Search results for: institutional misconduct

Authors: Handan Alan, Ulkü Baykal

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Personal characteristics help people understand and recognize both themselves and other people. They are also known to have direct effects on managerial behaviors. Managers’ personalities indicate how they think, perceive reality and relate to others, and affect their decision-making and problem-solving methods. This descriptive study aims to determine the personal characteristics of nurse managers and the personal and professional factors that affect them since sufficient data does not exist on personal characteristics despite the focus on the leadership and managerial characteristics in nursing. The study population consisted of nurses working in administrative positions at hospitals affiliated with the public hospitals union, research and practice hospitals affiliated with universities and private hospitals in cities in the Marmara Region. The study sample consisted of nurse managers working in the hospitals that permitted conducting the study (excluding private branch hospitals). The data were collected after obtaining the approval of the Clinical Research Ethics Committee of Çanakkale Onsekiz Mart University (Approval date: 1.7.2015, Decision No: 2015-01) and written official permissions from the administrations of the hospitals included in the study. The data analysis was carried out using means and standard deviations (SD) as descriptive statistics, one-way analysis of variance for inter-group comparisons and the independent samples t-test for paired group comparisons. A significance threshold of p < 0.05 was used to evaluate the findings. The data were collected using the Five Factor Personality Inventory. The study included 900 nurse managers, who obtained the highest mean score on the conscientiousness dimension (X=4.22 ±0.35). This dimension was followed by their mean scores on the agreeableness (X=4.06±0.40), intelligence (X=4.05±0.37), extroversion (X=3.50±0.43), and emotional instability (X=2.07±0.53) dimensions. Statistically significant differences were found between the independent variables of age, gender, marital status, education level, work institution, professional experience, institutional experience, managerial experience, administrative position, work unit and managerial education when compared using the five factor personality inventory (p < 0.05). In conclusion, the nurse managers described themselves having high conscientiousness. Statistically significant differences were found between the five factor personality inventory mean scores and their personal and professional characteristics.

Keywords: nurse manager, personality, personal characteristics, professional characteristics

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Authors: G. Ghamrawi, Y. Abunnasr, M. Fawaz, S. Yazigi

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Coastal cities are constantly exposed to environmental degradation and economic regression fueled by rapid and uncontrolled urban growth as well as continuous resource depletion. This is the case of the City of Mina in Tripoli (Lebanon), where lack of awareness to preserve social, ecological, and historical assets, coupled with the increasing development pressures, are threatening the socioeconomic status of the city residents, the quality of life and accessibility to the coast. To address these challenges, a holistic coastal urban design and planning approach was developed to analyze the environmental, political, legal, and socioeconomic context of the city. This approach aims to investigate the potential of balancing urban development with the protection and enhancement of cultural, ecological, and environmental assets under an integrated coastal zone management approach (ICZM). The analysis of Mina's different sectors adopted several tools that include direct field observation, interviews with stakeholders, analysis of available data, historical maps, and previously proposed projects. The findings from the analysis were mapped and graphically represented, allowing the recognition of character zones that become the design intervention units. Consequently, the thesis proposes an urban, city-scale intervention that identifies 6 different character zones (the historical fishing port, Abdul Wahab island, the abandoned Port Said, Hammam el Makloub, the sand beach, and the new developable area) and proposes context-specific design interventions that capitalize on the main characteristics of each zone. Moreover, the intervention builds on the institutional framework of ICZM as well as other studies previously conducted for the coast and adopts nature-based solutions with hybrid systems for providing better environmental design solutions for developing the coast. This enables the realization of an all-inclusive, well-connected shoreline with easy and free access towards the sea; a developed shoreline with an active local economy, and an improved urban environment.

Keywords: blue green infrastructure, coastal cities, hybrid solutions, integrated coastal zone management, sustainable development, urban planning

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Authors: Roberta Facchinetti, Sara Corrizzato, Silvia Cavalieri

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Increasing interconnection between data digitalization and linguistic investigation has given rise to unprecedented potentialities and challenges for corpus linguists, who need to master IT tools for data analysis and text processing, as well as to develop techniques for efficient and reliable annotation in specific mark-up languages that encode documents in a format that is both human and machine-readable. In the present paper, the challenges emerging from the compilation of a linguistic corpus will be taken into consideration, focusing on the English language in particular. To do so, the case study of the InterDiplo corpus will be illustrated. The corpus, currently under development at the University of Verona (Italy), represents a novelty in terms both of the data included and of the tag set used for its annotation. The corpus covers media interviews and debates with diplomats and international operators conversing in English with journalists who do not share the same lingua-cultural background as their interviewees. To date, this appears to be the first tagged corpus of international institutional spoken discourse and will be an important database not only for linguists interested in corpus analysis but also for experts operating in international relations. In the present paper, special attention will be dedicated to the structural mark-up, parts of speech annotation, and tagging of discursive traits, that are the innovational parts of the project being the result of a thorough study to find the best solution to suit the analytical needs of the data. Several aspects will be addressed, with special attention to the tagging of the speakers’ identity, the communicative events, and anthropophagic. Prominence will be given to the annotation of question/answer exchanges to investigate the interlocutors’ choices and how such choices impact communication. Indeed, the automated identification of questions, in relation to the expected answers, is functional to understand how interviewers elicit information as well as how interviewees provide their answers to fulfill their respective communicative aims. A detailed description of the aforementioned elements will be given using the InterDiplo-Covid19 pilot corpus. The data yielded by our preliminary analysis of the data will highlight the viable solutions found in the construction of the corpus in terms of XML conversion, metadata definition, tagging system, and discursive-pragmatic annotation to be included via Oxygen.

Keywords: spoken corpus, diplomats’ interviews, tagging system, discursive-pragmatic annotation, english linguistics

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Authors: Pavana Basavakumar, Devadas Bhat

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Diabetes is a disease which often goes undiagnosed until its secondary effects are noticed. Early detection of the disease is necessary to avoid serious consequences which could lead to the death of the patient. Conventional invasive tests for screening of diabetes are mostly painful, time consuming and expensive. There’s also a risk of infection involved, therefore it is very essential to develop non-invasive methods to screen and estimate the level of blood glucose. Extensive research is going on with this perspective, involving various techniques that explore optical, electrical, chemical and thermal properties of the human body that directly or indirectly depend on the blood glucose concentration. Thus, non-invasive blood glucose monitoring has grown into a vast field of research. In this project, an attempt was made to device a prototype for screening of diabetes by measuring electrical impedance of the skin and building a model to predict a patient’s condition based on the measured impedance. The prototype developed, passes a negligible amount of constant current (0.5mA) across a subject’s index finger through tetra polar silver electrodes and measures output voltage across a wide range of frequencies (10 KHz – 4 MHz). The measured voltage is proportional to the impedance of the skin. The impedance was acquired in real-time for further analysis. Study was conducted on over 75 subjects with permission from the institutional ethics committee, along with impedance, subject’s blood glucose values were also noted, using conventional method. Nonlinear regression analysis was performed on the features extracted from the impedance data to obtain a model that predicts blood glucose values for a given set of features. When the predicted data was depicted on Clarke’s Error Grid, only 58% of the values predicted were clinically acceptable. Since the objective of the project was to screen diabetes and not actual estimation of blood glucose, the data was classified into three classes ‘NORMAL FASTING’,’NORMAL POSTPRANDIAL’ and ‘HIGH’ using linear Support Vector Machine (SVM). Classification accuracy obtained was 91.4%. The developed prototype was economical, fast and pain free. Thus, it can be used for mass screening of diabetes.

