Search results for: post-conflict settings

Authors: S. H. Kazmi, T. Ahmed, K. Javed, A. Ghani

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In this paper static scheme of under-frequency based load shedding is considered for chemical and petrochemical industries with islanded distribution networks relying heavily on the primary commodity to ensure minimum production loss, plant downtime or critical equipment shutdown. A simplistic methodology is proposed for in-house implementation of this scheme using underfrequency relays and a step by step guide is provided including the techniques to calculate maximum percentage overloads, frequency decay rates, time based frequency response and frequency based time response of the system. Case study of FFL electrical system is utilized, presenting the actual system parameters and employed load shedding settings following the similar series of steps. The arbitrary settings are then verified for worst overload conditions (loss of a generation source in this case) and comprehensive system response is then investigated.

Keywords: islanding, under-frequency load shedding, frequency rate of change, static UFLS

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Authors: Pooja Sanathkumar, Srinidhi Murali, Sethuraman TV, Saravanan M, Paventhan Arumugam, Ashwin Ashok

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The last decade has witnessed a significant interest in visible light communication (VLC) technology, as VLC can potentially achieve high data rate links and secure communication channels. However, the use of VLC under mobile settings is fundamentally limited as its a line-of-sight (LOS) technology and there has been limited breakthroughs in realizing VLC for mobile settings. In this regard, this work targets to study the VLC channel under mobility. Through a use-case study analysis with experiment data traces this paper presents an empirical VLC channel study considering the application of VLC for smart lighting in an indoor room environment. This paper contributes a calibration study of a prototype VLC smart lighting system in an indoor environment and through the inferences gained from the calibration, and considering a user is carrying a mobile device fit with a VLC receiver, this work presents recommendations for user's position adjustments, with the goal to ensure maximum connectivity across the room.

Keywords: visible light communication, mobility, empirical study, channel characterization

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Authors: Chao-Ton Su, Li-Fei Chen

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The parameter design is crucial to improving the uniformity of a product or process. In the product design stage, parameter design aims to determine the optimal settings for the parameters of each element in the system, thereby minimizing the functional deviations of the product. In the process design stage, parameter design aims to determine the operating settings of the manufacturing processes so that non-uniformity in manufacturing processes can be minimized. The parameter design, trying to minimize the influence of noise on the manufacturing system, plays an important role in the high-tech companies. Taiwan has many well-known high-tech companies, which show key roles in the global economy. Quality remains the most important factor that enables these companies to sustain their competitive advantage. In Taiwan however, many high-tech companies face various quality problems. A common challenge is related to root causes and defect patterns. In the R&D stage, root causes are often unknown, and defect patterns are difficult to classify. Additionally, data collection is not easy. Even when high-volume data can be collected, data interpretation is difficult. To overcome these challenges, high-tech companies in Taiwan use more advanced quality improvement tools. In addition to traditional statistical methods and quality tools, the new trend is the application of powerful tools, such as neural network, fuzzy theory, data mining, industrial engineering, operations research, and innovation skills. In this study, several examples of optimizing the parameter settings for the manufacturing process in Taiwan’s tech companies will be presented to illustrate proposed approach’s effectiveness. Finally, a discussion of using traditional experimental design versus the proposed approach for process optimization will be made.

Keywords: quality engineering, parameter design, neural network, genetic algorithm, experimental design

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Authors: Sofia Serra-Dawa

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Adult relationships accrue on a variety of past social experiences, intentions, and emotions that might predispose and influence the approach to and construction of subsequent relationships. The Adult Attachment Theory (AAT) proposes four types of adult attachment, where attachment is built over two dimensions of anxiety and avoidance: secure, anxious-preoccupied, dismissive-avoidant, and fearful-avoidant. The AAT has been studied in multiple settings such as personal and therapeutic relationships, educational settings, sexual orientation, health, and religion. In music scholarship, the AAT has been used to frame class learning of student singers and study the relational behavior between voice teachers and students. Building on this study, the present inquiry studies how attachment types might characterize learning relationships of music students (in the Western Conservatory tradition), and whether particular instrumental experiences might correlate to given attachment styles. Given certain behavioral cohesive features of established traditions of instrumental playing and performance modes, it is hypothesized that student musicians will display specific characteristics correlated to instrumental traditions, demonstrating clear tendency of attachment style, which in turn has implications on subsequent professional interactions. This study is informed by the methodological framework of Adult Attachment Scale-R (Collins and Read, 1990), which was particularly chosen given its non-invasive questions and classificatory validation. It is further hypothesized that the analytical comparison of musicians’ profiles has the potential to serve as the baseline for other comparative behavioral observation studies [this component is expected to be verified and completed well before the conference meeting]. This research may have implications for practitioners concerned with matching and improving musical teaching and learning relationships and in (professional and amateur) long-term musical settings.

Keywords: adult attachment, music education, musicians attachment profile, musicians relationships

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Authors: C. Gopi Jinimole, A. Harsha

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For detecting strokes, Computed Tomography (CT) scan is preferred for imaging the abnormalities or infarction in the brain. Because of the problems in the window settings used to evaluate brain CT images, they are very poor in the early stage infarction detection. This paper presents an automatic estimation method for the window settings of the CT images for proper contrast of the hyper infarction present in the brain. In the proposed work the window width is estimated automatically for each slice and the window centre is changed to a new value of 31HU, which is the average of the HU values of the grey matter and white matter in the brain. The automatic window width estimation is based on the average of median of statistical central moments. Thus with the new suggested window centre and estimated window width, the hyper infarction or post-stroke regions in CT brain images are properly detected. The proposed approach assists the radiologists in CT evaluation for early quantitative signs of delayed stroke, which leads to severe hemorrhage in the future can be prevented by providing timely medication to the patients.

