Search results for: international guidelines
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5070

Search results for: international guidelines

1920 Investigating the Challenges Faced by English Language Teachers in Implementing Outcome Based Education the Outcome Based Education model in Engineering Universities of Sindh

Authors: Habibullah Pathan

Abstract:

The present study aims to explore problems faced by English Language Teachers (ELT) while implementing the Outcome Based Education (OBE) model in engineering universities of Sindh. OBE is an emerging model initiative of the International Engineering Alliance. Traditional educational systems are teacher-centered or curriculum-centered, in which learners are not able to achieve desired outcomes, but the OBE model enables learners to know the outcomes before the start of the program. OBE is a circular process that begins from the needs and demands of society to stakeholders who ask the experts to produce the alumnus who can fulfill the needs and ends up getting new enrollment in the respective programs who can work according to the demands. In all engineering institutions, engineering courses besides English language courses are taught on the OBE model. English language teachers were interviewed to learn the in-depth of the problems faced by them. The study found that teachers were facing problems including pedagogical, OBE training, assessment, evaluation and administrative support. This study will be a guide for public and private English language teachers to cope with these challenges while teaching the English language on the OBE model. OBE is an emerging model by which the institutions can produce such a product that can meet the demands.

Keywords: problems of ELT teachers, outcome based education (OBE), implementing, assessment

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1919 Transferring World Athletic Championship-Winning Principles to Entrepreneurship: The Case of Abdelkader El Mouaziz

Authors: Abderrahman Hassi, Omar Bacadi, Khaoula Zitouni

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Abdelkader El Mouaziz is a Moroccan long-distance runner with a career-best time of 2:06:46 in the Chicago Marathon. El Mouaziz is a winner of the Madrid Marathon in 1994, the London Marathon in 1999 and 2001, as well as the New York Marathon in 2001. While he was playing for the Moroccan national team, he used to train in the Ifrane-Azrou region owing to its altitude, fresh forests, non-polluted air and quietness. After winning so many international competitions and retiring, he left his native Casablanca and went back to the Ifrane-Azrou region and started a business that employs ten people. In March 2010, El Mouaziz opened a bed and breakfast called Tourtite with a nice view on the mountain near the city of Ifrane in the way to Azrou. He wanted to give back to the region that helped him become a sport legend. His management style is not different than his sport style: performance and competitiveness combined with fair play. The objective of the present case study is to further enhance the understanding of the dynamics of transferring athletic championship-winning principles to entrepreneurial activities. The case study is a real-life situation and experience designed to provoke and stimulate reflections about a particular approach of management, especially for start-up businesses.

Keywords: sport, winning principles, entrepreneurship, Abdelkader El Mouaziz

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1918 Adopting the Community Health Workers Master List Registry for Community Health Workforce in Kenya

Authors: Gikunda Aloise, Mjema Saida, Barasa Herbert, Wanyungu John, Kimani Maureen

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Background: Community Health Workforce (CHW) is health care providers at the community level (Level 1) and serves as a bridge between the community and the formal healthcare system. This human resource has enormous potential to extend healthcare services and ensures that the vulnerable, marginalized, and hard-to-reach populations have access to quality healthcare services at the community and primary health facility levels. However, these cadres are neither recognized, remunerated, nor in most instances, registered in a master list. Management and supervision of CHWs is not easy if their individual demographics, training capacity and incentives is not well documented through a centralized registry. Description: In February 2022, Amref supported the Kenya Ministry of Health in developing a community health workforce database called Community Health Workers Master List Registry (CHWML), which is hosted in Kenya Health Information System (KHIS) tracker. CHW registration exercise was through a sensitization meeting conducted by the County Community Health Focal Person for the Sub-County Community Health Focal Person and Community Health Assistants who uploaded information on individual demographics, training undertaken and incentives received by CHVs. Care was taken to ensure compliance with Kenyan laws on the availability and use of personal data as prescribed by the Data Protection Act, 2019 (DPA). Results and lessons learnt: By June 2022, 80,825 CHWs had been registered in the system; 78,174 (96%) CHVs and 2,636 (4%) CHAs. 25,235 (31%) are male, 55,505 (68%) are female & 85 (1%) are transgender. 39,979. (49%) had secondary education and 2500 (3%) had no formal education. Only 27 641 (34%) received a monthly stipend. 68,436 CHVs (85%) had undergone basic training. However, there is a need to validate the data to align with the current situation in the counties. Conclusions/Next steps: The use of CHWML will unlock opportunities for building more resilient and sustainable health systems and inform financial planning, resource allocation, capacity development, and quality service delivery. The MOH will update the CHWML guidelines in adherence to the data protection act which will inform standard procedures for maintaining, updating the registry and integrate Community Health Workforce registry with the HRH system.

Keywords: community health registry, community health volunteers (CHVs), community health workers masters list (CHWML), data protection act

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1917 Barriers to Participation in Sport for Children without Disability: A Systematic Review

Authors: S. Somerset, D. J. Hoare

Abstract:

Participation in sport is linked to better mental and physical health in children and adults. Studies have shown children who participate in sports benefit from improved social skills, self-confidence, communication skills and a better quality of life. Children who participate in sports from a young age are also more likely to continue to have active lifestyles during adulthood. This is an important consideration with a nation where physical activity levels are declining and the incidences of obesity are rising. Getting children active and keeping them active can provide long term health benefits to the individual but also a potential reduction in health costs in the future. This systematic review aims to identify the barriers to participation in sport for children aged up to 18 years and encompasses both qualitative and quantitative studies. The bibliographic databases, EMBASE, Medline, CINAHL and SportDiscus were searched. Additional hand searches were carried out on review articles found in the searches to identify any studies that may have been missed. Studies involving children up to 18 years without additional needs focusing on barriers to participation in sport were included. Randomised control trials, policy guidelines, studies with sport as an intervention, studies focusing on the female athlete triad, tobacco abuse, alcohol abuse, drug abuse, pre exercise testing, and cardiovascular disease were excluded. Abstract review, full paper review and quality appraisal were conducted by two researchers. A consensus meeting took place to resolve any differences at the abstract, full text and data extraction / quality appraisal stages. The CASP qualitative studies appraisal tool and the CASP cohort studies tool (excluding question 3 and 4 which refer to interventions) were used for quality appraisal in this review. The review identified several salient barriers to participation in sport for children. These barriers ranged from the uniform worn during school physical education lessons to the weather during participation in sport. The most commonly identified barriers in the review include parental support, time allocation, location of the activity and the cost of the activity. Therefore, it would be beneficial for a greater provision to be made within the school environment for children to participate sport. This can reduce the cost and time commitment required from parents to encourage participation. This would help to increase activity levels of children, which ultimately can only be a good thing.