Keywords: Clarke’s error grid, electrical impedance of skin, linear SVM, nonlinear regression, non-invasive blood glucose monitoring, screening device for diabetes

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Authors: Ilaria Barletta, Mahesh Mani, Björn Johansson

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The concept of sustainability encompasses economic, environmental, social and institutional considerations. Sustainable manufacturing (SM) is, therefore, a multi-faceted concept. It broadly implies the development and implementation of technologies, projects and initiatives that are concerned with the life cycle of products and services, and are able to bring positive impacts to the environment, company stakeholders and profitability. Because of this, achieving SM-related goals requires a holistic, life-cycle-thinking approach from manufacturing companies. Further, such an approach must rely on a logic of continuous improvement and ease of implementation in order to be effective. Currently, there exists in the academic literature no comprehensively structured frameworks that support manufacturing companies in the identification of the issues and the capabilities that can either hinder or foster sustainability. This scarcity of support extends to difficulties in obtaining quantifiable measurements in order to objectively evaluate solutions and programs and identify improvement areas within SM for standards conformance. To bridge this gap, this paper proposes the concept of a framework for assessing and continuously improving the sustainability of manufacturing companies. The framework addresses strategies and projects for SM and operates in three sequential phases: analysis of the issues, design of solutions and continuous improvement. A set of interviews, observations and questionnaires are the research methods to be used for the implementation of the framework. Different decision-support methods - either already-existing or novel ones - can be 'plugged into' each of the phases. These methods can assess anything from business capabilities to process maturity. In particular, the authors are working on the development of a sustainable manufacturing maturity model (SMMM) as decision support within the phase of 'continuous improvement'. The SMMM, inspired by previous maturity models, is made up of four maturity levels stemming from 'non-existing' to 'thriving'. Aggregate findings from the use of the framework should ultimately reveal to managers and CEOs the roadmap for achieving SM goals and identify the maturity of their companies’ processes and capabilities. Two cases from two manufacturing companies in Australia are currently being employed to develop and test the framework. The use of this framework will bring two main benefits: enable visual, intuitive internal sustainability benchmarking and raise awareness of improvement areas that lead companies towards an increasingly developed SM.

Keywords: life cycle management, continuous improvement, maturity model, sustainable manufacturing

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Authors: Ali Alahmari

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Saudi Arabia is facing increasing challenges in managing urban drainage, due to a combination of factors including climate change and urban expansion. Traditional drainage systems are unable to cope with demand, resulting in flooding and damage to property. Consequently, new ways of dealing with this issue need to be found and Sustainable Urban Drainage Systems (SUDS) appear to be a possible solution. This paper suggests that knowledge is a central issue in the adoption of Sustainable Urban Drainage approaches, as revealed through qualitative research with representative officials and professionals from key government departments and organisations in Riyadh. Semi-structured interviews were conducted with twenty-six participants. The interviews explored the challenges of adopting sustainable drainage approaches, and grounded theory analysis was used to examine the role of knowledge. However, a number of barriers have been identified with regard to the adoption of sustainable drainage approaches, such as the marginal status of sustainability in drainage decisions; lack of technical standards for other unconventional drainage solutions, and lack of consideration by decision makers of contributions from environmental and geographical studies. Due to centralisation, decision-making processes are complex and time-consuming, resulting in the discouragement of the adoption of new knowledge and approaches. Stakeholders with knowledge of sustainable approaches are often excluded from the hierarchical system of urban planning and drainage management. In addition, the multiplicity of actors involved in the implementation of the drainage system, as well as the different technical standards involved, often causes problems around coordination and cooperation. Although those with procedural and explicit knowledge have revealed a range of opportunities, such as a significant increase in government support for rainwater drainage in urban areas, they also identified a number of obstacles. These are mainly related to the lack of specialists in sustainable approaches, and a reluctance to involve external experts. Therefore, recommendations for overcoming some of these challenges are presented, which include enhancing the decision-making process through applying decentralisation and promoting awareness of sustainability through establishing educational and outreach programmes. This may serve to increase knowledge and facilitate the adoption of sustainable drainage approaches to promote sustainable development in the context of Saudi Arabia.

Keywords: climate change, decision-making processes, new knowledge and approaches, resistance to change, Saudi Arabia, SUDS, urban expansion

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Authors: Jimmy K. C. Lam, Carrie Wong

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One of the key goals on Learning and Teaching as documented in the University strategic plan 2012/13 – 2017/18 is to encourage active learning, the use of innovative teaching approaches and technology, and promoting the adoption of flexible and varied teaching delivery methods. This research reported the recent visited to Prof Eric Mazur at Harvard University on Peer Instruction: Collaborative learning in large class and innovative use of technology to enable new mode of learning. Peer Instruction is a research-based, interactive teaching method developed by Prof. Eric Mazur at Harvard University in the 1990s. It has been adopted across the disciplines, institutional type and throughout the world. One problem with conventional teaching lies in the presentation of the material. Frequently, it comes straight out of textbook/notes, giving students little incentive to attend class. This traditional presentation is always delivered as monologue in front of passive audience. Only exceptional lecturers are capable of holding students’ attention for an entire lecture period. Consequently, lectures simply reinforce students’ feelings that the most important step in mastering the material is memorizing a zoo of unrelated examples. In order to address these misconceptions about learning, Prof Mazur’s Team developed “Peer Instruction”, a method which involves students in their own learning during lectures and focuses their attention on underling concepts. Lectures are interspersed with conceptual questions called Concept Tests, designed to expose common difficulties in understanding the material. The students are given one or two minutes to think about the question and formulate their own answers; they then spend two or three minutes discussing their answers in a group of three or four, attempting to reach consensus on the correct answer. This process forces the students to think through the arguments being developed, and enable them to assess their understanding concepts before they leave the classroom. The findings from Peer Instruction and innovative use of technology on teaching at Harvard University were applied to the first year Textiles and Fashion students in Hong Kong. Survey conducted from 100 students showed that over 80% students enjoyed the flexibility of peer instruction and 70% of them enjoyed the instant feedback from the Clicker system (Student Response System used at Harvard University). Further work will continue to explore the possibility of peer instruction to art and fashion students.

