socio-political (outer) change. Changing structures of oppression, injustice, and violence—i.e. structures of separation—requires individual, interpersonal, and collective healing. While this presentation primarily examines and advocates for inside-out peacebuilding and social justice, it will also touch upon the effect of systems of separation on the inner condition and human experience. This research reimagines peacebuilding as a holistic inner-outer approach. This offers an alternative path forward those weaves together self-actualisation and social justice. While contextualised within north-western India with a small case study population, the findings speak also to other conflict contexts as well as our global peacebuilding and social justice milieu.

Keywords: holistic, inner peacebuilding, psycho-spiritual, systems youth

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Authors: Briante Barretto, Haley Carreon, Anesha-Maelene Ignacio

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This research paper explores the dynamic process of cultural resilience within the context of the modern tourism of two traditional island communities (Bali, Indonesia and Guam, Micronesia). It asks the question: How do indigenous people hold on to their foundational values that define their culture while moving forward in the modern world? Both Bali and Guam serve as famous destinations for tourists from all over the world, with millions of visitors on an annual basis. Both are continually being shaped in profound ways by the forces of modernity through globalization. And both are demonstrating cultural resilience while striving to find creative ways to sustain, preserve and strengthen their values and traditions within the context of a thriving modern tourist economy. This research paper, drawing on ethnographic methodologies, and in particular participant observation and in-depth interviews, explores the many challenges both communities face and the strategies and approaches they are learning to employ that help promote sustainable tourism while contributing to cultural preservation. Drawing on the insights gained from field work in both island communities, as well as the growing literature in this field study, the paper posits important lessons that can guide and inform indigenous communities that are being drawn into the global tourism market. One powerful idea emerges in the research and one that seems to guide and shape tourism policy both indigenous communities - that this current generation should be thought of as the ancestors of future generations, and thus they have a weighty responsibility to continue to learn and strive to sustain and preserve their cultures and traditions, their natural environments, and spiritual foundations for the future.

Keywords: bali, culture, environment, guam, tourism, values

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Authors: Kritin K. Verma, Brian L. Ransdell

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White patches are a symptom of vitiligo, a chronic autoimmune dermatological condition that causes a loss of pigmentation in the skin. Vitiligo can cause issues of self-esteem and quality of life while also progressing the development of other autoimmune diseases. Current treatments in allopathy and homeopathy exist; some treatments have been found to be toxic, whereas others have been helpful. Allopathy has seemed to offer several treatment plans, such as phototherapy, skin lightening preparations, immunosuppressive drugs, combined modality therapy, and steroid medications to improve vitiligo. This presentation will review the FDA-approved topical cream, Opzelura, a JAK inhibitor, and its effects on limiting vitiligo progression. Meanwhile, other non-conventional methods, such as Arsenic Sulphuratum Flavum used in homeopathy, will be debunked based on current literature. Most treatments still serve to arrest progression and induce skin repigmentation. Treatment plans may differ between patients due to depigmentation location on the skin. Since there is no gold standard plan for treating patients with vitiligo, the oral presentation will review all topical and systemic pharmacological therapies that fight the depigmentation of the skin and categorize their validity from a systematic review of the literature. Since treatment plans are limited in nature, all treatment methods will be mentioned and an attempt will be made to make a golden standard treatment process for these patients.

Keywords: vitiligo, phototherapy, immunosuppressive drugs, skin lightening preparations, combined modality therapy, arsenic sulphuratum flavum, homeopathy, allopathy, golden standard, Opzelura

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Authors: Sergey Svita, Valeriy Astapenko

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The presentation is devoted to the theoretical analysis of ultrashort electromagnetic pulses (USP) scattering on metallic nanospheres in a dielectric medium in the vicinity of surface plasmon resonance due to excitation of dipole and quadrupole surface plasmons.

Keywords: surface plasmon, scattering, metallic nanosphere

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Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

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Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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Authors: Gauri Shankar Shah

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Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

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Authors: Jessica Wood, Serge Desmarais

Abstract:

There has been recent resurgence in the popular and academic interest of consensual non-monogamous (CNM) relationships- an umbrella term that defines relationships in which each partner has openly agreed to engage in additional romantic and/or sexual relationships outside of their primary partnership. Despite an increase in the academic study of CNM, little psychological attention has been paid to the study of CNM, with the consideration of these relationships commonly occurring within related social science disciplines such as sociology or anthropology. As a discipline, psychology has a history of conducting research in the area of intimate relationships, and psychologists have amassed a wealth of theoretical knowledge in this field. However, historically individuals who engage in "alternative" sexual and romantic behaviours, such as non-heterosexual sex or sex with multiple partners have been pathologized within psychological research. Individuals in CNM relationships or individuals identifying as lesbian, gay, bisexual, trans or queer have often been excluded from research or “othered” in psychological interpretations of what healthy relationships entail. Thus, our current theoretical understandings of romantic relationships are limited to heterosexual, monogamous relationships. The goal of this presentation is to examine commonly cited components of relationship satisfaction (e.g., commitment, communication) and to critically assess how CNM experiences are presented in, or missing from, the psychological literature on romantic relationships. Additionally, the presentation will also consider how CNM relationships may add to our understanding or enhancement of traditional psychological theories and address issues related to heteronormativity and mononormativity within the discipline. Finally, we will close with a consideration of additional theoretical perspectives that may aid in our understanding of CNM relationships and suggest directions for future research.

Keywords: heteronormativity, mononormativity, psychological research, diverse relationships, gender, sexuality, feminism, queer theory

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