Search results for: physical education teacher

Authors: Andrew D. Henshaw, James M. Austin

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Introduction: Human trafficking is an increasingly serious transnational criminal enterprise and social security issue. Despite ongoing efforts to mitigate the phenomenon and a significant expansion of security scrutiny over past decades, it is not receding. This is true for many nations in Southeast Asia, widely recognized as the global hub for trafficked persons, including men, women, and children. Clearly, human trafficking is difficult to address because there are numerous drivers, causes, and motivators for it to persist, such as non-military and non-traditional security challenges, i.e., climate change, global warming displacement, and natural disasters. These make displaced persons and refugees particularly vulnerable. The issue is so large conservative estimates put a dollar value at around $150 billion-plus per year (Niethammer, 2020) spanning sexual slavery and exploitation, forced labor, construction, mining and in conflict roles, and forced marriages of girls and women. Coupled with corruption throughout military, police, and civil authorities around the world, and the active hands of powerful transnational criminal organizations, it is likely that such figures are grossly underestimated as human trafficking is misreported, under-detected, and deliberately obfuscated to protect those profiting from it. For example, the 2022 UN report on human trafficking shows a 56% reduction in convictions in that year alone (UNODC, 2022). Our Approach: To better understand this, our research utilizes a bespoke methodology. Applying a JAM (Juxtaposition Assessment Matrix), which we previously developed to detect flows of dark money around the globe (Henshaw, A & Austin, J, 2021), we now focus on the human trafficking paradigm. Indeed, utilizing a JAM methodology has identified key indicators of human trafficking not previously explored in depth. Being a set of structured analytical techniques that provide panoramic interpretations of the subject matter, this iteration of the JAM further incorporates behavioral and driver indicators, including the employment of Open-Source Artificial Intelligence (OS-AI) across multiple collection points. The extracted behavioral data was then applied to identify non-traditional indicators as they contribute to human trafficking. Furthermore, as the JAM OS-AI analyses data from the inverted position, i.e., the viewpoint of the traffickers, it examines the behavioral and physical traits required to succeed. This transposed examination of the requirements of success delivers potential leverage points for exploitation in the fight against human trafficking in a new and novel way. Findings: Our approach identified new innovative datasets that have previously been overlooked or, at best, undervalued. For example, the JAM OS-AI approach identified critical 'dark agent' lynchpins within human trafficking that are difficult to detect and harder to connect to actors and agents within a network. Our preliminary data suggests this is in part due to the fact that ‘dark agents’ in extant research have been difficult to detect and potentially much harder to directly connect to the actors and organizations in human trafficking networks. Our research demonstrates that using new investigative techniques such as OS-AI-aided JAM introduces a powerful toolset to increase understanding of human trafficking and transnational crime and illuminate networks that, to date, avoid global law enforcement scrutiny.

Keywords: human trafficking, open-source intelligence, transnational crime, human security, international human rights, intelligence analysis, JAM OS-AI, Dark Money

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Authors: Imen Asma Mbarek, Alexis Rusinek, Etienne Petit, Guy Sutter, Gautier List

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Over the past two decades, the automotive, aerospace and army industries have been paying an increasing attention to Finite Elements (FE) numerical simulations of the fracture process of their structures. Thanks to the numerical simulations, it is nowadays possible to analyze several problems involving costly and dangerous extreme loadings safely and at a reduced cost such as blast or ballistic impact problems. The present paper is concerned with ballistic impact and perforation problems involving ductile fracture of thin armor steel targets. The target fracture process depends usually on various parameters: the projectile nose shape, the target thickness and its mechanical properties as well as the impact conditions (friction, oblique/normal impact...). In this work, the investigations are concerned with the normal impact of a conical head-shaped projectile on thin armor steel targets. The main aim is to establish a comparative study of four fracture criteria that are commonly used in the fracture process simulations of structures subjected to extreme loadings such as ballistic impact and perforation. Usually, the damage initiation results from a complex physical process that occurs at the micromechanical scale. On a macro scale and according to the following fracture models, the variables on which the fracture depends are mainly the stress triaxiality ƞ, the strain rate, temperature T, and eventually the Lode angle parameter Ɵ. The four failure criteria are: the critical strain to failure model, the Johnson-Cook model, the Wierzbicki model and the Modified Hosford-Coulomb model MHC. Using the SEM, the observations of the fracture facies of tension specimen and of armor steel targets impacted at low and high incident velocities show that the fracture of the specimens is a ductile fracture. The failure mode of the targets is petalling with crack propagation and the fracture facies are covered with micro-cavities. The parameters of each ductile fracture model have been identified for three armor steels and the applicability of each criterion was evaluated using experimental investigations coupled to numerical simulations. Two loading paths were investigated in this study, under a wide range of strain rates. Namely, quasi-static and intermediate uniaxial tension and quasi-static and dynamic double shear testing allow covering various values of stress triaxiality ƞ and of the Lode angle parameter Ɵ. All experiments were conducted on three different armor steel specimen under quasi-static strain rates ranging from 10-4 to 10-1 1/s and at three different temperatures ranging from 297K to 500K, allowing drawing the influence of temperature on the fracture process. Intermediate tension testing was coupled to dynamic double shear experiments conducted on the Hopkinson tube device, allowing to spot the effect of high strain rate on the damage evolution and the crack propagation. The aforementioned fracture criteria are implemented into the FE code ABAQUS via VUMAT subroutine and they were coupled to suitable constitutive relations allow having reliable results of ballistic impact problems simulation. The calibration of the four damage criteria as well as a concise evaluation of the applicability of each criterion are detailed in this work.

Keywords: armor steels, ballistic impact, damage criteria, ductile fracture, SEM

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Authors: Sofia N. Gonçalves, Duarte M. S. Albuquerque, José C. F. Pereira

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Microwave technology has been gaining importance in contributing to decarbonization processes in high energy demand industries. Despite the several numerical models presented in the literature, a proper Verification and Validation exercise is still lacking. This is important and required to evaluate the physical process model accuracy and adequacy. Another issue addresses impedance matching, which is an important mechanism used in microwave experiments to increase electromagnetic efficiency. Such mechanism is not available in current computational tools, thus requiring an external numerical procedure. A numerical model was implemented to study the continuous processing of limestone with microwave heating. This process requires the material to be heated until a certain temperature that will prompt a highly endothermic reaction. Both a 2D and 3D model were built in COMSOL Multiphysics to solve the two-way coupling between Maxwell and Energy equations, along with the coupling between both heat transfer phenomena and limestone endothermic reaction. The 2D model was used to study and evaluate the required numerical procedure, being also a benchmark test, allowing other authors to implement impedance matching procedures. To achieve this goal, a controller built in MATLAB was used to continuously matching the cavity impedance and predicting the required energy for the system, thus successfully avoiding energy inefficiencies. The 3D model reproduces realistic results and therefore supports the main conclusions of this work. Limestone was modeled as a continuous flow under the transport of concentrated species, whose material and kinetics properties were taken from literature. Verification and Validation of the coupled model was taken separately from the chemical kinetic model. The chemical kinetic model was found to correctly describe the chosen kinetic equation by comparing numerical results with experimental data. A solution verification was made for the electromagnetic interface, where second order and fourth order accurate schemes were found for linear and quadratic elements, respectively, with numerical uncertainty lower than 0.03%. Regarding the coupled model, it was demonstrated that the numerical error would diverge for the heat transfer interface with the mapped mesh. Results showed numerical stability for the triangular mesh, and the numerical uncertainty was less than 0.1%. This study evaluated limestone velocity, heat transfer, and load influence on thermal decomposition and overall process efficiency. The velocity and heat transfer coefficient were studied with the 2D model, while different loads of material were studied with the 3D model. Both models demonstrated to be highly unstable when solving non-linear temperature distributions. High velocity flows exhibited propensity to thermal runways, and the thermal efficiency showed the tendency to stabilize for the higher velocities and higher filling ratio. Microwave efficiency denoted an optimal velocity for each heat transfer coefficient, pointing out that electromagnetic efficiency is a consequence of energy distribution uniformity. The 3D results indicated the inefficient development of the electric field for low filling ratios. Thermal efficiencies higher than 90% were found for the higher loads and microwave efficiencies up to 75% were accomplished. The 80% fill ratio was demonstrated to be the optimal load with an associated global efficiency of 70%.