Keywords: peer instruction, education, technology, fashion

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Authors: Anne Lemnitzer, Eric Tavarez

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The academic rigor of the geotechnical engineering curriculum indicates strong institutional and geographical variations. Geotechnical engineering deals with the most challenging civil engineering material, as opposed to structural engineering, environmental studies, transportation engineering, and water resources. Yet, technical expectations posed by the practicing professional community do not necessarily consider the challenges inherent to the disparity in academic rigor and disciplinary differences. To recognize the skill shortages among current graduates as well as identify opportunities to better equip graduate students in specific fields of geotechnical engineering, a two-part survey was developed in collaboration with the Earth Retaining Structures (ERS) Committee of the American Society of Civil Engineers. Earth Retaining Structures are critical components of infrastructure systems and integral components to many major engineering projects. Within the geotechnical curriculum, Earth Retaining Structures is either taught as a separate course or major subject within a foundation design class. Part 1 of the survey investigated the breadth and depth of the curriculum with respect to ERS by requesting faculty across the United States to provide data on their curricular content, integration of practice-oriented course content, student preparation for professional licensing, and level of technical competency expected upon student graduation. Part 2 of the survey enables a comparison of training provided versus training needed. This second survey addressed practicing geotechnical engineers in all sectors of the profession (e.g., private engineering consulting, governmental agencies, contractors, suppliers/manufacturers) and collected data on the expectations with respect to technical and non-technical skills of engineering graduates entering the professional workforce. Results identified skill shortages in soft skills, critical thinking, analytical and language skills, familiarity with design codes and standards, and communication with various stakeholders. The data will be used to develop educational tools to advance the proficiency and expertise of geotechnical engineering students to meet and exceed the expectations of the profession and to stimulate a lifelong interest in advancing the field of geotechnical engineering.

Keywords: geotechnical engineering, academic training, industry requirements, earth retaining structures

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Authors: Sharon Milberger, Jane Turner, Denise White-Perkins

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Michigan shares the overall U.S. national need for more highly qualified professionals who have knowledge and experience in the use of evidence-based practices to meet the special health care needs of children, adolescents, and adults with neurodevelopmental disabilities including autism spectrum disorder (DD/ASD). The Michigan Leadership Education in Neurodevelopmental Disabilities (MI-LEND) program is a consortium of six universities that spans the state of Michigan and serves more than 181,800 undergraduate, graduate, and professional students. The purpose of the MI LEND program is to improve the health of infants, children and adolescents with disabilities in Michigan by training individuals from different disciplines to assume leadership roles in their respective fields and work across disciplines. The MI-LEND program integrates “L.I.F.E.” perspectives into all training components. L.I.F.E. is an acronym for Leadership, Interdisciplinary, Family-Centered and Equity perspectives. This paper will describe how L.I.F.E. perspectives are embedded into all aspects of the MI-LEND training program including the application process, didactic training, community and clinical experiences, discussions, journaling and projects. Specific curriculum components will be described including content from a training module dedicated to Equity. Upon completion of the Equity module, trainees are expected to be able to: 1) Use a population health framework to identify key social determinants impacting families and children; 2) Explain how addressing bias and providing culturally appropriate linguistic care/services can influence patient/client health and wellbeing; and 3) Describe the impact of policy and structural/institutional factors influencing care and services for children with DD/ASD and their families. Each trainee completes two self-assessments: the Cultural and Linguistic Competence Health Practitioner Assessment and the other assessing social attitudes/implicit bias. Trainees also conduct interviews with a family with a child with DD/ASD. In addition, interdisciplinary Equity-related group activities are incorporated into face-to-face training sessions. Each MI-LEND trainee has multiple ongoing opportunities for self-reflection through discussion and journaling and completion of a L.I.F.E. project as a culminating component of the program. The poster will also discuss the challenges related to teaching and measuring successful outcomes related to diversity/equity perspectives.

Keywords: disability, diversity, equity, training

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Authors: Ayelet Gur

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Background: In recent years we are witnessing a welcome trend in which more children/persons with disabilities are living at home with their families and within their communities. This trend is related to various policy innovations as the UN Convention on the Rights of People with Disabilities that reflect a shift from the medical-institutional model to a human rights approach. We also witness the emergence of family centered approaches that perceive the family and not just the individual with the disability as a worthy target of policy planning, implementation and evaluation efforts. The current investigation aims to explore economic, psychological and social factors among households of families of children or adults with intellectual disabilities in Israel and to present policy recommendation. Methods: A national sample of 301 households was recruited through the education and employment settings of persons with intellectual disability. The main caregiver of the person with the disability (a parent) was interviewed. Measurements included the income and expense surveys; assets and debts questionnaire; the questionnaire on resources and stress; the social involvement questionnaire and Personal Wellbeing Index. Results: Findings indicate significant gaps in financial circumstances between households of families of children with intellectual disabilities and households of the general Israeli society. Households of families of children with intellectual disabilities report lower income and higher expenditures and loans than the general society. They experience difficulties in saving and coping with unexpected expenses. Caregivers (the parents) experience high stress, low social participation, low financial support from family, friend and non-governmental organizations and decreased well-being. They are highly dependent on social security allowances which constituted 40% of the household's income. Conclusions: Households' dependency on social security allowances may seem contradictory to the encouragement of persons with intellectual disabilities to favor independent living in light of the human rights approach to disability. New policy should aim at reducing caregivers' stress and enhance their social participation and support, with special emphasis on families of lower socio-economic status. Finally, there is a need to continue monitoring the economic and psycho-social needs of households of families of children with intellectual disabilities and other developmental disabilities.

Keywords: disability policy, family policy, intellectual and developmental disabilities, Israel, households study, parents of children with disabilities

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Authors: Chenchieh Chang

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Objectives: This study had two objectives. First, it used affective events theory to investigate the relationship between workplace bullying and the intention to resign in nurses, a topic rarely explored in previous studies. Second, according to the conservation of resource theory, individuals encountering work incidents will utilize resources that are at their disposal to strengthen or weaken the effects of the incidents on them. Such resources include social support that comes from their bosses, colleagues, family, and friends. To answer the question of whether different social supports exert distinct effects on alleviating stress experienced by nurses, this study examined the moderating effects of different social supports on the relationship between workplace bullying and nurses’ intention to resign. Method: This study was approved by an institutional review board (code number: 105070) and adopted purposive sampling to survey 911, full-time nurses. Results: Work-related bullying exerted a significant and positive effect on the intention to resign, whereas bullying pertaining to interpersonal relationships and body-related bullying nonsignificantly affected intention to resign. Support from supervisors enhanced the effect of work-related bullying on an intention to resign, whereas support from colleagues and family did not moderate said effect. Research Limitations/Implications: The self-reporting method and cross-sectional research　design adopted in this study might have resulted in common method variance and limited the ability to make causal inferences. This study suggests future studies to obtain measures of predictor and criterion variables from different sources or ensure a temporal, proximal, or psychological separation between predictor and criterion in the collection of data to avoid the common method bias. Practical Implications: First, businesses should establish a friendly work environment and prevent employees from encountering workplace bullying. Second, because social support cannot diminish the effect of workplace bullying on employees’ intention to resign, businesses should offer other means of assistance. For example, business managers may introduce confidential systems for employees to report workplace bullying; or they may establish consultation centers where employees can properly express their thoughts and feelings when encountering workplace bullying.

