Search results for: peer relation

Authors: D. Mulligan, D. Casey

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Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

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Authors: Stephen Bahooshy

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Co-producing services with the people that access them is considered best practice in the United Kingdom, with the Care Act 2014 arguing that people who access services and their carers should be involved in the design, commissioning and delivery of services. Co-production is a way of working with the community, breaking down barriers of access and providing meaningful opportunity for people to engage. Unfortunately, owing to a number of reported factors such as time constraints, practitioner experience and departmental budget restraints, this process is not always followed. In 2019, in a south London borough, d/Deaf people who access services were engaged in the design, commissioning and delivery of an information and advice service that would support their community to access local government services. To do this, sensory impairment social workers and commissioners collaborated to host a series of engagement events with the d/Deaf community. Interpreters were used to enable communication between the commissioners and d/Deaf participants. Initially, the community’s opinions, ideas and requirements were noted. This was then summarized and fed back to the community to ensure accuracy. Subsequently, a service specification was developed which included performance metrics, inclusive of qualitative and quantitative indicators, such as ‘I statements’, whereby participants respond on an adapted Likert scale how much they agree or disagree with a particular statement in relation to their experience of the service. The service specification was reviewed by a smaller group of d/Deaf residents and social workers, to ensure that it met the community’s requirements. The service was then tendered using the local authority’s e-tender process. Bids were evaluated and scored in two parts; part one was by commissioners and social workers and part two was a presentation by prospective providers to an evaluation panel formed of four d/Deaf residents. The internal evaluation panel formed 75% of the overall score, whilst the d/Deaf resident evaluation panel formed 25% of the overall tender score. Co-producing the evaluation panel with social workers and the d/Deaf community meant that commissioners were able to meet the requirements of this community by developing evaluation questions and tools that were easily understood and use by this community. For example, the wording of questions were reviewed and the scoring mechanism consisted of three faces to reflect the d/Deaf residents’ scores instead of traditional numbering. These faces were a happy face, a neutral face and a sad face. By making simple changes to the commissioning and tender evaluation process, d/Deaf people were able to have meaningful involvement in the design and commissioning process for a service that would benefit their community. Co-produced performance metrics means that it is incumbent on the successful provider to continue to engage with people accessing the service and ensure that the feedback is utilized. d/Deaf residents were grateful to have been involved in this process as this was not an opportunity that they had previously been afforded. In recognition of their time, each d/Deaf resident evaluator received a £40 gift voucher, bringing the total cost of this co-production to £160.

Keywords: co-production, community engagement, deaf and hearing impaired, service design

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Authors: Brajesh

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Introduction: It is generally believed that women's lack power to making decision may restrict their use of modern contraceptives practices. However, few studies have examined the different dimensions of women's empowerment and contraceptive use in Asian content. Pervasive gendered inequities and norms regarding the subordination of women give Asian men disproportionately more power than women, particularly in relation to the sex. We hypothesize that lack of sexual empowerment may pose an important barrier to reproductive health and adoption of family planning methods. Using the Demographic Health Survey, we examine the association between women’s sexual empowerment and contraceptive use in Nepal, Bangladesh and Pakistan. Objectives: To understand the trend and pattern of contraceptive choices and use among women due to sexual empowerment in selected south Asian countries. To examine the association between women’s sexual empowerment and contraceptive practices among non-pregnant married and partnered women in Nepal, Bangladesh and Pakistan. Methods: Data came from the latest round of Demographic and Health Surveys conducted between 2010-12 in and during deacde1990 -92 in Nepal, Bangladesh and Pakistan. Responses from married or cohabiting women aged 15-49 years were analyzed for six dimensions of empowerment and the current use of female-only methods or couple of methods. Bi-variate and multivariate multinomial regressions were used to identify associations between the empowerment dimensions and method use. Results: Positive associations were found between the overall empowerment score and method use in all countries (relative risk ratios, 1.1-1.3). In multivariate analysis, household economic decision-making was associated with the use of either female-only or couple methods (relative risk ratios -1. 1 for all), as was agreement on fertility preferences (RRR-1.3-1.6) and the ability to negotiate sexual activity (RRR -1. 1-1.2). In Bangladesh, women's negative attitudes toward domestic violence were correlated with the use of couple of methods (RRR -1. 1). Increasing levels of sexual empowerment were found to be associated with use of contraceptives, even after adjusting for demographic predictors of contraceptive use. This association is moderated by the wealth. Formal education, increasing wealth, and being in an unmarried partnership are associated with contraceptive use, whereas women who identify as being Muslim are less likely to use contraceptives than those who identify as being Hindus or other. These findings suggest that to achieve universal access to reproductive health services, gendered disparities in sexual empowerment, particularly among economically disadvantaged women, need to be better addressed. Conclusions: Intervention programs aimed at increasing contraceptive use may need to involve different approaches, including promoting couples' discussion of fertility preferences and family planning, improving women's self-efficacy in negotiating sexual activity and increasing their economic independence. Policies are needed to encourage the rural families to give their girls a chance of attending higher level education and professional course so that can get a better job opportunity and can economically support their family as son are expected to do.

Keywords: reproductive and child health (RCH), relative risk ratios (RRR), demographic and health survey (DHS), women’s sexual empowerment (WSE)

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Authors: Anju Vaidya

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Sanitation is concerned with proper disposal of human excreta, waste water and promotion of hygiene. Lack of sanitation impacts our environment affecting our finance, schooling, health, and thus exacerbating poverty, discrimination and exclusion of the marginalized group. Sanitation can be a route and one of the most important factor to reach the goals of all Millennium Development goals. This study aims at exploring what are the rights to sanitation of the people, how it is enacted and what challenges are being faced while implementing the right to sanitation in South-Asian countries (India, Nepal, Pakistan, Bangladesh, Srilanka) at government, non-government and international level. This study also aims at finding how right sanitation is interlinked with children rights. The available reports submitted by government and civil society organizations working in South-Asian countries from the website of the Office of High Commissioner for Human Rights that were submitted under International covenant on economic, social and cultural rights and Convention on rights of the child have been selected and analyzed. The study uses Literature review to analyze these UN documents submitted from 2000 to 2015 in the context of South-Asian countries. Preliminary insight reveals that sanitation is recognized as one of the important factor to attain adequate standard of living. It has been found that inadequate sanitation has been a major factor that affects all aspects of life and one of its devastating impacts is increased child mortality. Many efforts have been made at national and international level in South-Asian countries to improve the state of sanitation and sanitation services. Various approaches such as Community led Total Sanitation, School led Total Sanitation, establishing Open Defecation free zone, water supply services and other sanitation and hygiene awareness programs are being launched. Despite different efforts and programs being implemented, sanitation and hygiene practices and behavior change remains to be a big challenge. Disparity in access and imbalance between urban and rural services and geographical regions, inadequate financing, clear policy framework and fragile functionality are some of the significant challenges faced while implementing these programs. Children are one of the most vulnerable group that are affected to a large extent. The study brings into light varied approaches that are being made and challenges that are being faced by government, non-government and civil society organizations while implementing the programs and strategies related to sanitation. It also highlights the relation of sanitation as a human right with child rights. This can help the stakeholders and policymakers better understand that improving sanitation situation is a process that requires learning, planning and behavior change and achieving sanitation coverage targets and motivating behavior change requires additional tools based on participation, non-discrimination and process approaches for planning and feedback.

Keywords: challenges, child rights, open defecation, sanitation as a human right

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Authors: Mariam Anwaar, Kiran B. Ahmad

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Borderline Personality Disorder (BPD) is an invasive presence of affect instability, disturbance in self-concept and attachment in relationships. The profound indicator is the dichotomous approach of the world in which the ego categorizes individuals, especially their significant others, into secure or threatful beings, leaving little room for a complex combination of characteristics in one person. This defense mechanism of splitting their world has been described through the explanatory model of unconscious conflict theorized by Sigmund Freud’s Electra Complex in the Phallic Stage. The central role is of the father with whom the daughter experiences penis envy, thus identifying with the mother’s characteristics to receive the father’s attention. However, Margret Mahler, an object relation theorist, elucidates the central role of the mother and that the split occurs during the pre-Electra complex stage. Amid the 14 and 24 months of the infant, it acknowledges the world away from the mother as they have developed milestones such as crawling. In such novelty, the infant crawls away from the mother creating a sense of independence (individuation). On the other hand, being distant causes anxiety, making them return to their original object of security (separation). In BPD, the separation-individuation stage is disrupted, due to contradictory actions of the caregiver, which results in splitting the object into negative and positive aspects, repressing the former and adhering to the latter for survival. Thus, with time, the ego distorts the reality into dichotomous categories, using the splitting defenses, and the mental representation of the self is distorted due to the internalization of the negative objects. The explanatory model was recognized in the case study of Fizza, at 21-year-old Pakistani female, residing in Karachi. Her marital status is single with an occupation being a dental student. Fizza lives in a nuclear family but is surrounded by her extended family as they all are in close vicinity. She came with the complaints of depressive symptoms for two-years along with self-harm due to severe family conflicts. Through the intervention of Dialectical Behavior Therapy (DBT), the self-harming actions were reduced, however, this libidinal energy transformed into claustrophobic symptoms and, along with this, Fizza has always experienced vivid dreams. A retrospective method of Jungian dream-analysis was applied to locate the origins of the splitting in the unconscious. The result was the revelation of a sexual harassment trauma at the age of six-years which was displaced in the form of self-harm. In addition to this, the presence of a conflict at the separation-individuation stage was detected during the dream-analysis, and it was the underlying explanation of the claustrophobic symptoms. This qualitative case study implicates the use of a patient’s subjective experiences, such as dreams, to journey through the spiral of the unconscious in order to not only detect repressed memories but to use them in psychotherapy as a means of healing the patient.

