Search results for: inclusion and exclusion
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1851

Search results for: inclusion and exclusion

1491 Women Trainees' Perception on Non-Formal Educational Workshops in Improving Their Socio-Economic Status in Algeria and Costa Rica

Authors: Bahia Braktia, S. Anna Marcela Montenegro, Imene Abdessemed

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Adult education is still considered a crucial area of education. In a developing framework, it is regarded as a practical approach for social inclusion and poverty reduction. They are also perceived as a way to serve adults who did not have the chance to education in their early ages by providing them knowledge, skills and values. Non-formal adult education and trainings are critical means in a society to break poverty and unemployment, and to decrease the social inequality. This paper investigates the perception of women trainees about a series of workshops in natural beauty products, held in Algeria and Costa Rica and organized by a non-profit educational organization, to improve their socio-economic status. This research seeks to explore ways of empowering women by assessing their needs and providing them with skills to start their own business. A questionnaire is administered before the workshops and focus groups are held at the end. A qualitative research method is employed to analyze the data. Preliminary results show that the trainees aspire to create their businesses with the objectives of poverty reduction and social inclusion. The findings also reveal the need for small business funding programs and entrepreneurial training programs.

Keywords: adult education, non-formal education, socio-economic status, women empowerment

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1490 An Exploration of the Dimensions of Place-Making: A South African Case Study

Authors: W. J. Strydom, K. Puren

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Place-making is viewed here as an empowering process in which people represent, improve and maintain their spatial (natural or built) environment. With the above-mentioned in mind, place-making is multi-dimensional and include a spatial dimension (including visual properties or the end product/plan), a procedural dimension during which (negotiation/discussion of ideas with all relevant stakeholders in terms of end product/plan) and a psychological dimension (inclusion of intrinsic values and meanings related to a place in the end product/plan). These three represent dimensions of place-making. The purpose of this paper is to explore these dimensions of place-making in a case study of a local community in Ikageng, Potchefstroom, North-West Province, South Africa. This case study represents an inclusive process that strives to empower a local community (forcefully relocated due to Apartheid legislation in South Africa). This case study focussed on the inclusion of participants in the decision-making process regarding their daily environment. By means of focus group discussions and a collaborative design workshop, data is generated and ultimately creates a linkage with the theoretical dimensions of place-making. This paper contributes to the field of spatial planning due to the exploration of the dimensions of place-making and the relevancy of this process on spatial planning (especially in a South African setting).

Keywords: community engagement, place-making, planning theory, spatial planning

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1489 Technology and Educational Gaps: A Literature Review on the Proportionate Infusion of Technology into Education

Authors: Tamika Gordon

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As technology continues to progress every second, educational institutions attempt to stay abreast of the latest developments through the acquisition of technological devices. Within schools, soft and hard technologies have assisted with reaching more students and expedient communication. As schools continue to grow, the need for simultaneous communication and efficient feedback has grown, and technology has allowed for these avenues to be explored and incorporated within a variety of daily operations. With the rapid inclusion of technology comes the potential for less face-to-face interactions among stakeholders. Although technology plays an integral role in education, the elements of both soft and hard technological devices must be proportionally utilized and coexist for the overall advancement and longevity of organizations. Over 20 articles were referenced to obtain a multitude of views on technology reflecting effects for students and teachers. Throughout this literature review, the effects of technology in the workplace will be discussed including views of current researchers, pros and cons surrounding technological inclusion, and implications for future research and further consideration. Upon the completion of the literature review, the benefits and necessity of technology remained high, however, low availability of resources, limited exposure to technological devices, and decreasing soft skills remained high as well. Recommendations are made for proportionate balances of technology and face-to-face interactions in order to minimize societal, educational, and organizational gaps.

Keywords: communication, devices, education, organizations, technology

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1488 Consolidating a Regime of State Terror: A Historical Analysis of Necropolitics and the Evolution of Policing Practices in California as a Former Colony, Frontier, and Late-Modern Settler Society

Authors: Peyton M. Provenzano

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This paper draws primarily upon the framework of necropolitics and presents California as itself a former frontier, colony, and late-modern settler society. The convergence of these successive and overlapping regimes of state terror is actualized and traceable through an analysis of historical and contemporary police practices. At the behest of the Spanish Crown and with the assistance of the Spanish military, the Catholic Church led the original expedition to colonize California. The indigenous populations of California were subjected to brutal practices of confinement and enslavement at the missions. After the annex of California by the United States, the western-most territory became an infamous frontier where new settlers established vigilante militias to enact violence against indigenous populations to protect their newly stolen land. Early mining settlements sought to legitimize and fund vigilante violence by wielding the authority of rudimentary democratic structures. White settlers circulated petitions for funding to establish a volunteer company under California’s Militia Law for ‘protection’ against the local indigenous populations. The expansive carceral practices of Los Angelinos at the turn of the 19th century exemplify the way in which California solidified its regime of exclusion as a white settler society. Drawing on recent scholarship that queers the notion of biopower and names police as street-level sovereigns, the police murder of Kayla Moore is understood as the latest manifestation of a carceral regime of exclusion and genocide. Kayla Moore was an African American transgender woman living with a mental health disability that was murdered by Berkeley police responding to a mental health crisis call in 2013. The intersectionality of Kayla’s identity made her hyper-vulnerable to state-sanctioned violence. Kayla was a victim not only of the explicitly racial biopower of police, nor the regulatory state power of necropolitics but of the ‘asphyxia’ that was intended to invisibilize both her life and her murder.

