Search results for: nursing practice
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4678

Search results for: nursing practice

598 Narcissism and Kohut's Self-Psychology: Self Practices in Service of Self-Transcendence

Authors: Noelene Rose

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The DSM has been plagued with conceptual issues since its inception, not least discriminant validity and comorbidity issues. An attempt to remain a-theoretical in the divide between the psycho-dynamicists and the behaviourists contributed to much of this, in particular relating to the Personality Disorders. With the DSM-5, although the criterion have remained unchanged, major conceptual and structural directions have been flagged and proposed in section III. The biggest changes concern the Personality Disorders. While Narcissistic Personality Disorder (NPD) was initially tagged for removal, instead the addition of section III proposes a move away from a categorical approach to a more dimensional approach, with a measure of Global Function of Personality. This global measure is an assessment of impairment of self-other relations; a measure of trait narcissism. In the same way mainstream psychology has struggled in its diagnosis of narcissism, so too in its treatment. Kohut’s self psychology represents the most significant inroad in theory and treatment for the narcissistic disorders. Kohut had moved away from a categorical system, towards disorders of the self. According to this theory, disorders of the self are the result of childhood trauma (impaired attunement) resulting in a developmental arrest. Self-psychological, Psychodynamic treatment of narcissism, however, is expensive, in time and money and outside the awareness or access of most people. There is more than a suggestion that narcissism is on the increase, created in trauma and worsened by a fearful world climate. A dimensional model of narcissism, from mild to severe, requires cut off points for diagnosis. But where do we draw the line? Mainstream psychology is inclined to set it high when there is some degree of impairment in functioning in daily life. Transpersonal Psychology is inclined to set it low, with the concept that we all have some degree of narcissism and that it is the point and the path of our life journey to transcend our focus on our selves. Mainstream psychology stops its focus on trait narcissism with a healthy level of self esteem, but it is at this point that Transpersonal Psychology can complement the discussion. From a Transpersonal point of view, failure to begin the process of self-transcendence will also create emotional symptoms of meaning or purpose, often later in our lives, and is also conceived of as a developmental arrest. The maps for this transcendence are hidden in plain sight; in the chakras of kundalini yoga, in the sacraments of the Catholic Church, in the Kabbalah tree of life of Judaism, in Maslow’s hierarchy of needs, to name a few. This paper outlines some proposed research exploring the use of daily practices that can be incorporated into the therapy room; practices that utilise meditation, visualisation and imagination: that are informed by spiritual technology and guided by the psychodynamic theory of Self Psychology.

Keywords: narcissism, self-psychology, self-practice, self-transcendence

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597 Playwriting in a German Language Class: How Creativity in a Language Lesson Supports Learning and the Acquisition of Political Agency

Authors: Ioannis Souris

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In this paper, we would like to present how we taught German through playwriting and analyze the usefulness of this method for teaching languages and cultivating a sense of political agency in students and teachers alike. Last academic year, we worked at the German Saturday School in Greenwich, London. This school offers Saturday German lessons to children whose parents are German, living in London. The lessons are two hours long, and the children’s level of German varies according to how often or how much German is spoken at home or how often the families visit Germany (as well as other factors which will be discussed in more detail in the paper). The directors of the school provide teachers with learning material and course books, but they strongly encourage individual input on lesson structure and methods of teaching German. The class we taught consisted of six eight-to-nine-year-olds. Midway into the academic year, we ran out of teaching material, and we, therefore, decided to write a play. In the paper, we would like to explore the process we followed in creating or writing this play and how this encouraged the children to collaborate and exercise their skills in writing, storytelling, speaking, and opinion-sharing. We want to examine the impact this project had on the children who wrote and performed the play, the wider community of the Saturday school, and the development of our language teaching practice. We found, for instance, that some students, who were quiet or shy, became very open and outspoken in the process of writing and performing the play. They took the initiative and led the process, putting us, their teachers, in the role of simple observers or facilitators. When we showed the play in front of the school, the other children and teachers, as audience members, also became part of the process as they commented on the plot, language, and characters and gave feedback on further development. In the paper, we will discuss how this teaching project fits into recent developments in the research of creativity and the teaching of languages and how engagement with creative approaches to teaching has the potential to question and subvert traditional notions of ‘lesson’, ‘teacher’, and ‘student’. From the moment a questioning of norms takes place, we inadvertently raise questions about politics, agency, and resistance. We will conclude the paper with a definition of what we mean by ‘political agency’ within the context of our teaching project and education, in general, and why inspiring creativity and imagination within teaching can be considered a political act. Finally, our aim in this paper will be to propose the possibility of analyzing teaching languages through creativity and political agency theories.

Keywords: innovation in language teaching and learning, language acquisition and learning, language curriculum development, language education

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596 The Degree Project-Course in Swedish Teacher Education – Deliberative and Transformative Perspectives on the Formative Assessment Practice

Authors: Per Blomqvist

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The overall aim of this study is to highlight how the degree project-course in teacher education has developed over time at Swedish universities, above all regarding changes in the formative assessment practices in relation to student's opportunities to take part in writing processes that can develop both their independent critical thinking, subject knowledge, and academic writing skills. Theoretically, the study is based on deliberative and transformative perspectives of teaching academic writing in higher education. The deliberative perspective is motivated by the fact that it is the universities and their departments' responsibility to give the students opportunities to develop their academic writing skills, while there is little guidance on how this can be implemented. The transformative perspective is motivated by the fact that education needs to be adapted to the student's prior knowledge and developed in relation to the student group. Given the academisation of education and the new student groups, this is a necessity. The empirical data consists of video recordings of teacher groups' conversations at three Swedish universities. The conversations were conducted as so-called collective remembering interviews, a method to stimulate the participants' memory through social interaction, and focused on addressing issues on how the degree project-course in teacher education has changed over time. Topic analysis was used to analyze the conversations in order to identify common descriptions and expressions among the teachers. The result highlights great similarities in how the degree project-course has changed over time, both from a deliberative and a transformative perspective. The course is characterized by a “strong framing,” where the teachers have great control over the work through detailed instructions for the writing process and detailed templates for the text. This is justified by the fact that the education has been adapted based on the student teachers' lack of prior subject knowledge. The strong framing places high demands on continuous discussions between teachers about, for example, which tools the students have with them and which linguistic and textual tools are offered in the education. The teachers describe that such governance often leads to conflicts between teachers from different departments because reading and writing are always part of cultural contexts and are linked to different knowledge, traditions, and values. The problem that is made visible in this study raises questions about how students' opportunities to develop independence and make critical judgments in academic writing are affected if the writing becomes too controlled and if passing students becomes the main goal of education.

Keywords: formative assessment, academic writing, degree project, higher education, deliberative perspective, transformative perspective

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595 Development of a Bi-National Thyroid Cancer Clinical Quality Registry

Authors: Liane J. Ioannou, Jonathan Serpell, Joanne Dean, Cino Bendinelli, Jenny Gough, Dean Lisewski, Julie Miller, Win Meyer-Rochow, Stan Sidhu, Duncan Topliss, David Walters, John Zalcberg, Susannah Ahern

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Background: The occurrence of thyroid cancer is increasing throughout the developed world, including Australia and New Zealand, and since the 1990s has become the fastest increasing malignancy. Following the success of a number of institutional databases that monitor outcomes after thyroid surgery, the Australian and New Zealand Endocrine Surgeons (ANZES) agreed to auspice the development of a bi-national thyroid cancer registry. Objectives: To establish a bi-national population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand. Patients and Methods: The Australian and New Zealand Thyroid Cancer Registry (ANZTCR) captures clinical data for all patients, over the age of 18 years, diagnosed with thyroid cancer, confirmed by histopathology report, that have been diagnosed, assessed or treated at a contributing hospital. Data is collected by endocrine surgeons using a web-based interface, REDCap, primarily via direct data entry. Results: A multi-disciplinary Steering Committee was formed, and with operational support from Monash University the ANZTCR was established in early 2017. The pilot phase of the registry is currently operating in Victoria, New South Wales, Queensland, Western Australia and South Australia, with over 30 sites expected to come on board across Australia and New Zealand in 2018. A modified-Delphi process was undertaken to determine the key quality indicators to be reported by the registry, and a minimum dataset was developed comprising information regarding thyroid cancer diagnosis, pathology, surgery, and 30-day follow up. Conclusion: There are very few established thyroid cancer registries internationally, yet clinical quality registries have shown valuable outcomes and patient benefits in other cancers. The establishment of the ANZTCR provides the opportunity for Australia and New Zealand to further understand the current practice in the treatment of thyroid cancer and reasons for variation in outcomes. The engagement of endocrine surgeons in supporting this initiative is crucial. While the pilot registry has a focus on early clinical outcomes, it is anticipated that future collection of longer-term outcome data particularly for patients with the poor prognostic disease will add significant further value to the registry.

