Studies on Explanatory Models, Culture and Intellectual Disability

We did a series of studies on cultural factors associated with intellectual disability. Our study focused on the Tamil speaking people belonging to the local region. This helped us to gain insights into local perspectives and to understand their experiences with intellectual disability. We employed focus group discussions that provided in- depth information about the beliefs and practices of families of children with ID as well as perceptions of the individuals in the community. The study documented diverse and contradictory models of disability. Individuals held both biomedical and local beliefs that were rooted in their respective cultural and religious backgrounds. Individual variation within the same culture and religion was evident, emphasizing the heterogeneity in beliefs. However, the overall attitude towards ID in the community was negative. Our findings highlight the need to understand local beliefs and plan culturally sensitive interventions that focus on providing appropriate education and management strategies. Among the problems faced by families of children with ID, challenging behaviours appeared to be the most distressing. Higher the severity, greater the impairment for the child and more the burden associated with care-giving. Categorizing behaviour problems based on severity, would help early recognition and implementation of intervention strategies for the child, as well as provide improved support for the caregiver. In this context a culturally appropriate tool that can be easily administered and scored was needed. In our study, we strengthened the validation of the BASIC-MR, an already existing behaviour assessment tool for children with ID in India. A threshold score of ≥16 was established. The tool can be incorporated into routine clinical practice and challenging behaviours in children with ID, categorized as significant or not. Severity of behaviour problem is associated with psychiatric problems; hence the development of long term sequelae could be prevented if treated early. In view of the fact that challenging behaviours are associated with significant stress and poor coping among caregivers of children with ID, we studied this aspect in relation to the cultural correlates of challenging behaviours among this population. The results of the study indicate that challenging behaviours cause significant disruption in family life. Marital relationships are affected in addition to the neglect of the siblings. Mothers develop a negative attitude towards the child and their management, leading to a dysfunctional parent-child dyad. Our findings also showed that, social exclusion was the most distressing experience for the mothers, which led to isolation and hopelessness. The explanatory models held by the mothers supported a spiritual and cultural based belief. Availability of social support was minimal, forcing the caregivers, to use spiritual strategies. The study highlights the need to focus on minimizing stress, helping the caregiver use a variety of coping mechanisms and to look for ways in which social support can be harnessed. We undertook a randomized control trial to study the effect of a structured psychosocial intervention on the explanatory models, beliefs, family stress and behaviour problems. The findings showed that, caregivers who received the intervention trended towards a medical causal model and held multiple treatment models, post intervention compared to the treatment as usual group. Holding multiple models of treatment, which are inclusive of their cultural and religious beliefs appeared to offer explanations and meaning to their experiences of having a child with ID.? Reduced stress and better coping was associated with having multiple explanatory models. The long term follow up has shown significant reduction in behavior problems in the domain of rebellious and violent behaviours. In addition there is an improvement in the mother’s attitude towards the child with ID and better child rearing skills. This emphasizes a strong association between reduction in challenging behaviours and a positive attitude and better child management in the caregivers exposed to an individualized structured psychosocial intervention. The services that are available for children with ID in India are limited and the programs that do exist are focused primarily on the habilitation of the child. Caregiver needs are often overlooked. It is equally important therefore, that caregivers are targeted for intervention. Our study has shown that components of both psychoeducation and coping strategies are a necessary part of intervention for caregivers. When providing psycho-education, there is a need to understand the perspectives and narratives of the caregivers without challenging them and to simultaneously give them the biomedical perspectives. This approach would help the professionals to engage better, build a trusting relationship and provide a culturally sensitive intervention leading to better treatment outcomes. Thus, psychosocial intervention is crucial in all programs targeting individuals with ID. CONCLUSIONS: The conclusions of the studies done are: 1. Findings of the focus group study emphasized the need to understand ID in the socio-cultural context. The study documented the simultaneous use of diverse, multiple and contradictory models of intellectual disability drawing from biomedical, religious, social and cultural constructs. Consequently, cultural sensitivity is crucial to understanding complex human experiences and their social and cultural context. There is a need to increase population awareness and community resources to offer treatment and rehabilitation for people with ID, reduce stigma, improve coping skills and provide respite for families. 2. The behavioural assessment tool, BASIC-MR was strengthened in its validation aspect, by establishing a threshold score which would help to recognize clinically significant behavioural problems. It will allow for screening by nonspecialist professionals who have been trained in their use. 3. The case-control study demonstrated diverse EMs, beliefs and coping strategies among primary care-givers looking after children with ID. It also highlighted differences between those with and without clinically significant challenging behaviour. There is also a need to sensitize health care workers about the varied experiences and narratives of families caring for people with ID. 4. The results of the RCT suggested the usefulness of the structured individualized psychosocial program in increasing the number of treatment models, reduction of family stress and strengthening global adaptation as well as the long term improvement in attitude and child rearing skills

Enhancing Cybersecurity Content in Undergraduate Information Systems Programs: A Way Forward