Keywords: workplace bullying, intention to occupation leave, social supports, nurses

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Authors: Parvez Sattar

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There are around 150,000 female sex workers in Bangladesh, and the country hosts one of the largest brothels in the world. There are 20 brothel-villages in the country, of which 14 are recognized to be ‘official’, and at least 11 are currently operational. Although the national Constitution adopts a preventive policy against prostitution, law does not, as such, prohibit commercial sex work by an adult woman working in a brothel having made an affidavit in this regard. But, at the same time, the law renders at least some forms of floating and hotel based sex work illegal, while sex between males has been termed as sodomy and made culpable offence even on its own. All forms of sex works by MSM and Hijra are thus branded as criminal acts. Observations and findings drawn in this article are based on both primary and secondary sources collecting data from a series of field-based empirical studies conducted by the author through questionnaire survey, FGDs, key informant consultations and other PRA/PLA tools. General and specific conclusions have been based on analysis guided by international standards of human and labour rights approaches. It has been noted that neither the community attitudes nor the cultural mind-sets, or the State's institutional set up is supportive of the causes of sex workers engaged in the most exploitative forms of labour. Lack of respect for fundamental rights continues to diminish any chances of sex workers' reintegration to the mainstream of the society, perpetuates poverty, and increases their vulnerability to HIV/AIDS. To aggravate the scenario, the endemic practice of a complex debt-bondage masked by the so-called 'entry-cost' and ‘legal license’ to the industry is considered to be a somewhat accepted 'open secret' and that the police and administration keep their eyes off from such practices treating these as 'their internal affairs'. Often these practices are used by the Sardarni/Khala (landlady) and other 'managing' actors as the tool for further exploitation of the sex workers as well as a 'control strategy'. The paper concludes with the observation that the tabooed truths of commercial sex and sex workers are inherently embedded in the very factors that compel them into this endemically ostracised profession itself. While denial of both recognition and enjoyment of the fundamental human rights of sex workers is widespread, it is the same cycle of social vulnerability and economic exclusion that often confines these people within a continuous process of servitude and modern day slavery.

Keywords: commercial sex work and human rights, Labor protection in sex industry, Prostitution Law in Bangladesh, Sex work as modern day slavery

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Authors: L. Hoade, O. O. Onafowokan, K. Anderson, G. E. Bartlett, E. D. Fern, M. R. Norton, R. G. Middleton

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Aims: Femoroacetabular impingement (FAI) was first recognised as a potential driver for hip pain at the turn of the last millennium. While there is an increasing trend towards surgical management of FAI by arthroscopic means, open surgical hip dislocation and debridement (SHD) remains the Gold Standard of care in terms of reported outcome measures. (1) Long-term functional and survivorship outcomes of SHD as a treatment for FAI are yet to be sufficiently reported in the literature. This study sets out to help address this imbalance. Methods: We undertook a retrospective review of our institutional database for all patients who underwent SHD for FAI between January 2003 and December 2008. A total of 223 patients (241 hips) were identified and underwent a ten year review with a standardised radiograph and patient-reported outcome measures questionnaire. The primary outcome measure of interest was survivorship, defined as progression to total hip arthroplasty (THA). Negative predictive factors were analysed. Secondary outcome measures of interest were survivorship to further (non-arthroplasty) surgery, functional outcomes as reflected by patient reported outcome measure scores (PROMS) scores, and whether a learning curve could be identified. Results: The final cohort consisted of 131 females and 110 males, with a mean age of 34 years. There was an overall native hip joint survival rate of 85.4% at ten years. Those who underwent a THA were significantly older at initial surgery, had radiographic evidence of preoperative osteoarthritis and pre- and post-operative acetabular undercoverage. In those whom had not progressed to THA, the average Non-arthritic Hip Score and Oxford Hip Score at ten year follow-up were 72.3% and 36/48, respectively, and 84% still deemed their surgery worthwhile. A learning curve was found to exist that was predicated on case selection rather than surgical technique. Conclusion: This is only the second study to evaluate the long-term outcomes (beyond ten years) of SHD for FAI and the first outside the originating centre. Our results suggest that, with correct patient selection, this remains an operation with worthwhile outcomes at ten years. How the results of open surgery compared to those of arthroscopy remains to be answered. While these results precede the advent of collison software modelling tools, this data helps set a benchmark for future comparison of other techniques effectiveness at the ten year mark.

Keywords: femoroacetabular impingement, hip pain, surgical hip dislocation, hip debridement

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Authors: Woledegebrieal Aregay

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Introduction: Family planning is defined as the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is part of a strategy to reduce poverty, maternal, infant and child mortality; empowers women by lightening the burden of excessive childbearing. Family planning is achieved through the use of different contraceptive methods among which the most effective method is modern family planning methods like Long-Acting Reversible Contraceptive (LARCs) which are IUCD and Implant and these methods have multiple advantages over other reversible methods. Most importantly, once in place, they do not require maintenance and their duration of action is long, ranging from 3 to10 years. Methods: An institutional-based cross-sectional study was conducted in Gondar town among female college students from April-May. A simple random sampling technique was employed to recruit a total of 1166 study subjects. Descriptive variables were computed for all predictors & dependent variables. The presence of an association between covariates & LARC use was observed by two tables’ findings using the chi-square test. Bivariate logistic regression was conducted to identify all possible factors affecting LARC utilization & its crude Odds Ratio, 95% Confidence Interval (CI) & P-value was observed. A multivariable logistic regression model was developed to control possible confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) &P-values will be computed to identify significantly associated factors (P < 0.05) with LARC utilization. Result: Utilization of LARCs was 20.4%, the most common is Implant 86(96.5%), and followed by Intra-Uterine Contraceptive Device (IUCD) 3(3.5%). The result of the multivariate analysis revealed that the significant association of marital status of the respondent on utilization of LARC [AOR 3.965(2.051-7.665)], discussion of the respondent about LARC utilization with the husband/boyfriend [AOR 2.198(1.191-4.058)], and attitude of the respondent on implant was found to be associated [AOR 0.365(0.143-0.933)].Conclusion: The level of knowledge and attitude in this study was not satisfactory, the utilization of long-acting reversible contraceptives among college students was relatively satisfactory but if the knowledge and attitude of the participant has improved the prevalence of LARC were increased.

Keywords: utilization, long-acting reversible contraceptive, Ethiopia, Gondar

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Authors: Vicente Espinola, Luis Torres, Christhian Gonzalez

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Entrepreneurship is a topic of current interest in Mexico and the World, which has been fostered through public policies with great impact on its generation. The strategies used in Mexico have not been successful, being motivational strategies aimed at the masses with the intention that someone in the process generates a venture. The strategies used for its development have been "picking of winners" favoring those who have already overcome the initial stages of undertaking without effective support. This situation shows a disarticulation that appears even more in social entrepreneurship; due to this, it is relevant to research on those elements that could develop them and thus integrate a model of entrepreneurship and social innovation for Mexico. Social entrepreneurship should be generating social innovation, which is translated into business models in order to make the benefits reach the population. These models are proposed putting the social impact before the economic impact, without forgetting its sustainability in the medium and long term. In this work, we present a simple model of innovation and social entrepreneurship for Guanajuato, Mexico. This algorithm was based on how social innovation could be generated in a systemic way for Mexico through different institutions that promote innovation. In this case, the technological parks of the state of Guanajuato were studied because these are considered one of the areas of Mexico where its main objectives are to make technology transfer to companies but overlooking the social sector and entrepreneurs. An experimental design of n = 60 was carried out with potential entrepreneurs to identify their perception of the social approach that the enterprises should have, the skills they consider required to create a venture, as well as their interest in generating ventures that solve social problems. This experiment had a 2K design, the value of k = 3 and the computational simulation was performed in R statistical language. A simple model of interconnected variables is proposed, which allows us to identify where it is necessary to increase efforts for the generation of social enterprises. The 96.67% of potential entrepreneurs expressed interest in ventures that solve social problems. In the analysis of the variables interaction, it was identified that the isolated development of entrepreneurial skills would only replicate the generation of traditional ventures. The variable of social approach presented positive interactions, which may influence the generation of social entrepreneurship if this variable was strengthened and permeated in the processes of training and development of entrepreneurs. In the future, it will be necessary to analyze the institutional actors that are present in the social entrepreneurship ecosystem, in order to analyze the interaction necessary to strengt the innovation and social entrepreneurship ecosystem.