Keywords: asphyxia, biopower, california, carceral state, genocide, necropolitics, police, police violence

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1487 A Method for Evaluating Gender Equity of Cycling from Rawls Justice Perspective

Authors: Zahra Hamidi

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Promoting cycling, as an affordable environmentally friendly mode of transport to replace private car use has been central to sustainable transport policies. Cycling is faster than walking and combined with public transport has the potential to extend the opportunities that people can access. In other words, cycling, besides direct positive health impacts, can improve people mobility and ultimately their quality of life. Transport literature well supports the close relationship between mobility, quality of life, and, well being. At the same time inequity in the distribution of access and mobility has been associated with the key aspects of injustice and social exclusion. The pattern of social exclusion and inequality in access are also often related to population characteristics such as age, gender, income, health, and ethnic background. Therefore, while investing in transport infrastructure it is important to consider the equity of provided access for different population groups. This paper proposes a method to evaluate the equity of cycling in a city from Rawls egalitarian perspective. Since this perspective is concerned with the difference between individuals and social groups, this method combines accessibility measures and Theil index of inequality that allows capturing the inequalities ‘within’ and ‘between’ groups. The paper specifically focuses on two population characteristics as gender and ethnic background. Following Rawls equity principles, this paper measures accessibility by bikes to a selection of urban activities that can be linked to the concept of the social primary goods. Moreover, as growing number of cities around the world have launched bike-sharing systems (BSS) this paper incorporates both private and public bikes networks in the estimation of accessibility levels. Additionally, the typology of bike lanes (separated from or shared with roads), the presence of a bike sharing system in the network, as well as bike facilities (e.g. parking racks) have been included in the developed accessibility measures. Application of this proposed method to a real case study, the city of Malmö, Sweden, shows its effectiveness and efficiency. Although the accessibility levels were estimated only based on gender and ethnic background characteristics of the population, the author suggests that the analysis can be applied to other contexts and further developed using other properties, such as age, income, or health.

Keywords: accessibility, cycling, equity, gender

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1486 Artificial Intelligence in Vietnamese Higher Education: Benefits, Challenges and Ethics

Authors: Duong Van Thanh

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Artificial Intelligence (AI) has been recently a new trend in Higher Education systems globally as well as in the Vietnamese Higher Education. This study explores the benefits and challenges in applications of AI in 02 selected universities, ie. Vietnam National Universities in Hanoi Capital and the University of Economics in Ho Chi Minh City. Particularly, this paper focuses on how the ethics of Artificial Intelligence have been addressed among faculty members at these two universities. The AI ethical issues include the access and inclusion, privacy and security, transparency and accountability. AI-powered educational technology has the potential to improve access and inclusion for students with disabilities or other learning needs. However, there is a risk that AI-based systems may not be accessible to all students and may even exacerbate existing inequalities. AI applications can be opaque and difficult to understand, making it challenging to hold them accountable for their decisions and actions. It is important to consider the benefits that adopting AI-systems bring to the institutions, teaching, and learning. And it is equally important to recognize the drawbacks of using AI in education and to take the necessary steps to mitigate any negative impact. The results of this study present a critical concern in higher education in Vietnam, where AI systems may be used to make important decisions about students’ learning and academic progress. The authors of this study attempt to make some recommendation that the AI-system in higher education system is frequently checked by a human in charge to verify that everything is working as it should or if the system needs some retraining or adjustments.

Keywords: artificial intelligence, ethics, challenges, vietnam

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1485 A Comparison of qCON/qNOX to the Bispectral Index as Indices of Antinociception in Surgical Patients Undergoing General Anesthesia with Laryngeal Mask Airway

Authors: Roya Yumul, Ofelia Loani Elvir-Lazo, Sevan Komshian, Ruby Wang, Jun Tang

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BACKGROUND: An objective means for monitoring the anti-nociceptive effects of perioperative medications has long been desired as a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively. To this end, electroencephalogram (EEG) based tools including BIS and qCON were designed to provide information about the depth of sedation while qNOX was produced to inform on the degree of antinociception. The goal of this study was to compare the reliability of qCON/qNOX to BIS as specific indicators of response to nociceptive stimulation. METHODS: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board (IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to the endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed on all patients prior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. RESULTS: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from 74 ±13 mm Hg at baseline to 84 ± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76 ± 12 BPM at baseline to 80 ± 13 BPM during noxious stimuli [p=0.078] respectively). CONCLUSION: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices

Keywords: antinociception, BIS, general anesthesia, LMA, qCON/qNOX

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1484 A Systematic Analysis of Knowledge Development Trends in Industrial Maintenance Projects

Authors: Lilian Ogechi Iheukwumere-Esotu, Akilu Yunusa-Kaltungo, Paul Chan

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Industrial assets are prone to degradation and eventual failures due to repetitive loads and harsh environments in which they operate. These failures often lead to costly downtimes, which may involve loss of critical assets and/or human lives. The rising pressures from stakeholders for optimized systems’ outputs have further placed strains on business organizations. Traditional means of combating such failures are by adopting strategies capable of predicting, controlling, and/or reducing the likelihood of systems’ failures. Turnarounds, shutdowns, and outages (TSOs) projects are popular maintenance management activities conducted over a certain period of time. However, despite the critical and significant cost implications of TSOs, the management of the interface of knowledge between academia and industry to our best knowledge has not been fully explored in comparison to other aspects of industrial operations. This is perhaps one of the reasons for the limited knowledge transfer between academia and industry, which has affected the outcomes of most TSOs. Prior to now, the study of knowledge development trends as a failure analysis tool in the management of TSOs projects have not gained the required level of attention. Hence, this review provides useful references and their implications for future studies in this field. This study aims to harmonize the existing research trends of TSOs through a systematic review of more than 3,000 research articles published over 7 decades (1940- till date) which were extracted using very specific research criteria and later streamlined using nominated inclusion and exclusion parameters. The information obtained from the analysis were then synthesized and coded into 8 parameters, thereby allowing for a transformation into actionable outputs. The study revealed a variety of information, but the most critical findings can be classified into 4 folds: (1) Empirical validation of available conceptual frameworks and models is still a far cry in practice, (2) traditional project management views for managing uncertainties are still dominant, (3) Inconsistent approaches towards the adoption and promotion of knowledge management systems which supports creation, transfer and application of knowledge within and outside the project organization and, (4) exploration of social practices in industrial maintenance project environments are under-represented within the existing body of knowledge. Thus, the intention of this study is to depict the usefulness of a framework which incorporates fact findings emanating from careful analysis and illustrations of evidence based results as a suitable approach which can tackle reoccurring failures in industrial maintenance projects.