Keywords: computed tomography (CT), hyper infarction or post stroke region, Hounsefield Unit (HU), window centre (WC), window width (WW)

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Authors: Malephole Philomena Sefotho

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Nowadays, it is a fact that the majority of people, worldwide, are bilingual rather than monolingual due to the surge of globalisation and mobility. Consequently, bilingual education is a topical issue of discussion among researchers. Several studies that have focussed on it have highlighted the importance and need for incorporating learners’ linguistic repertoires in multilingual classrooms and move away from the colonial approach which is a monolingual bias – one language at a time. Researchers pointed out that a systematic approach that involves the concurrent use of languages and not a separation of languages must be implemented in bilingual classroom settings. Translanguaging emerged as a systematic approach that assists learners to make meaning of their world and it involves allowing learners to utilize all their linguistic resources in their classrooms. The South African language policy also room for diverse languages use in bi/multilingual classrooms. This study, therefore, sought to explore how teachers apply translanguaging in bilingual classrooms in incorporating learners’ linguistic repertoires. It further establishes teachers’ perspectives in the use of more than one language in teaching and learning. The participants for this study were language teachers who teach at bilingual primary schools in Johannesburg in South Africa. Semi-structured interviews were conducted to establish their perceptions on the concurrent use of languages. Qualitative research design was followed in analysing data. The findings showed that teachers were reluctant to allow translanguaging to take place in their classrooms even though they realise the importance thereof. Not allowing bilingual learners to use their linguistic repertoires has resulted in learners’ negative attitude towards their languages and contributed in learners’ loss of their identity. This article, thus recommends a drastic change to decolonised approaches in teaching and learning in multilingual settings and translanguaging as a decolonial move where learners are allowed to translanguage freely in their classroom settings for better comprehension and making meaning of concepts and/or related ideas. It further proposes continuous conversations be encouraged to bring eminent cultural and linguistic genocide to a halt.

Keywords: bilingualism, decolonisation, linguistic repertoires, translanguaging

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Authors: Kailin K. Zhang, Anne W. Thompson

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Electronic learning for continuing professional education (CPE) and interprofessional education (IPE) in healthcare have been shown to improve learners’ satisfaction, attitudes, and performance. Yet, their impact on behavior change in healthcare professionals through continuing interprofessional education (CIPE) is less known. A scoping review of 32 articles from 2010 to 2020 was conducted using the Arksey and O’Malley framework across all healthcare settings. It focused on evaluating the effectiveness of CIPE on behavior change of healthcare professionals, as well as identifying course features of electronic CIPE programs facilitating behavior change. Eight different types of electronic learning methods, including online programs, tele-education, and social media, were identified as interventions. More than 35,542 healthcare professionals participated in the interventions. Electronic learning for CIPE led to positive behavior outcomes in 30 out of 32 studies, especially through a change in patient care practices. The most successful programs provided interactive and authentic learning experiences tailored to learners’ needs while promoting the direct application of what was learned in their clinical settings. Future research should include monitoring of sustained behavior changes and their resultant patient outcomes.

Keywords: behavior change, continuing interprofessional education, distance learning, electronic learning

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Authors: Xiuzhan Guo, Arthur Berrill, Ajinkya Kulkarni, Kostya Belezko, Min Luo

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Ontology operations, e.g., aligning and merging, were studied and implemented extensively in different settings, such as categorical operations, relation algebras, and typed graph grammars, with different concerns. However, aligning and merging operations in the settings share some generic properties, e.g., idempotence, commutativity, associativity, and representativity, labeled by (I), (C), (A), and (R), respectively, which are defined on an ontology merging system (D~M), where D is a non-empty set of the ontologies concerned, ~ is a binary relation on D modeling ontology aligning and M is a partial binary operation on D modeling ontology merging. Given an ontology repository, a finite set O ⊆ D, its merging closure Ô is the smallest set of ontologies, which contains the repository and is closed with respect to merging. If (I), (C), (A), and (R) are satisfied, then both D and Ô are partially ordered naturally by merging, Ô is finite and can be computed, compared, and sorted efficiently, including sorting, selecting, and querying some specific elements, e.g., maximal ontologies and minimal ontologies. We also show that the ontology merging system, given by ontology V -alignment pairs and pushouts, satisfies the properties: (I), (C), (A), and (R) so that the merging system is partially ordered and the merging closure of a given repository with respect to pushouts can be computed efficiently.

Keywords: ontology aligning, ontology merging, merging system, poset, merging closure, ontology V-alignment pair, ontology homomorphism, ontology V-alignment pair homomorphism, pushout

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Authors: Daniel C. Bonzo

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Practical considerations lead to the use of unit of analysis within subjects, e.g., bleeding episodes or treatment-related adverse events, in rare disease settings. This is coupled with data augmentation techniques such as extrapolation to enlarge the subject base. In general, one can think about extrapolation of data as extending information and conclusions from one estimand to another estimand. This approach induces hierarchichal clustered data with varying cluster sizes. Extrapolation of clinical trial data is being accepted increasingly by regulatory agencies as a means of generating data in diverse situations during drug development process. Under certain circumstances, data can be extrapolated to a different population, a different but related indication, and different but similar product. We consider here the problem of estimation (point and interval) using a mixed-models approach under an extrapolation. It is proposed that estimators (point and interval) be constructed using weighting schemes for the clusters, e.g., equally weighted and with weights proportional to cluster size. Simulated data generated under varying scenarios are then used to evaluate the performance of this approach. In conclusion, the evaluation result showed that the approach is a useful means for improving statistical inference in rare disease settings and thus aids not only signal detection but risk-benefit evaluation as well.