Keywords: social innovation, model, entrepreneurship, technological parks

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Authors: Diana K. Kwok

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Despite the fact that Hong Kong government aims to develop an inclusive society, sexual minority students continue to encounter sexual prejudice without legal protection. They also have difficulties accessing relevant services from mental health and educational professionals, who do not receive systematic training to work with sexual minority students. Informed by the literature on sexual prejudice, heterosexual hegemony, genderism, as well as code of practice for frontline practitioners, the authors explored self-perceived knowledge of teachers and sexual minorities on sexuality and sexual prejudice, and how they perceive prejudice towards sexual minorities in Chinese cultural context. Semi-structure qualitative interviews were carried out with 31 school personnel informants (school teachers and counseling team members) and 25 sexual minority informants on their understanding of sexuality knowledge, their perception of sexual prejudice within school context in Hong Kong, as well as their suggested themes on teachers training on sexual prejudice reduction. This presentation specifically focuses on transcripts from sexual minority informants. Data analysis was carried out through NVivo, and followed the procedures spelt out in the qualitative research literature. Trustworthiness of the study was addressed through various strategies. Preliminary themes emerged from transcript content analysis: 1) A gap of knowledge between sexual minority informants and teachers; 2) Perception on sexual prejudice within cultural context; 3) Heterosexual hegemony and genderism within school system; 4) Needs for mandatory training: contents and strategies. The sexual minority informants found that teachers they encountered were predominantly adopted concepts of binary sex and dichotomous gender. Informants also indicated that the teachings of Confucianism cultural values, religiosity in Hong Kong might well be important cultural forces contributing to sexual prejudice manifested in school context. Although human rights and social justice concepts were embedded in professional code of practice of teachers and school helping professionals, informants found that teachers they encountered may face a dilemma when supporting sexual minority students navigating heterosexual hegemony and genderism in, as a consequence of their personal, institutional, cultural and religious backgrounds. Acknowledgments: The sexual prejudice project was funded by the Hong Kong Research Grant Council (ECS28401614), 2015 to 2017.

Keywords: sexual prejudice, Chinese teachers, Chinese sexual minorities, teacher training

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Authors: E. Didaskalou, C. Roussi-Vergou, E. Andreou, G. Skrzypiec, P. Slee

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There has been growing interest lately, in the study of victimization among adolescent students in Greece and elsewhere with a view to improve school policies concerning anti-bullying practices. Researchers have recently focused on investigating the relationships between the extent of students’ victimization and the distinct mechanisms that they employ for coping with this particular problem. In particular, the emphasis has been placed on exploring the relationship between the coping strategies students use to counteract bullying, their sense of belonging at school, and extent of their victimization. Methods: Within the research framework outlined above, we set out to: a) examine the frequency of self-reported victimization among secondary school students, b) investigate the coping strategies employed by students when confronted with school bullying and c) explore any differences between bullied and non-bullied students with regard to coping strategies and school belongingness. The sample consisted of 860 from fifteen secondary public schools in central Greece. The schools were typical Greek secondary schools and the principals volunteered to participate in this study. Participants’ age ranged from 12 to 16 years. Measures: a) Exposure to Victimization: The frequency of victimization was directly located by asking students the question: ‘Over the last term, how often have you been bullied or harassed by a student or students at this high school?’ b) Coping Strategies: The ‘Living and Learning at School: Bullying at School’ was administered to students, c) School belongingness was assessed by the Psychological Sense of School Membership Scale, that students completed. Results: Regarding the frequency of self-reported victimization, 1.5% of the students reported being victimized every day, 2.8% most days of the week, 2.1% one or more days a week, 2.9% about once a week, 22.6% less than once a week and 68.1% never. The coping strategies that the participants employed for terminating their victimization included: a) adult support seeking, b) emotional coping/keep away from school, c) keeping healthy and fit, d) demonstrating a positive attitude towards the bully, d) peer support seeking, e) emotional out bursting, f) wishful thinking and self-blaming, g) pretending as if it is not happening, h) displaying assertive behaviors and i) getting away from the bullies. Bullied from non-bullied children did not differ as much in coping, as in feelings of being rejected in school. Discussion: The findings are in accordance with accumulated research evidence which points to a strong relationship between student perceptions of school belongingness and their involvement in bullying behaviors. We agree with the view that a positive school climate is likely to serve as a buffer that mitigates wider adverse societal influences and institutional attitudes which favor violence and harassment among peers.

Keywords: school bullying, school belonging, student coping strategies, victimization

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Authors: Orkide Donma, Mustafa M. Donma

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Morbid obesity is a health threatening condition particularly in children. Generally, it leads to the development of metabolic syndrome (MetS) characterized by central obesity, elevated fasting blood glucose (FBG), triglyceride (TRG), blood pressure values and suppressed high density lipoprotein cholesterol (HDL-C) levels. However, some ambiguities exist during the diagnosis of MetS in children below 10 years of age. Therefore, clinicians are in the need of some surrogate markers for the laboratory assessment of pediatric MetS. In this study, the aim is to develop an index, which will be more helpful during the evaluation of further risks detected in morbid obese (MO) children. A total of 235 children with normal body mass index (N-BMI), with varying degrees of obesity; overweight (OW), obese (OB), MO as well as MetS participated in this study. The study was approved by the Institutional Ethical Committee. Informed consent forms were obtained from the parents of the children. Obesity states of the children were classified using BMI percentiles adjusted for age and sex. For the purpose, tabulated data prepared by WHO were used. MetS criteria were defined. Systolic and diastolic blood pressure values were measured. Parameters related to glucose and lipid metabolisms were determined. FBG, insulin (INS), HDL-C, TRG concentrations were determined. Diagnostic Obesity Notation Model Assessment Laboratory (DONMA_LAB) Index [ln TRG/HDL-C*INS] was introduced. Commonly used insulin resistance (IR) indices such as Homeostatic Model Assessment for IR (HOMA-IR) as well as ratios such as TRG/HDL-C, TRG/HDL-C*INS, HDL-C/TRG*INS, TRG/HDL-C*INS/FBG, log, and ln versions of these ratios were calculated. Results were interpreted using statistical package program (SPSS Version 16.0) for Windows. The data were evaluated using appropriate statistical tests. The degree for statistical significance was defined as 0.05. 35 N, 20 OW, 47 OB, 97 MO children and 36 with MetS were investigated. Mean ± SD values of TRG/HDL-C were 1.27 ± 0.69, 1.86 ± 1.08, 2.15 ± 1.22, 2.48 ± 2.35 and 4.61 ± 3.92 for N, OW, OB, MO and MetS children, respectively. Corresponding values for the DONMA_LAB index were 2.17 ± 1.07, 3.01 ± 0.94, 3.41 ± 0.93, 3.43 ± 1.08 and 4.32 ± 1.00. TRG/HDL-C ratio significantly differed between N and MetS groups. On the other hand, DONMA_LAB index exhibited statistically significant differences between N and all the other groups except the OW group. This index was capable of discriminating MO children from those with MetS. Statistically significant elevations were detected in MO children with MetS (p < 0.05). Multiple parameters are commonly used during the assessment of MetS. Upon evaluation of the values obtained for N, OW, OB, MO groups and for MO children with MetS, the [ln TRG/HDL-C*INS] value was unique in discriminating children with MetS.