Keywords: thyroid cancer, clinical registry, population health, quality improvement

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594 Early Childhood Education and Learning Outcomes in Lower Primary Schools, Uganda

Authors: John Acire, Wilfred Lajul, Ogwang Tom

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Using a qualitative research technique, this study investigates the influence of Early Childhood Education (ECE) on learning outcomes in lower primary schools in Gulu City, Uganda. The study, which is based on Vygotsky's sociocultural theory of human learning, fills gaps in the current literature on the influence of ECE on learning outcomes. The aims of the study include analyzing the state of learning outcomes, investigating ECE practices, and determining the influence of these practices on learning outcomes in lower primary schools. The findings highlight the critical significance of ECE in promoting children's overall development. Nursery education helps children improve their handwriting, reading abilities, and general cognitive development. Children who have received nursery education have improved their abilities to handle pencils, form letters, and engage in social interactions, highlighting the significance of fine motor skills and socializing. Despite the good elements, difficulties in implementing ECE practices were found, such as differences in teaching styles, financial limits, and potential weariness due to prolonged school hours. The study suggests focused interventions to improve the effectiveness of ECE practices, ensure their connection with educational goals and maximize their influence on children's development. The study's findings show that respondents agree on the importance of nursery education in supporting holistic development, socialization, language competency, and conceptual comprehension. Challenges in nursery education, such as differences in teaching techniques and insufficient resources, highlight the need for comprehensive measures to address these challenges. Furthermore, parental engagement in home learning activities was revealed as an important factor affecting early education outcomes. Children who were engaged at home performed better in lower primary, emphasizing the value of a supportive family environment. Finally, the report suggests measures to enhance parental participation, changes in teaching methods through retraining, and age-appropriate enrolment. Future studies might concentrate on the involvement of parents, ECE policy practice, and the influence of ECE teachers on lower primary school learning results. These ideas are intended to help create a more favorable learning environment by encouraging holistic development and preparing children for success in succeeding academic levels.

Keywords: early childhood education, learning outcomes in lower primary schools, early childhood education practices, how ECE practices influence learning outcomes in lower primary schools

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593 Hybrid Model of Strategic and Contextual Leadership in Pluralistic Organizations- A Qualitative Multiple Case Study

Authors: Ergham Al Bachir

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This study adopts strategic leadership (Upper Echelons) as the core theory and contextual leadership theory as the research lens. This research asks how the external context impacts strategic leadership effectiveness to achieve the outcomes in pluralistic organizations (PO). The study explores how the context influences the selection of CEOs, top management teams (TMT), and their leadership effectiveness. POs are characterized by the multiple objectives of their top management teams, divergent objectives, multiple strategies, and multiple governing authorities. The research question is explored by means of a qualitative multiple-case study focusing on healthcare, real estate, and financial services organizations. The data sources are semi-structured interviews, documents, and direct observations. The data analysis strategy is inductive and deploys thematic analysis and cross-case synthesis. The findings differentiate between national and international CEOs' delegation of authority and relationship with the Board of Directors. The findings identify the elements of the dynamic context that influence TMT and PO outcomes. The emergent hybrid strategic and contextual leadership framework shows how the different contextual factors influence strategic direction, PO context, selection of CEOs and TMT, and the outcomes in four pluralistic organizations. The study offers seven theoretical contributions to Upper Echelons, strategic leadership, and contextual leadership research. (1) The integration of two theories revealed how CEO’s impact on the organization is complementary to the contextual impact. (2) Conducting this study in the Middle East contributes to strategic leadership and contextual leadership research. (3) The demonstration of the significant contextual effects on the selection of CEOs. (4 and 5) Two contributions revealed new links between the context, the Board role, internal versus external CEOs, and national versus international CEOs. (6 and 7) This study offered two definitions: what accounts for CEO leadership effectiveness and organizational outcomes. Two methodological contributions were also identified: (1) Previous strategic leadership and Upper Echelons research are mainly quantitative, while this study adopts qualitative multiple-case research with face-to-face interviews. (2) The extrication of the CEO from the TMT advanced the data analysis in strategic leadership research. Four contributions are offered to practice: (1) The CEO's leadership effectiveness inside and outside the organization. (2) Rapid turnover of predecessor CEOs signifies the need for a strategic and contextual approach to CEOs' succession. (3) TMT composition and education impact on TMT-CEO and TMT-TMT interface. (4) Multilevel strategic contextual leadership development framework.

Keywords: strategic leadership, contextual leadership, upper echelons, pluralistic organizations, cross-cultural leadership

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592 Assess the Risk Behaviours and Safer Sex Practices among Male Attendees in a Sexual Health Setting

Authors: B. M. M. D. Mendis, L. I. Rajapaksa, P. S. K. Gunathunga, R. C. Fernando, M. Jayalath

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Background / introduction: During the year 2011, 8511 males received services from the sexual health clinics island wide. At present there is only limited information on the risk behaviours of male attendees. Information on risk behaviours related to STI /HIV transmission is helpful in planning suitable prevention interventions. Aim(s)/objectives: The objectives were to determines the sexual partners (other than the marital partner and regular partners) responsible for transmitting STI( Sexually transmitted infections)/ HIV and to understand the practice of safer sex. Methods: Study was a clinic based prospective study conducted for a one year period using an interviewer administered questionnaire. Results: 983 attendees were interviewed. . Mean age was 34.02 years. 75% of the sample had completed GCE O/L (ordinary level examination). Skilled labourers, drivers and forces/police comprised 40% of the sample. 50% admitted sex with a casual female, 12% with a casual male, and 13% with CSW (commercial sex workers) while MSW (male sex workers) exposures were minimal. It was identified that younger males had more contacts with males, and regular female partners while more older males with CSW. Anal sex among males was reported by 11.5%. 20.5% used alcohol frequently and 5.9% used drugs and 1.4% injected. Common STI were genital herpes (7.9%), Non gonococcal urethritis (6.2%) and gonorrhoea (6.2%). Among those who had contacts with FSW 6.7% gonorrhoea (GC), 8.2% non gonococcal urethritis (NGU), 7.5% genital herpes and 0.7% HIV. Non regular partner exposures 3.7% had gonorrhoea, 8.3% NGU, 6.6% genital herpes and 0.8% HIV. Among MSM contacts 10.6% had GC, 4.5% NGU, 5.3% genital herpes, 5.3% secondary syphilis and 0.8% HIV. Only 9.0% used condoms correctly. Friends, doctors, newspapers, internet, and forces were important sources of information on condoms. Non use of condoms were due to worry about satisfaction (24.6%) and faith in the partner (25.6%). Discussion/conclusion: Casual partners for unsafe sex is a concern. MSM and CSW are remained as an important source of infection. Early Syphilis and gonorrhoea infections were mostly seen among MSM exposures. The findings indicate that the male population in the sample had satisfactory education. However, still the unsafe sexual contacts are common. . Newspapers, internet were more important sources of information on condoms. Low condom use remains another concern.. More males contracted STI through casual partners. Therefore strategies used for prevention need to be revisited also emphasizing on general population where casual partners represent. . Increasing awareness of men and women through mass media and primary health care teams may be important strategies that can be used to keep the HIV epidemic in a low level.