Keywords: clustered data, estimand, extrapolation, mixed model

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Authors: Julia Wong, Hua Beng Lim, Petrina Goh, Johanna Foo, Caleb Ng, Nurul ‘Aqilah Bte Mohd Taufek

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Animal-assisted therapy (AAT) utilizes human-animal interaction to achieve specific therapeutic goals, and its efficacy has been demonstrated across various settings overseas. The use of AAT in Singapore, however, is still limited. Ang Mo Kio-Thye Hua Kwan (AMKH) is one of the first community hospitals in Singapore to use AAT to complement its occupational therapy services with elderly patients. This study explored the perspectives of AMKH’s occupational therapists (OTs) in relation to AAT to understand barriers and enablers in implementing and practising AAT. We also examined how OTs at-large across practice settings perceive AAT. A mixed method design was used. 64 OTs at-large participated in on online survey, and 7 AMKH OTs were interviewed individually via Zoom. Survey results were analysed with descriptive and Mann-Whitney U tests. Interviews were thematically analysed. AMKH OTs perceived various benefits of AAT articulated in overseas studies in domains such as motivation and participation, emotional, social interaction, sensory tactile stimulation, and cognition. Interestingly, this perception was also supported by 67% of OTs who had responded to the survey, even though most of the OTs who had participated in the survey had no experience in AAT. Despite the perceived benefits of AAT, both OTs from AMKH and those at-large articulated concerns on risks pertaining to AAT (e.g., allergies, unexpected animal behaviour, infections, etc). However, AMKH OTs shared several ways to mitigate these risks, demonstrating their ability to develop a safe program. For e.g., volunteers and their dogs must meet specific recruitment criteria, stringent protocols are used to screen and match dogs with patients, and there are strict exclusion criteria for patients participating in AAT. AMKH OTs’ experience suggests that additional skills and knowledge are required to implement AAT, therefore, healthcare institutions should first consider improving their staff training and risk mitigation knowledge before implementing AAT. They can also refer to AMKH’s AAT protocols and those found in overseas studies, but institutions must adapt the protocols to fit their institutional settings and patients’ profiles.

Keywords: animal-assisted therapy, dog-assisted therapy, occupational therapy, complementary therapy

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Authors: Abolaji Mayowa Akinyele

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The purpose of this study was to investigate student’s awareness, Knowledge and understanding of environmental issues for sustainable development. Findings revealed that; despite the positive attitude shown by students towards environmental education, a relatively low level of understanding of environmental concept was recorded in school settings regardless of efforts by government and other environmental agencies at creating awareness about environmental related issues. This brought about the investigation of students environmental education knowledge in high school settings. About 205 Students were randomly selected for data collection using validated instruments titled student’s knowledge and attitude questionnaire as well as student’s response to questions (interview) concerning global warming. T-test statistics, chi-square and simple percentage were the major statistical tools employed in data analysis. This study revealed that environment based-education (school curriculum) as well as efforts by government/environmental agencies (mass media) plays a major role in promoting students understanding, of environmental concepts, awareness of major environmental issues and positive attitude towards natural environment.

Keywords: environmental issues, sustainable development, students attitude, students knowledge

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Authors: Julia Wimmers Klick

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Interprofessional Education (IPE) is widely recognized as a valuable approach in healthcare education, despite the challenges it presents. This study explores IP surface anatomy lab sessions, with a focus on fostering trust and collaboration among healthcare students. The research is conducted within the context of rural healthcare settings in British Columbia (BC), where a medical school and a physical therapy (PT) program operate under the Faculty of Medicine at the University of British Columbia (UBC). While IPE sessions addressing soft skills have been implemented, the integration of hard skills, such as Anatomy, remains limited. To address this gap, a pilot feasibility study was conducted with a positive outcome, a follow-up study involved these IPE sessions aimed at exploring the influence of bonding and trust between medical and PT students. Data were collected through focus groups comprising participating students and faculty members, and a structured SWOC (Strengths, Weaknesses, Opportunities, and Challenges) analysis was conducted. The IPE sessions, 3 in total, consisted of a 2.5-hour lab on surface anatomy, where PT students took on the teaching role, and medical students were newly exposed to surface anatomy. The focus of the study was on the relationship-building process and trust development between the two student groups, rather than assessing the acquisition of surface anatomy skills. Results indicated that the surface anatomy lab served as a suitable tool for the application and learning of soft skills. Faculty members observed positive outcomes, including productive interaction between students, reversed hierarchy with PT students teaching medical students, practicing active listening skills, and using a mutual language of anatomy. Notably, there was no grade assessment or external pressure to perform. The students also reported an overall positive experience; however, the specific impact on the development of soft skill competencies could not be definitively determined. Participants expressed a sense of feeling respected, welcomed, and included, all of which contributed to feeling safe. Within the small group environment, students experienced becoming a part of a community of healthcare providers that bonded over a shared interest in health professions education. They enjoyed sharing diverse experiences related to learning across their varied contexts, without fear of judgment and reprisal that were often intimidating in single professional contexts. During a joint Christmas party for both cohorts, faculty members observed students mingling, laughing, and forming bonds. This emphasized the importance of early bonding and trust development among healthcare colleagues, particularly in rural settings. In conclusion, the findings emphasize the potential of IPE sessions to enhance trust and collaboration among healthcare students, with implications for their future professional lives in rural settings. Early bonding and trust development are crucial in rural settings, where healthcare professionals often rely on each other. Future research should continue to explore the impact of content-concentrated IPE on the development of soft skill competencies.