Keywords: multiphysics modeling, microwave heating, verification and validation, endothermic reactions modeling, impedance matching, limestone continuous processing

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Authors: Zahide Tepeli Temiz, Itir Tari Comert

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Attachment patterns based on early emotional interactions between infant and primary caregiver continue to be influential in adult life, in terms of mental health and behaviors of individuals. Several studies reveal that infant-caregiver relationships have impressed the affect regulation, coping with stressful and negative situations, general satisfaction of life, and self image in adulthood, besides the attachment styles. The present study aims to examine the relationships between university students’ attachment style and their self-esteem, alexithymic features, satisfaction of life, and level of resilience. In line with this aim, the hypothesis of the prediction of attachment styles (anxious and avoidant) over life satisfaction, self-esteem, alexithymia, and psychological resilience was tested. Additionally, in this study Structural Equational Modeling was conducted to investigate the mediational role of self-esteem in the relationship between attachment styles and alexithymia, life satisfaction, and resilience. This model was examined with path analysis. The sample of the research consists of 425 university students who take education from several region of Turkey. The participants who sign the informed consent completed the Demographic Information Form, Experiences in Close Relationships-Revised, Rosenberg Self-Esteem Scale, The Satisfaction with Life Scale, Toronto Alexithymia Scale, and Resilience Scale for Adults. According to results, anxious, and avoidant dimensions of insecure attachment predicted the self-esteem score and alexithymia in positive direction. On the other hand, these dimensions of attachment predicted life satisfaction in negative direction. The results of linear regression analysis indicated that anxious and avoidant attachment styles didn’t predict the resilience. This result doesn’t support the theory and research indicating the relationship between attachment style and psychological resilience. The results of path analysis revealed the mediational role self esteem in the relation between anxious, and avoidant attachment styles and life satisfaction. In addition, SEM analysis indicated the indirect effect of attachment styles over alexithymia and resilience besides their direct effect. These findings support the hypothesis of this research relation to mediating role of self-esteem. Attachment theorists suggest that early attachment experiences, including supportive and responsive family interactions, have an effect on resilience to harmful situations in adult life, ability to identify, describe, and regulate emotions and also general satisfaction with life. Several studies examining the relationship between attachment styles and life satisfaction, alexithymia, and psychological resilience draw attention to mediational role of self-esteem. Results of this study support the theory of attachment patterns with the mediation of self-image influence the emotional, cognitive, and behavioral regulation of person throughout the adulthood. Therefore, it is thought that any intervention intended for recovery in attachment relationship will increase the self-esteem, life satisfaction, and resilience level, on the one side, decrease the alexithymic features, on the other side.

Keywords: alexithymia, anxious attachment, avoidant attachment, life satisfaction, path analysis, resilience, self-esteem, structural equation

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Authors: Mohd Zaimmudin Mohd Zain, Patsy Perry, Lee Quinn

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This study explores how fashion consumers are influenced by fashion bloggers towards pre-purchase decision for online fashion products in a non-Western context. Malaysians rank among the world’s most avid online shoppers, with apparel the third most popular purchase category. However, extant research on fashion blogging focuses on the developed Western market context. Numerous international fashion retailers have entered the Malaysian market from luxury to fast fashion segments of the market; however Malaysian fashion consumers must balance religious and social norms for modesty with their dress style and adoption of fashion trends. Consumers increasingly mix and match Islamic and Western elements of dress to create new styles enabling them to follow Western fashion trends whilst paying respect to social and religious norms. Social media have revolutionised the way that consumers can search for and find information about fashion products. For online fashion brands with no physical presence, social media provide a means of discovery for consumers. By allowing the creation and exchange of user-generated content (UGC) online, they provide a public forum that gives individual consumers their own voices, as well as access to product information that facilitates their purchase decisions. Social media empower consumers and brands have important roles in facilitating conversations among consumers and themselves, to help consumers connect with them and one another. Fashion blogs have become an important fashion information sources. By sharing their personal style and inspiring their followers with what they wear on popular social media platforms such as Instagram, fashion bloggers have become fashion opinion leaders. By creating UGC to spread useful information to their followers, they influence the pre-purchase decision. Hence, successful Western fashion bloggers such as Chiara Ferragni may earn millions of US dollars every year, and some have created their own fashion ranges and beauty products, become judges in fashion reality shows, won awards, and collaborated with high street and luxury brands. As fashion blogging has become more established worldwide, increasing numbers of fashion bloggers have emerged from non-Western backgrounds to promote Islamic fashion styles, such as Hassanah El-Yacoubi and Dian Pelangi. This study adopts a qualitative approach using netnographic content analysis of consumer comments on two famous Malaysian fashion bloggers’ Instagram accounts during January-March 2016 and qualitative interviews with 16 Malaysian Generation Y fashion consumers during September-October 2016. Netnography adapts ethnographic techniques to the study of online communities or computer-mediated communications. Template analysis of the data involved coding comments according to the theoretical framework, which was developed from the literature review. Initial data analysis shows the strong influence of Malaysian fashion bloggers on their followers in terms of lifestyle and morals as well as fashion style. Followers were guided towards the mix and match trend of dress with Western and Islamic elements, for example, showing how vivid colours or accessories could be worked into an outfit whilst still respecting social and religious norms. The blogger’s Instagram account is a form of online community where followers can communicate and gain guidance and support from other followers, as well as from the blogger.

Keywords: fashion bloggers, Malaysia, qualitative, social media

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Authors: Afrah Saad Mohsen Al-Mahfadi

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The construction of dams can provide various ecosystem services, but it can also lead to ecological changes such as habitat loss and coastal degradation. Yemen faces multiple risks, including water crises and inadequate environmental policies, which are particularly detrimental to coastal zones like the Ahwar Delta in Abyan. This study aims to examine the impacts of dam construction on downstream wetlands and propose sustainable management approaches. Research Aim: The main objective of this study is to assess the different impacts of dam construction on downstream wetlands, specifically focusing on the Ahwar Delta in Yemen. Methodology: The study utilizes a literature review approach to gather relevant information on dam impacts and adaptation measures. Interviews with decision-making stakeholders and local community members are conducted to gain insights into the specific challenges faced in the Ahwar Delta. Additionally, sensing data, such as Arc-GIS and precipitation data from 1981 to 2020, are analyzed to examine changes in hydrological dynamics. Questions Addressed: This study addresses the following questions: What are the impacts of dam construction on downstream wetlands in the Ahwar delta? How can environmental management planning activities be implemented to minimize these impacts? Findings: The results indicate several future issues arising from dam construction in the coastal areas, including land loss due to rising sea levels and increased salinity in drinking water wells. Climate change has led to a decrease in rainfall rates, impacting vegetation and increasing sedimentation and erosion. Downstream areas with dams exhibit lower sediment levels and slower flowing habitats compared to those without dams. Theoretical Importance: The findings of this study provide valuable insights into the ecological impacts of dam construction on downstream wetlands. Understanding these dynamics can inform decision-makers about the need for adaptation measures and their potential benefits in improving coastal biodiversity under dam impacts. Data Collection and Analysis Procedures: The study collects data through a literature review, interviews, and sensing technology. The literature review helps identify relevant studies on dam impacts and adaptation measures. Interviews with stakeholders and local community members provide firsthand information on the specific challenges faced in the Ahwar Delta. Sensing data, such as Arc-GIS and precipitation data, are analyzed to understand changes in hydrological dynamics over time. Conclusion: The study concludes that while the situation can worsen due to dam construction, practical adaptation measures can help mitigate the impacts. Recommendations include improving water management, developing integrated coastal zone planning, raising awareness among stakeholders, improving health and education, and implementing emergency projects to combat climate change.

