Search results for: methodology
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5141

Search results for: methodology

1331 The Effectiveness of Kinesio Taping in Enhancing Early Post-Operative Outcomes Inpatients after Total Knee Replacement or Anterior Cruciate Ligament Reconstruction

Authors: B. A. Alwahaby

Abstract:

Background: The number of Total Knee Replacement (TKR) and Anterior Cruciate Ligament Reconstruction (ACLR) performed every year is increasing. The main aim of physiotherapy early recovery rehabilitation after these surgeries is to control pain and edema and regain Range of Motion (ROM) and physical activity. All of these outcomes need to be managed by safe and effective modalities. Kinesiotaping (KT) is an elastic non-invasive therapeutic tape that has become recognised in different physiotherapy situation as injury prevention, rehabilitation, and performance enhancement and been used with different conditions. However, there is still clinical doubt regarding the effectiveness of KT due to inconclusive supporting evidence. The aim of this systematic review is to collate all the available evidence on the effectiveness of KT in the early rehabilitation of ACLR and TKR patients and analyse whether the use of KT combined with standard rehabilitation would facilitate recovery of postoperative outcome than standard rehabilitation alone. Methodology: A systematic review was conducted. Medline, EMBASE, Scopus, AMED PEDro, CINAHL, and Web of Science databases were searched. Each study was assessed for inclusion and methodological quality appraisal was undertaken by two reviewers using the JBI critical appraisal tools. The studies were then synthesised qualitatively due to heterogeneity between studies. Results: Five moderate to low quality RCTs were located. All five studies demonstrated statistically significant improvements in pain, swelling, ROM, and functional outcomes (p < 0.05). Between group comparison, KT combined with standardised rehabilitation were shown to be significantly more effective than standardised rehabilitation alone for pain and swelling (p < 0.05). However, there were inconstant findings for ROM, and no statistically significant differences reported between groups for functional outcomes (p > 0.05). Conclusion: Research in the area is generally low quality; however, there is consistent evidence to support the use of KT combined with standardised post-operative rehabilitation for reducing pain and swelling. There is also some evidence that KT may be effective in combination with standardised rehabilitation to regain knee extension ROM faster than standardised rehabilitation alone, but further primary research is required to confirm this.

Keywords: anterior cruciate ligament reconstruction, ACLR, kinesio taping, KT, postoperative, total knee replacement, TKR

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1330 The Introduction of the Revolution Einstein’s Relative Energy Equations in Even 2n and Odd 3n Light Dimension Energy States Systems

Authors: Jiradeach Kalayaruan, Tosawat Seetawan

Abstract:

This paper studied the energy of the nature systems by looking at the overall image throughout the universe. The energy of the nature systems was developed from the Einstein’s energy equation. The researcher used the new ideas called even 2n and odd 3n light dimension energy states systems, which were developed from Einstein’s relativity energy theory equation. In this study, the major methodology the researchers used was the basic principle ideas or beliefs of some religions such as Buddhism, Christianity, Hinduism, Islam, or Tao in order to get new discoveries. The basic beliefs of each religion - Nivara, God, Ether, Atman, and Tao respectively, were great influential ideas on the researchers to use them greatly in the study to form new ideas from philosophy. Since the philosophy of each religion was alive with deep insight of the physical nature relative energy, it connected the basic beliefs to light dimension energy states systems. Unfortunately, Einstein’s original relative energy equation showed only even 2n light dimension energy states systems (if n = 1,…,∞). But in advance ideas, the researchers multiplied light dimension energy by Einstein’s original relative energy equation and get new idea of theoritical physics in odd 3n light dimension energy states systems (if n = 1,…,∞). Because from basic principle ideas or beliefs of some religions philosophy of each religion, you had to add the media light dimension energy into Einstein’s original relative energy equation. Consequently, the simple meaning picture in deep insight showed that you could touch light dimension energy of Nivara, God, Ether, Atman, and Tao by light dimension energy. Since light dimension energy was transferred by Nivara, God, Ether, Atman and Tao, the researchers got the new equation of odd 3n light dimension energy states systems. Moreover, the researchers expected to be able to solve overview problems of all light dimension energy in all nature relative energy, which are developed from Eistein’s relative energy equation.The finding of the study was called 'super nature relative energy' ( in odd 3n light dimension energy states systems (if n = 1,…,∞)). From the new ideas above you could do the summation of even 2n and odd 3n light dimension energy states systems in all of nature light dimension energy states systems. In the future time, the researchers will expect the new idea to be used in insight theoretical physics, which is very useful to the development of quantum mechanics, all engineering, medical profession, transportation, communication, scientific inventions, and technology, etc.

Keywords: 2n light dimension energy states systems effect, Ether, even 2n light dimension energy states systems, nature relativity, Nivara, odd 3n light dimension energy states systems, perturbation points energy, relax point energy states systems, stress perturbation energy states systems effect, super relative energy

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1329 Effectiveness of Mobile Health Augmented Cardiac Rehabilitation (MCard) on Health-Related Quality of Life among Post-Acute Coronary Syndrome Patients: A Randomized Controlled Trial

Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell

Abstract:

Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.

Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI

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1328 Societal Resilience Assessment in the Context of Critical Infrastructure Protection

Authors: Hannah Rosenqvist, Fanny Guay

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Critical infrastructure protection has been an important topic for several years. Programmes such as the European Programme for Critical Infrastructure Protection (EPCIP), Critical Infrastructure Warning Information Network (CIWIN) and the European Reference Network for Critical Infrastructure Protection (ENR-CIP) have been the pillars to the work done since 2006. However, measuring critical infrastructure resilience has not been an easy task. This has to do with the fact that the concept of resilience has several definitions and is applied in different domains such as engineering and social sciences. Since June 2015, the EU project IMPROVER has been focusing on developing a methodology for implementing a combination of societal, organizational and technological resilience concepts, in the hope to increase critical infrastructure resilience. For this paper, we performed research on how to include societal resilience as a form of measurement of the context of critical infrastructure resilience. Because one of the main purposes of critical infrastructure (CI) is to deliver services to the society, we believe that societal resilience is an important factor that should be considered when assessing the overall CI resilience. We found that existing methods for CI resilience assessment focus mainly on technical aspects and therefore that is was necessary to develop a resilience model that take social factors into account. The model developed within the project IMPROVER aims to include the community’s expectations of infrastructure operators as well as information sharing with the public and planning processes. By considering such aspects, the IMPROVER framework not only helps operators to increase the resilience of their infrastructures on the technical or organizational side, but aims to strengthen community resilience as a whole. This will further be achieved by taking interdependencies between critical infrastructures into consideration. The knowledge gained during this project will enrich current European policies and practices for improved disaster risk management. The framework for societal resilience analysis is based on three dimensions for societal resilience; coping capacity, adaptive capacity and transformative capacity which are capacities that have been recognized throughout a widespread literature review in the field. A set of indicators have been defined that describe a community’s maturity within these resilience dimensions. Further, the indicators are categorized into six community assets that need to be accessible and utilized in such a way that they allow responding to changes and unforeseen circumstances. We conclude that the societal resilience model developed within the project IMPROVER can give a good indication of the level of societal resilience to critical infrastructure operators.