Keywords: borderline personality disorder, dream-analysis, Electra complex, separation-individuation, splitting, unconscious

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Authors: Sadi Ali, Yaser Kishawi

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As part of Palestine, Gaza Strip (365 km2 and 1.8 million habitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely covers the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is to find non-conventional water resource from treated wastewater to irrigate 1500 hectares and serves over 100,000 inhabitants. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line & 9 infiltration basins - IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme – RRS – to capture the spreading plume). Currently, phase A is functioning since Apr 2009. Since Apr 2009, a monitoring plan is conducted to monitor the infiltration rate (I.R.) of the 9 basins. Nearly 23 million m3 of partially treated wastewater were infiltrated up to Jun 2014. It is important to maintain an acceptable rate to allow the basins to handle the coming quantities (currently 10,000 m3 are pumped an infiltrated daily). The methodology applied was to review and analysis the collected data including the I.R.s, the WW quality and the drying-wetting schedule of the basins. One of the main findings is the relation between the Total Suspended Solids (TSS) at BLWWTP and the I.R. at the basins. Since April 2009, the basins scored an average I.R. of about 2.5 m/day. Since then the records showed a decreasing pattern of the average rate until it reached the lower value of 0.42 m/day in Jun 2013. This was accompanied with an increase of TSS (mg/L) concentration at the source reaching above 200 mg/L. The reducing of TSS concentration directly improved the I.R. (by cleaning the WW source ponds at Biet Lahia WWTP site). This was reflected in an improvement in I.R. in last 6 months from 0.42 m/day to 0.66 m/day then to nearly 1.0 m/day as the average of the last 3 months of 2013. The wetting-drying scheme of the basins was observed (3 days wetting and 7 days drying) besides the rainfall rates. Despite the difficulty to apply this scheme accurately a control of flow to each basin was applied to improve the I.R. The drying-wetting system affected the I.R. of individual basins, thus affected the overall system rate which was recorded and assessed. Also the ploughing activities at the infiltration basins as well were recommended at certain times to retain a certain infiltration level. This breaks the confined clogging layer which prevents the infiltration. It is recommended to maintain proper quality of WW infiltrated to ensure an acceptable performance of IBs. The continual maintenance of settling ponds at BLWWTP, continual ploughing of basins and applying soil treatment techniques at the IBs will improve the I.R.s. When the new WWTP functions a high standard effluent quality (TSS 20mg, BOD 20 mg/l, and TN 15 mg/l) will be infiltrated, thus will enhance I.R.s of IBs due to lower organic load.

Keywords: soil aquifer treatment, recovery and reuse scheme, infiltration basins, North Gaza

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Authors: H. M. Ross-McAlpine

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Much of what is written on diplomacy, globalization and the global economy addresses the changing nature of relationships between major powers. While the most dramatic and influential changes have resulted from these developing relationships the world is not, on deeper inspection, governed neatly by major powers. Due to advances in technology, the shifting balance of power and a changing geopolitical order, small states have the ability to exercise a greater influence than ever before. Increasingly interdependent and ever complex, our world is too delicate to be handled by a mighty few. The pressure of global change requires small states to adapt their diplomatic practices and diversify their strategic alliances and relationships. The nature and practice of diplomacy must be re-evaluated in light of the pressures resulting from globalization. This research examines: how small states can best secure their foreign policy objectives? Small state theory is used as a foundation for exploring the case study of New Zealand. The research draws on secondary sources to evaluate the existing theory in relation to modern practices of diplomacy. As New Zealand lacks the required economic and military power to play an active, influential role in international affairs what strategies are used to exert influence? Furthermore, New Zealand lies in a remote corner of the Pacific and is geographically isolated from its nearest neighbors how does this affect security and trade priorities? The findings note a significant shift since the 1970’s in New Zealand’s diplomatic relations. This shift is arguably a direct result of globalization, regionalism and a growing independence from the traditional bi-lateral relationships. The need to source predictable trade, investment and technology are an essential driving force for New Zealand’s diplomatic relations. A lack of hard power aligns New Zealand’s prosperity with a secure, rules-based international system that increases the likelihood of a stable and secure global order. New Zealand’s diplomacy and prosperity has been intrinsically reliant on its reputation. A vital component of New Zealand’s diplomacy is preserving a reputation for integrity and global responsibility. It is the use of this soft power that facilitates the influence that New Zealand enjoys on the world stage. To weave a comprehensive network of successful diplomatic relationships, New Zealand must maintain a reputation of international credibility. Globalization has substantially influenced the practice of diplomacy for New Zealand. The current world order places economic and military might in the hands of a few, subsequently requiring smaller states to use other means for securing their interests. There are clear strategies evident in New Zealand’s diplomacy practice that draw attention to how other smaller states might best secure their foreign policy objectives. While these findings are limited, as with all case study research, there is value in applying the findings to other small states struggling to secure their interests in the wake of rapid globalization.

Keywords: diplomacy, foreign policy, globalisation, small state

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Authors: Yiorgos Hadjichristou

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The paper will focus on the strategic development deriving from the evolution of the traditional courtyard spatial organization towards a new, contemporary sustainable way of living. New sustainable approaches that engulf the social issues, the notion of place, the understanding of weather architecture blended together with the bioclimatic behaviour will be seen through a series of experimental case studies in the island of Cyprus, inspired and originated from its traditional wisdom, ranging from small scale of living to urban interventions. Weather and nature will be seen as co-architectural authors with architects as intelligently claimed by Jonathan Hill in his Weather Architecture discourse. Furthermore, following Pallasmaa’s understanding, the building will be seen not as an end itself and the elements of an architectural experience as having a verb form rather than being nouns. This will further enhance the notion of merging the subject-human and the object-building as discussed by Julio Bermudez. This eventually will enable to generate the discussion of the understanding of the building constructed according to the specifics of place and inhabitants, shaped by its physical and human topography as referred by Adam Sharr in relation to Heidegger’s thinking. The specificities of the divided island and the dealing with sites that are in vicinity with the diving Green Line will further trigger explorations dealing with the regeneration issues and the social sustainability offering unprecedented opportunities for innovative sustainable ways of living. The above premises will lead us to develop innovative strategies for a profound, both technical and social sustainability, which fruitfully yields to innovative living built environments, responding to the ever changing environmental and social needs. As a starting point, a case study in Kaimakli in Nicosia a refurbishment with an extension of a traditional house, already engulfs all the traditional/ vernacular wisdom of the bioclimatic architecture. It aims at capturing not only its direct and quite obvious bioclimatic features, but rather to evolve them by adjusting the whole house in a contemporary living environment. In order to succeed this, evolutions of traditional architectural elements and spatial conditions are integrated in a way that does not only respond to some certain weather conditions, but they integrate and blend the weather within the built environment. A series of innovations aiming at maximum flexibility is proposed. The house can finally be transformed into a winter enclosure, while for the most part of the year it turns into a ‘camping’ living environment. Parallel to experimental interventions in existing traditional units, we will proceed examining the implementation of the same developed methodology in designing living units and complexes. Malleable courtyard organizations that attempt to blend the traditional wisdom with the contemporary needs for living, the weather and nature with the built environment will be seen tested in both horizontal and vertical developments. A new social identity of people, directly involved and interacting with the weather and climatic conditions will be seen as the result of balancing the social with the technological sustainability, the immaterial and the material aspects of the built environment.