Keywords: barrier, children, participation, sport

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1916 Introducing Standardized Nursing Language in Reporting Nursing Care in Resource-Limited Care Environments: An Exploratory Study

Authors: Naomi Mutea, Jossete Jones

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The project aimed at exploring the views and perceptions of nurse leaders and educators regarding use of International Classification for Nursing Practice (ICNP) in an informal approach which involved face to face discussions, after which a decision would be made on whether to proceed and propose introduction of ICNP project in Kenya as a pilot project which would mean all nurses would use a standard approach to reporting and documenting nursing care. In addition the project was to determine the best approaches/methods that can be used to introduce ICNP in the Kenyan nursing education and practice environment using the findings of the pilot project. Further four cardex reports were reviewed to establish if nurses on the bedside used a standardized language in documenting and reporting care processes. The cardex reports showed that nurses do not use ICNP or any other standardized language. The results of the discussions revealed that this would be a challenge due to several challenges experienced in conducting nursing research in resource-limited environments. The following questions were asked during the informal discussions with the educators/leaders: •What is currently being taught in terms of standardized nursing language? •Are you familiar with ICNP? •Do you view it advantageous to have a standardized language? •What is the greatest need at the moment in terms of curriculum development for BSN regarding use of standardized nursing language? •If you had a wish to change something in your curriculum, what would that be?

Keywords: nursing, standardized language, ICNP, resource-limited care environments

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1915 The Effectiveness of a Self-Efficacy Psychoeducational Programme to Enhance Outcomes of Patients with End-Stage Renal Disease

Authors: H. C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological well-being, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes and it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

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1914 The Security Challenges of Urbanization and Environmental Degradation in the Niger-Delta Area of Nigeria

Authors: Gloria Ogungbade, Ogaba Oche, Moses Duruji, Chris Ehiobuche, Lady Ajayi

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Human’s continued sustenance on earth and the quality of living are heavily dependent on the environment. The major components of the environment being air, water and land are the supporting pillars of the human existence, which they depend on directly or indirectly for survival and well-being. Unfortunately, due to some of the human activities on the environment, there seems to be a war between humans and the environment, which is evident in his over-exploitation and inadequate management of the basic components of the environment. Since the discovery of crude oil in the Niger Delta, the region has experienced various forms of degradation caused by pollution from oil spillage, gas flaring and other forms of environmental pollution, as a result of reckless way and manner with which oil is being exploited by the International Oil Corporations (IOCs) operating within the region. The Nigerian government on the other, not having strong regulations guiding the activities of the operations of these IOCs, has done almost nothing to curtail the activities of these IOCs because of the revenue generated the IOCs, as such the region is deprived of the basic social amenities and infrastructures. The degree of environmental pollution suffered within the region affects their major sources of livelihood – being fishing and farming, and has also left the region in poverty, which has led to a large number of people migrating to the urban areas to escape poverty. This paper investigates how environment degradation impact urbanization and security in the region.

Keywords: environmental degradation, environmental pollution, gas flaring, oil spillage, urbanization

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1913 Analysis of the Statistical Characterization of Significant Wave Data Exceedances for Designing Offshore Structures

Authors: Rui Teixeira, Alan O’Connor, Maria Nogal

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The statistical theory of extreme events is progressively a topic of growing interest in all the fields of science and engineering. The changes currently experienced by the world, economic and environmental, emphasized the importance of dealing with extreme occurrences with improved accuracy. When it comes to the design of offshore structures, particularly offshore wind turbines, the importance of efficiently characterizing extreme events is of major relevance. Extreme events are commonly characterized by extreme values theory. As an alternative, the accurate modeling of the tails of statistical distributions and the characterization of the low occurrence events can be achieved with the application of the Peak-Over-Threshold (POT) methodology. The POT methodology allows for a more refined fit of the statistical distribution by truncating the data with a minimum value of a predefined threshold u. For mathematically approximating the tail of the empirical statistical distribution the Generalised Pareto is widely used. Although, in the case of the exceedances of significant wave data (H_s) the 2 parameters Weibull and the Exponential distribution, which is a specific case of the Generalised Pareto distribution, are frequently used as an alternative. The Generalized Pareto, despite the existence of practical cases where it is applied, is not completely recognized as the adequate solution to model exceedances over a certain threshold u. References that set the Generalised Pareto distribution as a secondary solution in the case of significant wave data can be identified in the literature. In this framework, the current study intends to tackle the discussion of the application of statistical models to characterize exceedances of wave data. Comparison of the application of the Generalised Pareto, the 2 parameters Weibull and the Exponential distribution are presented for different values of the threshold u. Real wave data obtained in four buoys along the Irish coast was used in the comparative analysis. Results show that the application of the statistical distributions to characterize significant wave data needs to be addressed carefully and in each particular case one of the statistical models mentioned fits better the data than the others. Depending on the value of the threshold u different results are obtained. Other variables of the fit, as the number of points and the estimation of the model parameters, are analyzed and the respective conclusions were drawn. Some guidelines on the application of the POT method are presented. Modeling the tail of the distributions shows to be, for the present case, a highly non-linear task and, due to its growing importance, should be addressed carefully for an efficient estimation of very low occurrence events.