Keywords: interprofessional education, rural healthcare settings, trust, surface anatomy

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Authors: Dina Dahood Dabash

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Palestine Refugee Camps have never been settings that can be overlooked; they even became (as physical settings) a cornerstone topic of negotiations whenever Palestinian matters are on the table (specifically in Jordan). Consequently, maintaining the familiar face of the camp with its dilapidated shelters and narrow streets that rarely allowed its residents to extinguish a fire or evacuate a building safely has become a fundamental method to protect the “right of the return” from the perspective of various stakeholders. When the Infrastructure and Camp Improvement Programme (ICIP) was established in 2007 as an additional UNRWA program, some concerns were raised around the newly established section, mainly due to its direct impact on the “image” of the camp through a provision of a relatively nonconventional service that differs from what the Agency used to provide in the past seventy years. By presenting the Urban Improvement Project in Jerash camp (UIP) -Jordan, this paper aims to contribute to the ongoing discussion around enduring the improvement of Palestine refugee camps “programmatically” in UNRWA or not. The UIP as a co-product by UNRWA and the camp’s community within one of the most vulnerable refugee camps in Jordan offers a remarkable opportunity to excerpt lessons that can contribute to the strategic shaping of the ICIP. The paper concludes with five mine uptakes mainly related to community engagement, power structures and UNRWA's role in camps.

Keywords: camp improvement program, Jerash camp, Palestine refugee camps, UNRWA.

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Authors: Omer Ibrahim Abdallh Omer

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Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.

Keywords: cancer, medications adherence, medication therapy management, pharmacist

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Authors: Lukasz Grzegorz Broda, Taiwo Oseni, Andrew Stranieri, Rodrigo Marino, Ronelle Welton, Mark Yates

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The oral health of residents in aged care centres in Australia is poor, contributing to infections, hospital admissions, and increased suffering. Although the use of electric toothbrushes has been deployed in many centres, smartbrushes that record and transmit information about brushing patterns and duration are not routinely deployed. Yet, the use of smartbrushes for aged care residents promises better oral care. Thus, a study aimed at investigating the appropriateness and suitability of a smartbrush for aged care residents is currently underway. Due to the peculiarity of the aged care setting, the incorporation of smartbrushes into residents’ care does require careful planning and design considerations. This paper describes an initial design process undertaken through the use of an actor to understand the important elements to be incorporated whilst installing a smartbrush for use in aged care settings. The design covers the configuration settings of the brush and app, including ergonomic factors related to brush and smartphone placement. A design science approach led to an installation re-design and a revised protocol for the planned study, the ultimate aim being to design installations to enhance perceived usefulness, ease of use, and attitudes towards the incorporation of smartbrushes for improving oral health care for aged care residents.

Keywords: smartbrush, applied computing, life and medical sciences, health informatics

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Authors: Claire Sciberras

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Introduction: Autism Spectrum Disorder (ASD) has become recognized as being the most common childhood neurological condition. Indeed, numerous studies demonstrate an increase in the prevalence rate of children diagnosed with ASD. Concurrent with these findings, the European Agency for Special Needs and Inclusive Education reported a similar escalating tendency in prevalence also in Malta. Such an increase within the educational context in Malta has led the European Agency to call for increased support within educational settings in Malta. However, although research has addressed the positive impact of mainstream education on learners with ASD, empirical studies vis-à-vis the internal and external strengths and weaknesses present within the support provided in mainstream settings in Malta is distinctly limited. In light of the aforementioned argument, Malta would benefit from research which focuses on analysing the strengths, weaknesses, opportunities, and threats (SWOTs) which are present within the support provision of learners with ASD in mainstream primary schools. Such SWOT analysis is crucial as lack of appropriate opportunities might jeopardize the educational and social experiences of persons with ASD throughout their schooling. Methodology: A mixed methodological approach would be well suited to examine the provision of support of learners with ASD as the combination of qualitative and quantitative approaches allows researchers to collect a comprehensive range of data and validate their results. Hence, it is intended that questionnaires will be distributed to all the stakeholders involved so as to acquire a broader perspective to be collected from a wider group who provide support to students with ASD across schools in Malta. Moreover, the use of a qualitative approach in the form of interviews with a sample group will be implemented. Such an approach will be considered as it would potentially allow the researcher to gather an in-depth perspective vis-à-vis to the nature of the services which are currently provided to learners with ASD. The intentions of the study: Through the analysis of the data collected vis-à-vis to the SWOTs within the provision of support of learners with ASD it is intended that; i) a description in regards to the educational provision for learners with ASD within mainstream primary schools in Malta in light of the experiences and perceptions of the stakeholders involved will be acquired; ii) an analysis of the SWOTs which exist within the services for learners with ASD in primary state schools in Malta is carried out and iii) based on the SWOT analysis, recommendations that can lead to improvements in practice in the field of ASD in Malta and beyond will be provided. Conclusion: Due to the heterogeneity of individuals with ASD which spans across several deficits related to the social communication and interaction domain and also across areas linked to restricted, repetitive behavioural patterns, educational settings need to alter their standards according to the needs of their students. Thus, the standards established by schools throughout prior phases do not remain applicable forever, and therefore these need to be reviewed periodically in accordance with the diversities and the necessities of their learners.