Keywords: industrial maintenance, knowledge management, maintenance projects, systematic review, TSOs

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1483 A Foucauldian Analysis of Postcolonial Hybridity in a Kuwaiti Novel

Authors: Annette Louise Dupont

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Background and Introduction: Broadly defined, hybridity is a condition of racial and cultural ‘cross-pollination’ which arises as a result of contact between colonized and colonizer. It remains a highly contested concept in postcolonial studies as it is implicitly underpinned by colonial notions of ‘racial purity.’ While some postcolonial scholars argue that individuals exercise significant agency in the construction of their hybrid subjectivities, others underscore associated experiences of exclusion, marginalization, and alienation. Kuwait and the Philippines are among the most disparate of contemporary postcolonial states. While oil resources transformed the former British Mandate of Kuwait into one of the world’s richest countries, enduring poverty in the former US colony of the Philippines drives a global diaspora which produces multiple Filipino hybridities. Although more Filipinos work in the Arabian Gulf than in any other region of the world, scholarly and literary accounts of their experiences of hybridization in this region are relatively scarce when compared to those set in North America, Australia, Asia, and Europe. Study Aims and Significance: This paper aims to address this existing lacuna by investigating hybridity and other postcolonial themes in a novel by a Kuwaiti author which vividly portrays the lives of immigrants and citizens in Kuwait and which gives a rare voice and insight into the struggles of an Arab-Filipino and European-Filipina. Specifically, this paper explores the relationships between colonial discourses of ‘black’ and ‘white’ and postcolonial discourses pertaining to ‘brown’ Filipinos and ‘brown’ Arabs, in order to assess their impacts on the protagonists’ hybrid subjectivities. Methodology: Foucault’s notions of discourse not only provide a conceptual basis for analyzing the colonial ideology of Orientalism, but his theories related to the social exclusion of the ‘mad’ also elucidate the mechanisms by which power can operate to marginalize, alienate and subjectify the Other, therefore a Foucauldian lens is applied to the analysis of postcolonial themes and hybrid subjectivities portrayed in the novel. Findings: The study finds that Kuwaiti and Filipino discursive practices mirror those of former white colonialists and colonized black laborers and that these discursive practices combine with a former British colonial system of foreign labor sponsorship to create a form of governmentality in Kuwait which is based on exclusion and control. The novel’s rich social description and the reflections of the key protagonist and narrator suggest that such fiction has a significant role to play in highlighting the historical and cultural specificities of experiences of postcolonial hybridity in under-researched geographic, economic, social, and political settings. Whereas hybridity can appear abstract in scholarly accounts, the significance of literary accounts in which the lived experiences of hybrid protagonists are anchored to specific historical periods, places and discourses, is that contextual particularities are neither obscured nor dehistoricized. Conclusions: The application of Foucauldian theorizations of discourse, disciplinary, and biopower to the analysis of this Kuwaiti literary text serves to extend an understanding of the effects of contextually-specific discourses on hybrid Filipino subjectivities, as well as a knowledge of prevailing social dynamics in a little-researched postcolonial Arabian Gulf state.

Keywords: Filipino, Foucault, hybridity, Kuwait

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1482 Exploring Inclusive Culture and Practice: The Perspectives of Macao Teachers in Informing Inclusive Teacher Education Programmes in Higher Education

Authors: Elisa Monteiro, Kiiko Ikegami

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The inclusion of children with diverse learning needs and/or disabilities in regular classrooms has been identified as crucial to the provision of educational equity and quality for all students. In this, teachers play an essential role, as they have a strong impact on student attainment. Whilst the adoption of inclusive practice is increasing, with potential benefits for the teaching profession, there is also a rise in the level of its challenges in Macao as many more students with learning disabilities are now being included in general education classes. Consequently, there has been a significant focus on teacher professional development to ensure that teachers are adequately prepared to teach in inclusive classrooms that give access to diverse students. Major changes in teacher education will need to take place to include more inclusive education content and to equip teachers with the necessary skills in the area of inclusive practice. This paper draws on data from in-depth interviews with 20 teachers to examine teachers’ views of support, challenges, and barriers to inclusive practices at the school and classroom levels. Thematic analysis was utilised to determine major themes within the data. Several themes emerged and serve to illustrate the identified barriers and the potential value of effective teacher education. Suggestions for increased professional development opportunities for inclusive education specific to higher education institutions are presented and the implications for practice and teacher education are discussed.

Keywords: inclusion, inclusive practice, teacher education, higher education

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1481 Intercultural Competencies as a Means to Rethink the Pedagogies of Diversity in Latin America

Authors: Marcelo Jose Cabarcas Ortega, Lissette Herrera, Juan Carlos Lemus Stave

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This work makes a rather theoretical reflection on a pedagogical response against the coloniality of knowledge and power. The purpose here is to reflect on the challenges and opportunities it opens up in the educational field. No doubt, ours derived in a more abstract than concrete reflection. The quest, nevertheless, to stimulate the interest in a non-violent, non-contemptuous education able to balance, improves and if necessary, transforms the relationships that have made it a space of privilege and exclusion. We all know the school has found itself in need of rethinking diversity while developing awareness of its own role in reproducing inequality. Intercultural education may provide an answer to that hurry when fostering critical awareness and dialogue.