Keywords: building as a verb, contemporary living, traditional bioclimatic wisdom, weather architecture

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Authors: Anna-Maria Ramezanzadeh

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Demand for Arabic language is growing worldwide, driven by increased interest in the multifarious purposes the language serves, both for the population of heritage learners and those studying Arabic as a foreign language. The diglossic, or indeed multiglossic nature of the language as used in Arabic speaking communities however, is seldom represented in the content of classroom courses. This disjoint between the nature of provision and students’ expectations can severely impact their engagement with course material, and their motivation to either commence or continue learning the language. The nature of motivation and its relationship to multiglossia is sparsely explored in current literature on Arabic. The theoretical framework here proposed aims to address this gap by presenting a model and instruments for the measurement of Arabic learners’ motivation in relation to the multiple strands of the language. It adopts and develops the Second Language Motivation Self-System model (L2MSS), originally proposed by Zoltan Dörnyei, which measures motivation as the desire to reduce the discrepancy between leaners’ current and future self-concepts in terms of the second language (L2). The tripartite structure incorporates measures of the Current L2 Self, Future L2 Self (consisting of an Ideal L2 Self, and an Ought-To Self), and the L2 Learning Experience. The strength of the self-concepts is measured across three different domains of Arabic: Classical, Modern Standard and Colloquial. The focus on learners’ self-concepts allows for an exploration of the effect of multiple factors on motivation towards Arabic, including religion. The relationship between Islam and Arabic is often given as a prominent reason behind some students’ desire to learn the language. Exactly how and why this factor features in learners’ L2 self-concepts has not yet been explored. Specifically designed surveys and interview protocols are proposed to facilitate the exploration of these constructs. The L2 Learning Experience component of the model is operationalized as learners’ task-based engagement. Engagement is conceptualised as multi-dimensional and malleable. In this model, situation-specific measures of cognitive, behavioural, and affective components of engagement are collected via specially designed repeated post-task self-report surveys on Personal Digital Assistant over multiple Arabic lessons. Tasks are categorised according to language learning skill. Given the domain-specific uses of the different varieties of Arabic, the relationship between learners’ engagement with different types of tasks and their overall motivational profiles will be examined to determine the extent of the interaction between the two constructs. A framework for this data analysis is proposed and hypotheses discussed. The unique combination of situation-specific measures of engagement and a person-oriented approach to measuring motivation allows for a macro- and micro-analysis of the interaction between learners and the Arabic learning process. By combining cross-sectional and longitudinal elements with a mixed-methods design, the model proposed offers the potential for capturing a comprehensive and detailed picture of the motivation and engagement of Arabic learners. The application of this framework offers a number of numerous potential pedagogical and research implications which will also be discussed.

Keywords: Arabic, diglossia, engagement, motivation, multiglossia, sociolinguistics

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Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Adam Szurlej

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Currently, in automotive transport to power vehicles, almost exclusively hydrocarbon based fuels are used. Due to increase of hydrocarbon fuels consumption, quality parameters are tightend for clean environment. At the same time efforts are undertaken for development of alternative fuels. The reasons why looking for alternative fuels for petroleum and diesel are: to increase vehicle efficiency and to reduce the environmental impact, reduction of greenhouse gases emissions and savings in consumption of limited oil resources. Significant progress was performed on development of alternative fuels such as methanol, ethanol, natural gas (CNG / LNG), LPG, dimethyl ether (DME) and biodiesel. In addition, biggest vehicle manufacturers work on fuel cell vehicles and its introduction to the market. Alcohols such as methanol and ethanol create the perfect fuel for spark-ignition engines. Their advantages are high-value antiknock which determines their application as additive (10%) to unleaded petrol and relative purity of produced exhaust gasses. Ethanol is produced in distillation process of plant products, which value as a food can be irrational. Ethanol production can be costly also for the entire economy of the country, because it requires a large complex distillation plants, large amounts of biomass and finally a significant amount of fuel to sustain the process. At the same time, the fermentation process of plants releases into the atmosphere large quantities of carbon dioxide. Natural gas cannot be directly converted into liquid fuels, although such arrangements have been proposed in the literature. Going through stage of intermediates is inevitable yet. Most popular one is conversion to methanol, which can be processed further to dimethyl ether (DME) or olefin (ethylene and propylene) for the petrochemical sector. Methanol uses natural gas as a raw material, however, requires expensive and advanced production processes. In relation to pollution emissions, the optimal vehicle fuel is LPG which is used in many countries as an engine fuel. Production of LPG is inextricably linked with production and processing of oil and gas, and which represents a small percentage. Its potential as an alternative for traditional fuels is therefore proportionately reduced. Excellent engine fuel may be biogas, however, follows to the same limitations as ethanol - the same production process is used and raw materials. Most essential fuel in the campaign of environment protection against pollution is natural gas. Natural gas as fuel may be either compressed (CNG) or liquefied (LNG). Natural gas can also be used for hydrogen production in steam reforming. Hydrogen can be used as a basic starting material for the chemical industry, an important raw material in the refinery processes, as well as a fuel vehicle transportation. Natural gas can be used as CNG which represents an excellent compromise between the availability of the technology that is proven and relatively cheap to use in many areas of the automotive industry. Natural gas can also be seen as an important bridge to other alternative sources of energy derived from fuel and harmless to the environment. For these reasons CNG as a fuel stimulates considerable interest in the worldwide.

Keywords: alternative fuels, CNG (Compressed Natural Gas), LNG (Liquefied Natural Gas), NGVs (Natural Gas Vehicles)

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Authors: Marc Toutain, Pascale Leconte, Antoine Gauthier

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Introduction: Eating Disorders (ED), such as anorexia, bulimia, and binge eating, are psychiatric illnesses that mostly affect young people. The main symptoms concern eating (restriction, excessive food intake) and weight control behaviors (laxatives, vomiting). Psychological comorbidities (depression, executive function disorders, etc.) and problematic behaviors toward physical activity (PA) are commonly associated with ED. Acquaintances on ED risk factors are still lacking, and more community sample studies are needed to improve prevention and early detection. To our knowledge, studies are needed to specifically investigate the link between ED risk level, PA, and psychological risk factors in a community sample of adolescents. The aim of this study is to assess the relation between ED risk level, exercise (type, frequency, and motivations for engaging in exercise), and psychological factors based on the Jacobi risk factors model. We suppose that a high risk of ED will be associated with the practice of high caloric cost PA, motivations oriented to weight and shape control, and psychological disturbances. Method: An online survey destined for students has been sent to several middle schools and colleges in northwest France. This survey combined several questionnaires, the Eating Attitude Test-26 assessing ED risk; the Exercise Motivation Inventory–2 assessing motivations toward PA; the Hospital Anxiety and Depression Scale assessing anxiety and depression, the Contour Drawing Rating Scale; and the Body Esteem Scale assessing body dissatisfaction, Rosenberg Self-esteem Scale assessing self-esteem, the Exercise Dependence Scale-Revised assessing PA dependence, the Multidimensional Assessment of Interoceptive Awareness assessing interoceptive awareness and the Frost Multidimensional Perfectionism Scale assessing perfectionism. Machine learning analysis will be performed in order to constitute groups with a tree-based model clustering method, extract risk profile(s) with a bootstrap method comparison, and predict ED risk with a prediction method based on a decision tree-based model. Expected results: 1044 complete records have already been collected, and the survey will be closed at the end of May 2022. Records will be analyzed with a clustering method and a bootstrap method in order to reveal risk profile(s). Furthermore, a predictive tree decision method will be done to extract an accurate predictive model of ED risk. This analysis will confirm typical main risk factors and will give more data on presumed strong risk factors such as exercise motivations and interoceptive deficit. Furthermore, it will enlighten particular risk profiles with a strong level of proof and greatly contribute to improving the early detection of ED and contribute to a better understanding of ED risk factors.

Keywords: eating disorders, risk factors, physical activity, machine learning

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Authors: Athini Ntloko

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Mycobacterium bovis and other species of Mycobacterium tuberculosis complex (MTBC) can result to a zoonotic infection known as Bovine tuberculosis (bTB). MTBC has members that may contaminate an extensive range of hosts, including wildlife. Diverse wild species are known to cause disease in domestic livestock and are acknowledged as TB reservoirs. It has been a main study worldwide to deliberate on bTB risk factors as a result and some studies focused on particular parts of risk factors such as wildlife and herd management. The significance of the study was to determine the incidence of Mycobacterium tuberculosis complex that is associated with soil, hayfeed and water. Questionnaires were administered to thirty (30) smallholding farm owners in the two villages (kwaMasele and Qungqwala) and three (3) three commercial farms (Fort Hare dairy farm, Middledrift dairy farm and Seven star dairy farm). Detection of M. tuberculosis complex was achieved by Polymerase Chain Reaction using primers for IS6110; whereas a genotypic drug resistance mutation was detected using Genotype MTBDRplus assays. Nine percent (9%) of respondents had more than 40 cows in their herd, while 60% reported between 10 and 20 cows in their herd. Relationship between farm size and vaccination for TB differed from forty one percent (41%) being the highest to the least five percent (5%). The highest number of respondents who knew about relationship between TB cases and cattle location was ninety one percent (91%). Approximately fifty one percent (51%) of respondents had knowledge about wild life access to the farms. Relationship between import of cattle and farm size ranged from nine percent (9%) to thirty five percent (35%). Cattle sickness in relation to farm size differed from forty three (43%) being the highest to the least three percent (3%); while thirty three percent (33%) of respondents had knowledge about health management. Respondents with knowledge about the occurrence of TB infections in farms were forty-eight percent (48%). The frequency of DNA isolation from samples ranged from the highest forty-five percent (45%) from water to the least twenty two percent (22%) from soil. Fort Hare dairy farm had the highest number of positive samples, forty four percent (44%) from water samples; whereas Middledrift dairy farm had the lowest positive from water, seventeen percent (17%). Twelve (22%) out of 55 isolates showed resistance to INH and RIF that is, multi-drug resistance (MDR) and nine percent (9%) were sensitive to either INH or RIF. The mutations at rpoB gene differed from 58% being the highest to the least (23%). Fifty seven percent (57%) of samples showed a S315T1 mutation while only 14% possessed a S531L in the katG gene. The highest inhA mutations were detected in T8A (80 %) and the least was observed in A16G (17%). The results of this study reveal that risk factors for bTB in cattle and dairy farm workers are a serious issue abound in the Eastern Cape of South Africa; with the possibility of widespread dissemination of multidrug resistant determinants in MTBC from the environment.