Keywords: dam impact, delta wetland, hydrology, Yemen

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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

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Authors: Shulamit Sternin, Raymond M. McKie, Carter Winberg, Robb N. Travers, Terry P. Humphreys, Elke D. Reissing

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Issues surrounding sexual consent negotiation have become a major topic of societal concern. The majority of current research focuses on the complexities of sexual consent negotiations and the multitude of nuanced issues that surround the consent obtainment of heterosexual adults in post-secondary educational institutions. To date, the only study that has addressed sexual consent negotiation behaviour in same-sex relationships focused on the extent to which individuals used a variety of different verbal and nonverbal sexual consent behaviours to initiate or respond to sexual activity. The results were consistent with trends found within heterosexual individuals; thus, suggesting that the current understanding of sexual consent negotiation, which is grounded in heterosexual research, can serve as a strong foundation for further exploration of sexual consent negotiation within same-sex relationships populations. The current study quantitatively investigated the differences between heterosexual men and gay and bisexual men (GBM) in their understanding of sexual consent negotiation. Exploring how the perceptions of GBM differ from heterosexual males provides insight into some of the unique challenges faced by GBM. Data were collected from a sample of 252 heterosexual men and 314 GBM from Canada, the United States, and Western Europe. Participants responded to the question, 'do you think sexual consent and sex negotiation is different for heterosexual men compared to gay men? If so, how?' by completed an online survey. Responses were analysed following Braun & Clarke’s (2006) six phase thematic analysis guidelines. Inter-rater coding was validated using Cohen’s Kappa value and was calculated at (ϰ = 0.84), indicating a very strong level of agreement between raters. The final thematic structure yielded four major themes: understanding of sexual interaction, unique challenges, scripted role, and universal consent. Respondents spoke to their understanding of sexual interaction, believing GBM sexual consent negotiation to be faster and more immediate. This was linked to perceptions of emotional attachment and the idea that sexual interaction and emotional involvement were distinct and separate processes in GBM sexual consent negotiation, not believed to be the case in heterosexual interactions. Unique challenges such as different protection concerns, role declaration, and sexualization of spaces were understood to hold differing levels of consideration for heterosexual men and GBM. The perception of a clearly defined sexual script for GBM was suggested as a factor that may create ambiguity surrounding sexual consent negotiation, which in turn holds significant implications on unwanted sexual experiences for GBM. Broadening the scope of the current understanding of sexual consent negotiation by focusing on heterosexual and GBM population, the current study has revealed variations in perception of sexual consent negotiation between these two populations. These differences may be understood within the context of sexual scripting theory and masculinity gender role theory. We suggest that sexual consent negotiation is a health risk factor for GBM that has not yet been adequately understood and addressed. Awareness of the perceptions that surround the sexual consent negotiation of both GBM and heterosexual men holds implications on public knowledge, which in turn can better inform policy making, education, future research, and clinical treatment.

Keywords: sexual consent, negotiation, heterosexual men, GBM, sexual script

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Authors: Damian Graham, Ashleigh H. Hall, Damani R. Sulph, Michael A. James, Shawn B. Vassell

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This paper assesses the design and feasibility of a Materials Recovery Facility (MRF) in Jamaica as a possible green industry approach to the nation’s economic and solid waste management problems. Jamaica is a developing nation that is vulnerable to climate change that can affect its blue economy and tourism on which it is heavily reliant. Jamaica’s National Solid Waste Management Authority (NSWMA) collects only a fraction of all the solid waste produced annually which is then transported to dumpsites. The remainder is either burnt by the population or disposed of illegally. These practices negatively impact the environment, threaten the sustainability of economic growth from blue economy and tourism and its waste management system is predominantly a cost centre. The implementation of an MRF could boost the manufacturing sector, contribute to economic growth, and be a catalyst in creating a green industry with multiple downstream value chains with supply chain linkages. Globally, there is a trend to reuse and recycle that created an international market for recycled solid waste. MRFs enable the efficient sorting of solid waste into desired recoverable materials thus providing a gateway for entrance to the international trading of recycled waste. Research into the current state and effort to improve waste management in Jamaica in contrast with the similar and more advanced territories are outlined. The study explores the concept of green industrialization and its applicability to vulnerable small state economies like Jamaica. The study highlights the possible contributions and benefits derived from MRFs as a seeding factory that can anchor the reverse and forward logistics of other green industries as part of a logistic-cantered economy. Further, the study showcases an engineering economic analysis that assesses the viability of the implementation of an MRF in Jamaica. This research outlines the potential cost of constructing and operating an MRF and provides a realistic cash flow estimate to establish a baseline for profitability. The approach considers quantitative and qualitative data, assumptions, and modelling using industrial engineering tools and techniques that are outlined. Techniques of facility planning, system analysis and operations research with a focus on linear programming techniques are expressed. Approaches to overcome some implementation challenges including policy, technology and public education are detailed. The results of this study present a reasonable judgment of the prospects of incorporating an MRF to improve Jamaica’s solid waste management and contribute to socioeconomic and environmental benefits and an alternate pathway for economic sustainability.

Keywords: engineering-economic analysis, facility design, green industry, MRF, manufacturing, plant layout, solid-waste management, sustainability, waste disposal

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Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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Authors: Maria Luiza Fulga, Georgeta Truca, Mihaela Alexandru, Andriescu Mariana, Crin Marcean

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The significance of nursing as a subject in the post-secondary healthcare curriculum is a major. We aimed to enable our students to assess the patient's risk, to establish prevention measures and to adapt to a specific learning context, in order to acquire the skills and abilities necessary for the nursing profession. In order to achieve these objectives, during the three years of study, teachers put an emphasis on acquiring communication skills, because in our country after the first cycle of hospital accreditation concluded in 2016, the National Authority for Quality of Health Management has introduced the criteria for the implementation and application of the nursing process according to the accreditation standards. According to these requirements, the nurse has to carry out the nursing assessment, based on communication as a distinct component, so that they can identify nursing diagnoses and implement the nursing plan. In this respect, we, the teachers, have refocused, by approaching various teaching strategies and preparing students for the real context of learning and applying what they learn. In the educational process, the tutors in the hospitals have an important role to play in acquiring professional skills. Students perform their activity in the hospital in accordance with the curriculum, in order to verify the practical applicability of the theoretical knowledge acquired in the school classes and also have the opportunity to acquire their skills in a real learning context. In clinical education, the student nurse learns in the middle of a guidance team which includes a practice tutor, who is a nurse that takes responsibility for the practical/clinical learning of the students in their field of activity. In achieving this objective, the tutor's abilities involve pedagogical knowledge, knowledge for the good of the individual and nursing theory, in order to be able to guide clinical practice in accordance with current requirements. The aim of this study is to find out the students’ confidence level in practice tutors in hospitals, the students’ degree of satisfaction in the pedagogical skills of the tutors and the practical applicability of the theoretical knowledge. In this study, we used as a method of investigation a student satisfaction questionnaire regarding the clinical practice in the hospital and the sample of the survey consisted of 100 students aged between 20 and 50 years, from the first, second and third year groups, with the General Nurse specialty (nurses responsible for general care), from 'Fundeni' Healthcare Post-Secondary School, Bucharest, Romania. Following the analysis of the data provided, we arrived the conclusion that the hospital tutor needs to improve his/her pedagogical skills, the knowledge of nursing diagnostics, and the implementation of the nursing plan, so that the applicability of the theoretical notions would be increased. Future plans include the pedagogical training of the medical staff, as well as updating the knowledge needed to implement the nursing process in order to meet current requirements.

Keywords: clinical training, nursing process, pedagogical skills, tutor

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Authors: Tesfaldet Mekonnen Estifanos, Chen Hui, Afewerki Weldezgi

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Background: Youth in general and young females in particular, remain at the center of the HIV/AIDS epidemic. Sexual risk-taking among young unmarried women is relatively high and are the most vulnerable and highly exposed to HIV/AIDS. Improvements in the status of HIV/AIDS knowledge and acceptance attitude towards people living with HIV (PLWHIV) plays a great role in averting the incidence of HIV/AIDS. Thus, the aim of the study was to explore the level and correlates of HIV/AIDS knowledge and accepting attitude toward PLWHIV. Methods: A cross-sectional study was conducted using data from the Uganda Demographic Health Survey 2016 (UDHS-2016). National level representative household surveys using a multistage cluster probability sampling method, face to face interviews with standard questionnaires were performed. Unmarried women aged 15-24 years with a sample size of 2019 were selected from the total sample of 8674 women aged 15-49 years and were analyzed using SPSS version 23. Independent variables such as age, religion, educational level, residence, and wealth index were included. Two binary outcome variables (comprehensive HIV/AIDS knowledge and acceptance attitude toward PLWHIV) were utilized. We used the chi-square test as well as multivariate regression analysis to explore correlations of explanatory variables with the outcome variables. The results were reported by odds ratios (OR) with 95% confidence interval (95% CI), taking a p-value less than 0.05 as significant. Results: Almost all (99.3%) of the unmarried women aged 15-24 years were aware of HIV/AIDS, but only 51.2% had adequate comprehensive knowledge on HIV/AIDS. Only 69.4% knew both methods: using a condom every time had sex, and having only one faithful uninfected partner can prevent HIV/AIDS transmission. About 66.6% of the unmarried women reject at least two common local misconceptions about HIV/AIDS. Moreover, an alarmingly few (20.3%) of the respondents had a positive acceptance attitude to PLWHIV. On multivariate analysis, age (20-24 years), living in urban, being educated and wealthier, were predictors of having adequate comprehensive HIV/AIDS knowledge. On the other hand, research participants with adequate comprehensive knowledge about HIV/AIDS were highly likely (OR, 1.94 95% CI, 1.52-2.46) to have a positive acceptance attitude to PLWHIV than those with inadequate knowledge. Respondents with no education, Muslim, and Pentecostal religion were emerged less likely to have a positive acceptance attitude to PLWHIV. Conclusion: This study found out the highly accepted level of awareness, but the knowledge and positive acceptance attitude are not encouraging. Thus, expanding access to comprehensive sexuality and strengthening educational campaigns on HIV/AIDS in communities, health facilities, and schools is needed with a greater focus on disadvantaged women having low educational level, poor socioeconomic status, and those residing in rural areas. Sexual risk behaviors among the most affected people - young women have also a role in the spread of HIV/AIDS. Hence, further research assessing the significant contributing factors for sexual risk-taking might have a positive impact on the fight against HIV/AIDS.