Keywords: extreme events, offshore structures, peak-over-threshold, significant wave data

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1912 Regular Laboratory Based Neonatal Simulation Program Increases Senior Clinicians’ Knowledge, Skills and Confidence Caring for Sick Neonates

Authors: Madeline Tagg, Choihoong Mui, Elizabeth Lek, Jide Menakaya

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Introduction: Simulation technology is used by neonatal teams to learn and refresh skills and gain the knowledge and confidence to care for sick neonates. In-situ simulation is considered superior to laboratory-based programmes as it closely mirrors real life situations. This study reports our experience of running regular laboratory-based simulation sessions for senior clinicians and nurses and its impact on their knowledge, skills and confidence. Methods: A before and after questionnaire survey was carried out on senior clinicians and nurses that attended a scheduled laboratory-based simulation session. Participants were asked to document their expectations before a 3-hour monthly laboratory programme started and invited to feedback their reflections at the end of the session. The session included discussion of relevant clinical guidelines, immersion in a scenario and video led debrief. The results of the survey were analysed in three skills based categories - improved, no change or a worsened experience. Results: 45 questionnaires were completed and analysed. Of these 25 (55%) were completed by consultants seven and six by nurses and trainee doctors respectively, and seven respondents were unknown. 40 (88%) rated the session overall and guideline review as good/excellent, 39 respondents (86%) rated the scenario session good/excellent and 40/45 fed back a good/excellent debrief session. 33 (73%) respondents completed the before and after questionnaire. 21/33 (63%) reflected an improved knowledge, skill or confidence in caring for sick new-bon babies, eight respondents reported no change and four fed back a worse experience after the session. Discussion: Most respondents found the laboratory based structured simulation session beneficial for their professional development. They valued equally the whole content of the programme such as guideline review and equipment training as well as the simulation and debrief sessions. Two out three participants stated their knowledge of caring for sick new-born babies had been transformed positively by the session. Sessions where simulation equipment failed or relevant staff were absent contributed to a poor educational experience. Summary: A regular structured laboratory-based simulation programme with a rich content is a credible educational resource for improving the knowledge, skills and confidence of senior clinicians caring for sick new born babies.

Keywords: knowledge, laboratory based, neonates, simulation

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1911 The Theory and Practice of Translanguaging: Scope, Potential and Limitations in a Multilingual Urban Context

Authors: Luzia Dominguez

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This paper explores the concept of ‘translanguaging’ and the relevance of its pedagogical application in the context of foreign language education in a multilingual urban environment. We review relevant literature discussing this theoretical concept, its scope, potential, and limitations when applied to the teaching of foreign languages. We then discuss its possible practical application in Welsh secondary schools, particularly in the most diverse areas of the Welsh capital, Cardiff (United Kingdom). The concept of translanguaging has evolved in scope, from its initial application in the teaching of Welsh and English in the Welsh bilingual context to finding a relevant space not only in the international arena of Sociolinguistics and language pedagogy but also being present in current Welsh educational policies and, presumably, practices. However, it is important to consider the actual pedagogical relevance of incorporating this concept into these policies, particularly in the teaching of Modern Foreign Languages. Additionally, it is important to examine any social factors that may influence the effectiveness of its application in the social context, in our case, a multilingual, ethnically diverse urban context. By analyzing these issues, we aim to explore possible teaching practices that could be pedagogically effective in applying the concept in Cardiff secondary schools.

Keywords: pedagogy, modern foreign languages, applied linguistics, sociolinguistics

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1910 Customer Behavior and Satisfaction of Domestic Low Cost Carrier in Chiang Mai, Thailand

Authors: Thiraporn Chumphuming, Nuttida Boonmathi, Supattra Thanomsiang, Tawatchai Noree, Suthee Boonchaloem, Rinyaphat Kecharananta

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This research aims to study about the formats of low-cost airlines’ services in domestic route by surveying customers’ requirements and satisfactions in choosing low-cost airlines to travel domestically. Chiang Mai International Airport and other regions in Chiang Mai are the bases where the information is quantitatively collected. Passengers and questionnaires of 400 are the data base in which the researchers collected information from. Statistic units used are Percentage, Weighted Average, and Standard Deviation. The result of the study reveals that the group of 400 representative samples chooses Air Asia the most from overall six low-cost airlines that provide domestic services. Most of the representative samples book plane tickets for their traveling and they book tickets during the promotion time that provides cheap-priced tickets. Averagely, the price for a seat in one flight is around 501-1,000 Thai baht. The result of the satisfaction’s survey analyzed by the Marketing Mix Factors (7Ps) of low-cost airlines, which is divided into 4 parts including services before ticket reservations, services before boarding/purchasing tickets (ground), In-flight services, and Services after boarding they are satisfied with the baggage claim point informing, also gives the information that the passengers are highly satisfied with every process or the services.

Keywords: low-cost airline, service, satisfaction, customers' behavior

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1909 English for Specific Purposes: Its Definition, Characteristics, and the Role of Needs Analysis

Authors: Karima Tayaa, Amina Bouaziz

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The rapid expansion in the scientific fields and the growth of communication technology increased the use of English as international language in the world. Hence, over the past few decades, many researchers have been emphasizing on how the teaching and learning of English as a foreign or as an additional language can best help students to perform successfully. English for specific purpose is today quite literally regarded as the most global language discipline which existed practically in every country in the world. ESP (English for Specific Purposes) involves teaching and learning the specific skills and language needed by particular learners for a particular purpose. The P in ESP is always a professional purpose which is a set of skills that learners currently need in their work or will need in their professional careers. It has had an early origin since 1960’s and has grown to become one of the most prominent of English language teaching today. Moreover, ESP learners are usually adults who have some quittances with English and learn the language so as to communicate and perform particular profession. Related activities are based on specific purposes and needs. They are integrated into subject matter area important to the learners. Unlike general English which focuses on teaching general language courses and all four language skills are equally stressed, ESP and practically needs analysis determine which language skills are the most needed by the learners and syllabus designed accordingly. This paper looked into the origin, characteristics, development of ESP, the difference between ESP and general English. Finally, the paper critically reviews the role of needs analysis in the ESP.