Keywords: hayfeed, isoniazid, multi-drug resistance, mycobacterium tuberculosis complex, polymerase chain reaction, rifampicin, soil, water

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Authors: Maria Luisa Barcena De Arellano, Sofya Pozdniakova, Pavelas Karkacas, Anja Kuhl, Istvan Baczko, Yury Ladilov, Vera Regitz-Zagrosek

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Introduction: Aging is associated with deterioration of the physiological function, leading to systemic inflammation and mitochondrial dysfunction that promote the development of cardiovascular diseases. Sex differences in aging-related cardiovascular diseases have been postulated. However, their precise mechanisms remain unclear. In the current study, we aimed to investigate the sex difference in the age-related alteration in Sirt1-AMPK signaling and its relation to the mitochondrial biogenesis and inflammation. Methods: Male and female human non-disease lateral left ventricular wall tissue (young (17–40 years; n= 7 male and 7 female) and old (50–68 years; n= 9 male and 8 female)) were used. qRT-PCR, western blot and immunohistochemistry assays were performed for expression analyses of Sirt1, AMPK, pAMPK, ac-Ku70, TFAM, PGC-1α, Sirt3, SOD2 and catalase. CD68 was used as a marker for macrophages and the ratio of IL-12:IL10 (pro-inflammatory phenotype (high IL-12/low IL-10) and anti-inflammatory phenotype (low IL-12/high IL-10) was used to examine the inflammatory stage in the heart. Results: Sirt1 expression was significantly higher in young females compared to young males, whereas in aged hearts Sirt1 expression was significantly downregulated in females, but not in males. In line with the Sirt1 downregulation in aged females, acetylation of nuclear Ku70, a direct target of Sirt1, in aged female hearts was significantly elevated. The activity of AMPK was significantly decreased in aged individuals, however no sex differences in the AMPK expression or activity were found in young or old individuals. The expression of mitochondrial proteins TOM40, SOD2 and Sirt3 was significantly higher in young females compared to young males, while in aged female hearts SOD2 and TOM40 were downregulated. In addition, the expression of catalase, a key cytosolic and mitochondrial anti-oxidative enzyme was significantly higher in young females and this female sex benefit was lost in aged hearts. In addition, the number of cardiac macrophages was significantly increased in old female, but not in male hearts. Consistently, the pro-inflammatory shift in old females was further confirmed by differences in the IL12/IL10 ratio in young female cardiac tissue in a favour of the anti-inflammatory mediator IL-10 (ratio 1:4) compared to young males (ratio 1:1). The anti-inflammatory environment in the heart was lost in aged females (ratio 1:1). Conclusion: Aging leads to the significant downregulation of Sirt1 expression and elevated acetylation of Ku70 in female, but not in male hearts. Furthermore, a beneficial upregulation of mitochondrial and anti-oxidative proteins in young females is lost with aging. Moreover, the malfunctions in the expression of Sirt1 and mitochondrial proteins in aged female hearts is accompanied by a significant pro-inflammatory shift. The study provides a molecular basis for the increased incidence of cardiovascular diseases in old women.

Keywords: inflammation, mitochondrial dysfunction, aging, Sirt1-AMPK axis

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Authors: Meng Wang

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Historically, young members (children) in the society have been oppressed by adults through direct violent acts. Direct violence was evident in rampant child labor and child maltreatment cases. After acknowledging the rights of children from the United Nations, it is believed in public that children have been protected against direct physical violence. Nevertheless, at present, this paper argues from Foucauldian and disability study standpoints that similar to the old times, children are oppressed objects in the context of child play, which is constructed by adults to substitute direct violence in regulating children. Particularly, this paper suggests that on the one hand, preschool play is a new way that adults adopt to oppress preschoolers and regulate the society as a whole; on the other hand, preschoolers are taught how to play as an acquired skill and master self-regulation through play. There is a line of contemporary research that centers on child play from social constructivism perspective. Yet, current teaching practices pertaining to child play including guided child play and free play, in fact, serve the interest of adults and society at large. By acknowledging and deconstructing the prevalence of 'evidence-based best practice' in early childhood education field within western society, reconstruction of child-adult power relation could be achieved and alternative truth could be found in early childhood education. To support the argument of this paper, an on-going observational case study is conducted in a preschool setting in the United States. Age range of children is 2.5 to 4 years old. Approximately 10 children (5 boys) are participating in this case study. Observation is conducted throughout the weekdays as children follow through the classroom routine with a lead and an assistant teacher. Classroom teachers are interviewed pertaining to their classroom management strategies. Preliminary research finding of this case study suggested that preschool teachers tended to utilize scenarios from preschoolers’ dramatic play to impart core cultural values to young children. These values were pre-determined by adults. In addition, if young children have failed to follow teachers' guidance in terms of playing in a correct way, children ran the risk of being excluded from the play scenario by peers and adults. Furthermore, this study tended to indicate that through child play, preschoolers are obliged to develop an internal violence system, that is self-regulation skill to regulate their own behavior; and if this internal system is unestablished based on various assessments by adults, then potentially there will be consequences of negative labeling and disabling toward young children intended by adults. In conclusion, this paper applies Foucauldian analysis into the context of child play. At present, within preschool, child play is not free as it seems to be. Young children are expected to perform cultural tasks through their play activities designed by adults. Adults utilize child play as technologies of governmentality to further predict and regulate future society at large.

Keywords: child play, developmentally appropriate practice, DAP, poststructuralism, technologies of governmentality

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Authors: Ana Paula S. Horodenski, Priscila Pelegrini, Salli Baggenstoss

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The brewing industry with artisanal concepts seeks to serve a specific market, with diversified production that has been gaining ground in the national environment, also in the Amazon region. This growth is due to the more demanding consumer, with a diversified taste that wants to try new types of beer, enjoying products with new aromas, flavors, as a differential of what is so widely spread through the big industrial brands. Thus, through qualitative research methods, the study aimed to investigate how is the process of managing the production of a craft brewery in a city in the northern State of Mato Grosso (BRAZIL), providing knowledge of production processes and strategies in the industry. With the efficient use of resources, it is possible to obtain the necessary quality and provide better performance and differentiation of the company, besides analyzing the best management model. The research is descriptive with a qualitative approach through a case study. For the data collection, a semi-structured interview was elaborated, composed of the areas: microbrewery characterization, artisan beer production process, and the company supply chain management. Also, production processes were observed during technical visits. With the study, it was verified that the artisan brewery researched develops preventive maintenance strategies with the inputs, machines, and equipment, so that the quality of the product and the production process are achieved. It was observed that the distance from the supplying centers makes the management of processes and the supply chain be carried out with a longer planning time so that the delivery of the final product is satisfactory. The production process of the brewery is composed of machines and equipment that allows the control and quality of the product, which the manager states that for the productive capacity of the industry and its consumer market, the available equipment meets the demand. This study also contributes to highlight one of the challenges for the development of small breweries in front of the market giants, that is, the legislation, which fits the microbreweries as producers of alcoholic beverages. This makes the micro and small business segment to be taxed as a major, who has advantages in purchasing large batches of raw materials and tax incentives because they are large employers and tax pickers. It was possible to observe that the supply chain management system relies on spreadsheets and notes that are done manually, which could be simplified with a computer program to streamline procedures and reduce risks and failures of the manual process. In relation to the control of waste and effluents affected by the industry is outsourced and meets the needs. Finally, the results showed that the industry uses preventive maintenance as a productive strategy, which allows better conditions for the production and quality of artisanal beer. The quality is directly related to the satisfaction of the final consumer, being prized and performed throughout the production process, with the selection of better inputs, the effectiveness of the production processes and the relationship with the commercial partners.

Keywords: artisanal brewery, production management, production processes, supply chain

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Authors: Mbonigaba Swale

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Malaria is an infection or disease caused by parasites (Plasmodium Falciparum — causes severe Malaria, plasmodium Vivax, Plasmodium Ovale, and Plasmodium Malariae), transmitted by bites of infected anopheles (female) mosquitoes to humans. These vectors comprise of two types in Africa, particularly in Uganda, i.e. anopheles fenestus and Anopheles gambaie (‘example Anopheles arabiensis,,); feeds on man inside the house mainly at dusk, mid-night and dawn and rests indoors and makes them effective transmitters (vectors) of the disease. People in both urban and rural areas have consistently become prone to repetitive attacks of malaria, causing a lot of deaths and significantly increasing the poverty levels of the rural poor. Malaria is a national problem; it causes a lot of maternal pre-natal and antenatal disorders, anemia in pregnant mothers, low birth weights for the newly born, convulsions and epilepsy among the infants. Cumulatively, it kills about one million children every year in sub-Saharan Africa. It has been estimated to account for 25-35% of all outpatient visits, 20-45% of acute hospital admissions and 15-35% of hospital deaths. Uganda is the leading victim country, for which Rakai and Masaka districts are the most affected. So, it is not clear whether these abhorrent situations and episodes of recurrences and failure to cure from the disease are a result of poor diagnosis, prescription and dosing, treatment habits and compliance of the patients to the drugs or the ethical domain of the stake holders in relation to the main stream methodology of malaria management. The research is aimed at offering an alternative approach to manage and deal absolutely with problem by using a knowledge based software model of Artificial Intelligence (Al) that is capable of performing common-sense and cognitive reasoning so as to take decisions like the human brain would do to provide instantaneous expert solutions so as to avoid speculative simulation of the problem during differential diagnosis in the most accurate and literal inferential aspect. This system will assist physicians in many kinds of medical diagnosis, prescribing treatments and doses, and in monitoring patient responses, basing on the body weight and age group of the patient, it will be able to provide instantaneous and timely information options, alternative ways and approaches to influence decision making during case analysis. The computerized system approach, a new model in Uganda termed as “Software Aided Treatment” (SAT) will try to change the moral and ethical approach and influence conduct so as to improve the skills, experience and values (social and ethical) in the administration and management of the disease and drugs (combination therapy and generics) by both the patient and the health worker.