Keywords: acceptance attitude, HIV/AIDS, knowledge, unmarried women

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Authors: Rick Evans

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Despite over 40 years of research into why women choose not to enroll or leave undergraduate engineering programs, along with the subsequent and serious efforts to attract more women, women receiving bachelor's degrees in engineering in the US have remained disappointingly low. We know that even despite their struggles to become more welcoming and inclusive, engineering programs remain gendered, raced and classed. However, our research team has found that women who participate and indeed thrive in undergraduate engineering project teams do so in numbers that far exceed their participation in undergraduate programs. We believe part of the answer lies in the ways that project teams facilitate experiential learning, specifically providing opportunities for members to play, practice and perform. We employ a multi-case study method and assume a feminist, activist and interpretive perspective. We seek to generate concrete and context-dependent knowledge in order to explore potentially new variables and hypotheses. Our focus is to learn from those select women who are thriving. For this oral or e-poster presentation, we will focus on the results of the second of our semi-structured interviews – the learning journey interview. During this interview, we ask participants to tell us the story/ies of their participation in project teams. Our results suggest these women find joy in their experience of developing and applying engineering expertise. They experience this joy and develop their expertise in the highly patterned progression of play, practice and performance. Play is a purposeful activity in which someone enters an imaginary world, a world not yet real to them. However, this imaginary world is still very much connected to the real world, in this case, a particular kind of engineering, in that the ways of engaging are already established, codified and rule-governed. As such, these women are novices motivated to join a community of actors. Practice, better understood as practices, a count noun, is an embodied, materially interconnected collection of actions organized around the shared understandings of that community of actors. Those shared understandings reveal a social order – a particular field of engineering. No longer novices, these women begin to develop and display their emergent identities as engineers. Perform is activity meant either to demonstrate competence and/or to enable, even teach play and practice to others. As performers, these women participants become models for others. They direct play and practice, contextualizing both within a field of engineering and the specific aims of the project team community. By playing, practicing and performing engineering, women claim their identities as engineers and, equally important, have those identities acknowledged by team members. If we hope to transform our gendered, raced, classed institutions, we need to learn more about women who thrive within those institutions. We need to learn more about their processes of becoming and belonging as engineers. Our research presentation begins with a description of project teams and our multi-case study method. We then offer detailed descriptions of play, practice, and performance using the voices of women in project teams.

Keywords: engineering education, gender, identity, project teams

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Authors: Leticia Lengler, Vania Estivalete, Vivian Flores Costa, Tais De Andrade, Lisiane Fellini Faller

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Social entrepreneurship has emerged and driven a new development perspective, and as the literature mentions, it is based on innovation, and mainly, on the creation of social value, rather than personal wealth and shareholders. In this field of study, one of the focuses of discussion refers to the distinct characteristics of the individuals responsible for socially directed initiatives, named as social entrepreneurs. To contribute to this perspective, the present study aims to identify the values related to work that guide the performance of social entrepreneurs, members of enterprises that have developed themselves within a social incubator at a federal institution of higher education in Brazil. Each person's value system is present in different facets of his life, manifesting himself in his choices and in the way he conducts the relationship with other people in society. Especially the values of work, the focus of this research, play a significant role in organizational studies, since they are considered one of the important guiding principles of the behavior of individuals in the work environment. Regarding the method of the study, a descriptive and qualitative research was carried out. In the data collection, 24 entrepreneurs, members of five different enterprises belonging to the social incubator, were interviewed. The research instrument consisted of three open questions, which could be answered with the support of a "disc of values", an artifact organized to clearly demonstrate the values of the work to the respondents. The analysis of the interviews took into account the categories defined a priori, based on the model proposed by previous authors who validated these constructs within their research contexts, contemplating the following dimensions: Self-determination and stimulation; Safety; Conformity; Universalism and benevolence; Achievement; and Power. It should be noted that, in order to provide a better understanding of the interviewees, in the "disc of values" used in the research, these dimensions were represented by the objectives that define them, being respectively: Challenge; Financial independence; Commitment; Welfare of others; Personal success; And Power. Some preliminary results show that, as guiding principles of the investigation, priority is given to work values related to Self-determination and stimulation, Conformity and Universalism and benevolence. Such findings point to the importance given by these individuals to independent thinking and acting, as well as to novelty and constant challenge. Still, they demonstrate the appreciation of commitment to their enterprise, the people who make it and the quality of their work. They also point to the relevance of the possibility of contributing to the greater social good, that is, of the search for the well-being of close people and of society, as it is implied in models of social entrepreneurship coming from literature. With a lower degree of priority, the values denominated Safety and Realization, as the financial question at work and the search for satisfaction and personal success, through the use of socially recognized skills were mentioned aspects with little emphasis by social entrepreneurs. The Power value was not considered as guiding principle of the work for the respondents.

Keywords: qualitative study, social entrepreneur, social incubator, values of work

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Authors: Geremew Geidare Kailo, Igor Gáspár, András Koris, Ivana Pajčin, Flóra Vitális, Vanja Vlajkov

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Three-dimension (3D) printing, a very popular additive manufacturing technology, has recently undergone rapid growth and replaced the use of conventional technology from prototyping to producing end-user parts and products. The 3D Printing technology involves a digital manufacturing machine that produces three-dimensional objects according to designs created by the user via 3D modeling or computer-aided design/manufacturing (CAD/CAM) software. The most popular 3D printing system is Fused Deposition Modeling (FDM) or also called Fused Filament Fabrication (FFF). A 3D-printed object is considered food safe if it can have direct contact with the food without any toxic effects, even after cleaning, storing, and reusing the object. This work analyzes the processing timeline of the filament (material for 3D printing) from unboxing to the extrusion through the nozzle. It is an important task to analyze the growth of bacteria on the 3D printed surface and in gaps between the layers. By default, the 3D-printed object is not food safe after longer usage and direct contact with food (even though they use food-safe filaments), but there are solutions for this problem. The aim of this work was to evaluate the 3D-printed object from different perspectives of food safety. Firstly, testing antimicrobial 3D printing filaments from a food safety aspect since the 3D Printed object in the food industry may have direct contact with the food. Therefore, the main purpose of the work is to reduce the microbial load on the surface of a 3D-printed part. Coating with epoxy resin was investigated, too, to see its effect on mechanical strength, thermal resistance, surface smoothness and food safety (cleanability). Another aim of this study was to test new temperature-resistant filaments and the effect of high temperature on 3D printed materials to see if they can be cleaned with boiling or similar hi-temp treatment. This work proved that all three mentioned methods could improve the food safety of the 3D printed object, but the size of this effect variates. The best result we got was with coating with epoxy resin, and the object was cleanable like any other injection molded plastic object with a smooth surface. Very good results we got by boiling the objects, and it is good to see that nowadays, more and more special filaments have a food-safe certificate and can withstand boiling temperatures too. Using antibacterial filaments reduced bacterial colonies to 1/5, but the biggest advantage of this method is that it doesn’t require any post-processing. The object is ready out of the 3D printer. Acknowledgements: The research was supported by the Hungarian and Serbian bilateral scientific and technological cooperation project funded by the Hungarian National Office for Research, Development and Innovation (NKFI, 2019-2.1.11-TÉT-2020-00249) and the Ministry of Education, Science and Technological Development of the Republic of Serbia. The authors acknowledge the Hungarian University of Agriculture and Life Sciences’s Doctoral School of Food Science for the support in this study