Keywords: English language teaching, English for general purposes, English for specific purposes, needs analysis

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1908 Investigation of Azol Resistance in Aspergillosis Caused by Gradient Test and Agar Plaque Methods

Authors: Zeynep Yazgan, Gökhan Aygün, Reyhan Çalışkan

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Objective: Invasive fungal infections are a serious threat in terms of morbidity and mortality, especially in immunocompromised patients. The most frequently isolated agents are Aspergillus genus fungi, and sensitivity to azoles, which are the first choice in treatment, decreases. In our study, we aimed to investigate the use of the agar plate screening method as a fast, easy, and practical method in determining azole resistance in Aspergillus spp. species. Methods: Our study was conducted with 125 Aspergillus spp. isolates produced from various clinical samples. Aspergillus spp. isolates were identified by conventional methods and azole resistance was determined by gradient test and agar plate screening method. Broth microdilution method was applied to resistant isolates, and CypA-L98H and CypA-M220 mutations in the cyp51A gene were investigated. Results: In our study, 55 A. fumigatus complex (44%), 42 A. flavus (33.6%), 6 A. terreus (5%), 4 A. niger (3%) and 18 Aspergillus spp. (14%) were identified. With the gradient test method, resistance to VOR and POS was detected in 1 (1.8%) of A.fumigatus isolates, and resistance to ITR was detected in 3 (5.45%). With the agar plate method, 1 of the A.fumigatus isolates (1.8%) had VOR, ITR, POS, 1 of the A.terreus isolates (16.7%) had VOR, 1 of the A.niger isolates (25%) had ITR. Resistance to VOR and POS was detected in 2 Aspergillus spp. isolates (11%), and resistance to ITR was detected in 1 (5.6%). Sensitivity and specificity were determined as 100% for VOR and POS in A. fumigatus species, 33.3% and 100% for ITR, respectively, 100% for ITR in A. flavus species, and 100% for ITR and POS in A. terreus species. By broth microdilution method in 7 isolates in which resistance was detected by gradient test and/or agar plate screening method; 1 A.fumigatus resistant to ITR, VOR, POS, 2 A.fumigatus resistant to ITR, 2 Aspergillus spp. ITR, VOR, POS MICs were determined as 2µg/ml and 8µg/ml, 8µg/ml and >32µg/ml, 0.5µg/ml and 4µg/ml, respectively. CypA-L98H mutations were detected in 5 of these isolates, CypA-M220 mutations were detected in 6, and no mutation was detected in 1. CypA-L98H and CypA-M220 mutations were detected in 1 isolate for which resistance was not detected. Conclusion: The need for rapid antifungal susceptibility screening tests is increasing in the treatment of aspergillosis. Although the sensitivity of the agar plate method was determined to be 33.3% for A.fumigatus ITR in our study, its sensitivity and specificity were determined to be 100% for ITR, VOR, and POS in other species. The low sensitivity value detected for A.fumigatus showed that agar plate drug concentrations should be updated in accordance with the latest regulations of EUCAST guidelines. The CypA-L98H and CypA-M220 mutations detected in our study suggested that the distribution of azole resistance-related mutations in different regions in our country should be investigated. In conclusion, it is thought that the agar plate method, which can be easily applied to detect azole resistance, is a fast and practical method in routine use and can contribute to both the determination of effective treatment strategies and the generation of epidemiological data.

Keywords: Aspergillus, agar plate, azole resistance, cyp51A, cypA-L98H, cypA-M220

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1907 Virtual and Visual Reconstructions in Museum Expositions

Authors: Ekaterina Razuvalova, Konstantin Rudenko

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In this article the most successful examples of international visual and virtual reconstructions of historical and culture objects, which are based on informative and communicative technologies, are represented. 3D reconstructions can demonstrate outward appearance, visualize different hypothesis, connected to represented object. Virtual reality can give us any daytime and season, any century and environment. We can see how different people from different countries and different era lived; we can get different information about any object; we can see historical complexes in real city environment, which are damaged or vanished. These innovations confirm the fact, that 3D reconstruction is important in museum development. Considering the most interesting examples of visual and virtual reconstructions, we can notice, that visual reconstruction is a 3D image of different objects, historical complexes, buildings and phenomena. They are constant and we can see them only as momentary objects. And virtual reconstruction is some environment with its own time, rules and phenomena. These reconstructions are continuous; seasons, daytime and natural conditions can change there. They can demonstrate abilities of virtual world existence. In conclusion: new technologies give us opportunities to expand the boundaries of museum space, improve abilities of museum expositions, create emotional atmosphere of game immersion, which can interest visitor. Usage of network sources allows increasing the number of visitors and virtual reconstruction opportunities show creative side of museum business.

Keywords: computer technologies, historical reconstruction, museums, museum expositions, virtual reconstruction

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1906 Consecration from the Margins: El Anatsui in Venice and the Turbine Hall

Authors: Jonathan Adeyemi

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Context: This study focuses on El Anatsui and his global acclaim in the art world despite his origins from the global artworld’s margins. It addresses the disparities in the treatment between Western and non-Western artists and questions whether Anatsui’s consecration is a result of exoticism or the growing consensus on decolonization. Research Aim: The aim of this study is to investigate how El Anatsui achieved global acclaim from the margins of the art world and determine if his consecration represents a mark of decolonization or the typical Western desire for exoticism. Methodology: The study utilizes a case study approach, literature analysis, and in-depth interviews. The artist, the organizers of the Venice Biennale, the relevant curators at Tate Modern London, and the October Gallery in London, and other galleries in Nigeria, which represent the artist were interviewed for data collection. Findings: The study seeks to determine the authenticity of the growing consensus on decolonization, inclusion, and diversity in the global artistic field. Preliminary findings show that domestic socio-economic and political factors debilitated the mechanisms for local validation in Nigeria, weakening the domestic foundation for international engagement. However, alternative systems of exhibition, especially in London and the USA contributed critically to providing the initial international visibility, which formed the foundation for his global acclaim. Out of the 21 winners of the Golden Lion for Lifetime Achievement since its inception at the 47th Venice Biennale in 1997, American artists have dominated with 10 recipients, 8 recipients from Europe, 2 recipients from Africa (2007 and 2015) and 1 from Asia. This aligns with Bourdieu’s concept of cultural and economic capital, which prevented Africa countries from participation until recently. Moreover, while the average age of recipients is 76 years, Anatsui received the award at the age of 71, while Malick Sidibé (Mali) was awarded at 72. Thus, the Venice Biennale award for El Anatsui incline more towards a commitment to decolonisation than exoticism. Theoretical Importance: This study contributes to the field by examining the dynamics of the art world's monopoly of legitimation and the role of national, ethnicity and cultural differences in the promotion of artists. It aims to challenge the Westernized hierarchy of valorization and consecration in the art world. The research supports Bourdieu’s artistic field theory, which emphasises the importance of cultural, economic and social capital in determining agents’ position and access to the field resources (symbolic capital). Bourdieu also established that dominated agents can change their position in the field’s hierarchy either by establishing or navigating alternative systems. Data Collection and Analysis Procedures: The opacity of art world’s operations places the required information within the purview of the insiders (agents). Thus, the study collects data through in-depth interviews with relevant and purposively selected individuals and organizations. The data was/will be analyzed using qualitative methods, such as thematic analysis and content analysis. The interpretive analytical approach adopted facilitated the construction of meanings that may not be apparent in the data or responses. Questions Addressed: The study addresses how El Anatsui achieved global acclaim despite being from the margins, whether his consecration represents decolonization or exoticism, and the extent to which the global artistic field embraces decolonization, inclusion, and diversity. Conclusion: The study will contribute to knowledge by providing insights into the extent of commitment to decolonization, inclusion, and diversity in the global artistic field. It also shed light on the mechanisms behind El Anatsui's rise to global acclaim and challenge Western-dominated artistic hierarchies.