Keywords: knowledge based software, management, treatment, diagnosis

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Authors: Farnaz Alborzi, Angelika Schmitz, Rainer Stamminger

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Reducing water temperatures in the wash phase of a washing programme and increasing the overall cycle durations are the latest trends in decreasing energy consumption of washing programmes. Since the implementation of the new energy efficiency classes in 2010, manufacturers seem to apply the aforementioned washing strategy with lower temperatures combined with longer programme durations extensively to realise energy-savings needed to meet the requirements of the highest energy efficiency class possible. A semi-representative on-line survey in eleven European countries (Czech Republic, Finland, France, Germany, Hungary, Italy, Poland, Romania, Spain, Sweden and the United Kingdom) was conducted by Bonn University in 2015 to shed light on consumer opinion and behaviour regarding the effects of the lower washing temperature and longer cycle duration in laundry washing on consumers’ acceptance of the programme. The risk of the long wash cycle is that consumers might not use the energy efficient Standard programmes and will think of this option as inconvenient and therefore switch to shorter, but more energy consuming programmes. Furthermore, washing in a lower temperature may lead to the problem of cross-contamination. Washing behaviour of over 5,000 households was studied in this survey to provide support and guidance for manufacturers and policy designers. Qualified households were chosen following a predefined quota: -Involvement in laundry washing: substantial, -Distribution of gender: more than 50 % female , -Selected age groups: -20–39 years, -40–59 years, -60–74 years, -Household size: 1, 2, 3, 4 and more than 4 people. Furthermore, Eurostat data for each country were used to calculate the population distribution in the respective age class and household size as quotas for the consumer survey distribution in each country. Before starting the analyses, the validity of each dataset was controlled with the aid of control questions. After excluding the outlier data, the number of the panel diminished from 5,100 to 4,843. The primary outcome of the study is European consumers are willing to save water and energy in a laundry washing but reluctant to use long programme cycles since they don’t believe that the long cycles could be energy-saving. However, the results of our survey don’t confirm that there is a relation between frequency of using Standard cotton (Eco) or Energy-saving programmes and the duration of the programmes. It might be explained by the fact that the majority of washing programmes used by consumers do not take so long, perhaps consumers just choose some additional time reduction option when selecting those programmes and this finding might be changed if the Energy-saving programmes take longer. Therefore, it may be assumed that introducing the programme duration as a new measure on a revised energy label would strongly influence the consumer at the point of sale. Furthermore, results of the survey confirm that consumers are more willing to use lower temperature programmes in order to save energy than accepting longer programme cycles and majority of them accept deviation from the nominal temperature of the programme as long as the results are good.

Keywords: duration, energy-saving, standard programmes, washing temperature

Procedia PDF Downloads 199

Authors: Bozena Tyliszczak, Anna Drabczyk, Sonia Kudlacik-Kramarczyk, Agnieszka Sobczak-Kupiec

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Introduction: Nanomaterials become one of the leading materials in the synthesis of various compounds. This is a reason for the fact that nano-size materials exhibit other properties compared to their macroscopic equivalents. Such a change in size is reflected in a change in optical, electric or mechanical properties. Among nanomaterials, particular attention is currently directed into gold nanoparticles. They find application in a wide range of areas including cosmetology or pharmacy. Additionally, nanogold may be a component of modern wound dressings, which antibacterial activity is beneficial in the viewpoint of the wound healing process. Specific properties of this type of nanomaterials result in the fact that they may also be applied in cancer treatment. Studies on the development of new techniques of the delivery of drugs are currently an important research subject of many scientists. This is due to the fact that along with the development of such fields of science as medicine or pharmacy, the need for better and more effective methods of administering drugs is constantly growing. The solution may be the use of drug carriers. These are materials that combine with the active substance and lead it directly to the desired place. A role of such a carrier may be played by gold nanoparticles that are able to covalently bond with many organic substances. This allows the combination of nanoparticles with active substances. Therefore gold nanoparticles are widely used in the preparation of nanocomposites that may be used for medical purposes with special emphasis on drug delivery. Methodology: As part of the presented research, synthesis of composites was carried out. The mentioned composites consisted of the polymer matrix and gold nanoparticles that were introduced into the polymer network. The synthesis was conducted with the use of a crosslinking agent, and photoinitiator and the materials were obtained by means of the photopolymerization process. Next, incubation studies were conducted using selected liquids that simulated fluids are occurring in the human body. The study allows determining the biocompatibility of the tested composites in relation to selected environments. Next, the chemical structure of the composites was characterized as well as their sorption properties. Conclusions: Conducted research allowed for the preliminary characterization of prepared polymer composites containing gold nanoparticles in the viewpoint of their application for biomedical use. Tested materials were characterized by biocompatibility in tested environments. What is more, synthesized composites exhibited relatively high swelling capacity that is essential in the viewpoint of their potential application as drug carriers. During such an application, composite swells and at the same time releases from its interior introduced active substance; therefore, it is important to check the swelling ability of such material. Acknowledgements: The authors would like to thank The National Science Centre (Grant no: UMO - 2016/21/D/ST8/01697) for providing financial support to this project. This paper is based upon work from COST Action (CA18113), supported by COST (European Cooperation in Science and Technology).

Keywords: nanocomposites, gold nanoparticles, drug carriers, swelling properties

Procedia PDF Downloads 89

Authors: Doris C. C. K. Kowaltowski, Marcella S. Deliberador

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The architectural design process, in general, is becoming more complex, as new technical, social, environmental, and economical requirements are imposed. For school buildings, this scenario is also valid. The quality of a school building depends on known design criteria and professional knowledge, as well as feedback from building performance assessments. To attain high-performance school buildings, a design process should add a multidisciplinary team, through an integrated process, to ensure that the various specialists contribute at an early stage to design solutions. The participation of stakeholders is of special importance at the programming phase when the search for the most appropriate design solutions is underway. The composition of a multidisciplinary team should comprise specialists in education, design professionals, and consultants in various fields such as environmental comfort and psychology, sustainability, safety and security, as well as administrators, public officials and neighbourhood representatives. Users, or potential users (teachers, parents, students, school officials, and staff), should be involved. User expectations must be guided, however, toward a proper understanding of a response of design to needs to avoid disappointment. In this context, appropriate tools should be introduced to organize such diverse participants and ensure a rich and focused response to needs and a productive outcome of programming sessions. In this paper, different stakeholder in a school design process are discussed in relation to their specific contributions and a tool in the form of a card game is described to structure the design debates and ensure a comprehensive decision-making process. The game is based on design patterns for school architecture as found in the literature and is adapted to a specific reality: State-run public schools in São Paulo, Brazil. In this State, school buildings are managed by a foundation called Fundação para o Desenvolvimento da Educação (FDE). FDE supervises new designs and is responsible for the maintenance of ~ 5000 schools. The design process of this context was characterised with a recommendation to improve the programming phase. Card games can create a common environment, to which all participants can relate and, therefore, can contribute to briefing debates on an equal footing. The cards of the game described here represent essential school design themes as found in the literature. The tool was tested with stakeholder groups and with architecture students. In both situations, the game proved to be an efficient tool to stimulate school design discussions and to aid in the elaboration of a rich, focused and thoughtful architectural program for a given demand. The game organizes the debates and all participants are shown to spontaneously contribute each in his own field of expertise to the decision-making process. Although the game was specifically based on a local school design process it shows potential for other contexts because the content is based on known facts, needs and concepts of school design, which are global. A structured briefing phase with diverse stakeholder participation can enrich the design process and consequently improve the quality of school buildings.