The ongoing barrage of data and infrastructure breaches is a constant reminder of the critical need to enhance the cybersecurity component of modern undergraduate information systems (IS) education. Although the most recent undergraduate information systems curricular guidelines (IS2010) highlight security in the context of data, enterprise architecture, and risk management, much more needs to be done. The IS education community needs to identify cybersecurity competencies and curricular content that further integrates cybersecurity principles and practices into IS curricular guidelines. Until this is completed at the IS community level, IS programs will need to fulfill this role individually. This paper contributes to both these efforts by reviewing relevant literature and initiatives – highlighting two primary paths of curricular development: (1) the evolution of IS curricular guidelines, and (2) the development of Cybersecurity as a standalone discipline. Using these resources, the paper summarizes best practices for integrating cybersecurity into curricula and explores the integration of IS into cybersecurity programs

Ischemic Cholangiopathy 11 Years after Liver Transplantation from Asymptomatic Chronic Hepatic Artery Thrombosis

Hepatic artery thrombosis is a concerning complication of orthotopic liver transplantation, and it most often occurs early in the posttransplant period. However, on rare occasions it can occur at a time remote from transplant. We present a case of ischemic cholangiopathy complicated by stricture and anastomotic bile leak from chronic hepatic artery thrombosis that occurred 11 years after the transplant. The initial biliary stenting helped with the resolution of the leak but she was found to have stones, sludge and copious pus at the time of stent exchange. Hepatic arteriography demonstrated complete occlusion of the transplant hepatic artery with periportal collaterals reconstituting intrahepatic hepatic arterial branches. The patient was subsequently referred for repeat liver transplantation

The potential for measuring ethnicity and health in a multicultural milieu - the case of type 2 diabetes in Australia

ObjectiveEthnicity influences health in many ways. For example, type 2&nbsp;diabetes (T2DM) is disproportionately prevalent among certain ethnic groups.&nbsp;Assessing ethnicity is difficult, and numerous proxy measures are used to&nbsp;capture its various components. Australian guidelines specify a set of&nbsp;variables for measuring ethnicity, and how such parameters should be&nbsp;categorised. Using T2DM data collections as an illustrative example, this&nbsp;study sought to examine how ethnicity is measured in Australian health&nbsp;databases and, by comparing current practice with Australia&rsquo;s existing&nbsp;benchmark recommendations, to identify potential areas for improvement of&nbsp;the health data landscape.DesignWe identified databases containing information from which ethnic&nbsp;group-specific estimates of T2DM burden may be gleaned. For each&nbsp;database, details regarding ethnicity variables were extracted, and compared&nbsp;with the Australian guidelines.&nbsp;ResultsData collection instruments for 32 relevant databases were reviewed.&nbsp;Birthplace was recorded in 27 databases (84%), but mode of birthplace&nbsp;assessment varied. Indigenous status was commonly recorded (78%, n=25), but&nbsp;only nine databases recorded other aspects of self-perceived race/ethnicity. Of&nbsp;28 survey/audit databases, 14 accommodated linguistic preferences other than&nbsp;English, and 11 either excluded non-English speakers or those for whom a&nbsp;translator was not available, or only offered questionnaires in English.ConclusionsConsiderable variation exists in the measurement of ethnicity in&nbsp;Australian health data- sets. While various markers of ethnicity provide&nbsp;complementary information about the ethnic profile within a data-set, nonuniform&nbsp;measurement renders comparison between data-sets difficult. A&nbsp;standardised approach is necessary, and identifying the ethnicity variables&nbsp;that are particularly relevant to the health sector is warranted. Including self identified&nbsp;ethnicity in Australia&rsquo;s set of recommended indicators and as a core&nbsp;component of the national census should be considered. Globalisation and&nbsp;increasing migration mean that these findings have implications internationally,&nbsp;including for multi-ethnic countries throughout North America and&nbsp;Europe.</div

Inside sales social media use and its strategic implications for salesperson-customer digital engagement and performance

Highlights Inside salespeople rely on four main strategies when it comes to using social media in their roles to engage with customers. Inside sales strategic social media use leads to higher levels of customer digital engagement and, ultimately, performance. Firm digital technology resources may shape the effects of inside sales strategic social media use. Abstract The nature of inside sales has shifted, increasing in autonomy, importance, and scope. Moreover, buyers are changing their preferences from face-to-face interactions to virtual-based relationships, leading to a future full of opportunities for inside salespeople using social media. The practitioner literature suggests that inside sales represent the sales business model of the digital era and a distinct strategic selling approach. While there has been a recent surge in theoretical research on inside sales, extant research fails to explore how and why inside salespeople uses social media as a critical tool. Research on social media use in sales has neglected to consider the growing role of inside sales, where sellers lack the opportunity to meet with customers face-to-face and must routinely rely on remote communication to interact with customers. As such, we use a grounded theory approach to investigate the “lived experiences” of inside salespeople at the intersection with social media in sales. Emergent from our findings is a framework depicting: inside sales strategic social media use → inside salesperson-customer digital engagement → inside sales performance. We also find that firm digital technology resources serve as enablement factors that shape the effects of the social media strategies that inside salespeople use