Keywords: food safety, 3D printing, filaments, microbial, temperature

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Authors: Amy Williamson, Kerry Armstrong, Jason Edwards, Patricia Obst

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Australian national policy endorses a responsive approach to work health and safety (WHS) regulation, combining positive motivators (education and guidance), with compliance monitoring and enforcement to encourage and secure compliance with legislation. Despite theoretical support for responsive regulation, there is limited evidence regarding how to achieve best results in practice. Using positive psychology as a novel paradigm, this study aims to investigate how non-punitive regulatory interactions can be improved to further encourage regulatory compliance in the construction industry. As part of a larger project, semi-structured interviews were conducted with 35 inspectorate staff and 11 managers in the Australian (Queensland) construction industry. Using an inductive, grounded approach, an in-depth qualitative investigation was conducted to identify the positive psychological principles which underpin effective use of the non-punitive aspects of responsive regulation. Results highlighted the importance of effective engagement between inspectors and industry managers. This involved the need to interact cooperatively and encourage compliance with WHS legislation. Several strategies were identified that assisted regulatory interactions and the ability of inspectors to engage. The importance of communication and interpersonal skills was reported to be critical to any interaction, regardless of the nature of the visit and regulatory tools used. In particular, the use of clear and open communication fostered trust and rapport which facilitated more positive interactions. The importance of respect and empathy was also highlighted. The need for provision of guidance and direction on how to achieve compliance was also reported. This related to ensuring companies understand their WHS obligations, providing specific advice regarding how to rectify a breach and meet compliance requirements, and ensuring sufficient follow up to confirm that compliance is successfully achieved. In the absence of imminent risk, allowing companies the opportunity to comply before further action is taken was also highlighted. Increased proactive engagement with industry to educate and promote the vision of safety at work was also reported. Finally, provision of praise and positive feedback was reported to assist interactions and encourage the continuation of good practices. Evidence from positive psychology and organisational psychology was obtained to support the use of each strategy in practice. In particular, the area of positive leadership provided a useful framework to consider the factors and conditions that drive positive interactions within the context of work health and safety and the specific relationship between inspectors and industry managers. This study provides fresh insight into key psychological principles which support non-punitive regulatory interactions in the area of workplace health and safety. The findings of this research contribute to a better understanding of how inspectors can enhance the efficacy of their regulatory interactions to improve compliance with legislation. Encouraging and assisting compliance through effective non-punitive activity offers a sustainable pathway for promoting safety and preventing fatalities and injuries in the construction industry.

Keywords: engagement, non-punitive approaches to compliance, positive interactions in the workplace, work health and safety compliance

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Authors: Syeda Fatima Manzelat

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The present study aims to study the groups of algal genera that are responsible for the biodeterioration, biodegradation, and biological pollution of the structures and features of the two historic parks of the UK. Different sites of Campbell Park and Great Linford Manor Park in Milton Keynes are selected to study the morphological, aesthetic, and physical effects of the algal growth. Specimens and swabs were collected mechanically from selected sites. Algal specimens are preserved in Lugol’s solution and labelled with standard information. Photomicrograph analysis of slides using taxonomic keys and visual observation identified algal species that are homogenously and non-homogenously mixed in the aerial, terrestrial, and aquatic habitats. A qualitative study revealed seven classes of Algae. Most of the algal genera isolated have proven records of potential biodegradation, discoloration, and biological pollution. Chlorophyceae was predominantly represented by eleven genera: Chlorella, Chlorococcum Cladophora, Coenochloris Cylindrocapsa, Microspora, Prasiola, Spirogyra, Trentepholia, Ulothrix and Zygnema. Charophyceae is represented by four genera: Cosmarium, Klebsormidium, Mesotaenium, and Mougeotia. Xanthophyceae with two genera, Tribonema and Vaucheria. Bacillariophyceae (Diatoms) are represented by six genera: Acnanthes, Bacillaria, Fragilaria, Gomphonema, Synedra, and Tabellaria, Dinophyceae with a Dinoflagellate. Rhodophyceae included Bangia and Batrachospermum, Cyanophyceae with five genera, Chroococcus, Gloeocapsa, Scytonema, Stigonema and Oscillatoria. The quantitative analysis by statistical method revealed that Chlorophyceae was the predominant class, with eleven genera isolated from different sites of the two parks. Coenochloris of Chlorophyceae was isolated from thirteen sites during the study, followed by Gloeocapsa of Cyanophyceae, which is isolated from 12 sites. These two algae impart varying shades of green colour on the surfaces on which they form biofilms. Prasiola, Vaucheria, and Trentepholia were isolated only from Great Linford Park. Trentepholia imparted a significant orange colour to the walls and trees of the sites. The compounds present in algae that are responsible for discoloration are the green pigment chlorophyll, orange pigment β-carotene, and yellow pigment quinone. Mesotaenium, Dinoflagellate, Gomphonema, Fragilaria, Tabellaria and two unidentified genera were isolated from Campbell Park only. Largest number of algal genera (25) were isolated from the canal of Campbell Park followed by (21) from the canal at Great Linford Manor Park. The Algae were found to grow on surfaces of walls, wooden fencings, metal sculptures, and railings. The Algae are reported to induce surface erosion, natural weathering, and cracking, leading to technical and mechanical instability and extensive damage to building materials. The algal biofilms secrete different organic acids, which are responsible for biosolubilization and biodeterioration of the building materials. The aquatic algal blooms isolated during the study release toxins which are responsible for allergy, skin rashes, vomiting, diarrhea, fever, muscle spasms, and lung and throat infections. The study identifies the places and locations at the historic sites which need to be paid attention. It provides an insight to the conservation strategies to overcome the negative impacts of bio colonization by algae. Prevention measures by different treatments need to be regularly monitored.

Keywords: algae, biodegradation, historic gardens, UK

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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: Kim Ji-Hyun, Jeon Hye-Seon, Kwon Oh-Yun, Park Eun-Young, Hwang Ui-Jae, Gwak Gyeong-Tae, Yoon Hyeo-Bin

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Stress urinary incontinence (SUI), a common women health problem, is an involuntary leakage of urine while sneezing, coughing, or physical exertion caused by insufficient strength of the pelvic floor and sphincter muscles. SUI also leads to decrease in quality of life and limits sexual activities. SUI is related to the increased bladder neck angle, bladder neck movement, funneling index, urethral width, and decreased urethral length. Various pelvic floor muscle electrical stimulation (ES) interventions have been applied to improve the symptoms of the people with SUI. ES activates afferent fibers of pudendal nerve and smoothly induces contractions of the pelvic floor muscles such as striated periurethral muscles and striated pelvic floor muscles. ES via intravaginal electrodes are the most frequently used types of the pelvic floor muscle ES for the female SUI. However, inserted electrode is uncomfortable and it increases the risks of infection. The purpose of this preliminary study was to determine if the 8-week transcutaneous pelvic floor ES would be effective to improve the symptoms and satisfaction of the females with SUI. Easy-K, specially designed ES equipment for the people with SUI, was used in this study. The oval shape stimulator can be placed on a toilet seat, and the surface has invaded electrode fit to contact with the entire vulva area while users are sitting on the stimulator. Five women with SUI were included in this experiment. Prior to the participation, subjects were instructed about procedures and precautions in using the ES. They have used the stimulator once a day for 20 minutes for each session at home. Outcome data was collected 3 times at the baseline, 4 weeks and 8 weeks after the intervention. Intravaginal sonography was used to measure the bladder neck angle, bladder neck movement, funneling index, thickness of an anterior rhabdosphincter and a posterior rhabdosphincter, urethral length, and urethral width. Leavator ani muscle (LAM) contraction strength was assessed by manual palpation according to the oxford scoring system. In addition, incontinence quality of life (IQOL) and female sexual function index (FSFI) questionnaires were used to obtain addition subjective information. Friedman test, a nonparametric statistical test, was used to determine the effectiveness of the ES. The Wilcoxon test was used for the post-hoc analysis and the significance level was set at .05. The bladder neck angle, funneling index and urethral width were significantly decreased after 8-weeks of intervention (p<.05). LAM contraction score, urethral length and anterior and posterior rhabdosphicter thickness were statistically increased by the intervention (p<.05). However, no significant change was found in the bladder neck movement. Although total score of the IQOL did not improve, the score of the ‘avoidance’ subscale of IQOL had significant improved (p<.05). FSFI had statistical difference in FSFI total score and ‘desire’ subscale (p<.05). In conclusion, 8-week use of a transcutaneous ES on peri-vulva area improved dynamic mechanical structures of the pelvic floor musculature as well as IQOL and conjugal relationship.