Keywords: decolonisation, exorticism, artistic field, culture game

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1905 Barriers and Facilitators to Physical Activity Among Older Adults Living in Long‐Term Care Facilities: A Systematic Review with Qualitative Evidence Synthesis

Authors: Ying Shi, June Zhang, Lu Shao, Xiyan Xie, Aidi Lao, Zhangan Wang

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Background: Low levels of physical activity are associated with poorer health outcomes, and this situation is more critical in older adults living in long‐term care facilities. Objectives: To systematically identify, appraise, and synthesize current qualitative research evidence regarding the barriers and facilitators to physical activity as reported by older adults and care staff in long‐term care facilities. Design: This is a systematic review with qualitative evidence synthesis adhering to PRISMA guidelines. Methods: We conducted a systematic search on PubMed, Science Citation Index Expanded, Social Sciences Citation Index, EMBASE, CINAHL, and PsychInfo databases from inception until 30 June 2023. Thematic synthesis was undertaken to identify the barriers and facilitators relating to physical activity. Then, we mapped them onto the Capability, Opportunity, Motivation, and Behavior model and Theoretical Domains Framework. Methodological quality was assessed using the CASP Qualitative Studies Checklist, and confidence in review findings was assessed using the GRADE-CERQual approach. Results: We included 32 studies after screening 10496 citations and 177 full texts. Seven themes and 17 subthemes were identified relating to barriers and facilitators influencing physical activity in elderly residents. The main themes were mapped onto COM-B) model-Capability (physical activity knowledge gaps and individual health issues), Opportunity (social support and macro-level resources) and Motivation (health beliefs, fear of falling or injury, and personal and social incentives to physical activity). Most subthemes were graded as high (n = 9) or moderate (n = 3) confidence. Conclusions and Implications: Our comprehensive synthesis of 32 studies provides a wealth of knowledge of barriers and facilitators to physical activity from both residents and care staff’s perspectives. Intervention components were also suggested within the context of long‐term care facilities. End users such as older residents, care staff, and researchers can have confidence in our findings when formulating policies and guidance on promoting physical activity among elderly residents in long‐term care facilities.

Keywords: long‐term care, older adults, physical activity, qualitative, systematic review

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1904 Managing Crowds at Sports Mega Events: Examining the Impact of ‘Fan Parks’ at International Football Tournaments between 2002 and 2016

Authors: Joel Rookwood

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Sports mega events have become increasingly significant in sporting, political and economic terms, with analysis often focusing on issues including resource expenditure, development, legacy and sustainability. Transnational tournaments can inspire interest from a variety of demographics, and the operational management of such events can involve contributions from a range of personnel. In addition to television audiences events also attract attending spectators, and in football contexts the temporary migration of fans from potentially rival nations and teams can present event organising committees and security personnel with various challenges in relation to crowd management. The behaviour, interaction and control of supporters has previously led to incidents of disorder and hooliganism, with damage to property as well as injuries and deaths proving significant consequences. The Heysel tragedy at the 1985 European Cup final in Brussels is a notable example, where 39 fans died following crowd disorder and mismanagement. Football disasters and disorder, particularly in the context of international competition, have inspired responses from police, law makers, event organisers, clubs and associations, including stadium improvements, legislative developments and crowd management practice to improve the effectiveness of spectator safety. The growth and internationalisation of fandom and developments in event management and tourism have seen various responses to the evolving challenges associated with hosting large numbers of visiting spectators at mega events. In football contexts ‘fan parks’ are a notable example. Since the first widespread introduction in European football competitions at the 2006 World Cup finals in Germany, these facilities have become a staple element of such mega events. This qualitative, longitudinal, multi-continent research draws on extensive semi-structured interview and observation data. As a frame of reference, this work considers football events staged before and after the development of fan parks. Research was undertaken at four World Cup finals (Japan 2002, Germany 2006, South Africa 2010 and Brazil 2014), four European Championships (Portugal 2004, Switzerland/Austria 2008, Poland/Ukraine 2012 and France 2016), four other confederation tournaments (Ghana 2008, Qatar 2011, USA 2011 and Chile 2015), and four European club finals (Istanbul 2005, Athens 2007, Rome 2009 and Basle 2016). This work found that these parks are typically temporarily erected, specifically located zones where supporters congregate together irrespective of allegiances to watch matches on large screens, and partake in other forms of organised on-site entertainment. Such facilities can also allow organisers to control the behaviour, confine the movement and monitor the alcohol consumption of supporters. This represents a notable shift in policy from previous football tournaments, when the widely assumed causal link between alcohol and hooliganism which frequently shaped legislative and police responses to disorder, also dissuaded some authorities from permitting fans to consume alcohol in and around stadia. It also reflects changing attitudes towards modern football fans. The work also found that in certain contexts supporters have increasingly engaged with such provision which impacts fan behaviour, but that this is relative to factors including location, facilities, management and security.