Keywords: community resilience, critical infrastructure protection, critical infrastructure resilience, societal resilience

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1327 Effects of Mindfulness Practice on Clinician Burnout: A Scoping Review

Authors: Hani Malik

Abstract:

Background: Clinician burnout is a growing phenomenon in current health systems worldwide. Increasing emotional exhaustion, depersonalisation, and reduced personal accomplishment threaten the effective delivery of healthcare. This can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in clinicians. Objectives: To conduct a scoping review and identify high-quality studies on mindfulness practice in clinician burnout, synthesize themes that emerge from these studies, and discuss the implications of the results to healthcare leadership and innovation. Methodology: A focused scoping review was carried out to investigate the effects of mindfulness practice on clinician burnout. High-ranking journals were targeted to analyse high-quality studies and synthesize common themes in the literature. Studies conducted on current, practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Grey literature and studies conducted only on allied health personnel were excluded from this review. Analysis:31 studies were included in this scoping review. Mindfulness practice was found to decrease emotional exhaustion and depersonalisation while improving mood, responses to stress, and vigour. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged which include: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to clinician mindfulness practice. Conclusion: Mindfulness had widely been reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate clinician leader will play a crucial role in addressing gaps in current practice, prioritise staff mental health, and provide a supportive platform for innovation.

Keywords: mindfulness practice, clinician burnout, healthcare leadership, COVID-19

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1326 Thermal Perception by Older People in Open Spaces in Madrid: Relationships between Weather Parameters and Personal Characteristics

Authors: María Teresa Baquero, Ester Higueras

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One of the challenges facing 21st century cities, is their adaptation to the phenomenon of an ageing population. International policies have been developed, such as the "Global Network for Age-friendly Cities and Communities". These cities must recognize the diversity of the elderly population, and facilitate an active, healthy, satisfied aging and promote inclusion. In order to promote active and healthy aging, older people should be encouraged to engage in physical activity, sunbathe, socialize and enjoy the public open spaces in the city. Some studies recognize thermal comfort as one of the factors that most influence the use of public open spaces. However, although some studies have shown vulnerability to thermal extremes and environmental conditions in older people, there is little research on thermal comfort for older adults, because it is usually analyzed based on the characteristics of the ¨average young person¨ without considering the physiological, physical and psychological differences that characterize the elderly. This study analyzes the relationship between the microclimate parameters as air temperature, relative humidity, wind speed and sky view factor (SVF) with the personal thermal perception of older adults in three public spaces in Madrid, through a mixed methodology that combines weather measurements with interviews, made during the year 2018. Statistical test like Chi-square, Spearman, and analysis of variance were used to analyze the relationship between preference votes and thermal sensation votes with environmental and personal parameters. The results show that there is a significant correlation between thermal sensation and thermal preference with the measured air temperature, age, level of clothing, the color of clothing, season, time of the day and kind of space while no influence of gender or other environmental variables was detected. These data would contribute to the design of comfortable public spaces that improve the welfare of the elderly contributing to "active and healthy aging" as one of the 21st century challenges cities face.

Keywords: healthy ageing, older adults, outdoor public space, thermal perception

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1325 Investigation on Development of Pv and Wind Power with Hydro Pumped Storage to Increase Renewable Energy Penetration: A Parallel Analysis of Taiwan and Greece

Authors: Robel Habtemariam

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Globally, wind energy and photovoltaics (PV) solar energy are among the leading renewable energy sources (RES) in terms of installed capacity. In order to increase the contribution of RES to the power supply system, large scale energy integration is required, mainly due to wind energy and PV. In this paper, an investigation has been made on the electrical power supply systems of Taiwan and Greece in order to integrate high level of wind and photovoltaic (PV) to increase the penetration of renewable energy resources. Currently, both countries heavily depend on fossil fuels to meet the demand and to generate adequate electricity. Therefore, this study is carried out to look into the two cases power supply system by developing a methodology that includes major power units. To address the analysis, an approach for simulation of power systems is formulated and applied. The simulation is based on the non-dynamic analysis of the electrical system. This simulation results in calculating the energy contribution of different types of power units; namely the wind, PV, non-flexible and flexible power units. The calculation is done for three different scenarios (2020, 2030, & 2050), where the first two scenarios are based on national targets and scenario 2050 is a reflection of ambitious global targets. By 2030 in Taiwan, the input of the power units is evaluated as 4.3% (wind), 3.7% (PV), 65.2 (non-flexible), 25.3% (flexible), and 1.5% belongs to hydropower plants. In Greece, much higher renewable energy contribution is observed for the same scenario with 21.7% (wind), 14.3% (PV), 38.7% (non-flexible), 14.9% (flexible), and 10.3% (hydro). Moreover, it examines the ability of the power systems to deal with the variable nature of the wind and PV generation. For this reason, an investigation has also been done on the use of the combined wind power with pumped storage systems (WPS) to enable the system to exploit the curtailed wind energy & surplus PV and thus increase the wind and PV installed capacity and replace the peak supply by conventional power units. Results show that the feasibility of pumped storage can be justified in the high scenario (that is the scenario of 2050) of RES integration especially in the case of Greece.

Keywords: large scale energy integration, photovoltaics solar energy, pumped storage systems, renewable energy sources

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1324 Brazilian Public Security: Governability and Constitutional Change

Authors: Gabriel Dolabella, Henrique Rangel, Stella Araújo, Carlos Bolonha, Igor de Lazari

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Public security is a common subject on the Brazilian political agenda. The seventh largest economy in the world has high crime and insecurity rates. Specialists try to explain this social picture based on poverty, inequality or public policies addressed to drug trafficking. This excerpt approaches State measures to handle that picture. Therefore, the public security - law enforcement institutions - is at the core of this paper, particularly the relationship among federal and state law enforcement agencies, mainly ruled by a system of urgency. The problems are informal changes on law enforcement management and public opinion collaboration to these changes. Whenever there were huge international events, Brazilian armed forces occupied streets to assure law enforcement - ensuring the order. This logic, considered in the long time, could impact the federal structure of the country. The post-madisonian theorists verify that urgency is often associated to delegation of powers, which is true for Brazilian law enforcement, but here there is a different delegation: States continuously delegate law enforcement powers to the federal government throughout the use of Armed Forces. Therefore, the hypothesis is: Brazil is under a political process of federalization of public security. The political framework addressed here can be explained by the disrespect of legal constraints and the failure of rule of law theoretical models. The methodology of analysis is based on general criteria. Temporally, this study investigates events from 2003, when discussions about the disarmament statute begun. Geographically, this study is limited to Brazilian borders. Materially, the analysis result from the observation of legal resources and political resources (pronouncements of government officials). The main parameters are based on post-madisonianism and federalization of public security can be assessed through credibility and popularity that allow evaluation of this political process of constitutional change. The objective is to demonstrate how the Military Forces are used in public security, not as a random fact or an isolated political event, in order to understand the political motivations and effects that stem from that use from an institutional perspective.

Keywords: public security, governability, rule of law, federalism

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1323 Little Girls and Big Stories: A Thematic Analysis of Gender Representations in Selected Asian Room to Read Storybooks

Authors: Cheeno Marlo Sayuno

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Room to Read is an international nonprofit organization aimed at empowering young readers through literature and literacy education. In particular, the organization is focused on girls’ education in schools and bettering their social status through crafting stories and making sure that these stories are accessible to them. In 2019, Room to Read visited the Philippines and partnered with Philippine children’s literature publishers Adarna House, Lampara Books, Anvil Publishing, and OMF-Hiyas with the goal of producing contextualized stories that Filipino children can read. The result is a set of 20 storybooks developed by Filipino writers and illustrators, the author of this paper included. The project led to narratives of experiences in storybook production from conceptualization to publication, towards translations and reimagining in online repository, storytelling, and audiobook formats. During the production process, we were particularly reminded of gender representations, child’s rights, and telling stories that can empower the children in vulnerable communities, who are the beneficiaries of the project. The storybooks, along with many others produced in Asia and the world, are available online through the literacycloud.org website of Room to Read. In this study, the goal is to survey the stories produced in Asia and look at how gender is represented in the storybooks. By analyzing both the texts and the illustrations of the storybooks produced across Asian countries, themes of portrayals of young boys and girls, their characteristics and narratives, and how they are empowered in the stories are identified, with the goal of mapping how Room to Read is able to address the problem of access to literacy among young girls and ensuring them that they can do anything, the way they are portrayed in the stories. The paper hopes to determine how gender is represented in Asian storybooks produced by the international nonprofit organization Room to Read. Thematic textual analysis was used as methodology, where the storybooks are analyzed qualitatively to identify arising themes of gender representation. This study will shed light on the importance of responsible portrayal of gender in storybooks and how it can impact and empower children. The results of the study can also aid writers and illustrators in developing gender-sensitive storybooks.