Keywords: electrical stimulation, Pelvic floor muscle, sonography, stress urinary incontinence, women health

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Authors: Kenji Tanaka, Kazumi Sugita, Yuto Mizushima

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This paper introduces a noteworthy form of English communication training for the officers and operators of the Osaka-Bay Marine Traffic Information Service (Osaka MARTIS) of the Japan Coast Guard working in the congested area at the Akashi Strait in Hyogo Prefecture, Japan. The authors of this paper, Marine Technical College’s (MTC) English language instructors, have been holding about forty lectures and exercises in basic and normal Maritime English (ME) for several groups of MARTIS personnel at Osaka MARTIS annually since they started the training in 2005. Trainees are expected to be qualified Maritime Third-Class Radio Operators who are responsible for providing safety information to a daily average of seven to eight hundred vessels that pass through the Akashi Strait, one of Japan’s narrowest channels. As of 2022, the instructors are conducting 55 remote lessons at MARTIS. One lesson is 90 minutes long. All 26 trainees are given oral and written assessments. The trainees need to pass the examination to become qualified operators every year, requiring them to train and maintain their linguistic levels even during the pandemic of Corona Virus Disease-19 (COVID-19). The vessel traffic information provided by Osaka MARTIS in Maritime English language is essential to the work involving the use of very high frequency (VHF) communication between MARTIS and vessels in the area. ME is the common language mainly used on board merchant, fishing, and recreational vessels, normally at sea. ME was edited and recommended by the International Maritime Organization in the 1970s, was revised in 2002, and has undergone continual revision. The vessel’s circumstances are much more serious at the strait than those at the open sea, so these vessels need ME to receive guidance from the center when passing through the narrow strait. The imminent and challenging situations at the strait necessitate that textbooks’ contents include the basics of the phrase book for seafarers as well as specific and additional navigational information, pronunciation exercises, notes on keywords and phrases, explanations about collocations, sample sentences, and explanations about the differences between synonyms especially those focusing on terminologies necessary for passing through the strait. Additionally, short Japanese-English translation quizzes about these topics, as well as prescribed readings about the maritime sector, are include in the textbook. All of these exercises have been trained in the remote education system since the outbreak of COVID-19. According to the guidelines of ME edited in 2009, the lowest level necessary for seafarers is B1 (lower individual users) of The Common European Framework of Reference for Languages: Learning, Teaching, Assessment (CEFR). Therefore, this vocational ME language training at Osaka MARTIS aims for its trainees to communicate at levels higher than B1. A noteworthy proof of improvement from this training is that most of the trainees have become qualified marine radio communication officers.

Keywords: akashi strait, B1 of CEFR, maritime english communication training, osaka martis

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Authors: Amberly Brigden, Ali Heawood, Emma C. Anderson, Richard Morris, Esther Crawley

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Background: Paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue. Health services see patients below the age of 12. This age group experience high levels of disability, with low levels of school attendance, high levels of fatigue, anxiety, functional disability and pain. CFS/ME interventions have been developed for adolescents, but the developmental needs of younger children suggest treatment should be tailored to this age group. Little is known about how intervention should be delivered to this age group, and further work is needed to explore this. Qualitative research aids patient-centered design of health intervention. Methods: Five to 11-year-olds and their parents were recruited from a specialist CFS/ME service. Semi-structured interviews explored the families’ experience of the condition and perspectives on treatment. Interactive and arts-based methods were used. Interviews were audio-recorded, transcribed and analysed thematically. Qualitative Results: 14 parents and 7 children were interviewed. Early analysis of the interviews revealed the importance of the social-ecological setting of the child, which led to themes being developed in the context of Systems Theory. Theme one relates to the level of the child, theme two the family system, theme three the organisational and societal systems, and theme four cuts-across all levels. Theme1: The child’s capacity to describe, understand and manage their condition. Younger children struggled to describe their internal experiences, such as physical symptoms. Parents felt younger children did not understand some concepts of CFS/ME and did not have the capabilities to monitor and self-regulate their behaviour, as required by treatment. A spectrum of abilities was described; older children (10-11-year-olds) were more involved in clinical sessions and had more responsibility for self-management. Theme2: Parents’ responsibility for managing their child’s condition. Parents took responsibility for regulating their child’s behaviour in accordance with the treatment programme. They structured their child’s environment, gave direct instructions to their child, and communicated the needs of their child to others involved in care. Parents wanted their child to experience a 'normal' childhood and took steps to shield their child from medicalization, including diagnostic labels and clinical discussions. Theme3: Parental isolation and the role of organisational and societal systems. Parents felt unsupported in their role of managing the condition and felt negative responses from primary care health services and schools were underpinned by a lack of awareness and knowledge about CFS/ME in younger children. This sometimes led to a protracted time to diagnosis. Parents felt that schools have the potential important role in managing the child’s condition. Theme4: Complexity and uncertainty. Many parents valued specialist treatment (which included activity management, physiotherapy, sleep management, dietary advice, medical management and psychological support), but felt it needed to account for the complexity of the condition in younger children. Some parents expressed uncertainty about the diagnosis and the treatment programme. Conclusions: Interventions for younger children need to consider the 'systems' (family, organisational and societal) involved in the child’s care. Future research will include interviews with clinicians and schools supporting younger children with CFS/ME.

Keywords: chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), pediatric, qualitative, treatment

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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: Simon Komesker, Achim Wagner, Martin Ruskowski

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In times of volatile markets with fluctuating demand and the uncertainty of global supply chains, flexible production systems are the key to an efficient implementation of a desired production program. In this publication, the authors present a holistic information concept taking into account various influencing factors for operating towards the global optimum. Therefore, a strategy for the implementation of multi-level planning for a flexible, reconfigurable production system with an alternative production concept in the automotive industry is developed. The main contribution of this work is a system structure mixing central and decentral planning and control evaluated in a simulation framework. The information system structure in current production systems in the automotive industry is rigidly hierarchically organized in monolithic systems. The production program is created rule-based with the premise of achieving uniform cycle time. This program then provides the information basis for execution in subsystems at the station and process execution level. In today's era of mixed-(car-)model factories, complex conditions and conflicts arise in achieving logistics, quality, and production goals. There is no provision for feedback loops of results from the process execution level (resources) and process supporting (quality and logistics) systems and reconsideration in the planning systems. To enable a robust production flow, the complexity of production system control is artificially reduced by the line structure and results, for example in material-intensive processes (buffers and safety stocks - two container principle also for different variants). The limited degrees of freedom of line production have produced the principle of progress figure control, which results in one-time sequencing, sequential order release, and relatively inflexible capacity control. As a result, modularly structured production systems such as modular production according to known approaches with more degrees of freedom are currently difficult to represent in terms of information technology. The remedy is an information concept that supports cross-system and cross-level information processing for centralized and decentralized decision-making. Through an architecture of hierarchically organized but decoupled subsystems, the paradigm of hybrid control is used, and a holonic manufacturing system is offered, which enables flexible information provisioning and processing support. In this way, the influences from quality, logistics, and production processes can be linked holistically with the advantages of mixed centralized and decentralized planning and control. Modular production systems also require modularly networked information systems with semi-autonomous optimization for a robust production flow. Dynamic prioritization of different key figures between subsystems should lead the production system to an overall optimum. The tasks and goals of quality, logistics, process, resource, and product areas in a cyber-physical production system are designed as an interconnected multi-agent-system. The result is an alternative system structure that executes centralized process planning and decentralized processing. An agent-based manufacturing control is used to enable different flexibility and reconfigurability states and manufacturing strategies in order to find optimal partial solutions of subsystems, that lead to a near global optimum for hybrid planning. This allows a robust near to plan execution with integrated quality control and intralogistics.