Keywords: event, facility, fan, management, park

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1903 A Development of Science Instructional Model Based on Stem Education Approach to Enhance Scientific Mind and Problem Solving Skills for Primary Students

Authors: Prasita Sooksamran, Wareerat Kaewurai

Abstract:

STEM is an integrated teaching approach promoted by the Ministry of Education in Thailand. STEM Education is an integrated approach to teaching Science, Technology, Engineering, and Mathematics. It has been questioned by Thai teachers on the grounds of how to integrate STEM into the classroom. Therefore, the main objective of this study is to develop a science instructional model based on the STEM approach to enhance scientific mind and problem-solving skills for primary students. This study is participatory action research, and follows the following steps: 1) develop a model 2) seek the advice of experts regarding the teaching model. Developing the instructional model began with the collection and synthesis of information from relevant documents, related research and other sources in order to create prototype instructional model. 2) The examination of the validity and relevance of instructional model by a panel of nine experts. The findings were as follows: 1. The developed instructional model comprised of principles, objective, content, operational procedures and learning evaluation. There were 4 principles: 1) Learning based on the natural curiosity of primary school level children leading to knowledge inquiry, understanding and knowledge construction, 2) Learning based on the interrelation between people and environment, 3) Learning that is based on concrete learning experiences, exploration and the seeking of knowledge, 4) Learning based on the self-construction of knowledge, creativity, innovation and 5) relating their findings to real life and the solving of real-life problems. The objective of this construction model is to enhance scientific mind and problem-solving skills. Children will be evaluated according to their achievements. Lesson content is based on science as a core subject which is integrated with technology and mathematics at grade 6 level according to The Basic Education Core Curriculum 2008 guidelines. The operational procedures consisted of 6 steps: 1) Curiosity 2) Collection of data 3) Collaborative planning 4) Creativity and Innovation 5) Criticism and 6) Communication and Service. The learning evaluation is an authentic assessment based on continuous evaluation of all the material taught. 2. The experts agreed that the Science Instructional Model based on the STEM Education Approach had an excellent level of validity and relevance (4.67 S.D. 0.50).

Keywords: instructional model, STEM education, scientific mind, problem solving

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1902 Trace Analysis of Genotoxic Impurity Pyridine in Sitagliptin Drug Material Using UHPLC-MS

Authors: Bashar Al-Sabti, Jehad Harbali

Abstract:

Background: Pyridine is a reactive base that might be used in preparing sitagliptin. International Agency for Research on Cancer classifies pyridine in group 2B; this classification means that pyridine is possibly carcinogenic to humans. Therefore, pyridine should be monitored at the allowed limit in sitagliptin pharmaceutical ingredients. Objective: The aim of this study was to develop a novel ultra high performance liquid chromatography mass spectrometry (UHPLC-MS) method to estimate the quantity of pyridine impurity in sitagliptin pharmaceutical ingredients. Methods: The separation was performed on C8 shim-pack (150 mm X 4.6 mm, 5 µm) in reversed phase mode using a mobile phase of water-methanol-acetonitrile containing 4 mM ammonium acetate in gradient mode. Pyridine was detected by mass spectrometer using selected ionization monitoring mode at m/z = 80. The flow rate of the method was 0.75 mL/min. Results: The method showed excellent sensitivity with a quantitation limit of 1.5 ppm of pyridine relative to sitagliptin. The linearity of the method was excellent at the range of 1.5-22.5 ppm with a correlation coefficient of 0.9996. Recoveries values were between 93.59-103.55%. Conclusions: The results showed good linearity, precision, accuracy, sensitivity, selectivity, and robustness. The studied method was applied to test three batches of sitagliptin raw materials. Highlights: This method is useful for monitoring pyridine in sitagliptin during its synthesis and testing sitagliptin raw materials before using them in the production of pharmaceutical products.

Keywords: genotoxic impurity, pyridine, sitagliptin, UHPLC -MS

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1901 Issues and Challenges for Plantation Agriculture in Cameron Highlands: Interpretations from Socio-Anthropological Viewpoints

Authors: A. H. M. Zehadul Karim

Abstract:

Cameron Highlands (4°28’N, 101°23’E) is an attractive mountainous region with steep slopes located in the state of Pahang, Malaysia stretching between 1070 and 1830m above sea level with a total land area of 71,218ha. It is one of the few places in Malaysia that has a tropical highland climate as the mean annual temperature of it is 18 °C (64 °F) thus making the atmosphere perfect for specialized agriculture. Being ecologically suitable, Cameron Highlands has recently been identified as a very strategic farming area, producing multifarious vegetables, flowers and tea with a commercial motive of marketing them to Singapore and all over the urban areas of Malaysia to meet the domestic and international demands. The main intricacies of this plantation agriculture are fully dependent on the policies formulated by a group of emerging entrepreneurs who employ foreign labourers to make these agricultural activities a success in the agrarian sector in Malaysia. Based on the socio-anthropological perspective, the paper entirely relies on empirical field data generated by interviewing 10 farm owners and 200 foreign workers to find out the intricacies of this plantation agriculture which makes the research innovative and pragmatically significant. The paper deals with important issues relating to this productive plantation agriculture of Cameron Highlands and as such, narrates the various exceptional and holistic skills adopted for this type of farming.

Keywords: Cameron Highlands Malaysia, plantation agriculture, issues and challenges, mechanisms

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1900 Examining Motivational Strategies of Foreign Manufacturing Firms in Ghana

Authors: Samuel Ato Dadzie

Abstract:

The objective of this study is to examine the influence of eclectic paradigm on motivational strategy of foreign subsidiaries in Ghana. This study uses binary regression model, and the analysis was based on 75 manufacturing investments made by MNEs from different countries in 1994–2008. The results indicated that perceived market size increases the probability of foreign firms undertaking a market seeking (MS) in Ghana, while perceived cultural distance between Ghana and foreign firm’s home countries decreased the probability of foreign firms undertaking an market seeking (MS) foreign direct investment (FDI) in Ghana. Furthermore, extensive international experience decreases the probability of foreign firms undertaking a market seeking (MS) foreign direct investment (FDI) in Ghana. Most of the studies done by earlier researchers were based on the advanced and emerging countries and offered support for the theory, which was used in generalizing the result that multinational corporations (MNCs) normally used the theory regarding investment strategy outside their home country. In using the same theory in the context of Ghana, the result does not offer strong support for the theory. This means that MNCs that come to Sub-Sahara Africa cannot rely much on eclectic paradigm for their motivational strategies because prevailing economic conditions in Ghana are different from that of the advanced and emerging economies where the institutional structures work.