Keywords: autism spectrum disorders, mainstream educational settings, provision of support, SWOT analysis

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Authors: Dragana Bubulj

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The Former Republic of Yugoslavia was a sort of protective umbrella, a unique concept of gathering different ethnical, cultural, and religious identities, as well as diverse intersections of those. After 43-months long civil war and states disintegration in 1995, which resulted in 5 post-Yugoslav countries, Yugoslav Diaspora experienced radical changes. In Germany, one of the countries with the highest percentage of Yugoslav emigration, segregation on ethno-national grounds was empowered by the outbreak of the conflict: firstly on a socio-cultural level, and followed by changes on the level of institutional organizing. Psycho-emotional and financial involvement of Diaspora into the war is also not to be neglected. People of Serbian origin have been additionally overstrained with the designation of Serbs as war criminals in German media and the public sphere. In this way, the path from 'being a Yugoslav' toward 'becoming a Serb', outside nowadays Serbia, has been qualitatively different in comparison to potential identity shiftings experienced by other members of Former Yugoslav population. This paper is part of an ongoing PhD research and tackles biographical narratives of academics of Serbian origin in one German region. Paper addresses processes of post-Yugoslav identity negotiations in Diaspora settings, nationalistic tendentious among second generation youth, and discusses - based on NS-references founded in collected data - question of historicity of biographies.

Keywords: biography, diaspora, ethnography, former republic of Yugoslavia, identity

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Authors: Jean Paul M. Milambo

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Purpose: Aromatase inhibitors (AIs) are indicated in the treatment of hormone-receptive breast cancer in postmenopausal women in various settings. Studies have shown cardiovascular events in some developed countries. To date the data is sparce for evidence-based recommendations in African clinical settings due to lack of cancer registries, capacity building and surveillance systems. Therefore, this study was conducted to assess the feasibility of HyBeacon® probe genotyping adjunctive to standard care for timely prediction and diagnosis of Aromatase inhibitors (AIs) associated adverse events in breast cancer survivors in Africa. Methods: Cross sectional study was conducted to assess the knowledge of POCT among six African countries using online survey and telephonically contacted. Incremental cost effectiveness ratio (ICER) was calculated, using diagnostic accuracy study. This was based on mathematical modeling. Results: One hundred twenty-six participants were considered for analysis (mean age = 61 years; SD = 7.11 years; 95%CI: 60-62 years). Comparison of genotyping from HyBeacon® probe technology to Sanger sequencing showed that sensitivity was reported at 99% (95% CI: 94.55% to 99.97%), specificity at 89.44% (95% CI: 87.25 to 91.38%), PPV at 51% (95%: 43.77 to 58.26%), and NPV at 99.88% (95% CI: 99.31 to 100.00%). Based on the mathematical model, the assumptions revealed that ICER was R7 044.55. Conclusion: POCT using HyBeacon® probe genotyping for AI-associated adverse events maybe cost effective in many African clinical settings. Integration of preventive measures for early detection and prevention guided by different subtype of breast cancer diagnosis with specific clinical, biomedical and genetic screenings may improve cancer survivorship. Feasibility of POCT was demonstrated but the implementation could be achieved by improving the integration of POCT within primary health cares, referral cancer hospitals with capacity building activities at different level of health systems. This finding is pertinent for a future envisioned implementation and global scale-up of POCT-based initiative as part of risk communication strategies with clear management pathways.

Keywords: breast cancer, diagnosis, point of care, South Africa, aromatase inhibitors

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Authors: Sky Chou, Joseph C. Chen

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This paper focuses on using Six Sigma methodologies to improve the surface roughness of a manufactured part produced by the CNC milling machine. It presents a case study where the surface roughness of milled aluminum is required to reduce or eliminate defects and to improve the process capability index C_p and C_pk for a CNC milling process. The six sigma methodology, DMAIC (design, measure, analyze, improve, and control) approach, was applied in this study to improve the process, reduce defects, and ultimately reduce costs. The Taguchi-based six sigma approach was applied to identify the optimized processing parameters that led to the targeted surface roughness specified by our customer. A L₉ orthogonal array was applied in the Taguchi experimental design, with four controllable factors and one non-controllable/noise factor. The four controllable factors identified consist of feed rate, depth of cut, spindle speed, and surface roughness. The noise factor is the difference between the old cutting tool and the new cutting tool. The confirmation run with the optimal parameters confirmed that the new parameter settings are correct. The new settings also improved the process capability index. The purpose of this study is that the Taguchi–based six sigma approach can be efficiently used to phase out defects and improve the process capability index of the CNC milling process.

Keywords: CNC machining, six sigma, surface roughness, Taguchi methodology

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Authors: Melissa C. Ingram

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This literature review sought to explore the dimensions of diversity that can affect classroom learning. This review is significant as it can aid educators in reaching more of their diverse student population and creating supportive classrooms for teachers and students. For this study, peer-reviewed articles were found and compiled using Google Scholar. Key terms used in the search include student individuality, classroom equality, student development, teacher development, and teacher individuality. Relevant educational standards such as Common Core and Partnership for the 21st Century were also included as part of this review. Student and teacher individuality and equality is discussed as well as methods to grow both within educational settings. Embracing student and teacher individuality was found to be key as it may affect how each person interacts with given information. One method to grow individuality and equality in educational settings included drafting and employing revised teaching standards which include various Common Core and U.S. State standards. Another was to use educational theories such as constructivism, cognitive learning, and Experiential Learning Theory. However, barriers to growing individuality, such as not acknowledging differences in a population’s dimensions of diversity, still exist. Studies found preserving the dimensions of diversity owned by both teachers and students yielded more positive and beneficial classroom experiences.