Keywords: architectural program, design process, school building design, stakeholder

Procedia PDF Downloads 375

Authors: J. Gabrielczyk, J. Kluitmann, T. Dammeyer, H. J. Jördening

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High-level expression of proteins in bacteria often causes production of insoluble protein aggregates, called inclusion bodies (IB). They contain mainly one type of protein and offer an easy and efficient way to get purified protein. On the other hand, proteins in IB are normally devoid of function and therefore need a special treatment to become active. Most refolding techniques aim at diluting the solubilizing chaotropic agents. Unfortunately, optimal refolding conditions have to be found empirically for every protein. For large-scale applications, a simple refolding process with high yields and high final enzyme concentrations is still missing. The constructed plasmid pASK-IBA63b containing the sequence of fructosyltransferase (FTF, EC 2.4.1.162) from Bacillus subtilis NCIMB 11871 was transformed into E. coli BL21 (DE3) Rosetta. The bacterium was cultivated in a fed-batch bioreactor. The produced FTF was obtained mainly as IB. For refolding experiments, five different amounts of IBs were solubilized in urea buffer with protein concentration of 0.2-8.5 g/L. Solubilizates were refolded with batch or continuous dialysis. The refolding yield was determined by measuring the protein concentration of the clear supernatant before and after the dialysis. Particle size was measured by dynamic light scattering. We tested the solubilization properties of fructosyltransferase IBs. The particle size measurements revealed that the solubilization of the aggregates is achieved at urea concentration of 5M or higher and confirmed by absorption spectroscopy. All results confirm previous investigations that refolding yields are dependent upon initial protein concentration. In batch dialysis, the yields dropped from 67% to 12% and 72% to 19% for continuous dialysis, in relation to initial concentrations from 0.2 to 8.5 g/L. Often used additives such as sucrose and glycerol had no effect on refolding yields. Buffer screening indicated a significant increase in activity but also temperature stability of FTF with citrate/phosphate buffer. By adding citrate to the dialysis buffer, we were able to increase the refolding yields to 82-47% in batch and 90-74% in the continuous process. Further experiments showed that in general, higher ionic strength of buffers had major impact on refolding yields; doubling the buffer concentration increased the yields up to threefold. Finally, we achieved corresponding high refolding yields by reducing the chamber volume by 75% and the amount of buffer needed. The refolded enzyme had an optimal activity of 12.5±0.3 x104 units/g. However, detailed experiments with native FTF revealed a reaggregation of the molecules and loss in specific activity depending on the enzyme concentration and particle size. For that reason, we actually focus on developing a process of simultaneous enzyme refolding and immobilization. The results of this study show a new approach in finding optimal refolding conditions for inclusion bodies at high concentrations. Straightforward buffer screening and increase of the ionic strength can optimize the refolding yield of the target protein by 400%. Gentle removal of chaotrope with continuous dialysis increases the yields by an additional 65%, independent of the refolding buffer applied. In general time is the crucial parameter for successful refolding of solubilized proteins.

Keywords: dialysis, inclusion body, refolding, solubilization

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Authors: Manushi Srivastava

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Introduction: Doctor’s role, and relation with respect to patient care is at the core of medical ethics. The rapid pace of medical advances along with increasing consumer awareness about their rights and hike in cost of effective health care demand a robust, transparent and patient-friendly medical care system. However, doctors’ role performance is still in the frame of activity-passivity model of Doctor-Patient Relationship (DPR) where doctors act as parent and use to instruct their patients, without their consensus that is not going to help in the 21st century. Thus the current situation is a new challenge for traditional doctor-patient relationship after the introduction of Consumer Protection Act (CPA) in medical profession and the same is evidenced by increasing cases of medical litigation. To strengthen this system of medical services, the doctor plays a vital role, and the same should be reviewed in the present context. Objective: To understand the opinion of consultants regarding medical negligence and effect of Consumer Protection Act in terms of current practices of patient care. Method: This is a cross-sectional study in which both quantitative and qualitative methods are applied. Total 69 consultants were selected from multi-specialty hospitals of densely populated Varanasi city catering a population of about 1.8 million. Two-stage sampling was used for selection of respondents. At the first stage, selection of major wards (Medicine, Surgery, Ophthalmology, Gynaecology, Orthopaedics, and Paediatrics) was carried out, which are more susceptible to medical negligence. At the second stage, selection of consultants from the respective wards was carried out. In-depth Interviews were conducted with the help of semi-structured schedule. Two case studies of medical negligence were also carried out as part of the qualitative study. Analysis: Data were analyzed with the help of SPSS software (21.0 trial version). Semi-structured research tool was used to know consultant’s opinion about the pattern of medical negligence cases, litigations and claims made by patient community and inclusion of government medical services in CPA. Statistical analysis was done to describe data, and non-parametric test was used to observe the association between the variables. Analysis of Verbatim was used in case-study. Findings and Conclusion: Majority (92.8%) of consultants felt changes in the behaviour of community (patient) after implementation of CPA, as it had increased awareness about their rights. Less than half of the consultants opined that Medical Negligence is an Unintentional act of doctors and generally occurs due to communication gap and behavioural problem between doctor and patients. Experienced consultants ( > 10 years) pointed out that unethical practice by doctors and mal-intention of patient to harass doctors were additional reasons of Medical Negligence. In-depth interview revealed that now patients’ community expects more transparency and hence they demand cafeteria approach in diagnosis and management of cases. Thus as study results, we propose ‘Agreement Model’ of DPR to re-ensure ethical practice in medical profession.

Keywords: doctors, communication, consumer protection act (CPA), medical error

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Authors: A. Falenski, A. Kaesbohrer, M. Filter

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Introduction: Risk assessments can be performed in various ways and in different degrees of complexity. In order to assess risks associated with imported foods additional information needs to be taken into account compared to a risk assessment on regional products. The present review is an overview on currently available best practise approaches and data sources used for food import risk assessments (IRAs). Methods: A literature review has been performed. PubMed was searched for articles about food IRAs published in the years 2004 to 2014 (English and German texts only, search string “(English [la] OR German [la]) (2004:2014 [dp]) import [ti] risk”). Titles and abstracts were screened for import risks in the context of IRAs. The finally selected publications were analysed according to a predefined questionnaire extracting the following information: risk assessment guidelines followed, modelling methods used, data and software applied, existence of an analysis of uncertainty and variability. IRAs cited in these publications were also included in the analysis. Results: The PubMed search resulted in 49 publications, 17 of which contained information about import risks and risk assessments. Within these 19 cross references were identified to be of interest for the present study. These included original articles, reviews and guidelines. At least one of the guidelines of the World Organisation for Animal Health (OIE) and the Codex Alimentarius Commission were referenced in any of the IRAs, either for import of animals or for imports concerning foods, respectively. Interestingly, also a combination of both was used to assess the risk associated with the import of live animals serving as the source of food. Methods ranged from full quantitative IRAs using probabilistic models and dose-response models to qualitative IRA in which decision trees or severity tables were set up using parameter estimations based on expert opinions. Calculations were done using @Risk, R or Excel. Most heterogeneous was the type of data used, ranging from general information on imported goods (food, live animals) to pathogen prevalence in the country of origin. These data were either publicly available in databases or lists (e.g., OIE WAHID and Handystatus II, FAOSTAT, Eurostat, TRACES), accessible on a national level (e.g., herd information) or only open to a small group of people (flight passenger import data at national airport customs office). In the IRAs, an uncertainty analysis has been mentioned in some cases, but calculations have been performed only in a few cases. Conclusion: The current state-of-the-art in the assessment of risks of imported foods is characterized by a great heterogeneity in relation to general methodology and data used. Often information is gathered on a case-by-case basis and reformatted by hand in order to perform the IRA. This analysis therefore illustrates the need for a flexible, modular framework supporting the connection of existing data sources with data analysis and modelling tools. Such an infrastructure could pave the way to IRA workflows applicable ad-hoc, e.g. in case of a crisis situation.

Keywords: import risk assessment, review, tools, food import

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Authors: Jens Hagman, Jenny Janhager Stier, Ellen Olausson, Anne Y. Faxer, Ana Magazinius

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Sweden has the second highest electric vehicle (plug-in hybrid and battery electric vehicle) sales per capita in Europe but in relation to sales of internal combustion engine electric vehicles sales are still minuscular (< 4%). Much research effort has been placed on various technical and user focused barriers and enablers for adoption of electric vehicles. Less effort has been placed on investigating the retail (dealership-customer) sales process of vehicles in general and electric vehicles in particular. Arguably, no one ought to be better informed about needs and desires of potential electric vehicle buyers than car salesmen, originating from their daily encounters with customers at the dealership. The aim of this paper is to explore the conditions of selling electric vehicle from a car salesmen’s perspective. This includes identifying barriers and enablers for electric vehicle sales originating from internal (dealership and brand) and external (customer, government) sources. In this interview study five car brands (manufacturers) that sell both electric and internal combustion engine vehicles have been investigated. A total of 15 semi-structured interviews have been conducted (three per brand, in rural and urban settings and at different dealerships). Initial analysis reveals several barriers and enablers, experienced by car salesmen, which influence electric vehicle sales. Examples of as reported by car salesmen identified barriers are: -Electric vehicles earn car salesmen less commission on average compared to internal combustion engine vehicles. -It takes more time to sell and deliver an electric vehicle than an internal combustion engine vehicle. -Current leasing contracts entails relatively low second-hand value estimations for electric vehicles and thus a high leasing fee, which negatively affects the attractiveness of electric vehicles for private consumers in particular. -High purchasing price discourages many consumers from considering electric vehicles. -The education and knowledge level of electric vehicles differs between car salesmen, which could affect their self-confidence in meeting well prepared and question prone electric vehicle buyers. Examples of identified enablers are: -Company car tax regulation promotes sales of electric vehicles; in particular, plug-in hybrid electric vehicles are sold extensively to companies (up to 95 % of sales). -Low operating cost of electric vehicles such as fuel and service is an advantage when understood by consumers. -The drive performance of electric vehicles (quick, silent and fun to drive) is attractive to consumers. -Environmental aspects are considered important for certain consumer groups. -Fast technological improvements, such as increased range are opening up a wider market for electric vehicles. -For one of the brands; attractive private lease campaigns have proved effective to promote sales. This paper gives insights of an important but often overlooked aspect for the diffusion of electric vehicles (and durable products in general); the interaction between car salesmen and customers at the critical acquiring moment. Extracted through interviews with multiple car salesmen. The results illuminate untapped potential for sellers (salesmen, dealerships and brands) to mitigating sales barriers and strengthening sales enablers and thus becoming a more important actor in the electric vehicle diffusion process.