Keywords: foreign subsidiary, motives, Ghana, foreign direct investment

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1899 Cyber Supply Chain Resilient: Enhancing Security through Leadership to Protect National Security

Authors: Katie Wood

Abstract:

Cyber criminals are constantly on the lookout for new opportunities to exploit organisation and cause destruction. This could lead to significant cause of economic loss for organisations in the form of destruction in finances, reputation and even the overall survival of the organization. Additionally, this leads to serious consequences on national security. The threat of possible cyber attacks places further pressure on organisations to ensure they are secure, at a time where international scale cyber attacks have occurred in a range of sectors. Stakeholders are wanting confidence that their data is protected. This is only achievable if a business fosters a resilient supply chain strategy which is implemented throughout its supply chain by having a strong cyber leadership culture. This paper will discuss the essential role and need for organisations to adopt a cyber leadership culture and direction to learn about own internal processes to ensure mitigating systemic vulnerability of its supply chains. This paper outlines that to protect national security there is an urgent need for cyber awareness culture change. This is required in all organisations, regardless of their sector or size, to implementation throughout the whole supplier chain to support and protect economic prosperity to make the UK more resilient to cyber-attacks. Through businesses understanding the supply chain and risk management cycle of their own operates has to be the starting point to ensure effective cyber migration strategies.

Keywords: cyber leadership, cyber migration strategies, resilient supply chain strategy, cybersecurity

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1898 Multilingual and Ideological Graffiti in Palestine

Authors: Olivia Martina Dalla Torre

Abstract:

The aim of this paper is to describe and analyse some urban writings that emerge in politically disputed areas, namely the Occupied Palestinian Territories, and more specifically in Deheishe refugee camp. These graffiti are visible on the walls of houses, all around the camp, and they convey messages of protest but also of hope or claim about the complex political situation in the occupied territories. These graffiti can be then interpreted as political and politicized semiotic resources. In this paper, after having introduced the political situation of the Palestinian Territories in a historical perspective, we will question a specific dimension of these writings, i.e., their multilingual and ideological aspect. To do this, we will focus on ethnographic fieldwork on Deheishe refugee camp and we will draw on the theoretical framework of the critical communication studies which assert that language practices are not neutral and that they need to be understood through the lens of the historical context of production, crossing space and time. By analysing the relationship between the discursive constructions of the messages and the languages used, we will point out some of the possible reasons and functions of the presence of these multilingual discursive productions. We will show that if, on the one hand, these graffiti confirm the huge presence of Western actors in the region, on the other hand, they attest the presence of an international movement against the Israeli occupation and against other struggles as well. Concluding, we will argue that multilingualism certainly represents a diversification of the linguistic landscape and that it gives a transnational and political dimension to the graffiti.

Keywords: communication, graffiti, multilingualism, Palestine, transnationalism

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1897 The Urgency of ASEAN Human Rights Court Establishment to Protect Human Rights in Southeast Asia

Authors: Tareq M. Aziz Elven

Abstract:

The issue of Human Rights enforcement in Southeast Asia has become the serious problem and attract the attention of international community. Principally, Association of Southeast Asian Nations (ASEAN) has mentioned the Human Rights as one of the focus and be a part of the ASEAN Charter in 2008. It was followed by the establishment of ASEAN Inter-Governmental Commission on Human Rights (AICHR). AICHR is the commission of Human Rights enforcement in Southeast Asia which has a duty, function, and an authority to conduct dissemination and protection of Human Rights. In the end of 2016, however, the function of protection mandated to AICHR have not achieved yet. It can be proved by several cases of Human Rights violation which still exist and have not settled yet. One of case which attracts the public attention recently is human rights violation towards Rohingya in Myanmar. Using the juridical-normative method, the research aims to examine the urgency of Human Rights court establishment in Southeast Asia region which able to issue the decision that binds the ASEAN members or the violating parties. The data shows that ASEAN needs to establish a regional court which intended to settle the Human Rights violations in ASEAN region. Furthermore, the research also highlights three strong factors should be settled by ASEAN for establishing human rights court i.e. the significant distinction of democracy and human rights development among the members, the strong implementation of non-intervention principle, and the financial matter to sustain the court.

Keywords: AICHR, ASEAN, human rights, human rights court

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1896 Data-Driven Strategies for Enhancing Food Security in Vulnerable Regions: A Multi-Dimensional Analysis of Crop Yield Predictions, Supply Chain Optimization, and Food Distribution Networks

Authors: Sulemana Ibrahim

Abstract:

Food security remains a paramount global challenge, with vulnerable regions grappling with issues of hunger and malnutrition. This study embarks on a comprehensive exploration of data-driven strategies aimed at ameliorating food security in such regions. Our research employs a multifaceted approach, integrating data analytics to predict crop yields, optimizing supply chains, and enhancing food distribution networks. The study unfolds as a multi-dimensional analysis, commencing with the development of robust machine learning models harnessing remote sensing data, historical crop yield records, and meteorological data to foresee crop yields. These predictive models, underpinned by convolutional and recurrent neural networks, furnish critical insights into anticipated harvests, empowering proactive measures to confront food insecurity. Subsequently, the research scrutinizes supply chain optimization to address food security challenges, capitalizing on linear programming and network optimization techniques. These strategies intend to mitigate loss and wastage while streamlining the distribution of agricultural produce from field to fork. In conjunction, the study investigates food distribution networks with a particular focus on network efficiency, accessibility, and equitable food resource allocation. Network analysis tools, complemented by data-driven simulation methodologies, unveil opportunities for augmenting the efficacy of these critical lifelines. This study also considers the ethical implications and privacy concerns associated with the extensive use of data in the realm of food security. The proposed methodology outlines guidelines for responsible data acquisition, storage, and usage. The ultimate aspiration of this research is to forge a nexus between data science and food security policy, bestowing actionable insights to mitigate the ordeal of food insecurity. The holistic approach converging data-driven crop yield forecasts, optimized supply chains, and improved distribution networks aspire to revitalize food security in the most vulnerable regions, elevating the quality of life for millions worldwide.