Keywords: room to read, asian storybooks, young girls, thematic analysis, child empowerment, literacy, education

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1322 One or More Building Information Modeling Managers in France: The Confusion of the Kind

Authors: S. Blanchard, D. Beladjine, K. Beddiar

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Since 2015, the arrival of BIM in the building sector in France has turned the corporation world upside down. Not only constructive practices have been impacted, but also the uses and the men who have undergone important changes. Thus, the new collaborative mode generated by the BIM and the digital model has challenged the supremacy of some construction actors because the process involves working together taking into account the needs of other contributors. New BIM tools have emerged and actors in the act of building must take ownership of them. It is in this context that under the impetus of a European directive and the French government's encouragement of new missions and job profiles have. Moreover, concurrent engineering requires that each actor can advance at the same time as the others, at the whim of the information that reaches him, and the information he has to transmit. However, in the French legal system around public procurement, things are not planned in this direction. Also, a consequent evolution must take place to adapt to the methodology. The new missions generated by the BIM in France require a good mastery of the tools and the process. Also, to meet the objectives of the BIM approach, it is possible to define a typical job profile around the BIM, adapted to the various sectors concerned. The multitude of job offers using the same terms with very different objectives and the complexity of the proposed missions motivated by our approach. In order to reinforce exchanges with professionals or specialists, we carried out a statistical study to answer this problem. Five topics are discussed around the business area: the BIM in the company, the function (business), software used and BIM missions practiced (39 items). About 1400 professionals were interviewed. These people work in companies (micro businesses, SMEs, and Groups) of construction, engineering offices or, architectural agencies. 77% of respondents have the status of employees. All participants are graduated in their trade, the majority having level 1. Most people have less than a year of experience in BIM, but some have 10 years. The results of our survey help to understand why it is not possible to define a single type of BIM Manager. Indeed, the specificities of the companies are so numerous and complex and the missions so varied, that there is not a single model for a function. On the other hand, it was possible to define 3 main professions around the BIM (Manager, Coordinator and Modeler) and 3 main missions for the BIM Manager (deployment of the method, assistance to project management and management of a project).

Keywords: BIM manager, BIM modeler, BIM coordinator, project management

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1321 The Saying of Conceptual Metaphors about Law, Righteousness, and Justice in the Old Testament: Cardinal Tendencies

Authors: Ivana Prochazkova

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Cognitive linguistics offers biblical scholarship a specific methodological tool for analysis and interpretation of metaphorical expressions. Its methodology makes it possible to study processes involved in constructing the meaning of individual metaphorical expressions and whole conceptual metaphors; to analyze their function in the text; to follow the semantic development of concepts and conceptual domains, and to trace semantic changes and their motivation. The legal language in the Hebrew canon is extremely specific and formalized. Especially in the preambles to the collections of laws in the Pentateuch, more general considerations of the motif of keeping and breaking the law are encountered. This is also true in the psalms and wisdom literature. Legal theory and the philosophy of law deal with these motifs today. Metaphors play an important role in texts that reflect on more general issues. The purpose of this conference contribution is to write all over the central metaphorical concept, conceptual metaphor ךרד תורה (TORAH/LAW IS A JOURNEY), its function in the Torah and principal trends of the further development in the Prophets and the Writings. The conceptual metaphor תורה ךרד (TORAH/LAW IS A JOURNEY) constitutes a coherent system in conjunction with other metaphors that include e.g., conceptual metaphors נחה תורה (TORAH/LAW LEADS); its variant רעה תורה (TORAH IS A SHEPHERD/GUIDE); מקור תורה (TORAH/LAW IS A FOUNTAIN/A SOURCE OF LIFE). Some conceptual metaphors are well known, and their using are conventional (עשׁר תורה TORAH/LAW IS RICHES, שׂשׂון תורה TORAH/LAW IS DELIGHT, דבשׁ תורה TORAH/LAW IS HONEY, שׁמשׁ תורה TORAH/LAW IS SUN ). But some conceptual metaphors are by its occurrence innovative and unique (e.g., שׁריון תורה TORAH /LAW IS BODY ARMOR, כובע תורה TORAH /LAW IS A HELMET, בגד תורה TORAH/LAW IS A GARMENT, etc.). There will be given examples. Conceptual metaphors will be described by means of some 'metaphorical vehicles,' which are Hebrew expressions in the source domain that are repeatedly used in metaphorical conceptualizations of the target domain(s). Conceptual metaphors will be further described by means of 'generic narrative structures,' which are the particular aspects of a conceptual metaphor that emerge during the metaphorical structuring of concepts. They are the units of the metaphorical vehicles – the Hebrew expressions in the source domain – that structure concepts in much the same way that the conceptual metaphor in the target domain does. And finally, they will be described by means of the network of correspondences that exist between metaphorical vehicles – or generic metaphorical structures – and the Hebrew expressions in the target domain.

Keywords: cognitive theology, conceptual metaphor in the Old Testament, conceptual metaphors of the Torah, conceptual domain of law, righteousness, and justice

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1320 The Sustainable Development for Coastal Tourist Building

Authors: D. Avila

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The tourism industry is a phenomenon that has become a growing presence in international socio-economic dynamics, which in most cases exceeds the control parameters in the various environmental regulations and sustainability of existing resources. Because of this, the effects on the natural environment at the regional and national levels represent a challenge, for which a number of strategies are necessary to minimize the environmental impact generated by the occupation of the territory. The hotel tourist building and sustainable development in the coastal zone, have an important impact on the environment and on the physical and psychological health of the inhabitants. Environmental quality associated with the comfort of humans to the sustainable development of natural resources; applied to the hotel architecture this concept involves the incorporation of new demands on all of the constructive process of a building, changing customs of developers and users. The methodology developed provides an initial analysis to determine and rank the different tourist buildings, with the above it will be feasible to establish methods of study and environmental impact assessment. Finally, it is necessary to establish an overview regarding the best way to implement tourism development on the coast, containing guidelines to improve and protect the natural environment. This paper analyzes the parameters and strategies to reduce environmental impacts derived from deployments tourism on the coast, through a series of recommendations towards sustainability, in the context of the Bahia de Banderas, Puerto Vallarta, Jalisco. The environmental impact caused by the implementation of tourism development, perceived in a coastal environment, forcing a series of processes, ranging from the identification of impacts, prediction and evaluation of them. For this purpose are described below, different techniques and valuation procedures: Identification of impacts. Methods for the identification of damage caused to the environment pursue general purpose to obtain a group of negative indicators that are subsequently used in the study of environmental impact. There are several systematic methods to identify the impacts caused by human activities. In the present work, develops a procedure based and adapted from the Ministry of works public urban reference in studies of environmental impacts, the representative methods are: list of contrast, arrays, and networks, method of transparencies and superposition of maps.