Keywords: classroom equality, student development, student individuality, teacher development, teacher individuality

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Authors: Ryotaro Ishikawa

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INTRODUCTION: Post-traumatic stress disorder (PTSD) is a psychiatric label for a collection of psychological symptoms following a traumatic event. PTSD is as a result of a traumatic experience such as rape or sexual assault. A victim may have PTSD if she/he has experienced the following symptoms for at least a month: a) Stressor, b) Intrusion symptoms, c) Avoidance, d) Negative alterations in cognitions and mood, e) Alterations in arousal and reactivity. Studies on the cognitive theory of PTSD emphasized the roles of (a) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (b) disorganized trauma memories in the development of PTSD. Mental contamination is primarily caused by experiences involving humans (e.g. violators or perpetrators) as opposed to substances (e.g. dirt or bodily fluids). Feelings of mental contamination may evoke following experiences of ill-treatment, sexual assault, domination, degradation, manipulation, betrayal, or humiliation. Some studies have demonstrated that traumatic thoughts related to sexual assault are particularly strong predictors of mental contamination. Treatment protocols based on cognitive-behavioral therapy appear to be beneficial in reducing the severity of PTSD and mental contamination. Studies on the cognitive theory of PTSD emphasized the roles of (A) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (B) disorganized trauma memories in the development of PTSD. We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. METHOD: The single-arm trial is a group setting CBT intervention. The primary outcome is the self-rated Posttraumatic Stress Diagnostic Scale, with secondary measurements of depressive severity and mental pollution questionnaire. Assessments are conducted at baseline, after a waiting period before CBT, during CBT, and after CBT. RESULTS: Participants are eligible for the study and complete the outcome measures at all assessment points. In our hypothesis, receiving CBT would lead to improvements in primary and secondary PTSD severity. CONCLUSION: We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. Our treatment would achieve favorable treatment outcomes for PTSD with mental contamination in Japanese clinical settings.

Keywords: CBT, cognitive theory, PTSD, mental pollution

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Authors: Fatema Salman, Ridha Hammam, Fatima Khairallah, Fatima Aradi, Nafeesa Abdulla, Mohammed Alsafar

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Purpose: This study aims at measuring the extent of nurses’ knowledge and attitudes toward the use of physical restraints in different hospital wards at Salmaniya Medical Complex (SMC). Background: The habitual use of physical restraint is a widespread practice among nurses working in the clinical settings. Restraints inflict many deleterious consequences on patients physically and psychologically which in turn increases their morbidity and mortality risk and jeopardizes care quality. Nurses’ knowledge and attitudes toward physical restraints are crucial determinants of the persistence of this practice. Literature review: the evidence of lack of knowledge among nurses regarding the use of physical restraints is overwhelming in various clinical settings, especially in two main areas which are the negative consequences and the available alternatives to physical restraints. Studies explored nurses’ attitudes toward physical restraints yielded inconsistent findings. Equally comparable, some studies found that nurses hold positive attitudes toward the use of physical restraints while some others reported just the opposite. Methods: Self-administered knowledge and attitudes scales to 106 nurses working in the SMC. Findings: nurses hold the moderate level of knowledge about restraints (M=58%) with weak negative attitudes (M = -20%) toward using it. Significant moderately-strong negative correlation (r= -0.57, r2= 0.32, p= 0.000) was uncovered between nurses knowledge and their attitudes which provided an empirical explanation of this phenomenon (use of physical restraints). Recommendations: Induction of awareness program that especially focuses on the negative consequences and encourages the use of alternatives is an evident need. This effort necessarily should be adjoined with policy and procedure adjustments.

Keywords: attitudes, knowledge, nurses, restraints

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Authors: Deborah Weidner, Melissa Morgera

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The model of care delivery in the Behavioral Health Network (BHN) is integrated across all five regions of Hartford Healthcare and thus spans the entirety of the state of Connecticut, with care provided in seven inpatient settings and over 30 ambulatory outpatient locations. While safety has been a core priority of the BHN in alignment with High Reliability practices, safety initiatives have historically been facilitated locally in each region or within each entity, with interventions implemented locally as opposed to throughout the network. To address this, the BHN introduced a network wide Safety Huddle during 2022. Launched in January, the BHN Safety Huddle brought together internal stakeholders, including medical and administrative leaders, along with executive institute leadership, quality, and risk management. By bringing leaders together and introducing a network-wide safety huddle into the way we work, the benefit has been an increase in awareness of safety events occurring in behavioral health areas as well as increased systemization of countermeasures to prevent future events. One significant discussion topic presented in huddles has pertained to environmental design and patient access to potentially dangerous items, addressing some of the most relevant factors resulting in harm to patients in inpatient and emergency settings for behavioral health patients. The safety huddle has improved visibility of potential environmental safety risks through the generation of over 15 safety alerts cascaded throughout the BHN and also spurred a rapid improvement project focused on standardization of patient belonging searches to reduce patient access to potentially dangerous items on inpatient units. Safety events pertaining to potentially dangerous items decreased by 31% as a result of standardized interventions implemented across the network and as a result of increased awareness. A second positive outcome originating from the BHN Safety Huddle was implementation of a recommendation to increase the emergency Narcan®(naloxone) supply on hand in ambulatory settings of the BHN after incidents involving accidental overdose resulted in higher doses of naloxone administration. By increasing the emergency supply of naloxone on hand in all ambulatory and residential settings, colleagues are better prepared to respond in an emergency situation should a patient experience an overdose while on site. Lastly, discussions in safety huddle spurred a new initiative within the BHN to improve responsiveness to assaultive incidents through a consultation service. This consult service, aligned with one of the network’s improvement priorities to reduce harm events related to assaultive incidents, was borne out of discussion in huddle in which it was identified that additional interventions may be needed in providing clinical care to patients who are experiencing multiple and/ or frequent safety events.