Keywords: children, index, laboratory, metabolic syndrome, obesity

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Authors: Mustafa Metin Donma, Orkide Donma

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Obesity is a disease with an ever-increasing prevalence throughout the world. The metabolic network associated with obesity is very complicated. In metabolic syndrome (MetS), it becomes even more difficult to understand. Within this context, hormones, cytokines, and many others participate in this complex matrix. The collaboration among all of these parameters is a matter of great wonder. Cortisol, as a stress hormone, is closely associated with obesity. Thyroid hormones are involved in the regulation of energy as well as glucose metabolism with all of its associates. Fetuin A is known for years; however, the involvement of this parameter in obesity discussions is rather new. Recently, it has been defined as one of the new generation markers of obesity. In this study, the aim was to introduce complex interactions among all to be able to make clear comparisons, at least for a part of this complicated matter. Morbid obese (MO) children participated in the study. Two groups with 46 MO children and 43 with MetS were constituted. All children included in the study were above 99th age- and sex-adjusted body mass index (BMI) percentiles according to World Health Organization criteria. Forty-three morbid obese children in the second group had also MetS components. Informed consent forms were filled by the parents of the participants. The institutional ethics committee has given approval for the study protocol. Data as well as the findings of the study were evaluated from a statistical point of view. Two groups were matched for their age and gender compositions. Significantly higher body mass index (BMI), waist circumference, thyrotropin, and insulin values were observed in the MetS group. Triiodothyronine concentrations did not differ between the groups. Elevated levels for thyroxin, cortisol, and fetuin-A were detected in the MetS group compared to the first group (p > 0.05). In MO MetS- group, cortisol was correlated with thyroxin and fetuin-A (p < 0.05). In the MO MetS+ group, none of these correlations were present. Instead, a correlation between cortisol and thyrotropin was found (p < 0.05). In conclusion, findings have shown that cortisol was the key player in severely obese children. The association of this hormone with the participants of thyroid hormone metabolism was quite important. The lack of association with fetuin A in the morbid obese MetS+ group has suggested the possible interference of MetS components in the behavior of this new generation obesity marker. The most remarkable finding of the study was the unique correlation between cortisol and thyrotropin in the morbid obese MetS+ group, suggesting that thyrotropin may serve as a target along with cortisol in the morbid obese MetS+ group. This association may deserve specific attention during the development of remedies against MetS in the pediatric population.

Keywords: children, cortisol, fetuin A, morbid obesity, thyrotropin

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Authors: Qingqing Feng, S. Thomas Ng, Frank J. Xu, Jiduo Xing

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Faced with unprecedented challenges including aging assets, lack of maintenance budget, overtaxed and inefficient usage, and outcry for better service quality from the society, today’s infrastructure systems has become the main focus of many metropolises to pursue sustainable urban development and improve resilience. Digital twin, being one of the most innovative enabling technologies nowadays, may open up new ways for tackling various infrastructure asset management (IAM) problems. Digital twin application for IAM, as its name indicated, represents an evolving digital model of intended infrastructure that possesses functions including real-time monitoring; what-if events simulation; and scheduling, maintenance, and management optimization based on technologies like IoT, big data and AI. Up to now, there are already vast quantities of global initiatives of digital twin applications like 'Virtual Singapore' and 'Digital Built Britain'. With digital twin technology permeating the IAM field progressively, it is necessary to consider the maturity of the application and how those institutional or industrial digital twin application processes will evolve in future. In order to deal with the gap of lacking such kind of benchmark, a draft maturity model is developed for digital twin application in the IAM field. Firstly, an overview of current smart cities maturity models is given, based on which the draft Maturity Model of Digital Twin Application for Infrastructure Asset Management (MM-DTIAM) is developed for multi-stakeholders to evaluate and derive informed decision. The process of development follows a systematic approach with four major procedures, namely scoping, designing, populating and testing. Through in-depth literature review, interview and focus group meeting, the key domain areas are populated, defined and iteratively tuned. Finally, the case study of several digital twin projects is conducted for self-verification. The findings of the research reveal that: (i) the developed maturity model outlines five maturing levels leading to an optimised digital twin application from the aspects of strategic intent, data, technology, governance, and stakeholders’ engagement; (ii) based on the case study, levels 1 to 3 are already partially implemented in some initiatives while level 4 is on the way; and (iii) more practices are still needed to refine the draft to be mutually exclusive and collectively exhaustive in key domain areas.

Keywords: digital twin, infrastructure asset management, maturity model, smart city

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Authors: Bridgette Merriman, Wen Fan

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Background: Existing cancer survivorship literature explores varying physical, psychosocial, and psychological late effects experienced by survivors of childhood cancer. However, adolescent and young adult (AYA) survivors of childhood cancer are understudied compared to their adult and pediatric cancer counterparts. Furthermore, existing quality of life (QoL) research fails to account for how cancer survivorship affects survivors across the lifespan. Given that prior research suggests positive cognitive appraisals of adverse events - such as cancer - mitigate detrimental psychosocial symptomologies later in life; it is crucial to understand cancer’s impacts on AYA survivors of childhood malignancies across the life course in order to best support these individuals and prevent maladaptive psychosocial outcomes. Methods: This qualitative study adopted the life-course perspective to investigate the experiences of AYA survivors of childhood malignancies. Eligible patients included AYA 21-30 years old who were diagnosed with cancer <18 years old and off active treatment for >2 years. Participants were recruited through social media posts. Study fulfillment included taking part in one semi-structured video interview to explore areas of survivorship previously identified as being specific to AYA survivors. Interviews were transcribed, coded, and analyzed in accordance with narrative analysis and life-course theory. This study was approved by the Boston College Institutional Review Board. Results: Of 28 individuals who met inclusion criteria and expressed interest in the study, nineteen participants (12 women, 7 men, mean age 25.4 years old) completed the study. Life course theory analysis revealed that events relating to childhood cancer are interconnected throughout the life course rather than isolated events. This “trail of survivorship” includes age at diagnosis, transitioning to life after cancer, and relationships with other childhood survivors. Despite variability in objective characteristics surrounding these events, participants recalled positive experiences regarding at least one checkpoint, ultimately finding positive meaning from their cancer experience. Conclusions: These findings suggest that favorable subjective experiences at these checkpoints are critical in fostering positive conceptions of childhood malignancy for AYA survivors of childhood cancer. Ultimately, healthcare professionals and communities may use these findings to guide support resources and interventions for childhood cancer patients and AYA survivors, therein minimizing detrimental psychosocial effects and maximizing resiliency.