Keywords: decoloniality, coloniality of power, diversity, interculturality

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1480 Sleep Ecology, Sleep Regulation and Behavior Problems in Maltreated Preschoolers: A Scoping Review

Authors: Sabrina Servot, Annick St-Amand, Michel Rousseau, Valerie Simard, Evelyne Touchette

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Child maltreatment has a profound impact on children’s development. In its victims, internalizing and externalizing problems are highly prevalent, and sleep problems are common. Furthermore, the environment they live in is often disorganized, lacking routine and consistency. In non-maltreated children, several studies documented the important role of sleep regulation and sleep ecology. A poor sleep ecology (e.g., lack of sleep hygiene and bedtime routine, inappropriate sleeping location) may lead to sleep regulation problems (e.g., short sleep duration, nocturnal awakenings), and sleep regulation problems may increase the risk of behavior problems. Therefore, this scoping review aims to map evidence about sleep ecology and sleep regulation and the associations between sleep ecology, sleep regulation, and behavior problems in maltreated preschoolers. Literature from 1993 was searched in PsycInfo, Pubmed, Medline, Eric, and Proquest Dissertations and Theses. Articles and thesis were comprehensively reviewed based upon inclusion/exclusion criteria: 1) it concerns maltreated children aged 1-5 years, and 2) it addresses at least one of the following: sleep ecology, sleep regulation, and/or their associations with behavior problems in maltreated preschoolers. From the 650 studies screened, nine of them were included. Data were charted according to study characteristics, nature of variable documented, measures, analyses performed, and results of each study, then synthesized in a narrative summary. The main results show all included articles were quantitative. Foster children samples were used in four studies, children experienced different types of maltreatment in six studies, while one was specifically about sexually abused children. Regarding sleep ecology, only one study describing maltreated preschoolers’ sleep ecology was found, while seven studies documented sleep regulation. Among these seven studies, 17 different sleep variables (e.g., parasomnia, dyssomnia, total 24-h sleep duration) were used, each study documenting from one to nine of them. Actigraphic measures were employed in three studies, the others used parent-reported questionnaires or sleep diaries. Maltreated children’s sleep was described and/or compared to non-maltreated children’s sleep, or an intervention group, showing mild differences. As for associations between sleep regulation and behavior problems, five studies investigated it and performed correlational or linear regression analyses between sleep and behavior problems, revealing some significant associations. No study was found about associations between sleep ecology and sleep regulation, between sleep ecology and behavior problems, or between these three variables. In conclusion, literature about sleep ecology, sleep regulation, and their associations with behavior problems are far more scarce in maltreated preschoolers than in non-maltreated ones. At present, there is especially a paucity of research about sleep ecology and the association between sleep ecology and sleep regulation in maltreated preschoolers, while studies on non-maltreated children showed sleep ecology plays a major role in sleep regulation. In addition, as sleep regulation is measured in many different ways among the studies, it is difficult to compare their findings. Finally, it seems necessary that research fill these gaps, as recommendations could be made to clinicians working with maltreated preschoolers regarding the use of sleep ecology and sleep regulation as intervention tools.

Keywords: maltreated preschoolers, sleep ecology, sleep regulation, behavior problems

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1479 Extent of Applying Evidence Based Practices in Inclusion Programs for Pupils with Intellectual Disability

Authors: Faris Algahtani

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The current study aimed to reveal the extent to which evidence-based practices are applied in programs to integrate students with intellectual disabilities from the point of view of their teachers in Yanbu Governorate, and to reveal statistically significant differences in their application of evidence-based practices according to the following variables: gender, educational qualification, experience and training courses. The researcher used the descriptive approach, and accordingly; she designed a questionnaire consisting of 22 phrases applied it to a random sample of (97) teachers of intellectual disability in the integration programs of the Ministry of Education in the government sector in Yanbu Governorate, with (49) male teachers and (48) female teachers. The study showed that teachers of students with intellectual disabilities apply evidence-based practices in programs to integrate students with intellectual disabilities to a large extent. Among the most prominent of these practices came reinforcement in the first place, followed by using visual stimuli/aids, and in the third-place came starting with less complex or challenging skills then moving to more difficult skills. The results also showed no statistically significant differences over the extent of the application attributed to the variables of experience, qualification or training. On the other hand, there were statistically significant differences over the extent of the application attributed to gender in favor of females.

Keywords: evidence-based practices, intellectual disability, inclusion programs, teachers of students with intellectual disabilities

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1478 Preoperative Anxiety Evaluation: Comparing the Visual Facial Anxiety Scale/Yumul Faces Anxiety Scale, Numerical Verbal Rating Scale, Categorization Scale, and the State-Trait Anxiety Inventory

Authors: Roya Yumul, Chse, Ofelia Loani Elvir Lazo, David Chernobylsky, Omar Durra

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Background: Preoperative anxiety has been shown to be caused by the fear associated with surgical and anesthetic complications; however, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting given the duration and concentration required to complete the 40-item extensive questionnaire. Our primary aim in the study is to investigate the correlation of the Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparison analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusions: Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul FACES Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul FACES Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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1477 Socio-cultural Influence on Teachers’ Preparedness for Inclusive Education: A Mixed Methods Study in the Nepalese Context

Authors: Smita Nepal

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Despite being on the global education reform agenda for over two decades, interpretations and practices of inclusive education vary widely across the world. In Nepal, similar to many other developing countries, inclusive education is still an emerging concept and limited research is available to date in relation to how inclusive education is conceptualized and implemented here. Moreover, very little is known about how teachers who are at the frontline of providing inclusive education understand this concept and how well they are prepared to teach inclusively. This study addresses this research gap by investigating an overarching research question, ‘How prepared are Nepalese teachers to practice inclusive pedagogy?’ Different societies and cultures may have different interpretations of the concepts of diversity and inclusion. Acknowledging that such contextual differences influence how these issues are addressed, such as preparing teachers for providing inclusive education, this study has investigated the research questions using a sociocultural conceptual framework. A sequential mixed-method research design involved quantitative data from 203 survey responses collected in the first phase, followed by qualitative data in the second phase collected through semi-structured interviews with teachers. Descriptive analysis of the quantitative data and reflexive thematic analysis of the qualitative data revealed a narrow understanding of inclusive education in the participating Nepalese teachers with limited preparedness for implementing inclusive pedagogy. Their interpretation of inclusion substantially included the need for non-discrimination and the provision of equal opportunities. This interpretation was found to be influenced by the social context where a lack of a deep understanding of human diversity was reported, leading to discriminatory attitudes and practices. In addition, common norms established in society that experiencing privileges or disadvantages was normal for diverse groups of people appeared to have led to limited efforts to enhance teachers’ understanding of and preparedness for inclusive education. This study has significant implications, not only in the Nepalese context but globally, for reform in policies and practices and for strengthening the teacher education and professional development system to promote inclusion in education. In addition, the significance of this research lies in highlighting the importance of further context-specific research in this area to ensure inclusive education in a real sense by valuing socio-cultural differences.