Keywords: data-driven strategies, crop yield prediction, supply chain optimization, food distribution networks

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1895 Greed and Grievance Revisisted: The Case of ISIL

Authors: Amjed Rasheed

Abstract:

Rebellions are driven by several incentives. They do not often occur because of historical grievances or political exclusion. They can be driven by the desire to control over natural resources, or by both. In the case of the Islamic State (ISIL), greed and grievance are both drive this radical group to operate in Iraq and Syria. This article aims to show that grievance was the trigger to the emergence of ISIL. It also aims to demonstrate that ISIL is using oil as a tool, to implements its political ends, than a purpose per se. In other words, the emergence of ISIL is based on socio-political conditions, which are domestically driven, and oil is not ISIL’s aim but a source of revenue to finance its activities. This paper applies conflict analysis methodology to analyse the conflict in Iraq and Syria, with a specific highlight to ISIL. By doing so, it gives ahistorical background on emergence of ISIL. It also provides an insightful explanation on the main dynamics and the tactics this organisation applies. It also delivers a sufficient explanation on how it recruits its members, both local and international. It concludes that tackling ISIL needs a more sophisticated approach than the one Obama administration has adopted. It is more a political issue to be tackled by political means, than a military one to be tackled by military means. The current war is an Intra-Sunni war, and therefore, Sunni states have to be on board to crackdown ISIL. Besides, the article finishes with the argument that democratisation is not necessarily the key answer to bring stability to the region, but a sort of governance that provides security and material needs to individuals.

Keywords: ISIL, Iraq, domestic politics, Islamic radicalisation

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1894 Hydrothermal Energy Application Technology Using Dam Deep Water

Authors: Yooseo Pang, Jongwoong Choi, Yong Cho, Yongchae Jeong

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Climate crisis, such as environmental problems related to energy supply, is getting emerged issues, so the use of renewable energy is essentially required to solve these problems, which are mainly managed by the Paris Agreement, the international treaty on climate change. The government of the Republic of Korea announced that the key long-term goal for a low-carbon strategy is “Carbon neutrality by 2050”. It is focused on the role of the internet data centers (IDC) in which large amounts of data, such as artificial intelligence (AI) and big data as an impact of the 4th industrial revolution, are managed. The demand for the cooling system market for IDC was about 9 billion US dollars in 2020, and 15.6% growth a year is expected in Korea. It is important to control the temperature in IDC with an efficient air conditioning system, so hydrothermal energy is one of the best options for saving energy in the cooling system. In order to save energy and optimize the operating conditions, it has been considered to apply ‘the dam deep water air conditioning system. Deep water at a specific level from the dam can supply constant water temperature year-round. It will be tested & analyzed the amount of energy saving with a pilot plant that has 100RT cooling capacity. Also, a target of this project is 1.2 PUE (Power Usage Effectiveness) which is the key parameter to check the efficiency of the cooling system.

Keywords: hydrothermal energy, HVAC, internet data center, free-cooling

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1893 Exploring the Challenges and Opportunities in Clinical Waste Management: The Case of Private Clinics, Selangor, Malaysia

Authors: Golyasamin Khanehzaei, Mohd. Bakri Ishak, Ahmad Makmom Hj Abdullah, Latifah Abd Manaf

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Abstract—Management of clinical waste is a critical problem worldwide. Immediate attention is required to manage the clinical waste in an appropriate way in newly developing economy country such as Malaysia. The increasing amount of clinical waste generated is resulted from rapid urbanization and growing number of private health care facilities in developing countries such as Malaysia. In order to develop a sensible clinical waste management system and improvement of the management, information on factors affecting clinical waste generation has the crucial role. This paper is the study of management characteristics of clinical waste and the level of efficiency of clinical waste management systems operating in private clinics located in Selangor, Malaysia. Are they following the proper international standards? By taking all of this in consideration the aim of this paper is to identify and discuss the current trend, current challenges and also the present opportunities among the challenges of clinical waste management in private clinics of Selangor, Malaysia. The SWOT analysis was characterized for the evaluation of strengths, weaknesses, opportunities and threats. The methodology for this study was constituted of direct observation, Informal interviews, Conducting SWOT analysis, conduction of one sustainability dimensions analysis and application. The results show that clinical waste management in private clinics is far from an ideal model.

Keywords: clinical waste, SWOT analysis, Selangor, Malaysia

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1892 The Impact of Coronal STIR Imaging in Routine Lumbar MRI: Uncovering Hidden Causes to Enhanced Diagnostic Yield of Back Pain and Sciatica

Authors: Maysoon Nasser Samhan, Somaya Alkiswani, Abdullah Alzibdeh

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Background: Routine lumbar MRIs for back pain may yield normal results despite persistent symptoms, which means the possibility of other causes for this pain, which was not shown on the routine images. Research suggests including coronal STIR imaging to detect additional pathologies like sacroiliitis. Objectives: This study aims to enhance diagnostic accuracy and aid in determining treatment processes for patients with persistent back pain who have normal routine lumbar MRI (T1 and T2 images) by incorporating coronal STIR into the examination. Methods: A prospectively conducted study involving 274 patients, 115 males and 159 females, with an age range of 6–92 years, reviewed their medical records and imaging data following a lumbar spine MRI. This study included patients with back pain and sciatica as their primary complaints, all of whom underwent lumbar spine MRIs at our hospital to identify potential pathologies. Using a GE Signa HD 1.5T MRI System, each patient received a standard MRI protocol that included T1 and T2 sagittal and axial sequences, as well as a coronal STIR sequence. We collected relevant MRI findings, including abnormalities and structural variations, from radiology reports. We classified these findings into tables and documented them as counts and percentages, using Fisher’s exact test to assess differences between categorical variables. We conducted a statistical analysis using Prism GraphPad software version 10.1.2. The study adhered to ethical guidelines, institutional review board approvals, and patient confidentiality regulations. Results: Exclusion of the coronal STIR sequence led to 83 subjects (30.29%) being classified as within normal limits on MRI examination. 36 patients without abnormalities on T1 and T2 sequences showed abnormalities on the coronal STIR sequence, with 26 cases attributed to spinal pathologies and 10 to non-spinal pathologies. In addition to that, Fisher's exact test demonstrated a significant association between sacroiliitis diagnosis and abnormalities identified solely through the coronal STIR sequence (P < 0.0001). Conclusion: Implementing coronal STIR imaging as part of routine lumbar MRI protocols has the potential to improve patient care by facilitating a more comprehensive evaluation and management of persistent back pain.

Keywords: magnetic resonance imaging, lumber MRI, radiology, neurology

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1891 Long Term Survival after a First Transient Ischemic Attack in England: A Case-Control Study

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

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Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.

Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model

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