Keywords: environmental impact, physical health, sustainability, tourist building

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1319 Change through Stillness: Mindfulness Meditation as an Intervention for Men with Self-Perceived Problematic Pornography Use

Authors: Luke Sniewski, Pante Farvid, Phil Carter, Rita Csako

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Background and Aims: Self-Perceived Problematic Porn Use (SPPPU) refers to individuals who identify as or perceive themselves to be addicted to porn. These individuals feel they are unable to regulate their porn consumption and experience adverse consequences as a result of their use in everyday life. To the author’s best knowledge, this research represents the first study to intervene with pornography use with mindfulness meditation, and aims to investigate the experiences and challenges of men with SPPPU as they engage in a mindfulness meditation intervention. As meditation is commonly characterized by sitting and observing one’s internal experience with non-reaction and acceptance, the study’s principal hypothesis was that consistent practice of meditation would develop the participant’s capacity to respond to cravings, urges, and unwanted thoughts in less reactive, more productive ways. Method: This 12-mixed method research utilised Single Case Experimental Design (SCED) methodology, with a standard AB design. Each participant was randomly assigned to an initial baseline time period between 2 to 5 weeks before learning the meditation technique and practicing it for the remainder of the 12-week study. The pilot study included 3 participants, while the intervention study included 12. The meditation technique used for the study involved a 15-minute guided breathing exercise in the morning, along with a 15-minute guided concentration meditation in the evening. Results: At the time of submission, only pilot study results were available. Results from the pilot study indicate an improved capacity for self-awareness of the uncomfortable mental and emotional states that drove their participants’ pornography use. Statistically significant reductions were also observed in daily porn use, total weekly time spent viewing porn, as well as lowered Pornography Craving Questionnaire (PCQ) and Problematic Pornography Use Scale (PPUS) scores. Conclusion: Pilot study results suggest that meditation could serve as a complementary tool for health professionals to provide clients in conjunction with therapeutic interventions. Study limitations, directions for future research, and clinical implications to be discussed as well.

Keywords: meditation, behavioural change, pornography, mindfulness

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1318 Identifying the Effects of the COVID-19 Pandemic on Syrian and Congolese Refugees’ Health and Economic Access in Central Pennsylvania

Authors: Mariam Shalaby, Kayla Krause, Raisha Ismail, Daniel George

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Introduction: The Pennsylvania State College of Medicine Refugee Initiative is a student-run organization that works with eleven Syrian and Congolese refugee families. Since 2016, it has used grant funding to make weekly produce purchases at a local market, provide tutoring services, and develop trusting relationships. This case study explains how the Refugee Initiative shifted focus to face new challenges due to the COVID-19 pandemic in 2020. Methodology: When refugees who had previously attained stability found themselves unable to pay the bills, the organization shifted focus from food security to direct assistance such as applying for unemployment compensation since many had recently lost jobs. When refugee families additionally struggled to access hygiene supplies, funding was redirected to purchase them. Funds were also raised from the community to provide financial relief from unpaid rent and bills. Findings: Systemic challenges were encountered in navigating federal/state unemployment and social welfare systems, and there was a conspicuous absence of affordable, language-accessible assistance that could help refugees. Finally, as struggling public schools failed to maintain adequate English as a Second Language (ESL) education, the group’s tutoring services were hindered by social distancing and inconsistent access to distance-learning platforms. Conclusion: Ultimately, the pandemic highlighted that a charity-based arrangement is helpful but not sustainable, and challenges persist for refugee families. Based on the Refugee Initiative's experiences over the past year of the COVID-19 pandemic, several needs must be addressed to aid refugee families at this time, including: increased access to affordable and language-accessible social services, educational resources, and simpler options for grant-based financial assistance. Interventions to increase these resources will aid refugee families in need in Central Pennsylvania and internationally

Keywords: COVID-19, health, pandemic, refugees

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1317 Evidence of the Effect of the Structure of Social Representations on Group Identification

Authors: Eric Bonetto, Anthony Piermatteo, Fabien Girandola, Gregory Lo Monaco

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The present contribution focuses on the effect of the structure of social representations on group identification. A social representation (SR) is defined as an organized and structured set of cognitions, produced and shared by members of a same group about a same social object. Within this framework, the central core theory establishes a structural distinction between central cognitions – or 'core' – and peripheral ones: the former are theoretically considered as more connected than the later to group members’ social identity and may play a greater role in SRs’ ability to allow group identification by means of a common vision of the object of representation. Indeed, the central core provides a reference point for the in-group as it constitutes a consensual vision that gives meaning to a social object particularly important to individuals and to the group. However, while numerous contributions clearly refer to the underlying role of SRs in group identification, there are only few empirical evidences of this aspect. Thus, we hypothesize an effect of the structure of SRs on group identification. More precisely, central cognitions (vs. peripheral ones) will lead to a stronger group identification. In addition, we hypothesize that the refutation of a cognition will lead to a stronger group identification than its activation. The SR mobilized here is that of 'studying' among a population of first-year undergraduate psychology students. Thus, a pretest (N = 82), using an Attribute-Challenge Technique, was designed in order to identify the central and the peripheral cognitions to use in the primings of our main study. The results of this pretest are in line with previous studies. Then, the main study (online; N = 184), using a social priming methodology, was based on a 2 (Structural status of the cognitions belonging to the prime: central vs. peripheral) x 2 (Type of prime: activation vs. refutation) experimental design in order to test our hypotheses. Results revealed, as expected, the main effect of the structure of the SR on group identification. Indeed, central cognitions trigger a higher level of identification than the peripheral ones. However, we observe neither effect of the type of prime, nor interaction effect. These results experimentally demonstrate for the first time the effect of the structure of SRs on group identification and indicate that central cognitions are more connected than peripheral ones to group members’ social identity. These results will be discussed considering the importance of understanding identity as a function of SRs and on their ability to potentially solve the lack of consideration of the definition of the group in Social Representations Theory.

Keywords: group identification, social identity, social representations, structural approach

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1316 A Statistical-Algorithmic Approach for the Design and Evaluation of a Fresnel Solar Concentrator-Receiver System

Authors: Hassan Qandil

Abstract:

Using a statistical algorithm incorporated in MATLAB, four types of non-imaging Fresnel lenses are designed; spot-flat, linear-flat, dome-shaped and semi-cylindrical-shaped. The optimization employs a statistical ray-tracing methodology of the incident light, mainly considering effects of chromatic aberration, varying focal lengths, solar inclination and azimuth angles, lens and receiver apertures, and the optimum number of prism grooves. While adopting an equal-groove-width assumption of the Poly-methyl-methacrylate (PMMA) prisms, the main target is to maximize the ray intensity on the receiver’s aperture and therefore achieving higher values of heat flux. The algorithm outputs prism angles and 2D sketches. 3D drawings are then generated via AutoCAD and linked to COMSOL Multiphysics software to simulate the lenses under solar ray conditions, which provides optical and thermal analysis at both the lens’ and the receiver’s apertures while setting conditions as per the Dallas-TX weather data. Once the lenses’ characterization is finalized, receivers are designed based on its optimized aperture size. Several cavity shapes; including triangular, arc-shaped and trapezoidal, are tested while coupled with a variety of receiver materials, working fluids, heat transfer mechanisms, and enclosure designs. A vacuum-reflective enclosure is also simulated for an enhanced thermal absorption efficiency. Each receiver type is simulated via COMSOL while coupled with the optimized lens. A lab-scale prototype for the optimum lens-receiver configuration is then fabricated for experimental evaluation. Application-based testing is also performed for the selected configuration, including that of a photovoltaic-thermal cogeneration system and solar furnace system. Finally, some future research work is pointed out, including the coupling of the collector-receiver system with an end-user power generator, and the use of a multi-layered genetic algorithm for comparative studies.