Keywords: inclusive education, inclusive pedagogy, sociocultural context, teacher preparation

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1476 Self-Stigmatization of Deaf and Hard-of-Hearing Students

Authors: Nadezhda F. Mikahailova, Margarita E. Fattakhova, Mirgarita A. Mironova, Ekaterina V. Vyacheslavova, Vladimir A. Mikahailov

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Stigma is a significant obstacle to the successful adaptation of deaf students to the conditions of an educational institution, especially for those who study in inclusion. The aim of the study was to identify the spheres of life which are the most significant for developing of the stigma of deaf students; to assess the influence of factors associated with deafness on the degree of their self-stigmatization (time and degree of hearing loss, type of education - inclusion / differentiation) and to find out who is more prone to stigma - which characteristics of personality, identity, mental health and coping are specific for those deaf who demonstrates stigmatizing attitudes. The study involved 154 deaf and hard-of-hearing students (85 male and 69 female) aged from 18 to 45 years - 28 students of the Herzen State Pedagogical University (St. Petersburg), who study in inclusion, 108 students of the National Research Technological University and 18 students of the Aviation Technical College (Kazan) - students in groups with a sign language interpreter. We used the following methods: modified questionnaire 'Self-assessment and coping strategies' (Jambor & Elliot, 2005), Scale of self-esteem (Rosenberg et al, 1995), 'Big-Five' (Costa&McCrae, 1997), TRF (Becker, 1989), WCQ (Lazarus & Folkman, 1988), self-stigma scale (Mikhailov, 2008). The severity of self-stigmatization of deaf and hard of hearing students was determined by the degree of deafness and the time they live with hearing loss, learning conditions, the type of self-identification (acculturation), personality traits, and the specifics of coping behavior. Persons with congenital hearing loss more often noted a benevolent and sympathetic attitude towards them on the part of the hearers and less often, due to deafness, limited themselves to visiting public places than late deaf people, which indicates 'get rid of' the experience of their defect and normalization of the state. Students studying in conditions of inclusion more often noted the dismissive attitude of society towards deaf people. Individuals with mild to moderate hearing loss were more likely to fear marriage and childbearing because of their deafness than students with profound hearing loss. Those who considered themselves disabled (49% of all respondents) were more inclined to cope with seeking social support and less used 'distancing' coping. Those who believed that their quality of life and social opportunities were most influenced by the attitude of society towards the deaf (39%) were distinguished by a less pronounced sense of self-worth, a desire for autonomy, and frequent usage of 'avoidance' coping strategies. 36.4% of the respondents noted that there have been situations in their lives when people learned that they are deaf, began to treat them worse. These respondents had predominantly deaf acculturation, but more often, they used 'bicultural skills,' specific coping for the deaf, and had a lower level of extraversion and emotional stability. 31.2% of the respondents tried to hide from others that they have hearing problems. They considered themselves to be in a culture of hearing, used coping strategies 'bicultural skills,' and had lower levels of extraversion, cooperation, and emotional stability. Acknowledgment: Supported by the RFBR № 19-013-0040

Keywords: acculturation, coping, deafness, stigmatization

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1475 The Social Structuring of Mate Selection: Assortative Marriage Patterns in the Israeli Jewish Population

Authors: Naava Dihi, Jon Anson

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Love, so it appears, is not socially blind. We show that partner selection is socially constrained, and the freedom to choose is limited by at least two major factors or capitals: on the one hand, material resources and education, locating the partners on a scale of personal achievement and economic independence. On the other, the partners' ascriptive belonging to particular ethnic, or origin, groups, differentiated by the groups' social prestige, as well as by their culture, history and even physical characteristics. However, the relative importance of achievement and ascriptive factors, as well as the overlap between them, varies from society to society, depending on the society's structure and the factors shaping it. Israeli social structure has been shaped by the waves of new immigrants who arrived over the years. The timing of their arrival, their patterns of physical settlement and their occupational inclusion or exclusion have together created a mosaic of social groups whose principal common feature has been the country of origin from which they arrived. The analysis of marriage patterns helps illuminate the social meanings of the groups and their borders. To the extent that ethnic group membership has meaning for individuals and influences their life choices, the ascriptive factor will gain in importance relative to the achievement factor in their choice of marriage partner. In this research, we examine Jewish Israeli marriage patterns by looking at the marriage choices of 5,041 women aged 15 to 49 who were single at the census in 1983, and who were married at the time of the 1995 census, 12 years later. The database for this study was a file linking respondents from the 1983 and the 1995 censuses. In both cases, 5 percent of household were randomly chosen, so that our sample includes about 4 percent of women in Israel in 1983. We present three basic analyses: (1) Who was still single in 1983, using personal and household data from the 1983 census (binomial model), (2) Who married between 1983 and a1995, using personal and household data from the 1983 census (binomial model), (3) What were the personal characteristics of the womens’ partners in 1995, using data from the 1995 census (loglinear model). We show (i) that material and cultural capital both operate to delay marriage and to increase the probability of remaining single; and (ii) while there is a clear association between ethnic group membership and education, endogamy and homogamy both operate as separate forces which constraint (but do not determine) the choice of marriage partner, and thus both serve to reproduce the current pattern of relationships, as well as identifying patterns of proximity and distance between the different groups.