Keywords: STI, HIV, Males, safe sex practices

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591 Pelvic Floor Training in Elite Athletes: Fact or Fiction

Authors: Maria Barbano Acevedo-Gomez, Elena Sonsoles Rodriguez-Lopez, Sofia Olivia Calvo-Moreno, Angel Basas-Garcia, Cristophe Ramirez

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Introduction: Urinary incontinence (UI) is defined as the involuntary leakage of urine. In persons who practice sport, its prevalence is 36.1% (95% CI 26.5%-46.8%) and varies as it seems to depend on the intensity of exercise, movements, and impact on the ground. Such high impact sports are likely to generate higher intra-abdominal pressures and leading to pelvic floor muscle weakness. Even though the emphasis of this research is on female athletes, all women should perform pelvic floor muscle exercises as a part of their general physical exercise. Pelvic floor exercises are generally considered the first treatment against urinary incontinence. Objective: The main objective of the present study was to determine the knowledge of the pelvic floor and of the UI in elite athletes and know if they incorporate pelvic floor strengthening in their training. Methods: This was an observational study conducted on 754 elite athletes. After collecting questions about the pelvic floor, UI, and sport-related data, participants completed the questionnaire International Consultation on Incontinence Questionnaire-UI Short-Form (ICIQ-SF). Results: 57.3% of the athletes reflect not having knowledge of their pelvic floor, 48.3% do not know what strengthening exercises are, and around 90% have never practiced them. 78.1% (n=589) of all elite athletes do not include pelvic floor exercises in their training. Of the elite athletes surveyed, 33% had UI according to ICIQ-SF (mean age 23.75 ± 7.74 years). In response to the question 'Do you think you have or have had UI?', Only 9% of the 754 elite athletes admitted they presently had UI, and 13.3% indicated they had had UI at some time. However, 22.7% (n=171) reported they had experienced urine leakage while training. Of the athletes who indicated they did not have UI in the ICIQ-SF, 25.7% stated they did experience urine leakage during training (χ² [1] = 265.56; p < 0.001). Further, 12.3% of the athletes who considered they did not have UI and 60% of those who admitted they had had UI on some occasion stated they had suffered some urine leakage in the past 3 months (χ² [1] = 287.59; p < 0.001). Conclusions: There is a lack of knowledge about UI in sport. Through the use of validated questionnaires, we observed a UI prevalence of 33%, and 22.7% reported they experienced urine leakage while training. These figures contrast with only 9% of athletes who reported they had or had in the past had UI. This discrepancy could reflect the great lack of knowledge about UI in sports and that sometimes an athlete may consider that urine leakage is normal and a consequence of the demands of training. These data support the idea that coaches, physiotherapists, and other professionals involved in maximizing the performance of athletes should include pelvic floor muscle exercises in their training programs. Measures such as this could help to prevent UI during training and could be a starting point for future studies designed to develop adequate prevention and treatment strategies for this embarrassing problem affecting young athletes, both male and female.

Keywords: athletes, pelvic floor, performance, prevalence, sport, training, urinary incontinence

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590 Well-Being in the Workplace: Do Christian Leaders Behave Differently?

Authors: Mariateresa Torchia, Helene Cristini, Hannele Kauppinen

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Leadership plays a vital role in organizations. Leaders provide directions and facilitate the processes that enable organizations to achieve their goals and objectives. However, while productivity and financial objectives are often given the greatest emphasis, leaders also have the responsibility for instituting standards of ethical conduct and moral values that guide the behavior of employees. Leaders’ behaviors such as support, empowerment and a high-quality relationship with their employees might not only prevent stress, but also improve employees’ stress coping meanwhile contributing to their affective well-being. Stemming from Girard’s Mimetic Theory, this study aims at understanding how leaders can foster well-being in organizations. To do so, we explore which is the role leaders play in conflict management, resentment management and negative emotions dissipation. Furthermore, we examine whether and to what extent religiosity impacts the way in which leaders operate in relation to employees’ well-being. Indeed, given that organizational values are crucial to ethical behavior and firms’ values may be steeled by a deep sense of spirituality and religious identification, there is a need to take a closer look at the role religion and spirituality play in influencing the way leaders impact employees’ well-being. Thus, religion might work as an overarching logic that provides a set of principles guiding leaders’ everyday practices and relations with employees. We answer our research questions using a qualitative approach. We interviewed 27 Christian leaders (members of the Christian Entrepreneurs and Leaders Association – EDC, a non-profit organization created in 1926 including 3,000 French Christian Leaders & Entrepreneurs). Our results show that well-being can have a different meaning in relation to the type of companies, size, culture, country of analysis. Moreover the values and believes of leaders influence the way they see and foster well-being among employees. Furthermore, leaders can have both a positive or negative impact on well-being. Indeed on the one side, they could increase well-being in the company while on the other hand, they could be the source of resentment and conflicts among employees. Finally, we observed that Christian leaders possess characteristics that are sometimes missing in leaders (humility, inability to compare with others, attempt to be coherent with their values and beliefs, interest in the common good instead of the personal interest, having tougher dilemmas, collectively undertaking the firm). Moreover the Christian leader believes that the common good should come before personal interest. In other words, to them, not only short –termed profit shouldn’t guide strategical decisions but also leaders should feel responsible for their employees’ well-being. Last but not least, the study is not an apologia of Christian, yet it discusses the implications of these values through the light of Girard’s mimetic theory for both theory and practice.

Keywords: Christian leaders, employees well-being, leadership, mimetic theory

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589 Live Music Promotion in Burundi Country

Authors: Aster Anderson Rugamba

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Context: Live music in Burundi is currently facing neglect and a decline in popularity, resulting in artists struggling to generate income from this field. Additionally, live music from Burundi has not been able to gain traction in the international market. It is essential to establish various structures and organizations to promote cultural events and support artistic endeavors in music and performing arts. Research Aim: The aim of this research is to seek new knowledge and understanding in the field of live music and its content in Burundi. Furthermore, it aims to connect with other professionals in the industry, make new discoveries, and explore potential collaborations and investments. Methodology: The research will utilize both quantitative and qualitative research methodologies. The quantitative approach will involve a sample size of 57 musician artists in Burundi. It will employ closed-ended questions and gather quantitative data to ensure a large sample size and high external validity. The qualitative approach will provide deeper insights and understanding through open-ended questions and in-depth interviews with selected participants. Findings: The research expects to find new theories, methodologies, empirical findings, and applications of existing knowledge that can contribute to the development of live music in Burundi. By exploring the challenges faced by artists and identifying potential solutions, the study aims to establish live music as a catalyst for development and generate a positive impact on both the Burundian and international community. Theoretical Importance: Theoretical contributions of this research will expand the current understanding of the live music industry in Burundi. It will propose new theories and models to address the issues faced by artists and highlight the potential of live music as a lucrative and influential industry. By bridging the gap between theory and practice, the research aims to provide valuable insights for academics, professionals, and policymakers. Data Collection and Analysis Procedures: Data will be collected through surveys, interviews, and archival research. Surveys will be administered to the sample of 57 musician artists, while interviews will be conducted to gain in-depth insights from selected participants. The collected data will be analyzed using both quantitative and qualitative methods, including statistical analysis and thematic analysis, respectively. This mixed-method approach will ensure a comprehensive and rigorous examination of the research questions addressed.