Keywords: COMSOL, concentrator, energy, fresnel, optics, renewable, solar

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1315 Structure-Guided Optimization of Sulphonamide as Gamma–Secretase Inhibitors for the Treatment of Alzheimer’s Disease

Authors: Vaishali Patil, Neeraj Masand

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In older people, Alzheimer’s disease (AD) is turning out to be a lethal disease. According to the amyloid hypothesis, aggregation of the amyloid β–protein (Aβ), particularly its 42-residue variant (Aβ42), plays direct role in the pathogenesis of AD. Aβ is generated through sequential cleavage of amyloid precursor protein (APP) by β–secretase (BACE) and γ–secretase (GS). Thus in the treatment of AD, γ-secretase modulators (GSMs) are potential disease-modifying as they selectively lower pathogenic Aβ42 levels by shifting the enzyme cleavage sites without inhibiting γ–secretase activity. This possibly avoids known adverse effects observed with complete inhibition of the enzyme complex. Virtual screening, via drug-like ADMET filter, QSAR and molecular docking analyses, has been utilized to identify novel γ–secretase modulators with sulphonamide nucleus. Based on QSAR analyses and docking score, some novel analogs have been synthesized. The results obtained by in silico studies have been validated by performing in vivo analysis. In the first step, behavioral assessment has been carried out using Scopolamine induced amnesia methodology. Later the same series has been evaluated for neuroprotective potential against the oxidative stress induced by Scopolamine. Biochemical estimation was performed to evaluate the changes in biochemical markers of Alzheimer’s disease such as lipid peroxidation (LPO), Glutathione reductase (GSH), and Catalase. The Scopolamine induced amnesia model has shown increased Acetylcholinesterase (AChE) levels and the inhibitory effect of test compounds in the brain AChE levels have been evaluated. In all the studies Donapezil (Dose: 50µg/kg) has been used as reference drug. The reduced AChE activity is shown by compounds 3f, 3c, and 3e. In the later stage, the most potent compounds have been evaluated for Aβ42 inhibitory profile. It can be hypothesized that this series of alkyl-aryl sulphonamides exhibit anti-AD activity by inhibition of Acetylcholinesterase (AChE) enzyme as well as inhibition of plaque formation on prolong dosage along with neuroprotection from oxidative stress.

Keywords: gamma-secretase inhibitors, Alzzheimer's disease, sulphonamides, QSAR

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1314 Estimating Algae Concentration Based on Deep Learning from Satellite Observation in Korea

Authors: Heewon Jeong, Seongpyo Kim, Joon Ha Kim

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Over the last few tens of years, the coastal regions of Korea have experienced red tide algal blooms, which are harmful and toxic to both humans and marine organisms due to their potential threat. It was accelerated owing to eutrophication by human activities, certain oceanic processes, and climate change. Previous studies have tried to monitoring and predicting the algae concentration of the ocean with the bio-optical algorithms applied to color images of the satellite. However, the accurate estimation of algal blooms remains problems to challenges because of the complexity of coastal waters. Therefore, this study suggests a new method to identify the concentration of red tide algal bloom from images of geostationary ocean color imager (GOCI) which are representing the water environment of the sea in Korea. The method employed GOCI images, which took the water leaving radiances centered at 443nm, 490nm and 660nm respectively, as well as observed weather data (i.e., humidity, temperature and atmospheric pressure) for the database to apply optical characteristics of algae and train deep learning algorithm. Convolution neural network (CNN) was used to extract the significant features from the images. And then artificial neural network (ANN) was used to estimate the concentration of algae from the extracted features. For training of the deep learning model, backpropagation learning strategy is developed. The established methods were tested and compared with the performances of GOCI data processing system (GDPS), which is based on standard image processing algorithms and optical algorithms. The model had better performance to estimate algae concentration than the GDPS which is impossible to estimate greater than 5mg/m³. Thus, deep learning model trained successfully to assess algae concentration in spite of the complexity of water environment. Furthermore, the results of this system and methodology can be used to improve the performances of remote sensing. Acknowledgement: This work was supported by the 'Climate Technology Development and Application' research project (#K07731) through a grant provided by GIST in 2017.

Keywords: deep learning, algae concentration, remote sensing, satellite

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1313 A Combination of Mesenchymal Stem Cells and Low-Intensity Ultrasound for Knee Meniscus Regeneration: A Preliminary Study

Authors: Mohammad Nasb, Muhammad Rehan, Chen Hong

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Background Meniscus defects critically alter knee function and lead to degenerative changes. Regenerative medicine applications including stem cell transplantation have showed a promising efficacy in finding alternatives to overcome traditional treatment limitations. However, stem cell therapy remains limited due to the substantially reduced viability and inhibitory microenvironment. Since tissue growth and repair are under the control of biochemical and mechanical signals, several approaches have recently been investigated (e.g., low intensity pulsed ultrasound [LIPUS]) to promote the regeneration process. This study employed LIPUS to improve growth and osteogenic differentiation of mesenchymal stem cells derived from human embryonic stem cells to improve the regeneration of meniscus tissue. Methodology: The Mesenchymal stromal cells (MSCs) were transplanted into the epicenter of the injured meniscus in rabbits, which were randomized into two main groups: a treatment group (n=32 New Zealand rabbits) including 4 subgroups of 8 rabbits in each subgroup (LIPUS treatment, MSC treatment, LIPUS with MSC and control), and a second group (n=9) to track implanted cells and their progeny using green fluorescence protein (GFP). GFP consists of the MSC and LIPUS-MSC combination subgroups. Rabbits were then subjected to histological, immunohistochemistry, and MRI assessment. Results: The quantity of the newly regenerated tissue in the combination treatment group that had Ultrasound irradiation after mesenchymal stem cells were better at all end points. Likewise, Tissue quality scores were also greater in knees treated with both approaches compared with controls and single treatment at all end points, achieving significance at twelve and twenty-four weeks [p < 0.05], and [p = 0.008] at twelve weeks. Differentiation into type-I and II collagen-expressing cells were higher in the combination group at up to twenty-four weeks. Conclusions: the combination of mesenchymal stem cells and LIPUS showed greater adhering to the sites of meniscus injury, differentiate into cells resembling meniscal fibrochondrocytes, and improve both quality and quantity of meniscal regeneration.