Keywords: Israel, nuptiality, ascription, achievement

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1474 Comparison of the Yumul Faces Anxiety Scale to the Categorization Scale, the Numerical Verbal Rating Scale, and the State-Trait Anxiety Inventory for Preoperative Anxiety Evaluation

Authors: Ofelia Loani Elvir Lazo, Roya Yumul, David Chernobylsky, Omar Durra

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Background: It is crucial to detect the patient’s existing anxiety to assist patients in a perioperative setting which is to be caused by the fear associated with surgical and anesthetic complications. However, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting, given the duration and concentration required to complete the 40-item questionnaire. Our primary aim in the study is to investigate the correlation of the Yumul Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparative analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusıons: Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul Faces Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul Faces Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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1473 Creating an Inclusive Classroom: Country Case Studies Analysis on Mainstream Teachers’ Teaching-Efficacy and Attitudes towards Inclusive Education in Japan and Singapore

Authors: Yei Mian Adrian Yap

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How we idealize the regular schools to be inclusive as much as possible hinges on mainstream teachers’ attitudes and teaching-efficacy towards the inclusion of students with special needs in the regular schools. This research studies the Japanese and Singaporean mainstream teachers’ attitudes and teaching-efficacy towards the inclusion of students with special needs in the regular classrooms by investigating what key variables influence their attitudes and teaching-efficacy and how they strategize to address their challenges to include their students with special needs in their regular classrooms. In order to understand the nature of teachers’ attitudes and teaching-efficacy towards the inclusive education, a mixed-method research methodology was carried out in Japan and Singapore; it involved an explanatory sequential method of employing quantitative research first before qualitative research. In the quantitative research, 189 Japanese and 183 Singaporean teachers were invited to participate in the questionnaires and out of these participants, 38 Japanese and 15 Singaporean teachers shared their views during their semi-structured interviews. Based on the empirical findings, Japanese teachers’ attitudes and teaching-efficacy were more likely to be influenced by their experiences in teaching students with special needs, knowledge about disability legislation, presence of their disabled family members and level of confidence to teach students with special needs. On the other hand, Singaporean teachers’ attitudes and teaching-efficacy were affected by gender, educational level, received trainings in special needs education, knowledge about disability legislation and level of confidence to teach students with special needs. Both country results also demonstrated that there was a positive correlation between their teaching-efficacy and attitude. Narrative findings further expanded the reasons behind these quantitative factors that shaped teachers’ attitudes and teaching-efficacy. Also it discussed the various problems faced by Japanese and Singaporean teachers and how they identified their coping strategies to circumvent their challenges in including their students with special needs in their regular classrooms. The significance of this research manifests in necessary educational reforms in both countries especially in the context of inclusive education. These findings may not be as definitive as expected but it is believed that it could provide useful information on the current situation about teachers’ concerns towards the inclusive education. In conclusion, this research could potentially make its positive contribution to the body of literature on teachers’ attitudes and teaching-efficacy in the context of Asian developed countries and these findings could posit that regular teachers’ positive attitudes and strong sense of teaching self-efficacy could directly improve the success rate of inclusion of students with special needs in the regular classrooms.

Keywords: attitudes, inclusive education, special education, teaching-efficacy

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1472 Comparison Between Bispectral Index Guided Anesthesia and Standard Anesthesia Care in Middle Age Adult Patients Undergoing Modified Radical Mastectomy

Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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1471 Quality Education as a Tool for Global Poverty Alleviation

Authors: Ibrahim Auwalu

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The main thrust of this paper is the examination of Quality Education as opposed to low level knowledge acquisition in the promotion of quality of life, health, individual and national growth and development. The paper reviews the role education plays in developed, developing and third world economies. It further explores the real meaning of poverty in the context it exists. That is poverty in terms of its dimensions– shortened lives, illiteracy, social exclusion and lack of material means to improve family circumstances. The paper concludes that education not only helps individuals escape poverty by developing the skills needed to improve their livelihoods, but also generates productivity gains that fuel economic growth.

Keywords: quality, education, global, poverty alleviation

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1470 Inclusion Body Refolding at High Concentration for Large-Scale Applications

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

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

Keywords: dialysis, inclusion body, refolding, solubilization

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1469 The Effect of Outliers on the Economic and Social Survey on Income and Living Conditions

Authors: Encarnación Álvarez, Rosa M. García-Fernández, Francisco J. Blanco-Encomienda, Juan F. Muñoz

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The European Union Survey on Income and Living Conditions (EU-SILC) is a popular survey which provides information on income, poverty, social exclusion and living conditions of households and individuals in the European Union. The EUSILC contains variables which may contain outliers. The presence of outliers can have an impact on the measures and indicators used by the EU-SILC. In this paper, we used data sets from various countries to analyze the presence of outliers. In addition, we obtain some indicators after removing these outliers, and a comparison between both situations can be observed. Finally, some conclusions are obtained.

Keywords: poverty line, headcount index, risk of poverty, skewness coefficient

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1468 Structural Performance Evaluation of Concrete Beams Reinforced with Recycled and Virgin Plastic Fibres

Authors: Vighnesh Daas, David B. Tann, Mahmood Datoo

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The incorporation of recycled plastic fibres in concrete as reinforcement is a potential sustainable alternative for replacement of ordinary steel bars. It provides a scope for waste reduction and re-use of plastics in the construction industry on a large scale. Structural use of fibre reinforced concrete is limited to short span members and low reliability classes. In this study, recycled carpet fibres made of 95% polypropylene with length of 45mm were used for experimental investigations. The performance of recycled polypropylene fibres under structural loading has been compared with commercially available virgin fibres at low volume fractions of less than 1%. A series of 100 mm cubes and 125x200x2000 mm beams were used to conduct strength tests in bending and compression to measure the influence of type and volume of fibres on the structural behaviour of fibre reinforced concrete beams. The workability of the concrete mix decreased as a function of fibre content and resulted in a modification of the mix design. The beams failed in a pseudo-ductile manner with an enhanced bending capacity. The specimens showed significant improvement in the post-cracking behaviour and load carrying ability as compared to conventional reinforced concrete members. This was associated to the binding properties of the fibres in the concrete matrix. With the inclusion of fibres at low volumes of 0-0.5%, there was reduction in crack sizes and deflection. This study indicates that the inclusion of recycled polypropylene fibres at low volumes augments the structural behaviour of concrete as compared to conventional reinforced concrete as well as virgin fibre reinforced concrete.