Keywords: business music in burundi, music in burundi, promotion of art, burundi music culture

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588 Challenges for Competency-Based Learning Design in Primary School Mathematics in Mozambique

Authors: Satoshi Kusaka

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The term ‘competency’ is attracting considerable scholarly attention worldwide with the advance of globalization in the 21st century and with the arrival of a knowledge-based society. In the current world environment, familiarity with varied disciplines is regarded to be vital for personal success. The idea of a competency-based educational system was mooted by the ‘Definition and Selection of Competencies (DeSeCo)’ project that was conducted by the Organization for Economic Cooperation and Development (OECD). Further, attention to this topic is not limited to developed countries; it can also be observed in developing countries. For instance, the importance of a competency-based curriculum was mentioned in the ‘2013 Harmonized Curriculum Framework for the East African Community’, which recommends key competencies that should be developed in primary schools. The introduction of such curricula and the reviews of programs are actively being executed, primarily in the East African Community but also in neighboring nations. Taking Mozambique as a case in point, the present paper examines the conception of ‘competency’ as a target of frontline education in developing countries. It also aims to discover the manner in which the syllabus, textbooks and lessons, among other things, in primary-level math education are developed and to determine the challenges faced in the process. This study employs the perspective of competency-based education design to analyze how the term ‘competency’ is defined in the primary-level math syllabus, how it is reflected in the textbooks, and how the lessons are actually developed. ‘Practical competency’ is mentioned in the syllabus, and the description of the term lays emphasis on learners' ability to interactively apply socio-cultural and technical tools, which is one of the key competencies that are advocated in OECD's ‘Definition and Selection of Competencies’ project. However, most of the content of the textbooks pertains to ‘basic academic ability’, and in actual classroom practice, teachers often impart lessons straight from the textbooks. It is clear that the aptitude of teachers and their classroom routines are greatly dependent on the cultivation of their own ‘practical competency’ as it is defined in the syllabus. In other words, there is great divergence between the ‘syllabus’, which is the intended curriculum, and the content of the ‘textbooks’. In fact, the material in the textbooks should serve as the bridge between the syllabus, which forms the guideline, and the lessons, which represent the ‘implemented curriculum’. Moreover, the results obtained from this investigation reveal that the problem can only be resolved through the cultivation of ‘practical competency’ in teachers, which is currently not sufficient.

Keywords: competency, curriculum, mathematics education, Mozambique

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587 Magnitude of Transactional Sex and Its Determinant Factors Among Women in Sub-Saharan Africa: Systematic Review and Meat Analysis

Authors: Gedefaye Nibret Mihretie

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Background: Transactional sex is casual sex between two people to receive material incentives in exchange for sexual favors. Transactional sex is associated with negative consequences, which increase the risk of sexually transmitted diseases, including HIV/AIDS, unintended pregnancy, unsafe abortion, and physiological trauma. Many primary studies in Sub-Saharan Africa have been conducted to assess the prevalence and associated factors of transactional sex among women. These studies had great discrepancies and inconsistent results. Hence, this systematic review and meta-analysis aimed to synthesize the pooled prevalence of the practice of transactional sex among women and its associated factors in Sub-Saharan Africa. Method: Cross-sectional studies were systematically searched from March 6, 2022, to April 24, 2022, using PubMed, Google Scholar, HINARI, Cochrane Library, and grey literature. The pooled prevalence of transactional sex and associated factors was estimated using DerSemonial-Laird Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic was used to assess the studies' heterogeneity. A funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was performed to minimize the underline heterogeneity depending on the study years, source of data, sample sizes and geographical location. Results: Four thousand one hundred thirty articles were extracted from various databases. The final thirty-two studies were included in this systematic review, including 108,075 participants. The pooled prevalence of transactional sex among women in Sub-Saharan Africa was 12.55%, with a confidence interval of 9.59% to 15.52%. Educational status (OR = .48, 95%CI, 0.27, 0.69) was the protective factors of transactional sex whereas, alcohol use (OR = 1.85, 95% CI: 1.19, 2.52), early sex debut (OR = 2.57, 95%CI, 1.17, 3.98), substance abuse (OR = 4.21, 95% CI: 2.05, 6.37), having history of sexual experience abuse (OR = 4.08, 95% CI: 1.38, 6.78), physical violence abuse (OR = 6.59, 95% CI: 1.17, 12.02), and sexual violence abuse (OR = 3.56, 95% CI: 1.15, 8.27) were the risk factors of transactional sex. Conclusion: The prevalence of transactional sex among women in Sub-Saharan Africa was high. Educational status, alcohol use, substance abuse, early sex debut, having a history of sexual experiences, physical violence, and sexual violence were predictors of transaction sex. Governmental and other stakeholders are designed to reduce alcohol utilization, provide health information about the negative consequences of early sex debut, substance abuse, and reduce sexual violence, ensuring gender equality through mass media, which should be included in state policy.

Keywords: women’s health, child health, reproductive health, midwifery

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586 Inpatient Drug Related Problems and Pharmacist Intervention at a Tertiary Care Teaching Hospital in South India: A Retrospective Study

Authors: Bollu Mounica

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Background: Nowadays drug related problems were seen very commonly within the health care practice. These could result in the medication errors, adverse events, drug interactions and harm to patients. Pharmacist has an identified role in minimizing and preventing such type of problems. Objectives: To detect the incidence of drug related problems for the hospitalized patient, and to analyze the clinical pharmacist interventions performed during the review of prescription orders of the general medicine, psychiatry, surgery, pediatrics, gynaecology units of a large tertiary care teaching hospital. Methods: It was a retrospective, observational and interventional study. The analysis took place daily with the following parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, as well as the resulting clinical interventions. For a period starting November 2012 until December 2014, the inpatient medication charts and orders were identified and rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services in a tertiary care teaching hospital on routine daily activities. Data was collected and evaluated. The causes of this problem were identified. Results: A total of 360 patients were followed. Male (71.66%) predominance was noted over females (28.33%). Drug related problems were more commonly seen in patients aged in between 31-60. Most of the DRP observed in the study resulted from the dispensing errors (26.11%), improper drug selection (17.22%), followed by untreated indications (14.4%) Majority of the clinical pharmacist recommendations were on need for proper dispensing (26.11%), and drug change (18.05%). Minor significance of DRPs were noted high (41.11 %), whereas (35.27 %) were moderate and (23.61 %) were major. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high (86.66%). Conclusion: Our study showed that the prescriptions reviewed had some drug therapy problem and the pharmacist interventions have promoted positive changes needed in the prescriptions. In this context, routine participation of clinical pharmacists in clinical medical rounds facilitates the identification of DRPs and may prevent their occurrence.

Keywords: drug related problems, clinical pharmacist, drug prescriptions, drug related problems, intervention

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585 The Future of the Architect's Profession in France with the Emergence of Building Information Modelling

Authors: L. Mercier, D. Beladjine, K. Beddiar

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The digital transition of building in France brings many changes which some have been able to face very quickly, while others are struggling to find their place and the interest that BIM can bring in their profession. BIM today is already adopted or initiated by construction professionals. However, this change, which can be drastic for some, prevents them from integrating it definitively. This is the case with architects. The profession is shared on the practice of BIM in its exercise. The risk of not adopting this new working method now and of not wanting to switch to its new digital tools leads us to question the future of the profession in view of the gap that is likely to be created within project management. In order to deal with the subject efficiently, our work was based on a documentary watch on BIM and then on the profession of architect, which allowed us to establish links on these two subjects. The observation of the economic model towards which the agencies tend and the trend of the sought after profiles made it possible to develop the opportunities and the brakes likely to impact the future of the profession of architect. The centralization of research directs work towards the conclusion that the model implemented by companies does not allow to integrate BIM within their structure. A solution hypothesis was then issued, focusing on the development of agencies through the diversity of profiles, skills to be integrated internally with the aim of diversifying their skills, and their business practices. In order to address this hypothesis of a multidisciplinary agency model, we conducted a survey of architectural firms. It is built on the model of Anglo-Saxon countries, which do not have the same functioning in comparison to the French model. The results obtained showed a risk of gradual disappearance on the market from small agencies in favor of those who will have and could take this BIM working method. This is why the architectural profession must, first of all, look at what is happening within its training before absolutely wanting to diversify the profiles to integrate into its structure. This directs the study on the training of architects. The schools of French architects are generally behind schedule if we allow the comparison to the schools of engineers. The latter is currently experiencing a slight improvement with the emergence of masters and BIM options during the university course. If the training of architects develops towards learning BIM and the agencies have the desire to integrate different but complementary profiles, then they will develop their skills internally and therefore open their profession to new functions. The place of BIM Management on projects will allow the architect to remain in control of the project because of their overall vision of the project. In addition, the integration of BIM and more generally of the life cycle analysis of the structure will make it possible to guarantee eco-design or eco-construction by approaching the constraints of sustainable development omnipresent on the planet.