Keywords: customer barriers, electric vehicle promotion, sales of electric vehicles, interviews with car salesmen

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Authors: Vitor M. Vilas Boas, Cleison D. Silva, Gustavo S. Mafra, Alexandre Trofino Neto

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Motor imagery (MI) based brain-computer interfaces (BCI) uses event-related (de)synchronization (ERS/ ERD), typically recorded using electroencephalography (EEG), to translate brain electrical activity into control commands. To mitigate undesirable artifacts and noise measurements on EEG signals, methods based on band-pass filters defined by a specific frequency band (i.e., 8 – 30Hz), such as the Infinity Impulse Response (IIR) filters, are typically used. Spatial techniques, such as Common Spatial Patterns (CSP), are also used to estimate the variations of the filtered signal and extract features that define the imagined motion. The CSP effectiveness depends on the subject's discriminative frequency, and approaches based on the decomposition of the band of interest into sub-bands with smaller frequency ranges (SBCSP) have been suggested to EEG signals classification. However, despite providing good results, the SBCSP approach generally increases the computational cost of the filtering step in IM-based BCI systems. This paper proposes the use of the Fast Fourier Transform (FFT) algorithm in the IM-based BCI filtering stage that implements SBCSP. The goal is to apply the FFT algorithm to reduce the computational cost of the processing step of these systems and to make them more efficient without compromising classification accuracy. The proposal is based on the representation of EEG signals in a matrix of coefficients resulting from the frequency decomposition performed by the FFT, which is then submitted to the SBCSP process. The structure of the SBCSP contemplates dividing the band of interest, initially defined between 0 and 40Hz, into a set of 33 sub-bands spanning specific frequency bands which are processed in parallel each by a CSP filter and an LDA classifier. A Bayesian meta-classifier is then used to represent the LDA outputs of each sub-band as scores and organize them into a single vector, and then used as a training vector of an SVM global classifier. Initially, the public EEG data set IIa of the BCI Competition IV is used to validate the approach. The first contribution of the proposed method is that, in addition to being more compact, because it has a 68% smaller dimension than the original signal, the resulting FFT matrix maintains the signal information relevant to class discrimination. In addition, the results showed an average reduction of 31.6% in the computational cost in relation to the application of filtering methods based on IIR filters, suggesting FFT efficiency when applied in the filtering step. Finally, the frequency decomposition approach improves the overall system classification rate significantly compared to the commonly used filtering, going from 73.7% using IIR to 84.2% using FFT. The accuracy improvement above 10% and the computational cost reduction denote the potential of FFT in EEG signal filtering applied to the context of IM-based BCI implementing SBCSP. Tests with other data sets are currently being performed to reinforce such conclusions.

Keywords: brain-computer interfaces, fast Fourier transform algorithm, motor imagery, sub-band common spatial patterns

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Authors: Richard Mababu Mukiur

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Leadership is an important drive that plays a key role in the success and development of organizations, particularly in the current context of digital transformation, highly competitivity and globalization. Leaders are persons that hold a dominant and privileged position within an organization, field, or sector of activities and are able to manage, motivate and exercise a high degree of influence over other in order to achieve the institutional goals. They achieve commitment and engagement of others to embrace change, and to make good decisions. Leadership studies in higher education institutions have examined how effective leaders hold their organizations, and also to find approaches which fit best in the organizations context for its better management, transformation and improvement. Moreover, recent studies have highlighted the impact of leadership styles on organizational performance and innovation capacities, since some styles give better results than others. Effective leadership is part of learning process that take place through day-to-day tasks, responsibilities, and experiences that influence the organizational performance, innovation and engagement of employees. The adoption of appropriate leadership styles can improve organization results and encourage learning process, team skills and performance, and employees' motivation and engagement. In the case of case of Information Technology sector, leadership styles are particularly crucial since this sector is leading relevant changes and transformations in the knowledge society. In this context, the main objective of this study is to analyze managers leadership styles with their relation to organizational performance and innovation that may be mediated by learning organization process and demographic variables. Therefore, it was hypothesized that the transformational and transactional leadership will be the main style adopted in Information Technology sector and will influence organizational performance and innovation capacity. A sample of 540 participants from Information technology sector has been determined in order to achieve the objective of this study. The Multifactor Leadership Questionnaire was administered as the principal instrument, Scale of innovation and Learning Organization Questionnaire. Correlations and multiple regression analysis have been used as the main techniques of data analysis. The findings indicate that leadership styles have a relevant impact on organizational performance and innovation capacity. The transformational and transactional leadership are predominant styles in Information technology sector. The effective leadership style tend to be characterized by the capacity of generating and sharing knowledge that improve organization performance and innovation capacity. Managers are adopting and adapting their leadership styles that respond to the new organizational, social and cultural challenges and realities of contemporary society. Managers who encourage innovation, foster learning process, share experience are useful to the organization since they contribute to its development and transformation. Learning process capacity and demographic variables (age, gender, and job tenure) mediate the relationship between leadership styles, innovation capacity and organizational performance. The transformational and transactional leadership tend to enhance the organizational performance due to their significant impact on team-building, employees' engagement and satisfaction. Some practical implications and future lines of research have been proposed.

Keywords: leadership styles, tranformational leadership, organisational performance, organisational innovation

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Authors: Susan C. Graham

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Authenticity has grown to be ubiquitous within the tourism vernacular. Yet, agreement regarding what authenticity means in relation to tourism remains nebulous. In its simplest form, authenticity in tourism refers to products and experiences that provide insights into the social, cultural, economic, natural, historical, and political life of a place. But this definition is unwieldy in its scope and may not help industry leaders nor tourist in identifying that which is authentic. Much of what is projected as authentic is a carefully curated and crafted message developed by marketers to appeal to visitors and bears little resemblance to the everyday lives of locals. So perhaps one way to identify authentic tourism experiences is to ask locals themselves. The purpose of this study was to explore the perspectives of locals with respect to what constituted an authentic tourism experience in Prince Edward Island (PEI), Canada. Over 600 volunteers in a tourism research panel were sent a survey asking them to describe authentic PEI experiences within ten sub-categories relevant to the local tourism industry. To make participation more manageable, each respondent was asked their perspectives on any three of the tourism sub-categories. Over 400 individuals responded, providing 1391 unique responses. The responses were grouped thematically using interpretive phenomenological analysis whereby the participants’ responses were clustered into higher order groups to extract meaning. Two interesting thematic observations emerged: first, that respondents tended to clearly articulate and differentiate between intra- versus interpersonal experiences as a means of authentically experiencing PEI; and second, while respondents explicitly valued unstaged experiences over staged, several exceptions to this general rule were expressed. Responses could clearly be grouped into those that emphasized “going off the beaten path,” “exploring pristine and untouched corners,” “lesser known,” “hidden”, “going solo,” and taking the opportunity to “slow down.” Each of these responses was “self” centered, and focused on the visitor discovering and exploring in search of greater self-awareness and inner peace. In contrast, other responses encouraged the interaction of visitors with locals as a means of experiencing the authentic place. Respondents sited “going deep-sea fishing” to learn about local fishers and their communities, stopping by “local farm stands” and speaking with farmers who worked the land for generations,” patronizing “local restaurants, pubs, and b&bs”, and partaking in performances or exhibits by local artists. These kinds of experiences, the respondents claimed, provide an authentic glimpse into a place’s character. The second set of observations focused on the distinction between staged and unstaged experiences, with respondents overwhelmingly advocating for unstaged. Responses were clear in shunning “touristy,” “packaged,” and “fake” offerings for being inauthentic and misrepresenting the place as locals view it. Yet many respondents made exceptions for certain “staged” experiences, including (quite literally) the stage production of Anne of Green Gables based on the novel of the same name, the theatrical re-enactment of the founding of Canada, and visits to PEI’s many provincial and national parks, all of which respondents considered both staged and authentic at the same time.