Keywords: fibre reinforced concrete, polypropylene, recycled, strength

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1467 The Network Relative Model Accuracy (NeRMA) Score: A Method to Quantify the Accuracy of Prediction Models in a Concurrent External Validation

Authors: Carl van Walraven, Meltem Tuna

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Background: Network meta-analysis (NMA) quantifies the relative efficacy of 3 or more interventions from studies containing a subgroup of interventions. This study applied the analytical approach of NMA to quantify the relative accuracy of prediction models with distinct inclusion criteria that are evaluated on a common population (‘concurrent external validation’). Methods: We simulated binary events in 5000 patients using a known risk function. We biased the risk function and modified its precision by pre-specified amounts to create 15 prediction models with varying accuracy and distinct patient applicability. Prediction model accuracy was measured using the Scaled Brier Score (SBS). Overall prediction model accuracy was measured using fixed-effects methods that accounted for model applicability patterns. Prediction model accuracy was summarized as the Network Relative Model Accuracy (NeRMA) Score which ranges from -∞ through 0 (accuracy of random guessing) to 1 (accuracy of most accurate model in concurrent external validation). Results: The unbiased prediction model had the highest SBS. The NeRMA score correctly ranked all simulated prediction models by the extent of bias from the known risk function. A SAS macro and R-function was created to implement the NeRMA Score. Conclusions: The NeRMA Score makes it possible to quantify the accuracy of binomial prediction models having distinct inclusion criteria in a concurrent external validation.

Keywords: prediction model accuracy, scaled brier score, fixed effects methods, concurrent external validation

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1466 Blunt Abdominal Trauma Management in Adult Patients: An Investigation on Safety of Discharging Patients with Normal Initial Findings

Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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1465 The Efficacy of Vestibular Rehabilitation Therapy for Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Authors: Ammar Aljabri, Alhussain Halawani, Alaa Ashqar, Omar Alageely

Abstract:

Objective: mild Traumatic Brain Injury (mTBI) or concussion is a common yet undermanaged and underreported condition. This systematic review and meta-analysis aim to determine the efficacy of VRT as a treatment option for mTBI. Method: This review and meta-analysis was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included RCTs and pre-VRT/post-VRT retrospective chart reviews. Records meeting the inclusion criteria were extracted from the following databases: Medline, Embase, and Cochrane Register of Controlled Trials (CENTRAL). Results: Eight articles met the inclusion criteria, and six RCTs were included in the meta-analysis. VRT demonstrated significant improvement in decreasing perceived dizziness at the end of the intervention program, as shown by DHI scores (SMD= -0.33, 95% CI -0.62 to -0.03, p=0.03, I2= 0%). However, no significant reduction in DHI was evident after two months of follow-up (SMD= 0.15, 95% CI -0.23 to 0.52, p=0.44, I2=0%). Quantitative analysis also depicts significant reduction in both VOMS (SMD=-0.40, 95% CI -0.60 to -0.20, p<0.0001, I2=0%) and PCSS (SMD= -0.39, 95% CI -0.71 to -0.07, p=0.02, I2=0%) following the intervention. Lastly, there was no significant difference between intervention groups on BESS scores (SMD= -31, 95% CI -0.71 to 0.10, p=0.14, I2=0%) and return to sport/function (95% CI 0.32 to 30.80, p=0.32, I2=82%). Conclusions: Current evidence on the efficacy of VRT for mTBI is limited. This review and analysis provide evidence that supports the role of VRT in improving perceived symptoms following concussion. There is still a need for high-quality trials evaluating the benefit of VRT using a standardized approach.

Keywords: concussion, traumatic brain injury, vestibular rehabilitation, neurorehabilitation

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1464 Interconnections of Circular Economy, Circularity, and Sustainability: A Systematic Review and Conceptual Framework

Authors: Anteneh Dagnachew Sewenet, Paola Pisano

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The concept of circular economy, circularity, and sustainability are interconnected and promote a more sustainable future. However, previous studies have mainly focused on each concept individually, neglecting the relationships and gaps in the existing literature. This study aims to integrate and link these concepts to expand the theoretical and practical methods of scholars and professionals in pursuit of sustainability. The aim of this systematic literature review is to comprehensively analyze and summarize the interconnections between circular economy, circularity, and sustainability. Additionally, it seeks to develop a conceptual framework that can guide practitioners and serve as a basis for future research. The review employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. A total of 78 articles were analyzed, utilizing the Scopus and Web of Science databases. The analysis involved summarizing and systematizing the conceptualizations of circularity and its relationship with the circular economy and long-term sustainability. The review provided a comprehensive overview of the interconnections between circular economy, circularity, and sustainability. Key themes, theoretical frameworks, empirical findings, and conceptual gaps in the literature were identified. Through a rigorous analysis of scholarly articles, the study highlighted the importance of integrating these concepts for a more sustainable future. This study contributes to the existing literature by integrating and linking the concepts of circular economy, circularity, and sustainability. It expands the theoretical understanding of how these concepts relate to each other and provides a conceptual framework that can guide future research in this field. The findings emphasize the need for a holistic approach in achieving sustainability goals. The data collection for this review involved identifying relevant articles from the Scopus and Web of Science databases. The selection of articles was made based on predefined inclusion and exclusion criteria. The PRISMA protocol guided the systematic analysis of the selected articles, including summarizing and systematizing their content. This study addressed the question of how circularity is conceptualized and related to both the circular economy and long-term sustainability. It aimed to identify the interconnections between these concepts and bridge the gap in the existing literature. The review provided a comprehensive analysis of the interconnections between the circular economy, circularity, and sustainability. It presented a conceptual framework that can guide practitioners in implementing circular economy strategies and serve as a basis for future research. By integrating these concepts, scholars, and professionals can enhance the theoretical and practical methods in pursuit of a more sustainable future. The findings emphasize the importance of taking a holistic approach to achieve sustainability goals and highlight conceptual gaps that can be addressed in future studies.