Keywords: quality, safety, behavioral health, risk management

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Authors: Sky Chou, Joseph C. Chen

Abstract:

This paper focuses on using six sigma methodologies to reach the desired shrinkage of a manufactured high-density polyurethane (HDPE) part produced by the injection molding machine. It presents a case study where the correct shrinkage is required to reduce or eliminate defects and to improve the process capability index Cp and Cpk for an injection molding process. To improve this process and keep the product within specifications, the six sigma methodology, design, measure, analyze, improve, and control (DMAIC) approach, was implemented in this study. The six sigma approach was paired with the Taguchi methodology to identify the optimized processing parameters that keep the shrinkage rate within the specifications by our customer. An L9 orthogonal array was applied in the Taguchi experimental design, with four controllable factors and one non-controllable/noise factor. The four controllable factors identified consist of the cooling time, melt temperature, holding time, and metering stroke. The noise factor is the difference between material brand 1 and material brand 2. After the confirmation run was completed, measurements verify that the new parameter settings are optimal. With the new settings, the process capability index has improved dramatically. The purpose of this study is to show that the six sigma and Taguchi methodology can be efficiently used to determine important factors that will improve the process capability index of the injection molding process.

Keywords: injection molding, shrinkage, six sigma, Taguchi parameter design

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Authors: Shehroz Mukhtar, Maqsood Ahmed, Abdullah Mukhtar, Choudhry Shahid, Waqar Javaid

Abstract:

Code switching is a common phenomenon, generally observed in multilingual communities across the globe. A critical look at code switching literature reveals that mostly code switching has been studied in classroom in learning and teaching context while code switching outside classroom in settings such as café, hostel and so on have been the least explored areas. Current research investigated the reasons for code switching in the interactive practices of students and their perceptions regarding the same outside the classroom settings. This paper is the study of the common practice that prevails in the Universities of Sialkot that bilinguals mix two languages when they speak in different class room situations. In Pakistani classrooms where Multilingual are in abundance i.e. they can speak two or more than two languages at the same time, the code switching or language combination is very common. The teachers of Sialkot switch from one language to another consciously or unconsciously while teaching English in the class rooms. This phenomenon has not been explored in the Sialkot’s teaching context. In Sialkot private educational institutes does not encourage code-switching whereas the public or government institutes use it frequently. The crux of this research is to investigate and identify the importance of code switching by taking its users in consideration. Survey research method and survey questionnaire will be used to get exact data from teachers and students. We will try to highlight the functions and importance of code switching in foreign language classrooms of Sialkot and will explore why this trend is emerging in Sialkot.

Keywords: code switching, bilingual context, L1, L2

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Authors: Shehroz Mukhtar, Maqsood Ahmed, Abdullah Mukhtar, Choudhry Shahid, Waqar Javaid

Abstract:

Code switching is a common phenomenon, generally observed in multilingual communities across the globe. A critical look at code-switching literature reveals that mostly code-switching has been studied in the classrooms in learning and teaching contexts, while code-switching outside the classroom in settings such as café, hostels and so on has been the least explored areas. The current research investigated the reasons for code-switching in the interactive practices of students and their perceptions regarding the same outside the classroom settings. This paper is the study of the common practice that prevails in the Universities of Sialkot that bilinguals mix two languages when they speak in different classroom situations. In Pakistani classrooms where Multilingual is in abundance, i.e. they can speak two or more two languages at the same time, code-switching or language combination is very common. The teachers of Sialkot switch from one language to another consciously or unconsciously while teaching English in the classrooms. This phenomenon has not been explored in Sialkot’s teaching context. In Sialkot, private educational institutes do not encourage code-switching, whereas public or government institutes use it frequently. The crux of this research is to investigate and identify the importance of code-switching by taking its users into consideration. The survey research method and survey questionnaire will be used to get exact data from teachers and students. We will try to highlight the functions and importance of code switching in foreign language classrooms of Sialkot and will explore why this trend is emerging in Sialkot.

Keywords: code switching, foreign language classrooms, bilingual context, use of L1, importance of L2.

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Authors: Ana Violante, Jodie Maccarrone, Maria Fimiani

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In the United States, over 30 million people are hospitalized annually for conditions that require acute, 24-hour, supervised care. The experience of hospitalization can be traumatic, exposing the patient to loss of control, autonomy, and productivity. Furthermore, 40% of patients admitted to hospitals for general medical illness have a comorbid psychiatric diagnosis. Research suggests individuals admitted with psychiatric comorbidities experience poorer health outcomes, higher utilization rates and increased overall cost of care. Empirical work suggests hospital settings that include a consultation liaison (CL) service report reduced length of stay, lower costs per patient, improved medical staff and patient satisfaction and reduced readmission after 180 days. Despite the overall positive impact CL services can have on patient care, it is estimated that only 1% - 2.8% of hospital admits receive these services, and most research has been conducted by the field of psychiatry. Health psychologists could play an important role in increasing access to this valuable service, though the extent to which health psychologists participate in CL settings is not well known. Objective: Outline the preliminary findings from an empirical study to understand how many APPIC internship training programs offer adult consultation liaison rotations within inpatient hospital settings nationally, as well as describe the specific nature of these training experiences. Research Method/Design: Data was exported into Excel from the 2022-2023 APPIC Directory categorized as “health psychology” sites. It initially returned a total of 537 health training programs out 1518 total programs (35% of all APPIC programs). A full review included a quantitative and qualitative comprehensive review of the APPIC program summary, the site website, and program brochures. The quantitative review extracted the number of training positions; amount of stipend; location or state of program, patient, population, and rotation. The qualitative review examined the nature of the training experience. Results: 29 (5%) of all APPIC health psychology internship training programs (2%) respectively of all APPIC training internship programs offering internship CL training were identified. Of the 29 internship training programs, 16 were exclusively within a pediatric setting (55%), 11 were exclusively within an adult setting (38%), and two were a mix of pediatric and adult settings (7%). CL training sites were located to 19 states, offering a total of 153 positions nationally, with Florida containing the largest number of programs (4). Only six programs offered 12-month training opportunities while the rest offered CL as a major (6 month) to minor (3-4 month) rotation. The program’s stipend for CL training positions ranged from $25,000 to $62,400, with an average of $32,056. Conclusions: These preliminary findings suggest CL training and services are currently limited. Training opportunities that do exist are mostly limited to minor, short rotations and governed by psychiatry. Health psychologists are well-positioned to better define the role of psychology in consultation liaison services and enhance and formalize existing training protocols. Future research should explore in more detail empirical outcomes of CL services that employ psychology and delineate the contributions of psychology from psychiatry and other disciplines within an inpatient hospital setting.