Keywords: holonic manufacturing system, modular production system, planning, and control, system structure

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Authors: Ronahlee Asuncion

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The nature of their work and employment relationship make domestic workers easy prey to abuse, maltreatment, and exploitation. Considering their plight, this research was conceptualized and examined the: a) level of awareness of Filipino domestic workers on occupational safety and health (OSH); b) their issues/problems/concerns on OSH; c) their intervention strategies at work to address OSH related issues/problems/concerns; d) issues/problems/concerns of government, employers, and non-government organizations with regard to implementation of OSH to Filipino domestic workers; e) the role of government, employers and non-government organizations to help Filipino domestic workers address OSH related issues/problems/concerns; and f) the necessary policy amendments/initiatives/programs to address OSH related issues/problems/concerns of Filipino domestic workers. The study conducted a survey using non-probability sampling, two focus group discussions, two group interviews, and fourteen face-to-face interviews. These were further supplemented with an email correspondence to a key informant based in another country. Books, journals, magazines, and relevant websites further substantiated and enriched data of the research. Findings of the study point to the fact that domestic workers have low level of awareness on OSH because of poor information drive, fragmented implementation of the Domestic Workers Act, inactive campaign at the barangay level, weakened advocacy for domestic workers, absence of law on OSH for domestic workers, and generally low safety culture in the country among others. Filipino domestic workers suffer from insufficient rest, long hours of work, heavy workload, occupational stress, poor accommodation, insufficient hours of sleep, deprivation of day off, accidents and injuries such as cuts, burns, slipping, stumbling, electrical grounding, and fire, verbal, physical and sexual abuses, lack of medical assistance, none provision of personal protective equipment (PPE), absence of knowledge on the proper way of lifting, working at heights, and insufficient food provision. They also suffer from psychological problems because of separation from one’s family, limited mobility in the household where they work, injuries and accidents from using advanced home appliances and taking care of pets, low self-esteem, ergonomic problems, the need to adjust to all household members who have various needs and demands, inability to voice their complaints, drudgery of work, and emotional stress. With regard to illness or health problems, they commonly experience leg pains, back pains, and headaches. In the absence of intervention programs like those offered in the formal employment set up, domestic workers resort to praying, turn to family, relatives and friends for social and emotional support, connect with them through social media like Facebook which also serve as a means of entertainment to them, talk to their employer, and just try to be optimistic about their situation. Promoting OSH for domestic workers is very challenging and complicated because of interrelated factors such as cultural, knowledge, attitudinal, relational, social, resource, economic, political, institutional and legal problems. This complexity necessitates using a holistic and integrated approach as this is not a problem requiring simple solutions. With this recognition comes the full understanding that its success involves the action and cooperation of all duty bearers in attaining decent work for domestic workers.

Keywords: decent work, Filipino domestic workers, occupational safety and health, working conditions

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Authors: Jelena Filipovic, Marija Bodroza-Solarov, Milenko Kosutic, Nebojsa Novkovic, Vladimir Filipovic, Vesna Vucurovic

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Spelt wheat is suitable raw material for extruded products such as pasta, special types of bread and other products of altered nutritional characteristics compared to conventional wheat products. During the process of extrusion, spelt is exposed to high temperature and high pressure, during which raw material is also mechanically treated by shear forces. Spelt wheat is growing without the use of pesticides in harsh ecological conditions and in marginal areas of cultivation. So it can be used for organic and health safe food. Pasta is the most popular foodstuff; its consumption has been observed to rise. Pasta quality depends mainly on the properties of flour raw materials, especially protein content and its quality but starch properties are of a lesser importance. Pasta is characterized by significant amounts of complex carbohydrates, low sodium, total fat fiber, minerals, and essential fatty acids and its nutritional value can be improved with additional functional component. Over the past few decades, wheat pasta has been successfully formulated using different ingredients in pasta to cater health-conscious consumers who prefer having a product rich in protein, healthy lipids and other health benefits. Flaxseed flour is used in the production of bakery and pasta products that have properties of functional foods. However, it should be taken into account that food products retain the technological and sensory quality despite the added flax seed. Flaxseed contains important substances in its composition such as vitamins and minerals elements, and it is also an excellent source of fiber and one of the best sources of ω-3 fatty acids and lignin. In this paper, the quality and identification of spelt extruded product with the addition of flax seed, which is positively contributing to the nutritive and technology changes of the product, is investigated. ω-3 fatty acids are polyunsaturated essential fatty acids, and they must be taken with food to satisfy the recommended daily intake. Flaxseed flour is added in the quantity of 10/100 g of sample and 20/100 g of sample on farina. It is shown that the presence of ω-3 fatty acids in pasta can be clearly distinguished from other fatty acids by gas chromatography with mass spectrometry. Addition of flax seed flour influence chemical content of pasta. The addition of flax seed flour in spelt pasta in the quantities of 20g/100 g significantly increases the share of ω-3 fatty acids, which results in improved ratio of ω-6/ω-3 1:2.4 and completely satisfies minimum daily needs of ω-3 essential fatty acids (3.8 g/100 g) recommended by FDA. Flex flour influenced the pasta quality by increasing of hardness (2377.8 ± 13.3; 2874.5 ± 7.4; 3076.3 ± 5.9) and work of shear (102.6 ± 11.4; 150.8 ± 11.3; 165.0 ± 18.9) and increasing of adhesiveness (11.8 ± 20.6; 9.,98 ± 0.12; 7.1 ± 12.5) of the final product. Presented data point at good indicators of technological quality of spelt pasta with flax seed and that GC-MS analysis can be used in the quality control for flax seed identification. Acknowledgment: The research was financed by the Ministry of Education and Science of the Republic of Serbia (Project No. III 46005).

Keywords: GC-MS analysis, ω-3 fatty acids, flex seed, spelt wheat, daily needs

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Authors: Poulomi Bhadra, Manjushree Palit, Sanjeev P. Sahni

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Forensic science uses all branches of science for criminal investigation and trial and has increasingly emerged as an important tool in the administration of justice. However, the growth and development of this field in India has not been as rapid or widespread as compared to the more developed Western countries. For successful administration of justice, it is important that all agencies involved in law enforcement adopt an inter-professional approach towards forensic science, which is presently lacking. In light of the alarmingly high average acquittal rate in India, this study aims to examine the lack of understanding and appreciation of the importance and scope of forensic evidence and expert opinions amongst law professionals such as lawyers and judges. Based on a study of trial court cases from Delhi and surrounding areas, the study underline the areas in forensics where the criminal justice system has noticeably erred. Using this information, the authors examine the extent of forensic understanding amongst legal professionals and attempt to conclusively identify the areas in which they need further appraisal. A cross-sectional study done using a structured questionnaire was conducted amongst law professionals across age, gender, type and years of experience in court, to determine their understanding of DNA, fingerprints and other interdisciplinary scientific materials used as forensic evidence. In our study, we understand the levels of understanding amongst lawyers with regards to DNA and fingerprint evidence, and how it affects trial outcomes. We also aim to understand the factors that prevent credible and advanced awareness amongst legal personnel, amongst others. The survey identified the areas in modern and advanced forensics, such as forensic entomology, anthropology, cybercrime etc., in which Indian legal professionals are yet to attain a functional understanding. It also brings to light, what is commonly termed as the ‘CSI-effect’ in the Western courtrooms, and provides scope to study the existence of this phenomenon and its effects on the Indian courts and their judgements. This study highlighted the prevalence of unchallenged expert testimony presented by the prosecution in criminal trials and impressed upon the judicial system the need for independent analysis and evaluation of the scientist’s data and/or testimony by the defense. Overall, this study aims to define a clearer and rigid understanding of why legal professionals should have basic understanding of the interdisciplinary nature of forensic sciences. Based on the aforementioned findings, the author suggests various measures by which judges and lawyers might obtain an extensive knowledge of the advances and promising potentialities of forensic science. This includes promoting a forensic curriculum in legal studies at Bachelor’s and Master’s level as well as in mid-career professional courses. Formation of forensic-legal consultancies, in consultation with the Department of Justice, will not only assist in training police, military and law personnel but will also encourage legal research in this field. These suggestions also aim to bridge the communication gap that presently exists between law practitioners, forensic scientists and the general community’s awareness of the criminal justice system.