Keywords: circularity, circular economy, sustainability, innovation

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1463 Regional Disparities in Microfinance Distribution: Evidence from Indian States

Authors: Sunil Sangwan, Narayan Chandra Nayak

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Over the last few decades, Indian banking system has achieved remarkable growth in its credit volume. However, one of the most disturbing facts about this growth is the uneven distribution of financial services across regions. Having witnessed limited success from all the earlier efforts towards financial inclusion targeting the rural poor and the underprivileged, provision of microfinance, of late, has emerged as a supplementary mechanism. There are two prominent modes of microfinance distribution in India namely Bank-SHG linkage (SBLP) and private Microfinance Institutions (MFIs). Ironically, such efforts also seem to have failed to achieve the desired targets as the microfinance services have witnessed skewed distribution across the states of the country. This study attempts to make a comparative analysis of the geographical skew of the SBLP and MFI in India and examine the factors influencing their regional distribution. The results indicate that microfinance services are largely concentrated in the southern region, accounting for about 50% of all microfinance clients and 49% of all microfinance loan portfolios. This is distantly followed by an eastern region where client outreach is close to 25% only. The north-eastern, northern, central, and western regions lag far behind in microfinance sectors, accounting for only 4%, 4%, 10%, and 7 % client outreach respectively. The penetration of SHGs is equally skewed, with the southern region accounting for 46% of client outreach and 70% of loan portfolios followed by an eastern region with 21% of client outreach and 13% of the loan portfolio. Contrarily, north-eastern, northern, central, western and eastern regions account for 5%, 5%, 10%, and 13% of client outreach and 3%, 3%, 7%, and 4% of loan portfolios respectively. The study examines the impact of literacy rate, rural poverty, population density, primary sector share, non-farm activities, loan default behavior and bank penetration on the microfinance penetration. The study is limited to 17 major states of the country over the period 2008-2014. The results of the GMM estimation indicate the significant positive impact of literacy rate, non-farm activities and population density on microfinance penetration across the states, while the rise in loan default seems to deter it. Rural poverty shows the significant negative impact on the spread of SBLP, while it has a positive impact on MFI penetration, hence indicating the policy of exclusion being adhered to by the formal financial system especially towards the poor. However, MFIs seem to be working as substitute mechanisms to banks to fill the gap. The findings of the study are a pointer towards enhancing financial literacy, non-farm activities, rural bank penetration and containing loan default for achieving greater microfinance prevalence.

Keywords: bank penetration, literacy rate, microfinance, primary sector share, rural non-farm activities, rural poverty

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1462 Challenges for Persons with Disabilities During COVID-19 Pandemic in Thailand

Authors: Tavee Cheausuwantavee

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: COVID-19 pandemic significantly has impacted everyone’s life. Persons with disabilities (PWDs) in Thailand have been also effected by COVID-19 situation in many aspects of their lives, while there have been no more appropriate services of the government and providers. Research projects had been only focused on health precaution and protection. Rapid need assessments on populations and vulnerable groups were limited and conducted via social media and an online survey. However, little is known about the real problems and needs of Thai PWDs during the COVID-19 pandemic for an effective plan and integral services for those PWDs. Therefore, this study aims to explore the diverse problems and needs of Thai PWDs in the COVID -19 pandemic. Results from the study can be used by the government and other stakeholders for further effective services. Methods: This study was used a mixed-method design that consisted of both quantitative and qualitative measures. In terms of the quantitative approach, there were 744 PWDs and caregivers of all types of PWDs selected by proportional multistage stratified random sampling according to their disability classification and geographic location. Questionnaires with 59 items regarding participant characteristics, problems, and needs in health, education, employment, and other social inclusion, were distributed to all participants and some caregivers completed questionnaires when PWDs were not able to due to limited communication and/or literacy skills. Completed questionnaires were analyzed by descriptive statistics. For qualitative design, 62 key informants who were PWDs or caregivers were selected by purposive sampling. Ten focus groups, each consisting of 5-6 participants and 7 in-depth interviews from all the groups identified above, were conducted by researchers across five regions. Focus group and in-depth interview guidelines with 6 items regarding problems and needs in health, education, employment, other social inclusion, and their coping during COVID -19 pandemic. Data were analyzed using a modification of thematic content analysis. Results: Both quantitative and qualitative studies showed that PWDs and their caregivers had significant problems and needs all aspects of their life, including income and employment opportunity, daily living and social inclusion, health, and education, respectively. These problems and needs were related to each other, forming a vicious cycle. Participants also learned from negative pandemic to more positive life aspects, including their health protection, financial plan, family cohesion, and virtual technology literacy and innovation. Conclusion and implications: There have been challenges facing all life aspects of PWDs in Thailand during the COVID -19 pandemic, particularly incomes and daily living. All challenges have been the vicious cycle and complicated. There have been also a positive lesson learned of participants from the pandemic. Recommendations for government and stakeholders in the COVID-19 pandemic for PWDs are the following. First, the health protection strategy and policy of PWDs should be promoted together with other quality of life development including income generation, education and social inclusion. Second, virtual technology and alternative innovation should be enhanced for proactive service providers. Third, accessible information during the pandemic for all PWDs must be concerned. Forth, lesson learned from the pandemic should be shared and disseminated for crisis preparation and a positive mindset in the disruptive world.

Keywords: challenge, COVID-19, disability, Thailand

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