Keywords: consultation liaison, health psychology, hospital setting, training

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Authors: Yvonne Howard

Abstract:

This project currently under development is centered around current learning processes, including a thorough literature review and ongoing practical experiences gained as a deputy head in a school. These daily experiences with students engaging in animal-assisted interventions and the school therapy dog form a strong base for this research. The primary objective of this research is to comprehensively explore the impact of dog-assisted well-being interventions on student motivation and affective engagement within primary and secondary school settings. The educational domain currently encounters a significant challenge due to the lack of substantial research in this area. Despite the perceived positive outcomes of such interventions being acknowledged and shared in various settings, the evidence supporting their effectiveness in an educational context remains limited. This study aims to bridge the gap in the research and shed light on the potential benefits of dog-assisted well-being interventions in promoting student motivation and affective engagement. The significance of this topic recognizes that education is not solely confined to academic achievement but encompasses the overall well-being and emotional development of students. Over recent years, there has been a growing interest in animal-assisted interventions, particularly in healthcare settings. This interest has extended to the educational context. While the effectiveness of these interventions in these areas has been explored in other fields, the educational sector lacks comprehensive research in this regard. Through a systematic and thorough research methodology, this study seeks to contribute valuable empirical data to the field, providing evidence to support informed decision-making regarding the implementation of dog-assisted well-being interventions in schools. This research will utilize a mixed-methods design, combining qualitative and quantitative measures to assess the research objectives. The quantitative phase will include surveys and standardized scales to measure student motivation and affective engagement, while the qualitative phase will involve interviews and observations to gain in-depth insights from students, teachers, and other stakeholders. The findings will contribute evidence-based insights, best practices, and practical guidelines for schools seeking to incorporate dog-assisted interventions, ultimately enhancing student well-being and improving educational outcomes.

Keywords: therapy dog, wellbeing, engagement, motivation, AAI, intervention, school

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Authors: Alon Gelbman, Daniel Laven

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The paper focuses on a case study of a small-scale heritage tourism venture that seeks to influence tourism development in Nazareth’s old city. This is an exploratory case study that uses qualitative research methods including extensive participant observation and in-depth interviews with the venture’s senior management group and selected employees. Study findings indicate a model of the relationship between community-based tourism development, heritage, and peace-building in a city that has experienced a wide range of cross-cultural conflicts. This model represents an alternative view to the notion that heritage serves to enhance differences and dissonance between different cultural groups. In contrast, findings from this study suggest that heritage in the form of tourism; can help create shared interests between different communities in settings characterized by cross-cultural conflict. This model represents an alternative view to the notion that heritage serves to enhance differences and dissonance between different cultural groups. In contrast, findings from this study suggest that heritage in the form of tourism; can help create shared interests between different communities in settings characterized by cross-cultural conflict.

Keywords: cultural heritage tourism, tourism and peace, community-based tourism, sustainable tourism, cross-cultural conflict, Nazareth historic city

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Authors: Melissa Hachem, Lynda Bensefa-Colas, Isabelle Momas

Abstract:

We evaluated the impact of the first lockdown restriction measures (March-May 2020) in the Paris area on (1) the variation of in-vehicle ultrafine particle (UFP) and black carbon (BC) concentrations between pre-and post-lockdown period and (2) the professional drivers working conditions and practices. The study was conducted on 33 Parisian taxi drivers. UFP and BC were measured inside their vehicles with DiSCmini® and microAeth®, respectively, on two typical working days before and after the first lockdown. The job-related characteristics were self-reported. Our results showed that after the first lockdown, the number of clients significantly decreased as well as the taxi driver's journey duration. Taxi drivers significantly opened their windows more and reduced the use of air recirculation. UFP decreased significantly by 32% and BC by 31% after the first lockdown, with a weaker positive correlation compared to before the lockdown. The reduction of in-vehicle UFP was explained mainly by the reduction of traffic flow and ventilation settings, though the latter probably varied according to the traffic condition. No predictor explained the variation of in-vehicle BC concentration between pre-and post-lockdown periods, suggesting different sources of UFP and BC. The road traffic was not anymore the dominant source of BC post-lockdown. We emphasize the role of traffic emissions on in-vehicle air pollution and that preventive measures such as ventilation settings will help to better manage air quality inside a vehicle in order to minimize exposure of professional drivers, as well as passengers, to air pollutants.

Keywords: black carbon, COVID-19, France, lockdown, taxis, ultrafine particles

Procedia PDF Downloads 167