Keywords: building information modelling, BIM, BIM management, BIM manager, BIM architect

Procedia PDF Downloads 100
584 Urinary Incontinence and Performance in Elite Athletes

Authors: María Barbaño Acevedo Gómez, Elena Sonsoles Rodríguez López, Sofía Olivia Calvo Moreno, Ángel Basas García, Christophe RamíRez Parenteau

Abstract:

Introduction: Urinary incontinence (UI) is defined as the involuntary leakage of urine. In persons who practice sport, its prevalence is 36.1% (95% CI 26.5% –46.8%) and varies as it seems to depend on the intensity of exercise, movements and impact on the ground. Such high impact sports are likely to generate higher intra-abdominal pressures and leading to pelvic floor muscle weakness. Although physical exercise reduces the risk of suffering from many diseases the mentality of an elite athlete is not to optimize their health, achieving their goals can put their health at risk. Furthermore, feeling or suffering from any discomfort during training seems to be normal within the elite sport demands. Objective: The main objective of the present study was to know the effects of UI in sports performance in athletes. Methods: This was an observational study conducted in 754 elite athletes. After collecting questions about pelvic floor, UI and sport-related data, participants completed the questionnaire International Consultation on Incontinence Questionnaire-UI Short- Form (ICIQ-SF) and ISI (index of incontinence severity). Results: 48.8% of the athletes declare having losses also in rest, preseason and / or competition (χ2 [3] = 3.64; p = 0.302), being the competition period (29.1%) the most frequent where suffer from urine leakage. Of the elite athletes surveyed, 33% had UI according ICIQ-SF (mean age 23.75 ± 7.74 years). Elite athletes with UI (5.31 ± 1.07 days) dedicate significantly more days per week to training [M = 0.28; 95% CI = 0.08-0.48; t (752) = 2.78; p = 0.005] than those without UI. Regarding frequency, 59.7% lose urine once a week, 25.6% lose urine more than 3 times a week, and 14.7% daily. Based on the amount, approximately 15% claim to lose a moderate and abundant. Athletes with the highest number of urine leaks during their training, the UI affects them more in their daily life (r = 0.259; p = 0.001), they present a greater number of losses in their day to day (r = 0.341; p <0.001 ) and greater severity of UI (r = 0.341; p <0.001). Conclusions: Athletes consider that UI affects them negatively in their daily routine, 30.9% affirm having a severity between moderate and severe in their daily routine, and 29.1% loss urine in competition period. An interesting fact is that more than half of the samples collected were elite athletes who compete at the highest level (Olympic Games, World and European Championship), the dedication to sport occupies a big piece in their life. The most frequent period where athletes suffers urine leakage is in competition and there are many emotions that athletes manage to get their best performance, if we add urine losses in that moments it is possible that their performance could be affected.

Keywords: athletes, performance, prevalence, sport, training, urinary incontinence

Procedia PDF Downloads 114
583 Microbiological Analysis on Anatomical Specimens of Cats for Use in Veterinary Surgery

Authors: Raphael C. Zero, Marita V. Cardozo, Thiago A. S. S. Rocha, Mariana T. Kihara, Fernando A. Ávila, Fabrício S. Oliveira

Abstract:

There are several fixative and preservative solutions for use on cadavers, many of them using formaldehyde as the fixative or anatomical part preservative. In some countries, such as Brazil, this toxic agent has been increasingly restricted. The objective of this study was to microbiologically identify and quantify the key agents in tanks containing 96GL ethanol or sodium chloride solutions, used respectively as fixatives and preservatives of cat cadavers. Eight adult cat corpses, three females and five males, with an average weight of 4.3 kg, were used. After injection via the external common carotid artery (120 ml/kg, 95% 96GL ethyl alcohol and 5% pure glycerin), the cadavers were fixed in a plastic tank with 96GL ethanol for 60 days. After fixing, they were stored in a 30% sodium chloride aqueous solution for 120 days in a similar tank. Samples were collected at the start of the experiment - before the animals were placed in the ethanol tanks, and monthly thereafter. The bacterial count was performed by Pour Plate Method in BHI agar (Brain Heart Infusion) and the plates were incubated aerobically and anaerobically for 24h at 37ºC. MacConkey agar, SPS agar (Sulfite Polymyxin Sulfadizine) and MYP Agar Base were used to isolate the microorganisms. There was no microbial growth in the samples prior to alcohol fixation. After 30 days of fixation in the alcohol solution, total aerobic and anaerobic (<1.0 x 10 CFU/ml) were found and Pseudomonas sp., Staphylococcus sp., Clostridium sp. were the identified agents. After 60 days in the alcohol fixation solution, total aerobes (<1.0 x 10 CFU/ml) and total anaerobes (<2.2 x 10 CFU/mL) were found, and the identified agents were the same. After 30 days of storage in the aqueous solution of 30% sodium chloride, total aerobic (<5.2 x 10 CFU/ml) and total anaerobes (<3.7 x 10 CFU/mL) were found and the agents identified were Staphylococcus sp., Clostridium sp., and fungi. After 60 days of sodium chloride storage, total aerobic (<3.0 x 10 CFU / ml) and total anaerobes (<7.0 x 10 CFU/mL) were found and the identified agents remained the same: Staphylococcus sp., Clostridium sp., and fungi. The microbiological count was low and visual inspection did not reveal signs of contamination in the tanks. There was no strong odor or purification, which proved the technique to be microbiologically effective in fixing and preserving the cat cadavers for the four-month period in which they are provided to undergraduate students of University of Veterinary Medicine for surgery practice. All experimental procedures were approved by the Municipal Legal Department (protocol 02.2014.000027-1). The project was funded by FAPESP (protocol 2015-08259-9).

Keywords: anatomy, fixation, microbiology, small animal, surgery

Procedia PDF Downloads 266
582 Mitigating the Vulnerability of Subsistence Farmers through Ground Water Optimisation

Authors: Olayemi Bakre

Abstract:

The majoritant of the South African rural populace are directly or indirectly engaged in agricultural practices for a livelihood. However, impediments such as the climate change and inadequacy of governmental support has undermined the once thriving subsistence farming communities of South Africa. Furthermore, the poor leadership in hydrology, coupled with lack of depths in skills to facilitate the understanding and acceptance of groundwater from national level to local governance has made it near impossible for subsistence farmers to optimally benefit from the groundwater beneath their feet. The 2012 drought experienced in South Africa paralysed the farming activities across several subsistence farming communities across the KwaZulu-Natal Province. To revamp subsistence farming, a variety of interventions and strategies such as the Resource Poor Farmers (RPF) and Water Allocation Reforms (WAR) have been launched by the Department of Water and Sanitation (DWS) as an agendum to galvanising the defunct subsistence farming communities of KwaZulu-Natal as well as other subsistence farming communities across South Africa. Despite the enormous resources expended on the subsistence farming communities whom often fall under the Historically Disadvantaged Individuals (HDI); indicators such as the unsustainable farming practices, poor crop yield, pitiable living condition as well as the poor standard of living, are evidential to the claim that these afore cited interventions and a host of other similar strategies indicates that these initiatives have not yield the desired result. Thus, this paper seeks to suggest practicable interventions aimed at salvaging the vulnerability of subsistence farmers within the province understudy. The study pursued a qualitative approach as the view of experts on ground water and similarly related fields from the DWS were solicited as an agendum to obtaining in-depth perspective into the current study. Some of the core challenges undermining the sustainability and growth of subsistence farming in the area of study were - inadequacy of experts (engineers, scientist, researchers) in ground water; water shortages; lack of political will as well as lack of coordination among stakeholders. As an agendum to optimising the ground water usage for subsistence farming, this paper advocates the strengthening of geohydrological skills, development of technical training capacity, interactive participation among stakeholders as well as the initiation of Participatory Action Research as an agenda to optimising the available ground water in KwaZulu-Natal which is intended to orchestrate a sustainable and viable subsistence farming practice within the province.