Keywords: stem cells, regenerative medicine, osteoarthritis, knee

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1312 Study on the Relative Factors of Introducing Table Vinegar in Reducing Urinary Tract Infection in Patients with Long-Term Indwelling Catheter

Authors: Yu-Ju Hsieh, Lin-Hung Lin, Wen-Hui Chang

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This study was designed as an interventional research and intended to validate whether the introduction of drinking vinegar every day can reduce and even prevent urinary tract infection in Taiwan home stayed disabilities who using indwelling catheter. The data was collected from the subjects who have received home care case at northern Taiwan, according to the questionnaire and a medical records retroactive methodology, the subjects were informed and consent to drink 15ml of table vinegar in a daily diet, and through routine urine testing and culture study. Home care nurses would assist collecting urine at the point of before and after a meal from total 35 studied subjects per month, and total collected 4 times for testing. The results showed that when the average age of study subjects was 65.46 years and catheter indwelling time was 15 years, drinking table vinegar could inhibit the activity of E. coli O157: H7 and reduce its breeding. Before drinking table vinegar daily, the subjects’ urine pH value was 7.0-8.0, and the average was 7.5, and the urine PH value dropped to 6.5 after drinking table vinegar for a month. There were two purple urine cases whose urine were changed from purple to normal color after two weeks of drinking, and the protein and bacteria values of urine gradually improved. Urine smell unpleasant before attending to this study, and the symptom improved significantly only after 1 week, and the urine smell returned to normal ammonia and became clean after 1 month later. None of these subjects received treatment in a hospital due to urinary tract infection, and there were no signs of bleeding in all cases during this study. The subjects of this study are chronic patients with a long-term bedridden catheterization; drinking cranberry juice is an economic burden for them, and also highly prohibited for diabetes patients. By adapting to use cheaper table vinegar to acidified urine and improve its smell and ease Purple Urine Syndrome, to furthermore, proven urinary tract infection, it can also to reduce the financial burden on families, the cost of social resources and the rate of re-admission.

Keywords: table vinegar, urinary tract infection, disability patients, long-term indwelling catheter

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1311 Predicting Mass-School-Shootings: Relevance of the FBI’s ‘Threat Assessment Perspective’ Two Decades Later

Authors: Frazer G. Thompson

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The 1990s in America ended with a mass-school-shooting (at least four killed by gunfire excluding the perpetrator(s)) at Columbine High School in Littleton, Colorado. Post-event, many demanded that government and civilian experts develop a ‘profile’ of the potential school shooter in order to identify and preempt likely future acts of violence. This grounded theory research study seeks to explore the validity of the original hypotheses proposed by the Federal Bureau of Investigation (FBI) in 2000, as it relates to the commonality of disclosure by perpetrators of mass-school-shootings, by evaluating fourteen mass-school-shooting events between 2000 and 2019 at locations around the United States. Methods: The strategy of inquiry seeks to investigate case files, public records, witness accounts, and available psychological profiles of the shooter. The research methodology is inclusive of one-on-one interviews with members of the FBI’s Critical Incident Response Group seeking perspective on commonalities between individuals; specifically, disclosure of intent pre-event. Results: The research determined that school shooters do not ‘unfailingly’ notify others of their plans. However, in nine of the fourteen mass-school-shooting events analyzed, the perpetrator did inform the third party of their intent pre-event in some form of written, oral, or electronic communication. In the remaining five instances, the so-called ‘red-flag’ indicators of the potential for an event to occur were profound, and unto themselves, might be interpreted as notification to others of an imminent deadly threat. Conclusion: Data indicates that conclusions drawn in the FBI’s threat assessment perspective published in 2000 are relevant and current. There is evidence that despite potential ‘red-flag’ indicators which may or may not include a variety of other characteristics, perpetrators of mass-school-shooting events are likely to share their intentions with others through some form of direct or indirect communication. More significantly, implications of this research might suggest that society is often informed of potential danger pre-event but lacks any equitable means by which to disseminate, prevent, intervene, or otherwise act in a meaningful way considering said revelation.

Keywords: columbine, FBI profiling, guns, mass shooting, mental health, school violence

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1310 Managing Maritime Security in the Mediterranean Sea: The Roles of the EU in Tackling Irregular Migration

Authors: Shazwanis Shukri

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The Mediterranean Sea, at the crossroads of three continents has always been the focus of pan-European and worldwide attention. Over the past decade, the Mediterranean Sea has become a hotbed for irregular migration particularly from the African continent toward the Europe. Among the major transit routes in the Mediterranean Sea include the Strait of Gibraltar, Canary Island and island of Lampedusa. In recent years, Mediterranean Sea has witnessed significant numbers of accidents and shipwrecks involving the irregular migrants and refugees trying to reach Europe via the sea. The shipwrecks and traffickers exploitation of migrants draw most of the attention particularly for the European Union (EU). This incident has been a wakeup call for the EU and become the top political agenda in the EU policy to tackle irregular migration and human smuggling at sea. EU has repeatedly addressed irregular migration as one of the threats the EU and its citizens may be confronted with and therefore immediate measures are crucial to tackle the crisis. In light of this, various initiatives have been adopted by the EU to strengthen external border control and restrict access to irregular migrants, notably through the enforcement of Frontex and Eunavfor Med. This paper analyses current development of counter-migration operations by the EU in response to migration crisis in the Mediterranean Sea. The analysis is threefold. First, this study examines the patterns and trends of irregular migration’s movements from recent perspective. Second, this study concentrates on the evolution of the EU operations that are in place in the Mediterranean Sea, notably by Frontex and Eunavfor Med to curb the influx of irregular migrants to the European countries, including, among others, Greece and Italy. Third, this study investigates the EU approaches to fight against the proliferation of human trafficking networks at sea. This study is essential to determine the roles of the EU in tackling migration crisis and human trafficking in the Mediterranean Sea and the effectiveness of their counter-migration operations to reduce the number of irregular migrants travelling via the sea. Elite interviews and document analysis were used as a methodology in this study. The study discovers that the EU operations have successfully contributed to reduce the numbers of irregular migrant’s arrival to Europe. The study also shows that the operations were effective to disrupt smugglers business models particularly from Libya. This study provides essential understanding about the roles of the EU not limited to tackle the migration crisis and disrupt trafficking networks, but also pledged to prevent further loss of lives at sea.

Keywords: European union, frontex, irregular migration, Mediterranean sea

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1309 Anomalies of Visual Perceptual Skills Amongst School Children in Foundation Phase in Olievenhoutbosch, Gauteng Province, South Africa

Authors: Maria Bonolo Mathevula

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Background: Children are important members of communities playing major role in the future of any given country (Pera, Fails, Gelsomini, &Garzotto, 2018). Visual Perceptual Skills (VPSs) in children are important health aspect of early childhood development through the Foundation Phases in school. Subsequently, children should undergo visual screening before commencement of schooling for early diagnosis ofVPSs anomalies because the primary role of VPSs is to capacitate children with academic performance in general. Aim : The aim of this study was to determine the anomalies of visual VPSs amongst school children in Foundation Phase. The study’s objectives were to determine the prevalence of VPSs anomalies amongst school children in Foundation Phase; Determine the relationship between children’s academic and VPSs anomalies; and to investigate the relationship between VPSs anomalies and refractive error. Methodology: This study was a mixed method whereby triangulated qualitative (interviews) and quantitative (questionnaire and clinical data) was used. This was, therefore, descriptive by nature. The study’s target population was school children in Foundation Phase. The study followed purposive sampling method. School children in Foundation Phase were purposively sampled to form part of this study provided their parents have given a signed the consent. Data was collected by the use of standardized interviews; questionnaire; clinical data card, and TVPS standard data card. Results: Although the study is still ongoing, the preliminary study outcome based on data collected from one of the Foundation Phases have suggested the following:While VPSs anomalies is not prevalent, it, however, have indirect relationship with children’s academic performance in Foundation phase; Notably, VPSs anomalies and refractive error are directly related since majority of children with refractive error, specifically compound hyperopic astigmatism, failed most subtests of TVPS standard tests. Conclusion: Based on the study’s preliminary findings, it was clear that optometrists still have a lot to do in as far as researching on VPSs is concerned. Furthermore, the researcher recommends that optometrist, as the primary healthcare professionals, should also conduct the school-readiness pre-assessment on children before commencement of their grades in Foundation phase.