Keywords: medical sociology, pediatric oncology, survivorship, qualitative, life course perspective

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Authors: Jessica Ding

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The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

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Authors: Amelia Faotusia

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The blue economy concept was coined by Pacific nations in recognition of the importance of sustainably managing their extensive marine territories. This is especially important for major ocean-based economic sectors of Pacific economies, such as coastal tourism. There is an absence of research, however, on the key ways in which the blue economy concept has emerged in discourse and public policy in Pacific countries, as well as how it articulates with coastal tourism. This research helps to fill such a gap with a specific focus on Tonga through the application of a post-positivist research approach to conduct a desktop study of relevant national documents and qualitative interviews with relevant government staff, civil society organizations, and tourism operators. The findings of the research reflect the importance of institutional integration and partnerships for a successful blue economy transition and are presented in the form of two case studies corresponding to two sub-sectors of Tonga’s coastal tourism sector: (i) the whale-watching and swimming industry, and (ii) beach resorts and restaurants. A thematic analysis applied to the interview data of both cases then enabled the identification of key areas and issues for socio-economic policy intervention and recommendations in support of blue economy transitions in Tonga’s coastal tourism sector. Examples of the relevant areas and issues that emerged included the importance of foreign direct investment, local market access, community-based special management areas, as well as the need to address the anthropogenic impacts of tropical cyclones, whale tourism, plastic litter on coastal assets, and ecosystems. Policy and practical interventions in support of addressing such issues include a proposed restructuring of the whale-watching and swimming licensing system; integration of climate resilience, adaptation, and capacity building as priorities of local blue economy interventions; as well as strengthening of the economic sustainability dimension of blue economy policies. Finally, this research also revealed the need for further specificity and research on the influence and value of local Tongan culture and traditional knowledge, particularly within existing customary marine tenure systems, on Tonga’s national and sectoral blue economy policies and transitions.

Keywords: blue economy, coastal tourism, integrated ocean management, ecosystem resilience

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Authors: O. Katz-Shufan, T. Simon-Tuval, L. Sabag, L. Granek, D. R. Shahar

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Meals provided at catering systems are a common source of workers' nutrition and were found as contributing high amounts calories and fat. Thus, eating daily catering food can lead to overweight and chronic diseases. On the other hand, the institutional dining room may be an ideal environment for implementation of intervention programs that promote healthy eating. This may improve diners' lifestyle and reduce their prevalence of overweight, obesity and chronic diseases. The significance of this study is in developing an intervention program based on the diners’ dietary habits, preferences and their attitudes towards various intervention programs. In addition, a successful catering-based intervention program may have a significant effect simultaneously on a large group of diners, leading to improved nutrition, healthier lifestyle, and disease-prevention on a large scale. In order to develop the intervention program, we conducted a qualitative study. We interviewed 13 diners who eat regularly at catering systems, using a semi-structured interview. The interviews were recorded, transcribed and then analyzed by the thematic method, which identifies, analyzes and reports themes within the data. The interviews revealed several major themes, including expectation of diners to be provided with healthy food choices; their request for nutrition-expert involvement in planning the meals; the diners' feel that there is a conflict between sensory attractiveness of the food and its' nutritional quality. In the context of the catering-based intervention programs, the diners prefer scientific and clear messages focusing on labeling healthy dishes only, as opposed to the labeling of unhealthy dishes; they were interested in a nutritional education program to accompany the intervention program. Based on these findings, we have developed an intervention program that includes: changes in food served such as replacing several menu items and nutritional improvement of some of the recipes; as well as, environmental changes such as changing the location of some food items presented on the buffet, placing positive nutritional labels on healthy dishes and an ongoing healthy nutrition campaign, all accompanied by a nutrition education program. The intervention program is currently being tested for its impact on health outcomes and its cost-effectiveness.

Keywords: catering system, food services, intervention, nutrition policy, public health, qualitative research

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Authors: Fathi Abid, Bilel Kaffel

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The olive tree, the olive harvest during winter season and the production of olive oil better known by professionals under the name of the crushing operation have interested institutional traders such as olive-oil offices and private companies such as food industry refining and extracting pomace olive oil as well as export-import public and private companies specializing in olive oil. The major problem facing producers of olive oil each winter campaign, contrary to what is expected, it is not whether the harvest will be good or not but whether the sale price will allow them to cover production costs and achieve a reasonable margin of profit or not. These questions are entirely legitimate if we judge by the importance of the issue and the heavy complexity of the uncertainty and competition made tougher by a high level of indebtedness and the experience and expertise of speculators and producers whose objectives are sometimes conflicting. The aim of this paper is to study the formation mechanism of olive oil prices in order to learn about speculators’ behavior and expectations in the market, how they contribute by their industry knowledge and their financial alliances and the size the financial challenge that may be involved for them to build private information hoses globally to take advantage. The methodology used in this paper is based on two stages, in the first stage we study econometrically the formation mechanisms of olive oil price in order to understand the market participant behavior by implementing ARMA, SARMA, GARCH and stochastic diffusion processes models, the second stage is devoted to prediction purposes, we use a combined wavelet- ANN approach. Our main findings indicate that olive oil market participants interact with each other in a way that they promote stylized facts formation. The unstable participant’s behaviors create the volatility clustering, non-linearity dependent and cyclicity phenomena. By imitating each other in some periods of the campaign, different participants contribute to the fat tails observed in the olive oil price distribution. The best prediction model for the olive oil price is based on a back propagation artificial neural network approach with input information based on wavelet decomposition and recent past history.

Keywords: olive oil price, stylized facts, ARMA model, SARMA model, GARCH model, combined wavelet-artificial neural network, continuous-time stochastic volatility mode

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Authors: Ignacio W. Loor

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In the context of informal settlements in Quito, this paper provides evidence that slopes and deep ravines typical of Andean cities, around which marginalized urban communities sit, constitute a platform for green infrastructure that supports mobility for pedestrians in an incremental fashion. This is informally shaped green infrastructure that provides connectivity to other mobility infrastructures such as roads and public transport, which permits relegated dwellers reach their daily destinations and reclaim their rights to the city. This is relevant in that walking has been increasingly neglected as a viable mean of transport in Latin American cities, in favor of rather motorized means, for which the mobility benefits of green infrastructure have remained invisible to policymakers, contributing to the progressive isolation of informal settlements. This research leverages greatly on an ecological rejuvenation programme led by the municipality of Quito and the Andean Corporation for Development (CAN) intended for rehabilitating the ecological functionalities of ravines. Accordingly, four ravines in different stages of rejuvenation were chosen, in order to through ethnographic methods, capture the practices they support to dwellers of informal settlements across different stages, particularly in terms of issues of mobility. Then, by presenting fragments of interviews, description of observed phenomena, photographs and narratives published in institutional reports and media, the production process of mobility infrastructure over unoccupied slopes and ravines, and the roles that this infrastructure plays in the mobility of dwellers and their quotidian practices are explained. For informal settlements, which normally feature scant urban infrastructure, mobility embodies an unfavourable driver for the possibilities of dwellers to actively participate in the social, economic and political dimensions of the city, for which their rights to the city are widely neglected. Nevertheless, informal green infrastructure for mobility provides some alleviation. This infrastructure is incremental, since its features and usability gradually evolves as users put into it knowledge, labour, devices, and connectivity to other infrastructures in different dimensions which increment its dependability. This is evidenced in the diffusion of knowledge of trails and routes of footpaths among users, the implementation of linking stairs and bridges, the improved access by producing public spaces adjacent to the ravines, the illuminating of surrounding roads, and ultimately, the restoring of ecological functions of ravines. However, the perpetuity of this type of infrastructure is also fragile and vulnerable to the course of urbanisation, densification, and expansion of gated privatised spaces.