Keywords: subsistence farming, ground water optimisation, resource poor farmers, and water allocation reforms, hydrology

Procedia PDF Downloads 232
581 Effectiveness of N-Acetylcysteine in the Treatment of Adults with Trichotillomania: An Evidenced Based Review

Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

Abstract:

Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

Procedia PDF Downloads 90
580 Developing Gifted Students’ STEM Career Interest

Authors: Wing Mui Winnie So, Tian Luo, Zeyu Han

Abstract:

To fully explore and develop the potentials of gifted students systematically and strategically by providing them with opportunities to receive education at appropriate levels, schools in Hong Kong are encouraged to adopt the "Three-Tier Implementation Model" to plan and implement the school-based gifted education, with Level Three refers to the provision of learning opportunities for the exceptionally gifted students in the form of specialist training outside the school setting by post-secondary institutions, non-government organisations, professional bodies and technology enterprises. Due to the growing concern worldwide about low interest among students in pursuing STEM (Science, Technology, Engineering, and Mathematics) careers, cultivating and boosting STEM career interest has been an emerging research focus worldwide. Although numerous studies have explored its critical contributors, little research has examined the effectiveness of comprehensive interventions such as “Studying with STEM professional”. This study aims to examine the effect on gifted students’ career interest during their participation in an off-school support programme designed and supervised by a team of STEM educators and STEM professionals from a university. Gifted students were provided opportunities and tasks to experience STEM career topics that are not included in the school syllabus, and to experience how to think and work like a STEM professional in their learning. Participants involved 40 primary school students joining the intervention programme outside the normal school setting. Research methods included adopting the STEM career interest survey and drawing tasks supplemented with writing before and after the programme, as well as interviews before the end of the programme. The semi-structured interviews focused on students’ views regarding STEM professionals; what’s it like to learn with a STEM professional; what’s it like to work and think like a STEM professional; and students’ STEM identity and career interest. The changes in gifted students’ STEM career interest and its well-recognised significant contributors, for example, STEM stereotypes, self-efficacy for STEM activities, and STEM outcome expectation, were collectively examined from the pre- and post-survey using T-test. Thematic analysis was conducted for the interview records to explore how studying with STEM professional intervention can help students understand STEM careers; build STEM identity; as well as how to think and work like a STEM professional. Results indicated a significant difference in STEM career interest before and after the intervention. The influencing mechanism was also identified from the measurement of the related contributors and the analysis of drawings and interviews. The potential of off-school support programme supervised by STEM educators and professionals to develop gifted students’ STEM career interest is argued to be further unleashed in future research and practice.

Keywords: gifted students, STEM career, STEM education, STEM professionals

Procedia PDF Downloads 58
579 Long-Term Foam Roll Intervention Study of the Effects on Muscle Performance and Flexibility

Authors: T. Poppendieker

Abstract:

A new innovative tool for self-myofascial release is widely and increasingly used among athletes of various sports. The application of the foam roll is suggested to improve muscle performance and flexibility. Attempts to examine acute and somewhat long term effects of either have been conducted over the past ten years. However, the results of muscle performance have been inconsistent. It is suggested that regular use over a long period of time results in a different, muscle performance improving outcome. This study examines long-term effects of regular foam rolling combined with a short plyometric routine vs. solely the same plyometric routine on muscle performance and flexibility over a period of six weeks. Results of counter movement jump (CMJ), squat jump (SJ), and isometric maximal force (IMF) of a 90° horizontal squat in a leg-press will serve as parameters for muscle performance. Data on the range of motion (ROM) of the sit and reach test will be used as a parameter for the flexibility assessment. Muscle activation will be measured throughout all tests. Twenty male and twenty female members of a Frankfurt area fitness center chain (7.11) with an average age of 25 years will be recruited. Women and men will be randomly assigned to a foam roll (FR) and a control group. All participants will practice their assigned routine three times a week over the period of six weeks. Tests on CMJ, SJ, IMF, and ROM will be taken before and after the intervention period. The statistic software program SPSS 22 will be used to analyze the data of CMJ, SJ, IMF, and ROM under consideration of muscle activation by a 2 x 2 x 2 (time of measurement x gender x group) analysis of variance with repeated measures and dependent t-test analysis of pre- and post-test. The alpha level for statistic significance will be set at p ≤ 0.05. It is hypothesized that a significant difference in outcome based on gender differences in all four tests will be observed. It is further hypothesized that both groups may show significant improvements in their performance in the CMJ and SJ after the six-week period. However, the FR group is hypothesized to achieve a higher improvement in the two jump tests. Moreover, the FR group may increase IMF as well as flexibility, whereas the control group may not show likewise progress. The results of this study are crucial for the understanding of long-term effects of regular foam roll application. The collected information on the matter may help to motivate the incorporation of foam rolling into training routines, in order to improve athletic performances.

Keywords: counter movement jump, foam rolling, isometric maximal force, long term effects, self-myofascial release, squat jump

Procedia PDF Downloads 276
578 Principles for the Realistic Determination of the in-situ Concrete Compressive Strength under Consideration of Rearrangement Effects

Authors: Rabea Sefrin, Christian Glock, Juergen Schnell

Abstract:

The preservation of existing structures is of great economic interest because it contributes to higher sustainability and resource conservation. In the case of existing buildings, in addition to repair and maintenance, modernization or reconstruction works often take place in the course of adjustments or changes in use. Since the structural framework and the associated load level are usually changed in the course of the structural measures, the stability of the structure must be verified in accordance with the currently valid regulations. The concrete compressive strength of the existing structures concrete and the derived mechanical parameters are of central importance for the recalculation and verification. However, the compressive strength of the existing concrete is usually set comparatively low and thus underestimated. The reasons for this are too small numbers, and large scatter of material properties of the drill cores, which are used for the experimental determination of the design value of the compressive strength. Within a structural component, the load is usually transferred over the area with higher stiffness and consequently with higher compressive strength. Therefore, existing strength variations within a component only play a subordinate role due to rearrangement effects. This paper deals with the experimental and numerical determination of such rearrangement effects in order to calculate the concrete compressive strength of existing structures more realistic and economical. The influence of individual parameters such as the specimen geometry (prism or cylinder) or the coefficient of variation of the concrete compressive strength is analyzed in experimental small-part tests. The coefficients of variation commonly used in practice are adjusted by dividing the test specimens into several layers consisting of different concretes, which are monolithically connected to each other. From each combination, a sufficient number of the test specimen is produced and tested to enable evaluation on a statistical basis. Based on the experimental tests, FE simulations are carried out to validate the test results. In the frame of a subsequent parameter study, a large number of combinations is considered, which had not been investigated in the experimental tests yet. Thus, the influence of individual parameters on the size and characteristic of the rearrangement effect is determined and described more detailed. Based on the parameter study and the experimental results, a calculation model for a more realistic determination of the in situ concrete compressive strength is developed and presented. By considering rearrangement effects in concrete during recalculation, a higher number of existing structures can be maintained without structural measures. The preservation of existing structures is not only decisive from an economic, sustainable, and resource-saving point of view but also represents an added value for cultural and social aspects.