Keywords: foundation phase, visual perceptual skills, school children, refractive error

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1308 Apollo Quality Program: The Essential Framework for Implementing Patient Safety

Authors: Anupam Sibal

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Apollo Quality Program(AQP) was launched across the Apollo Group of Hospitals to address the four patient safety areas; Safety during Clinical Handovers, Medication Safety, Surgical Safety and the six International Patient Safety Goals(IPSGs) of JCI. A measurable, online, quality dashboard covering 20 process and outcome parameters was devised for monthly monitoring. The expected outcomes were also defined and categorized into green, yellow and red ranges. An audit methodology was also devised to check the processes for the measurable dashboard. Documented clinical handovers were introduced for the first time at many locations for in-house patient transfer, nursing-handover, and physician-handover. Prototype forms using the SBAR format were made. Patient-identifiers, read-back for verbal orders, safety of high-alert medications, site marking and time-outs and falls risk-assessment were introduced for all hospitals irrespective of accreditation status. Measurement of Surgical-Site-Infection (SSI) for 30 days postoperatively, was done. All hospitals now tracked the time of administration of antimicrobial prophylaxis before surgery. Situations with high risk of retention of foreign body were delineated and precautionary measures instituted. Audit of medications prescribed in the discharge summaries was made uniform. Formularies, prescription-audits and other means for reduction of medication errors were implemented. There is a marked increase in the compliance to processes and patient safety outcomes. Compliance to read-back for verbal orders rose from 86.83% in April’11 to 96.95% in June’15, to policy for high alert medications from 87.83% to 98.82%, to use of measures to prevent wrong-site, wrong-patient, wrong procedure surgery from 85.75% to 97.66%, to hand-washing from 69.18% to 92.54%, to antimicrobial prophylaxis within one hour before incision from 79.43% to 93.46%. Percentage of patients excluded from SSI calculation due to lack of follow-up for the requisite time frame decreased from 21.25% to 10.25%. The average AQP scores for all Apollo Hospitals improved from 62 in April’11 to 87.7 in Jun’15.

Keywords: clinical handovers, international patient safety goals, medication safety, surgical safety

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1307 Oestrogen Replacement In Post-Oophorectomy Women

Authors: Joana Gato, Ahmed Abotabekh, Panayoti Bachkangi

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Introduction: Oestrogen is an essential gonadal hormone that plays a vital role in the reproductive system of women1. The average age of menopause in the UK is 512. Women who go through premature menopause should be offered Hormone replacement therapy (HRT). Similarly, women who undergo surgical menopause should be offered HRT, unless contraindicated, depending on the indication of their surgery2,3. Aim: To assess if the patients in our department are counselled regarding HRT after surgical treatment and if HRT was prescribed. Methodology: A retrospective audit in a busy district hospital, examining all the patients who had a hysterectomy. The audit examined if HRT was discussed pre-operatively, prescribed on discharge and if a follow up was arranged. For women with contraindication to HRT, the audit assessed if the reasons were discussed pre-operatively and communicated to the Inclusion criteria: woman having a total or subtotal hysterectomy, with or without bilateral salpingo-ophorectomy (BSO), between April and September 2022. Exclusion criteria: woman having a vaginal hysterectomy. Results: 40 patients in total had hysterectomy; 27 (68%) were under the age of 51. 15 out of 27 patients bad BSO. 9 women were prescribed HRT, but 8 were offered HRT immediately, and 1 of them were offered a follow up. Of women who underwent surgical menopause, 7 were not given any HRT. The HRT choice was diverse, however, the majority was prescribed oral HRT. 40% of women undergoing surgical menopause did not have a discussion about HRT prior to their surgery. In postmenopausal women (n=13; 33%), still two were given HRT for preexisting menopausal symptoms. Discussion: Only 59% of the pre-menopausal patients had oophorectomy, therefore undergoing surgical menopause. Of these, 44% were not given any HRT, and 40% had no discussion about HRT prior to surgery. Interestingly, the majority of these women have no obvious contraindication to HRT. The choice of HRT was diverse, but the majority was commenced on oral HRT. Our unit is still working towards meeting all the NICE guidance standards of offering HRT and information prior to surgery to women planning to undergo surgical menopause. Conclusion: Starting HRT at the onset of menopause has been shown to improve quality of life and reduce the risk of cardiovascular disease and osteoporotic fractures4. Our unit still has scope for improvement to comply with the current NICE guidance. All pre-menopausal women undergoing surgical menopause should have a discussion regarding HRT prior to surgery and be offered it if there are no contraindications. This discussion should be clearly documented in the notes. At the time of this report, some of the patients have not yet had a follow up, which we recognize as a limitation to our audit.

Keywords: hormone replacement therapy, menopause, premature ovarian insufficiency, surgical management

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1306 Feasibility of Two Positive-Energy Schools in a Hot-Humid Tropical Climate: A Methodological Approach

Authors: Shashwat, Sandra G. L. Persiani, Yew Wah Wong, Pramod S. Kamath, Avinash H. Anantharam, Hui Ling Aw, Yann Grynberg

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Achieving zero-energy targets in existing buildings is known to be a difficult task, hence targets are addressed at new buildings almost exclusively. Although these ultra-efficient case-studies remain essential to develop future technologies and drive the concepts of Zero-energy, the immediate need to cut the consumption of the existing building stock remains unaddressed. This work aims to present a reliable and straightforward methodology for assessing the potential of energy-efficient upgrading in existing buildings. Public Singaporean school buildings, characterized by low energy use intensity and large roof areas, were identified as potential objects for conversion to highly-efficient buildings with a positive energy balance. A first study phase included the development of a detailed energy model for two case studies (a primary and a secondary school), based on the architectural drawings provided, site-visits and calibrated using measured end-use power consumption of different spaces. The energy model was used to demonstrate compliances or predict energy consumption of proposed changes in the two buildings. As complete energy monitoring is difficult and substantially time-consuming, short-term energy data was collected in the schools by taking spot measurements of power, voltage, and current for all the blocks of school. The figures revealed that the bulk of the consumption is attributed in decreasing order of magnitude to air-conditioning, plug loads, and lighting. In a second study-phase, a number of energy-efficient technologies and strategies were evaluated through energy-modeling to identify the alternatives giving the highest energy saving potential, achieving a reduction in energy use intensity down to 19.71 kWh/m²/y and 28.46 kWh/m²/y for the primary and the secondary schools respectively. This exercise of field evaluation and computer simulation of energy saving potential aims at a preliminary assessment of the positive-energy feasibility enabling future implementation of the technologies on the buildings studied, in anticipation of a broader and more widespread adoption in Singaporean schools.

Keywords: energy simulation, school building, tropical climate, zero energy buildings, positive energy

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1305 Georgiana G. King’s The Way of Saint James. A Pioneer Cultural Guide of a Pilgrimage Route

Authors: Paula Pita-Galán

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In 1920 Georgiana Goddard King, an Art Historian and Professor at Bryn Mawr College (PA, USA), published The Way of Saint James (New York: P.G. Putnam’s Sons), one of the earliest modern guides of this pilgrimage route. In its three volumes, the author described the towns and villages crossed by the Camino, talking about the history, traditions, monuments, and the people that she had met during her own pilgrimage together with the photographer Edith H. Lowber. The two women walked the route from Toulouse to Santiago in several journeys that took place between 1911 and 1914, travelling with funds of the Hispanic Society of New York. The cultural interest that motivated the journey explains how King intertwines in her narration history, anthropology, geography, art history, and religion, giving; as a result, the book targeted intellectuals, curious travelers, and tourist rather than pilgrims in a moment in which the pilgrimage to Santiago had almost disappeared as a practice. The Way of Saint James is barely known nowadays, so the aim of this research is disseminate it, focusing on the modernity of its approach and pointing at the link that it has with Georgiana King’s understanding of art as a product of the culture and civilization that produces it. In this paper, we will analyze The Way of Saint James in its historiographical context as it was written during the rise of the interest on Spain and its culture in the United States of America; paying special attention on the relationship of the author with the Hispanic Society and sir Archer Milton Huntington. On the other hand, we will look into Georgiana Goddard King’s work as an scholar by analyzing her works and the personal papers (letters, notes, and manuscripts) that she left in Bryn Mawr College, where I have been researching with a Fulbright grant. As a result, we will understand the pioneer approach of this unique guide of the Way of Saint James as a reflection of Georgiana King’s own modernity as an scholar. The wide cultural interests of King gave, as a result, a guide that offers a transversal knowledge of The Way of Saint James, together with King’s impressions and experiences, in the same way of current guides but far from the ‘objective’ and formalist methodology followed by her colleagues. This kind of modernity was badly understood at her time and helped the oblivion of this book as well as her author.