Keywords: green infrastructure, informal settlements, urban mobility, walkability

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Authors: Emilio Galdeano-Gómez, Ángeles Godoy-Durán, Juan C. Pérez-Mesa, Laura Piedra-Muñoz

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Eco-efficiency is receiving ever-increasing interest as an indicator of sustainability, as it links environmental and economic performances in productive activities. In agriculture, these indicators and their determinants prove relevant due to the close relationships in this activity between the use of natural resources, which is generally limited, and the provision of basic goods to society. In this context, various analyses have focused on eco-efficiency by considering individual family farms as the basic production unit. However, not only must the measure of efficiency be taken into account, but also the existence of a series of factors which constitute socio-economic, political-institutional, and environmental determinants. Said factors have been studied to a lesser extent in the literature. The present work analyzes eco-efficiency at a micro level, focusing on small-scale family farms as the main decision-making units in horticulture in southeast Spain, a sector which represents about 30% of the fresh vegetables produced in the country and about 20% of those consumed in Europe. The objectives of this study are a) to obtain a series of eco-efficiency indicators by estimating several pressure ratios and economic value added in farming, b) to analyze the influence of specific social, economic and environmental variables on the aforementioned eco-efficiency indicators. The present work applies the method of Data Envelopment Analysis (DEA), which calculates different combinations of environmental pressures (water usage, phytosanitary contamination, waste management, etc.) and aggregate economic value. In a second stage, an analysis is conducted on the influence of the socio-economic and environmental characteristics of family farms on the eco-efficiency indicators, as endogeneous variables, through the use of truncated regression and bootstrapping techniques, following Simar-Wilson methodology. The results reveal considerable inefficiency in aspects such as waste management, while there is relatively little inefficiency in water usage and nitrogen balance. On the other hand, characteristics, such as product specialization, the adoption of quality certifications and belonging to a cooperative do have a positive impact on eco-efficiency. These results are deemed to be of interest to agri-food systems structured on small-scale producers, and they may prove useful to policy-makers as regards managing public environmental programs in agriculture.

Keywords: data envelopment analysis, eco-efficiency, family farms, horticulture, socioeconomic features

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Authors: Min Ju Kim, Beom Jin Park, Deuk Jae Sung, Na Yeon Han, Kichoon Sim

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Purpose: The purpose of this study is to determine the significant magnetic resonance (MR) imaging factors of lateral pelvic lymph node (LPLN) on the assessment of survival outcomes of neoadjuvant combined chemotherapy and radiation therapy (CRT) in patients with mid/low rectal cancer. Materials and Methods: The institutional review board approved this retrospective study of 63 patients with mid/low rectal cancer who underwent MR before and after CRT and patient consent was not required. Surgery performed within 4 weeks after CRT. The location of LPLNs was divided into following four groups; 1) common iliac, 2) external iliac, 3) obturator, and 4) internal iliac lymph nodes. The short and long axis diameters, numbers, shape (ovoid vs round), signal intensity (homogenous vs heterogenous), margin (smooth vs irregular), and diffusion-weighted restriction of LPLN were analyzed on pre- and post-CRT images. For treatment response using size, lymph node groups were defined as group 1) short axis diameter ≤ 5mm on both MR, group 2) > 5mm change into ≤ 5mm after CRT, and group 3) persistent size > 5mm before and after CRT. Clinical findings were also evaluated. The disease-free survival and overall survival rate were evaluated and the risk factors for survival outcomes were analyzed using cox regression analysis. Results: Patients in the group 3 (persistent size >5mm) showed significantly lower survival rates than the group 1 and 2 (Disease-free survival rates of 36.1% and 78.8, 88.8%, p < 0.001). The size response (group 1-3), multiplicity of LPLN, the level of carcinoembryonic antigen (CEA), patient’s age, T and N stage, vessel invasion, perineural invasion were significant factors affecting disease-free survival rate or overall survival rate using univariate analysis (p < 0.05). The persistent size (group 3) and multiplicity of LPLN were independent risk factors among MR imaging features influencing disease-free survival rate (HR = 10.087, p < 0.05; HR = 4.808, p < 0.05). Perineural invasion and T stage were shown as independent histologic risk factors (HR = 16.594, p < 0.05; HR = 15.891, p < 0.05). Conclusion: The persistent size greater than 5mm and multiplicity of LPLN on both pre- and post-MR after CRT were significant MR factors affecting survival outcomes in the patients with mid/low rectal cancer.

Keywords: rectal cancer, MRI, lymph node, combined chemoradiotherapy

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Authors: Jacqueline M. Dias, Amina A Khowaja

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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum

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Authors: Banu Baybars Hawks

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To date, academic attention in social sciences remains inadequate with regard to research and analysis of public opinion in Turkey. Most of the existing research has assessed the public opinion during political election periods. Therefore, it is of great interest to find out what the public thinks about current issues in Turkey, and how to interpret the results to be able to reveal whether they may have any reflections on social, political, and cultural structure of the country. Accordingly, the current study seeks to fill the gap in the social sciences literature in English regarding Turkey’s social and political stand which may be perceived to be very different by other nations. Without timely feedback from public surveys, various programs for improving different services and institutions functioning in the country might not achieve their expected goal, nor can decisions about which programs to implement be made rationally. Additionally, the information gathered may not only yield important insights into public’s opinion regarding current agenda in Turkey, but also into the correlates shaping public policies. Agenda-setting studies including agenda-building, agenda melding, reversed agenda-setting and information diffusion studies will be used to explain the roles of factors and actors in the formation of public opinion in Turkey. Knowing the importance of public agenda in the agenda setting and building process, this paper aims to reveal the social and political tendencies of the Turkish public. For that purpose, a survey will be carried out in December of 2014 to determine the social and political trends in Turkey for that same year. The subjects for the study, which utilize a questionairre in one-on-one interviews, will include 1,000 individuals aged 18 years and older from 26 cities representing general population. A stratified random sampling frame will be used. The topics covered by the survey include: The most important current problem in Turkey; the Economy; Terror; Approaches to the Kurdish Issue; Evaluations of the Government and Opposition Parties; Evaluations of Institutional Efficiency; Foreign Policy; the Judicial System/Constitution; Democracy and the Media; and, Social Relations/Life in Turkey. Since the beginning of the 21st century, Turkey has been undergoing a rapid transformation. The reflections of the changes can be seen in all areas from economics to politics. It is my hope that findings of this study may shed light on the important aspects of institutions, variables setting the agenda, and formation process of public opinion in Turkey.

Keywords: public opinion, media, agenda setting, information diffusion, government, freedom, Turkey

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