Keywords: forensic science, Indian legal professionals, interdisciplinary awareness, legal education

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Authors: Tamrat Girma Biru

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Multidrug-resistant tuberculosis (MDR-TB) is defined as resistant to at least Refampicin and Isoniazed: the most two power full TB drugs. It is a leading cause of high rates of morbidity and mortality, and increasing psychosocial challenges to patients, especially when co-infected with Human Immunodeficiency Virus (HIV). Ethiopia faces the highest rates of MDR-TB infection in the world. Objectives: The main objective of this study was to identify the psychosocial challenges of MDR-TB patients, to investigate the extent of the psychosocial challenges on (self-esteem, depression, and stigma) that MDR-TB patients encounter, to examine whether there is a sex difference in experiencing psychosocial challenges and assess the counseling needs of MDR-TB patients. Methodology: A cross-sectional study was conducted at St. Peter TB Specialized Hospital, Addis Ababa on 40 patients (25 males and 15 females) who are hospitalized for treatment. The patients were identified by using purposive sampling and made fill a questionnaire measuring their level of self-esteem, depression and stigma. Besides, data were collected from 16 participants, 28 care providers and 8 guardians, using semi-structured interview. The obtained data were analyzed using SPSS statistical program, descriptive statistics, independent t-test, and qualitative description. Results and Discussion: The results of the study showed that the majority (80%) of the respondents had suffered psychological challenges and social discriminations. Thus, the significance of MDR-TB and its association with HIV/AIDS problems is considered. Besides the psychosocial challenges, various aggravating factors such as length of treatment, drug burden and insecurity in economy together highly challenges the life of patients. In addition, 60% of participants showed low level of self-esteem. The patients also reported that they experienced high self-stigma and stigma by other members of the society. The majority of the participants (75%) showed moderate and severe level of depression. In terms of sex there is no difference between the mean scores of males and females in the level of depression and stigmatization by others and by themselves. But females showed lower level of self-esteem than males. The analysis of the t-test also shows that there were no statistically significant sex difference on the level of depression and stigma. Based on the qualitative data MDR-TB patients face various challenges in their life sphere such as: Psychological (depression, low self value, lowliness, anxiety), social (stigma, isolation from social relations, self-stigmatization,) and medical (drug side effect, drug toxicity, drug burden, treatment length, hospital stays). Recommendations: Based on the findings of this study possible recommendations were forwarded: develop and extend MDR-TB disease awareness creation through by media (printing and electronic), school net TB clubs, and door to door community education. Strengthen psychological wellbeing and social relationship of MDR-TB patients using proper and consistent psychosocial support and counseling. Responsible bodies like Ministry of Health (MOH) and its stakeholders and Non Governmental Organizations (NGOs) need to assess the challenges of patients and take measures on this pressing issue.

Keywords: psychosocial challenges, counseling, multi-drug resistant tuberculosis (MDR-TB), tuberculosis therapy

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Authors: Hongyan Chen, Megan Jobson, Andrew J. Masters, Maria Gonzalez-Miquel, Simon Halstead, Mayri Diaz de Rienzo

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Ionic liquids offer excellent advantages over conventional solvents for industrial extraction of metals from aqueous solutions, where such extraction processes bring opportunities for recovery, reuse, and recycling of valuable resources and more sustainable production pathways. Recent research on the use of ionic liquids for extraction confirms their high selectivity and low volatility, but there is relatively little focus on how their properties can be best exploited in practice. This work addresses gaps in research on process modelling and simulation, to support development, design, and optimisation of these processes, focusing on the separation of the highly similar transition metals, cobalt, and nickel. The study exploits published experimental results, as well as new experimental results, relating to the separation of Co and Ni using trihexyl (tetradecyl) phosphonium chloride. This extraction agent is attractive because it is cheaper, more stable and less toxic than fluorinated hydrophobic ionic liquids. This process modelling work concerns selection and/or development of suitable models for the physical properties, distribution coefficients, for mass transfer phenomena, of the extractor unit and of the multi-stage extraction flowsheet. The distribution coefficient model for cobalt and HCl represents an anion exchange mechanism, supported by the literature and COSMO-RS calculations. Parameters of the distribution coefficient models are estimated by fitting the model to published experimental extraction equilibrium results. The mass transfer model applies Newman’s hard sphere model. Diffusion coefficients in the aqueous phase are obtained from the literature, while diffusion coefficients in the ionic liquid phase are fitted to dynamic experimental results. The mass transfer area is calculated from the surface to mean diameter of liquid droplets of the dispersed phase, estimated from the Weber number inside the extractor. New experiments measure the interfacial tension between the aqueous and ionic phases. The empirical models for predicting the density and viscosity of solutions under different metal loadings are also fitted to new experimental data. The extractor is modelled as a continuous stirred tank reactor with mass transfer between the two phases and perfect phase separation of the outlet flows. A multistage separation flowsheet simulation is set up to replicate a published experiment and compare model predictions with the experimental results. This simulation model is implemented in gPROMS software for dynamic process simulation. The results of single stage and multi-stage flowsheet simulations are shown to be in good agreement with the published experimental results. The estimated diffusion coefficient of cobalt in the ionic liquid phase is in reasonable agreement with published data for the diffusion coefficients of various metals in this ionic liquid. A sensitivity study with this simulation model demonstrates the usefulness of the models for process design. The simulation approach has potential to be extended to account for other metals, acids, and solvents for process development, design, and optimisation of extraction processes applying ionic liquids for metals separations, although a lack of experimental data is currently limiting the accuracy of models within the whole framework. Future work will focus on process development more generally and on extractive separation of rare earths using ionic liquids.

Keywords: distribution coefficient, mass transfer, COSMO-RS, flowsheet simulation, phosphonium

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Authors: Jaci Marie Mastrandrea, Rosario Haro

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening and intervention is directly associated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project was to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated, evidence-based PC referral criteria. The tool was initially implemented using paper forms, and data was collected over a period of eight weeks. Patients were screened by nurses on the SLCTC oncology treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher received an educational handout on the topic of PC and education about PC and symptom management. A score of five or higher indicates that PC referral is strongly recommended, and the patient’s EHR is flagged for the oncology provider to review orders for PC referral. The PSNA tool was approved by Sky Lakes administration for full integration into Epic-Beacon. The project lead collaborated with the Sky Lakes’ information systems team and representatives from Epic on the tool’s aesthetic and functionality within the Epic system. SLCTC nurses and physicians were educated on how to document the PSNA within Epic and where to view results. Results: Prior to the implementation of the PSNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the completed screening assessments of 100 patients under active treatment at the SLCTC. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting criteria were flagged in EPIC for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met the criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative and supportive care, symptom management, outpatient oncology, palliative screening tool

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Authors: Kavitha Puthanveedu, Kasi Sekar, Preeti Jacob, Kavita Jangam

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In India, The Juvenile Justice (Care and Protection of Children) Act, 2015, the law related to children alleged and found to be in conflict with law, proposes to address to the rehabilitation of children in conflict with law by catering to the basic rights by providing care and protection, development, treatment, and social re-integration. A major concern in addressing the issues of children in conflict with law in Kerala the southernmost state in India identified were: 1. Lack of psychological assessment for children in conflict with law, 2. Poor psychosocial intervention for children in conflict with law on bail, 3. Lack of psychosocial intervention or proper care and protection of CCL residing at observation and special home, 4. Lack convergence with systems related with mental health care. Aim: To develop individual care plan for children in conflict with law. Methodology: NIMHANS a premier Institute of Mental Health and Neurosciences, collaborated with Social Justice Department, Govt. of Kerala to address this issue by developing a participatory methodology to implement psychosocial care in the existing services by integrating the activities through multidisciplinary and multisectoral approach as per the Sec. 18 of JJAct 2015. Developing individual care plan: Key informant interviews, focus group discussion with multiple stakeholders consisting of legal officers, police, child protection officials, counselors, and home staff were conducted. Case studies were conducted among children in conflict with law. A checklist on 80 psychosocial problems among children in conflict with law was prepared with eight major issues identified through the quantitative process such as family and parental characteristic, family interactions and relationships, stressful life event, social and environmental factors, child’s individual characteristics, education, child labour and high-risk behavior. Standardised scales were used to identify the anxiety, caseness, suicidality and substance use among the children. This provided a background data understand the psychosocial problems experienced by children in conflict with law. In the second stage, a detailed plan of action was developed involving multiple stakeholders that include Special juvenile police unit, DCPO, JJB, and NGOs. The individual care plan was reviewed by a panel of 4 experts working in the area of children, followed by the review by multiple stakeholders in juvenile justice system such as Magistrates, JJB members, legal cum probation officers, district child protection officers, social workers and counselors. Necessary changes were made in the individual care plan in each stage which was pilot tested with 45 children for a period of one month and standardized for administering among children in conflict with law. Result: The individual care plan developed through scientific process was standardized and currently administered among children in conflict with law in the state of Kerala in the 3 districts that will be further implemented in other 14 districts. The program was successful in developing a systematic approach for the psychosocial intervention of children in conflict with law that can be a forerunner for other states in India.

Keywords: psychosocial care, individual care plan, multidisciplinary, multisectoral

Procedia PDF Downloads 254