Keywords: existing structures, in-situ concrete compressive strength, rearrangement effects, recalculation

Procedia PDF Downloads 99
577 Comprehensive Analysis of Electrohysterography Signal Features in Term and Preterm Labor

Authors: Zhihui Liu, Dongmei Hao, Qian Qiu, Yang An, Lin Yang, Song Zhang, Yimin Yang, Xuwen Li, Dingchang Zheng

Abstract:

Premature birth, defined as birth before 37 completed weeks of gestation is a leading cause of neonatal morbidity and mortality and has long-term adverse consequences for health. It has recently been reported that the worldwide preterm birth rate is around 10%. The existing measurement techniques for diagnosing preterm delivery include tocodynamometer, ultrasound and fetal fibronectin. However, they are subjective, or suffer from high measurement variability and inaccurate diagnosis and prediction of preterm labor. Electrohysterography (EHG) method based on recording of uterine electrical activity by electrodes attached to maternal abdomen, is a promising method to assess uterine activity and diagnose preterm labor. The purpose of this study is to analyze the difference of EHG signal features between term labor and preterm labor. Free access database was used with 300 signals acquired in two groups of pregnant women who delivered at term (262 cases) and preterm (38 cases). Among them, EHG signals from 38 term labor and 38 preterm labor were preprocessed with band-pass Butterworth filters of 0.08–4Hz. Then, EHG signal features were extracted, which comprised classical time domain description including root mean square and zero-crossing number, spectral parameters including peak frequency, mean frequency and median frequency, wavelet packet coefficients, autoregression (AR) model coefficients, and nonlinear measures including maximal Lyapunov exponent, sample entropy and correlation dimension. Their statistical significance for recognition of two groups of recordings was provided. The results showed that mean frequency of preterm labor was significantly smaller than term labor (p < 0.05). 5 coefficients of AR model showed significant difference between term labor and preterm labor. The maximal Lyapunov exponent of early preterm (time of recording < the 26th week of gestation) was significantly smaller than early term. The sample entropy of late preterm (time of recording > the 26th week of gestation) was significantly smaller than late term. There was no significant difference for other features between the term labor and preterm labor groups. Any future work regarding classification should therefore focus on using multiple techniques, with the mean frequency, AR coefficients, maximal Lyapunov exponent and the sample entropy being among the prime candidates. Even if these methods are not yet useful for clinical practice, they do bring the most promising indicators for the preterm labor.

Keywords: electrohysterogram, feature, preterm labor, term labor

Procedia PDF Downloads 551
576 Effects of the Quality Construction of Public Construction in Taiwan to Implementation Three Levels Quality Management Institution

Authors: Hsin-Hung Lai, Wei Lo

Abstract:

Whether it is in virtue or vice for a construction quality of public construction project, it is one of the important indicators for national economic development and overall construction, the impact on the quality of national life is very deep. In recent years, a number of scandal of public construction project occurred, the requirements of the government agencies and the public require the quality of construction of public construction project are getting stricter than ever, the three-level public construction project construction quality of quality control system implemented by the government has a profound impact. This study mainly aggregated the evolution of ISO 9000 quality control system, the difference between the practice of implementing management of construction quality by many countries and three-level quality control of our country, so we explored and found that almost all projects of enhancing construction quality are dominated by civil organizations in foreign countries, whereas, it is induced by the national power in our country and develop our three-level quality control system and audit mechanism based on IOS system and implement the works by legislation, we also explored its enhancement and relevance with construction quality of public construction project that are intervened by such system and national power, and it really presents the effectiveness of construction quality been enhanced by the audited result. The three-level quality control system of our country to promote the policy of public construction project is almost same with the quality control system of many developed countries; however our country mainly implements such system on public construction project only, we promote the three-level quality control system is for enhancing the quality of public construction project, for establishing effective quality management system, so as to urge, correct and prevent the defects of quality management by manufacturers, whereas, those developed countries is comprehensively promoting (both public construction project and civil construction) such system. Therefore, this study is to explore the scope for public construction project only; the most important is the quality recognition by the executor, either good quality or deterioration is not a single event, there is a certain procedure extends from the demand and feasibility analysis, design, tendering, contracting, construction performance, inspection, continuous improvement, completion and acceptance, transferring and meeting the needs of the users, all of mentioned above have a causal relationship and it is a systemic problems. So the best construction quality would be manufactured and managed by reasonable cost if it is by extensive thinking and be preventive. We aggregated the implemented results in the past 10 years (2005 to 2015), the audited results of both in central units and local ones were slightly increased in A-grade while those listed in B-grade were decreased, although the levels were not evidently upgraded, yet, such result presents that the construction quality of concept of manufacturers are improving, and the construction quality has been established in the design stage, thus it is relatively beneficial to the enhancement of construction quality of overall public construction project.

Keywords: ISO 9000, three-level quality control system, audit and review mechanism for construction implementation, quality of construction implementation

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575 Contribution at Dimensioning of the Energy Dissipation Basin

Authors: M. Aouimeur

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The environmental risks of a dam and particularly the security in the Valley downstream of it,, is a very complex problem. Integrated management and risk-sharing become more and more indispensable. The definition of "vulnerability “concept can provide assistance to controlling the efficiency of protective measures and the characterization of each valley relatively to the floods's risk. Security can be enhanced through the integrated land management. The social sciences may be associated to the operational systems of civil protection, in particular warning networks. The passage of extreme floods in the site of the dam causes the rupture of this structure and important damages downstream the dam. The river bed could be damaged by erosion if it is not well protected. Also, we may encounter some scouring and flooding problems in the downstream area of the dam. Therefore, the protection of the dam is crucial. It must have an energy dissipator in a specific place. The basin of dissipation plays a very important role for the security of the dam and the protection of the environment against floods downstream the dam. It allows to dissipate the potential energy created by the dam with the passage of the extreme flood on the weir and regularize in a natural manner and with more security the discharge or elevation of the water plan on the crest of the weir, also it permits to reduce the speed of the flow downstream the dam, in order to obtain an identical speed to the river bed. The problem of the dimensioning of a classic dissipation basin is in the determination of the necessary parameters for the dimensioning of this structure. This communication presents a simple graphical method, that is fast and complete, and a methodology which determines the main features of the hydraulic jump, necessary parameters for sizing the classic dissipation basin. This graphical method takes into account the constraints imposed by the reality of the terrain or the practice such as the one related to the topography of the site, the preservation of the environment equilibrium and the technical and economic side.This methodology is to impose the loss of head DH dissipated by the hydraulic jump as a hypothesis (free design) to determine all the others parameters of classical dissipation basin. We can impose the loss of head DH dissipated by the hydraulic jump that is equal to a selected value or to a certain percentage of the upstream total head created by the dam. With the parameter DH+ =(DH/k),(k: critical depth),the elaborate graphical representation allows to find the other parameters, the multiplication of these parameters by k gives the main characteristics of the hydraulic jump, necessary parameters for the dimensioning of classic dissipation basin.This solution is often preferred for sizing the dissipation basins of small concrete dams. The results verification and their comparison to practical data, confirm the validity and reliability of the elaborate graphical method.

Keywords: dimensioning, energy dissipation basin, hydraulic jump, protection of the environment

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574 Factors Affecting Harvested Rain Water Quality and Quantity in Yatta Area, Palestine