Keywords: georgiana goddard king, the way of saint james, pilgrimage, cultural heritage, guide

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1304 Pediatric Hearing Aid Use: A Study Based on Data Logging Information

Authors: Mina Salamatmanesh, Elizabeth Fitzpatrick, Tim Ramsay, Josee Lagacé, Lindsey Sikora, JoAnne Whittingham

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Introduction: Hearing loss (HL) is one of the most common disorders that presents at birth and in early childhood. Universal newborn hearing screening (UNHS) has been adopted based on the assumption that with early identification of HL, children will have access to optimal amplification and intervention at younger ages, therefore, taking advantage of the brain’s maximal plasticity. One particular challenge for parents in the early years is achieving consistent hearing aid (HA) use which is critical to the child’s development and constitutes the first step in the rehabilitation process. This study examined the consistency of hearing aid use in young children based on data logging information documented during audiology sessions in the first three years after hearing aid fitting. Methodology: The first 100 children who were diagnosed with bilateral HL before 72 months of age since 2003 to 2015 in a pediatric audiology clinic and who had at least two hearing aid follow-up sessions with available data logging information were included in the study. Data from each audiology session (age of child at the session, average hours of use per day (for each ear) in the first three years after HA fitting) were collected. Clinical characteristics (degree of hearing loss, age of HA fitting) were also documented to further understanding of factors that impact HA use. Results: Preliminary analysis of the results of the first 20 children shows that all of them (100%) have at least one data logging session recorded in the clinical audiology system (Noah). Of the 20 children, 17(85%) have three data logging events recorded in the first three years after HA fitting. Based on the statistical analysis of the first 20 cases, the median hours of use in the first follow-up session after the hearing aid fitting in the right ear is 3.9 hours with an interquartile range (IQR) of 10.2h. For the left ear the median is 4.4 and the IQR is 9.7h. In the first session 47% of the children use their hearing aids ≤5 hours, 12% use them between 5 to 10 hours and 22% use them ≥10 hours a day. However, these children showed increased use by the third follow-up session with a median (IQR) of 9.1 hours for the right ear and 2.5, and of 8.2 hours for left ear (IQR) IQR is 5.6 By the third follow-up session, 14% of children used hearing aids ≤5 hours, while 38% of children used them ≥10 hours. Based on the primary results, factors like age and level of HL significantly impact the hours of use. Conclusion: The use of data logging information to assess the actual hours of HA provides an opportunity to examine the: a) challenges of families of young children with HAs, b) factors that impact use in very young children. Data logging when used collaboratively with parents, can be a powerful tool to identify problems and to encourage and assist families in maximizing their child’s hearing potential.

Keywords: hearing loss, hearing aid, data logging, hours of use

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1303 Sustainable Development in Orthodontics: Orthodontic Archwire Waste

Authors: Saarah Juman, Ilona Johnson, Stephen Richmond, Brett Duane, Sheelagh Rogers

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Introduction: Researchers suggest that within 50 years or less, the available supply of a range of metals will be exhausted, potentially leading to increases in resource conflict and largescale production shortages. The healthcare, dental and orthodontic sectors will undoubtedly be affected as stainless steel instruments are generally heavily relied on. Although changing orthodontic archwires are unavoidable and necessary to allow orthodontic tooth movement through the progression of an archwire sequence with fixed appliances, they are thought to be manufactured in excess of what is needed. Furthermore, orthodontic archwires require trimming extraorally to allow safe intraoral insertion, thus contributing to unnecessary waste of natural resources. Currently, there is no evidence to support the optimisation of archwire length according to orthodontic fixed appliance stage. As such, this study aims to quantify archwire excess (extraoral archwire trimmings) for different stages of orthodontic fixed appliance treatment. Methodology: This prospective, observational, quantitative study observed trimmings made extraorally against pre-treatment study models by clinicians over a 3-month period. Archwires were categorised into one of three categories (initial aligning, sequence, working/finishing arcwhires) within the orthodontic fixed appliance archwire sequence. Data collection included archwire material composition and the corresponding length and weight of excess archwire. Data was entered using a Microsoft Excel spreadsheet and imported into statistical software to obtain simple descriptive statistics. Results: Measurements were obtained for a total of 144 archwires. Archwire materials included nickel titanium and stainless steel. All archwires observed required extraorally trimming to allow safe intraoral insertion. The manufactured lengths of orthodontic initial aligning, sequence, and working/finishing arcwhires were at least 31%, 26%, and 39% in excess, respectively. Conclusions: Orthodontic archwires are manufactured to be excessively long at all orthodontic archwire sequence stages. To conserve natural resources, this study’s findings support the optimisation of orthodontic archwire lengths by manufacturers according to the typical stages of an orthodontic archwire sequence.

Keywords: archwire, orthodontics, sustainability, waste

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1302 Blue Finance: A Systematical Review of the Academic Literature on Investment Streams for Marine Conservation

Authors: David Broussard

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This review article delves into the realm of marine conservation finance, addressing the inadequacies in current financial streams from the private sector and the underutilization of existing financing mechanisms. The study emphasizes the emerging field of “blue finance”, which contributes to economic growth, improved livelihoods, and marine ecosystem health. The financial burden of marine conservation projects typically falls on philanthropists and governments, contrary to the polluter-pays principle. However, the private sector’s increasing commitment to NetZero and growing environmental and social responsibility goals prompts the need for alternative funding sources for marine conservation initiatives like marine protected areas. The article explores the potential of utilizing several financing mechanisms like carbon credits and other forms of payment for ecosystem services in the marine context, providing a solution to the lack of private funding for marine conservation. The methodology employed involves a systematic and quantitative approach, combining traditional review methods and elements of meta-analysis. A comprehensive search of the years 2000 - 2023, using relevant keywords on the Scopus platform, resulted in a review of 252 articles. The temporal evolution of blue finance studies reveals a significant increase in annual articles from 2010 to 2022, with notable peaks in 2011 and 2022. Marine Policy, Ecosystem Services, and Frontiers in Marine Science are prominent journals in this field. While the majority of articles focus on payment for ecosystem services, there is a growing awareness of the need for holistic approaches in conservation finance. Utilizing bibliometric techniques, the article showcases the dominant share of payment for ecosystem services in the literature with a focus on blue carbon. The classification of articles based on various criteria, including financing mechanisms and conservation types, aids in categorizing and understanding the diversity of research objectives and perspectives in this complex field of marine conservation finance.

Keywords: biodiversity offsets, carbon credits, ecosystem services, impact investment, payment for ecosystem services

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