An eye tracking based framework for safety improvement of offshore operations

Offshore drilling operations consist of complex and high-risk processes. Lack of situational awareness in drilling operations has become an important human factor issue that causes safety accidents. Prolonged work shifts and fatigue are some of the crucial issues that impact performance. Eye tracking technology can be used to distinguish the degree of awareness or alertness of participants that might be related to fatigue or onsite distractions. Oculomotor activity can be used to obtain visual cues that can quantify the drilling operators’ situational awareness that might enable us to develop warning alarms to alert the driller. Such systems can help reduce accidents and save non-productive time. In this paper, eye movement characteristics were investigated to differentiate the situational awareness between a representative expert and a group of novices using a scenario-based Virtual Reality Drilling Simulator. Significant visual oculomotor activity differences were identified between the expert and the novices that indicate an eye-tracking based system can detect the distraction and alertness exhibited by the workers. Results show promise on developing a framework which implements a real-time eye tracking technology in various drilling operations at drilling rigs and Real Time Operation Centers to improve process safety

Identification and Inference with Many Invalid Instruments

We analyze linear models with a single endogenous regressor in the presence of many instrumental variables. We weaken a key assumption typically made in this literature by allowing all the instruments to have direct effects on the outcome. We consider restrictions on these direct effects that allow for point identification of the effect of interest. The setup leads to new insights concerning the properties of conventional estimators, novel identification strategies, and new estimators to exploit those strategies. A key assumption underlying the main identification strategy is that the product of the direct effects of the instruments on the outcome and the effects of the instruments on the endogenous regressor has expectation zero. We argue in the context of two specific examples with a group structure that this assumption has substantive content.

The impact of adsorption–desorption reactions on the chemistry of Himalayan rivers and the quantification of silicate weathering rates

A.K. was supported by a NERC DTP studentship (NE/S007164/1). This work was funded by the NERC grant NE/T007214/1.Common environmental adsorbents (clay minerals, metal-oxides, metal-oxyhydroxides and organic matter) can significantly impact the chemistry of aqueous fluids via adsorption–desorption reactions. The dissolved chemistry of rivers have routinely been used to quantify silicate mineral dissolution rates, which is a key process for removing carbon dioxide (CO2) from the atmosphere over geological timescales. The sensitivity of silicate weathering rates to climate is disproportionately weighted towards regions with high erosion rates. This study quantifies the impact of adsorption-desorption reactions on the chemistry of three large Himalayan rivers over a period of two years, utilising both the adsorbed and dissolved phases. The concentration of riverine adsorbed cations are found to vary principally as a function of the concentration and cation exchange capacity (CEC) of the suspended sediment. Over the study period, the adsorbed phase is responsible for transporting ∼70% of the mobile (adsorbed and dissolved) barium and ∼10% of the mobile calcium and strontium. The relative partitioning of cations between the adsorbed and dissolved phases follows a systematic order in both the monsoon and the dry-season (preferentially adsorbed: Ba > Sr & Ca > Mg & K > Na). Excess mobile sodium (Na*=Na-Cl) to silicon (Si) riverine ratios are found to vary systematically during an annual hydrological cycle due to the mixing of low temperature and geothermal waters. The desorption of sodium from uplifted marine sediments is one key process that may increase the Na*/Si ratios. Accounting for the desorption of sodium reduces silicate weathering rate estimates by up to 83% in the catchments. This study highlights that surficial weathering processes alone are unable to explain the chemistry of the rivers studied due to the influence of hydrothermal reactions, which may play an important role in limiting the efficiency of silicate weathering and hence modulating atmospheric CO2 concentrations over geological time.Peer reviewe

Photostabilization of polyvinyl chloride by some new thiadiazole derivatives

(5-Amino-1,3,4-thiadiazole-2-yl)phenol and it derivatives have been synthesized and characterized by spectral methods lik (FT-IR, UV-Vis, and 1H NMR) and elemental analysis beside the measurements of their physical properties. All the prepared compounds were used as photo stabilizer with polyvinyl chloride. The rate of photo degradation and photo stabilization for PVC films were monitored with irradiation time by measuring the carbonyl (Ico) index values. In addition, the effect of concentrations additives on the rate of photo degradation and photo stabilization process was also studied. We found that the rates were increased with increasing of additives concentrations. Besides, the effect of film thickness is studied and the results showed that the increasing of film thickness will decrease the rate of photo degradation as the following sequences: [5] > [2] > [1] > [3] > [4] > PVC. Degree of deterioration (α), average number of cuts per single polymer chain (s), were calculated for PVC films as a control and that which contains the additives. According to the experimental results obtained several mechanisms were suggested depending on the structure of the additive. Among then UV absorption and radical scavenger for photo stabilizer additive mechanisms were suggested