Keywords: authentic, local, Prince Edward Island, tourism

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Authors: Mona Mihailescu, Rebeca Tudor, Irina A. Paun, Cristian Kusko, Eugen I. Scarlat, Mihai Kusko

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Specific intensity distributions in the laser beams are required in many fields: optical communications, material processing, microscopy, optical tweezers. In optical communications, the information embedded in specific beams and the superposition of multiple beams can be used to increase the capacity of the communication channels, employing spatial modulation as an additional degree of freedom, besides already available polarization and wavelength multiplexing. In this regard, optical vortices present interest due to their potential to carry independent data which can be multiplexed at the transmitter and demultiplexed at the receiver. Also, in the literature were studied their combinations: 1) axial or perpendicular superposition of multiple optical vortices or 2) with other laser beam types: Bessel, Airy. Optical vortices, characterized by stationary ring-shape intensity and rotating phase, are achieved using computer generated holograms (CGH) obtained by simulating the interference between a tilted plane wave and a wave passing through a helical phase object. Here, we propose a method to combine information through the reunion of two CGHs. One is obtained using the helical phase distribution, characterized by its topological charge, m. The other is obtained using conical phase distribution, characterized by its radial factor, r0. Each CGH is obtained using plane wave with different tilts: km and kr for CGH generated from helical phase object and from conical phase object, respectively. These reunions of two CGHs are calculated to be phase optical elements, addressed on the liquid crystal display of a spatial light modulator, to optically process the incident beam for investigations of the diffracted intensity pattern in far field. For parallel reunion of two CGHs and high values of the ratio between km and kr, the bright ring from the first diffraction order, specific for optical vortices, is changed in an asymmetric intensity pattern: a number of circle arcs. Both diffraction orders (+1 and -1) are asymmetrical relative to each other. In different planes along the optical axis, it is observed that this asymmetric intensity pattern rotates around its centre: in the +1 diffraction order the rotation is anticlockwise and in the -1 diffraction order, the rotation is clockwise. The relation between m and r0 controls the diameter of the circle arcs and the ratio between km and kr controls the number of arcs. For perpendicular reunion of the two CGHs and low values of the ratio between km and kr, the optical vortices are multiplied and focalized in different planes, depending on the radial parameter. The first diffraction order contains information about both phase objects. It is incident on the phase masks placed at the receiver, computed using the opposite values for topological charge or for the radial parameter and displayed successively. In all, the proposed method is exploited in terms of constructive parameters, for the possibility offered by the combination of different types of beams which can be used in robust optical communications.

Keywords: asymmetrical diffraction orders, computer generated holograms, conical phase distribution, optical vortices, spatial light modulator

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Authors: Eman AbdelSabour

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Sustainability is increasingly being considered as a critical aspect in shaping the urban environment. It works as an invention development basis for global urban growth. Currently, different models and structures impact the means of interpreting the criteria that would be included in defining a sustainable city. There is a collective need to improve the growth path to an extremely durable path by presenting different suggestions regarding multi-scale initiatives. The global rise in urbanization has led to increased demand and pressure for better urban planning choice and scenarios for a better sustainable urban alternative. The need for an assessment tool at the urban scale was prompted due to the trend of developing increasingly sustainable urban development (SUD). The neighborhood scale is being managed by a growing research committee since it seems to be a pertinent scale through which economic, environmental, and social impacts could be addressed. Although neighborhood design is a comparatively old practice, it is in the initial years of the 21st century when environmentalists and planners started developing sustainable assessment at the neighborhood level. Through this, urban reality can be considered at a larger scale whereby themes which are beyond the size of a single building can be addressed, while it still stays small enough that concrete measures could be analyzed. The neighborhood assessment tool has a crucial role in helping neighborhood sustainability to perform approach and fulfill objectives through a set of themes and criteria. These devices are also known as neighborhood assessment tool, district assessment tool, and sustainable community rating tool. The primary focus of research has been on sustainability from the economic and environmental aspect, whereas the social, cultural issue is rarely focused. Therefore, this research is based on Doha, Qatar, the current urban conditions of the neighborhoods is discussed in this study. The research problem focuses on the spatial features in relation to the socio-cultural aspects. This study is outlined in three parts; the first section comprises of review of the latest use of wellbeing assessment methods to enhance decision process of retrofitting physical features of the neighborhood. The second section discusses the urban settlement development, regulations and the process of decision-making rule. An analysis of urban development policy with reference to neighborhood development is also discussed in this section. Moreover, it includes a historical review of the urban growth of the neighborhoods as an atom of the city system present in Doha. Last part involves developing quantified indicators regarding subjective well-being through a participatory approach. Additionally, applying GIS will be utilized as a visualizing tool for the apparent Quality of Life (QoL) that need to develop in the neighborhood area as an assessment approach. Envisaging the present QoL situation in Doha neighborhoods is a process to improve current condition neighborhood function involves many days to day activities of the residents, due to which areas are considered dynamic.

Keywords: neighborhood, subjective wellbeing, decision support tools, Doha, retrofiring

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Authors: Gelareh Ghaderi

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the overall objective of this study is to develop two alternative plans of spatial and infrastructural development for the Netwerkstad Twente (Twente region) until 2040 and to assess the impacts of those two alternative plans. This region is located on the eastern border of the Netherlands, and it comprises of five municipalities. Based on the strengths and opportunities of the five municipalities of the Netwerkstad Twente, and in order develop the region internationally, strengthen the job market and retain skilled and knowledgeable young population, two alternative visions have been developed; environmental oriented vision, and economical oriented vision. Environmental oriented vision is based mostly on preserving beautiful landscapes. Twente would be recognized as an educational center, driven by green technologies and environment-friendly economy. Market-oriented vision is based on attracting and developing different economic activities in the region based on visions of the five cities of Netwerkstad Twente, in order to improve the competitiveness of the region in national and international scale. On the basis of the two developed visions and strategies for achieving the visions, land use and infrastructural development are modeled and assessed. Based on the SWOT analysis, criteria were formulated and employed in modeling the two contrasting land use visions by the year 2040. Land use modeling consists of determination of future land use demand, assessment of suitability land (Suitability analysis), and allocation of land uses on suitable land. Suitability analysis aims to determine the available supply of land for future development as well as assessing their suitability for specific type of land uses on the basis of the formulated set of criteria. Suitability analysis was operated using CommunityViz, a Planning Support System application for spatially explicit land suitability and allocation. Netwerkstad Twente has highly developed transportation infrastructure, consists of highways network, national road network, regional road network, street network, local road network, railway network and bike-path network. Based on the assumptions of speed limitations on different types of roads provided, infrastructure accessibility level of predicted land use parcels by four different transport modes is investigated. For evaluation of the two development scenarios, the Multi-criteria Evaluation (MCE) method is used. The first step was to determine criteria used for evaluation of each vision. All factors were categorized as economical, ecological and social. Results of Multi-criteria Evaluation show that Environmental oriented cities scenario has higher overall score. Environment-oriented scenario has impressive scores in relation to economical and ecological factors. This is due to the fact that a large percentage of housing tends towards compact housing. Twente region has immense potential, and the success of this project will define the Eastern part of The Netherlands and create a real competitive local economy with innovations and attractive environment as its backbone.

Keywords: economical oriented vision, environmental oriented vision, infrastructure, land use, multi criteria assesment, vision

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Authors: Sandra Costa-Santos, Nadia Bertolino, Stephen Hicks, Vanessa May, Camilla Lewis

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This paper aims to elaborate the architectural theory on place-making that supported Claremont Court housing scheme (Edinburgh, United Kingdom). Claremont Court (1959-62) is a large post-war mixed development housing scheme designed by Basil Spence, which included ‘place-making’ as one of its founding principles. Although some stylistic readings of the housing scheme have been published, the theory on place-making that allegedly ruled the design has yet to be clarified. The architecture allows us to mark or make a place within space in order to dwell. Under the framework of contemporary philosophical theories of place, this paper aims to explore the relationship between place and dwelling through a cross-disciplinary reading of Claremont Court, with a view to develop an architectural theory on place-making. Since dwelling represents the way we are immersed in our world in an existential manner, this theme is not just relevant for architecture but also for philosophy and sociology. The research in this work is interpretive-historic in nature. It examines documentary evidence of the original architectural design, together with relevant literature in sociology, history, and architecture, through the lens of theories of place. First, the paper explores how the dwelling types originally included in Claremont Court supported ideas of dwelling or meanings of home. Then, it traces shared space and social ties in order to study the symbolic boundaries that allow the creation of a collective identity or sense of belonging. Finally, the relation between the housing scheme and the supporting theory is identified. The findings of this research reveal Scottish architect Basil Spence’s exploration of the meaning of home, as he changed his approach to the mass housing while acting as President of the Royal Incorporation of British Architects (1958-60). When the British Government was engaged in various ambitious building programmes, he sought to drive architecture to a wider socio-political debate as president of the RIBA, hence moving towards a more ambitious and innovative socio-architectural approach. Rather than trying to address the ‘genius loci’ with an architectural proposition, as has been stated, the research shows that the place-making theory behind the housing scheme was supported by notions of community-based on shared space and dispositions. The design of the housing scheme was steered by a desire to foster social relations and collective identities, rather than by the idea of keeping the spirit of the place. This research is part of a cross-disciplinary project funded by the Arts and Humanities Research Council. The findings present Claremont Court as a signifier of Basil Spence’s attempt to address the post-war political debate on housing in United Kingdom. They highlight the architect’s theoretical agenda and challenge current purely stylistic readings of Claremont Court as they fail to acknowledge its social relevance.

Keywords: architectural theory, dwelling, place-making, post-war housing

Procedia PDF Downloads 235