Authors: Nibal Al-Batsh, Issam Al-Khatib, Subha Ghannam

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Yatta is the study area for this research, located 9 km south of Hebron City in the West Bank in Palestine. It has been connected to a water network since 1974 serving nearly 85% of the households. The water network is old and inadequate to meet the needs of the population. The water supply made available to the area is also very limited, estimated to be around 20 l/c.d. Residents are thus forced to rely on water vendors which supply water with a lower quality compared to municipal water while being 400% more expensive. As a cheaper and more reliable alternative, rainwater harvesting is a common practice in the area, with the majority of the households owning at least one cistern. Rainwater harvesting is of great socio-economic importance in areas where water sources are scarce or polluted. The quality of harvested rainwater used for drinking and domestic purposes in the Yatta area was assessed throughout a year long period. A total of 100 water samples were collected from (50 rainfed cisterns) with an average capacity of 69 m3, adjacent to cement-roof catchment with an average area of 145 m2. Samples were analyzed for a number of parameters including: pH, Alkalinity, Hardness, Turbidity, Total Dissolved Solids (TDS), NO3, NH4, chloride and salinity. Microbiological contents such as Total Coliforms (TC) and Fecal Coliforms (FC) bacteria were also analyzed. Results showed that most of the rainwater samples were within WHO and EPA guidelines set for chemical parameters while revealing biological contamination. The pH values of mixed water ranged from 6.9 to 8.74 with a mean value of 7.6. collected Rainwater had lower pH values than mixed water ranging from 7.00 to 7.57 with a mean of 7.21. Rainwater also had lower average values of conductivity (389.11 µScm-1) compared to that of mixed water (463.74 µScm-1) thus indicating lower values of salinity (0.75%). The largest TDS value measured in rainwater was 316 mg/l with a mean of 199.86 mg /l. As far as microbiological quality is concerned, TC and FC were detected in 99%, 52% of collected rainwater samples, respectively. The research also addressed the impact of different socio-economic attributes on rainwater harvesting using information collected through a survey from the area. Results indicated that the majority of homeowners have the primary knowledge necessary to collect and store water in cisterns. Most of the respondents clean both the cisterns and the catchment areas. However, the research also arrives at a conclusion that cleaning is not done in a proper manner. Results show that cisterns with an operating capacity of 69 m3 would provide sufficient water to get through the dry summer months. However, the catchment area must exceed 146 m2 to produce sufficient water to fill a cistern of this size in a year receiving average precipitation.

Keywords: rainwater harvesting, runoff coefficient, water quality, microbiological contamination

Procedia PDF Downloads 268
573 Mitigation of Indoor Human Exposure to Traffic-Related Fine Particulate Matter (PM₂.₅)

Authors: Ruchi Sharma, Rajasekhar Balasubramanian

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Motor vehicles emit a number of air pollutants, among which fine particulate matter (PM₂.₅) is of major concern in cities with high population density due to its negative impacts on air quality and human health. Typically, people spend more than 80% of their time indoors. Consequently, human exposure to traffic-related PM₂.₅ in indoor environments has received considerable attention. Most of the public residential buildings in tropical countries are designed for natural ventilation where indoor air quality tends to be strongly affected by the migration of air pollutants of outdoor origin. However, most of the previously reported traffic-related PM₂.₅ exposure assessment studies relied on ambient PM₂.₅ concentrations and thus, the health impact of traffic-related PM₂.₅ on occupants in naturally ventilated buildings remains largely unknown. Therefore, a systematic field study was conducted to assess indoor human exposure to traffic-related PM₂.₅ with and without mitigation measures in a typical naturally ventilated residential apartment situated near a road carrying a large volume of traffic. Three PM₂.₅ exposure scenarios were simulated in this study, i.e., Case 1: keeping all windows open with a ceiling fan on as per the usual practice, Case 2: keeping all windows fully closed as a mitigation measure, and Case 3: keeping all windows fully closed with the operation of a portable indoor air cleaner as an additional mitigation measure. The indoor to outdoor (I/O) ratios for PM₂.₅ mass concentrations were assessed and the effectiveness of using the indoor air cleaner was quantified. Additionally, potential human health risk based on the bioavailable fraction of toxic trace elements was also estimated for the three cases in order to identify a suitable mitigation measure for reducing PM₂.₅ exposure indoors. Traffic-related PM₂.₅ levels indoors exceeded the air quality guidelines (12 µg/m³) in Case 1, i.e., under natural ventilation conditions due to advective flow of outdoor air into the indoor environment. However, while using the indoor air cleaner, a significant reduction (p < 0.05) in the PM₂.₅ exposure levels was noticed indoors. Specifically, the effectiveness of the air cleaner in terms of reducing indoor PM₂.₅ exposure was estimated to be about 74%. Moreover, potential human health risk assessment also indicated a substantial reduction in potential health risk while using the air cleaner. This is the first study of its kind that evaluated the indoor human exposure to traffic-related PM₂.₅ and identified a suitable exposure mitigation measure that can be implemented in densely populated cities to realize health benefits.

Keywords: fine particulate matter, indoor air cleaner, potential human health risk, vehicular emissions

Procedia PDF Downloads 111
572 An Appraisal of Mining Sector Corporate Social Responsibility Processes in Mhondoro-Ngezi, Zimbabwe

Authors: A. T. Muruviwa

Abstract:

To-date, the discourse on corporate social responsibility (CSR) has primarily centred on the actions and inactions of corporations; hence, the dominant focus on CSR has been on impacts and outcomes. The obscuring effect of this approach has, arguably, resulted in the emergence of what may be termed a ‘Northern’ agenda on CSR theory and practice, in contrast to an emergency ‘Southern’ discourse, which appears to highlight the crucial issues of poverty reduction, infrastructure development and the broader questions of social provisioning and community empowerment. Some scholars have explicitly called for a CSR research agenda that focuses on the 'reciprocal duties' of the stakeholders in the CSR process rather than fixate on the actions and inactions of business. It is against the backdrop of these contestations that this study assesses the reciprocal relationships amongst CSR stakeholders in a Zimbabwean platinum mining town, with a view to demonstrating how such relationships – and the expectations and obligations embedded in them – impact on the success or failure of CSR initiatives. The existence of mutual relations between the corporation and its stakeholders signifies the successes of CSR processes and hence the outcomes. The company is Zimplats Mining Company; the community is Mhondoro-Ngezi, and the stakeholders are clearly identified in the study. The study utilised a triangulated design, with data collected using a mini survey, focus groups, in-depth interview and observation. The key findings are that the CSR process in the study community is dominated by the mining company. Despite the existence of a CSR framework that recognises government, local leaders and community members as legitimate stakeholders, there is little evidence of concrete contributions made by these stakeholders towards the realisation of CSR objectives. As a result, the community development process – in so far as CSR is concerned – fails to address the developmental concerns of the various stakeholders. On the basis of these findings, the study concludes that there is a crisis of reciprocity in the CSR process in Mhondoro-Ngezi, and that a situation where the conceptualisation of local development needs and the deployment of specific development tools seems to be driven by one stakeholder almost to the exclusion of all others, can only present contradictory development outcomes. The significance of this study is that it allows for the development of a more nuanced and robust CSR discourse. Rather than focusing on the corporate and stakeholder perspectives and outcomes of CSR initiatives, this study examines the CSR- development nexus by interrogating the idea of reciprocal responsibility as a sin qua non to CSR success. This analytical strategy and focus allow the researcher to gain a clear understanding of how stakeholder relationships and duties influence CSR processes and also the overall outcome. At a more practical level, the findings of the study should help to shape the policy on corporate community relationships with a view to enhancing the role of mining in development.

Keywords: community development, processes, reciprocity, stakeholders

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571 Evaluation of the Standard Practice of Availability of Anti-Tuberculosis Drugs in Community Pharmacies

Authors: Udaykumar R., M. S. Ganachari

Abstract:

In order to engage community pharmacies in Tuberculosis care, a survey has been conducted in Belgaum city, Karnataka state, India. After the survey divided into two groups one is control group and another one is intervention group. One is dispensing of anti-tuberculosis drugs, and another one is non-availability of anti-tuberculosis drugs. Those community pharmacists who are voluntarily interesting for becoming DOTS (Directly observed treatment short course) provider and RNTCP (Revised national tuberculosis control programme) objectives. Structured training is conducted for community pharmacist who are dispensing anti-tuberculosis drugs. The training module includes record maintaining, reporting to the RNTCP, Medication adherence etc. In case of non-availability of anti-tuberculosis drugs, the district RNTCP has been given training for community pharmacist by providing free of drugs to the community pharmacies. So, community pharmacies can dispense anti-tuberculosis drugs to the patients. The target of this study is Private community pharmacies. A simple random sampling method is used and 550 private community pharmacy shops has been involved in Belgaum city of Karnataka state, India. Significance of the Study: This study mainly focused on training of DOTS (Directly observed treatment short course) to the private community pharmacist. Indian Govt. Considers Private Providers as Assets for TB Control and Care to Achieve National Strategic Plan for TB Elimination 2017-2025. The Govt. has not fully tapped the Potential of Private Pharmacies to Fight TB. Providing DOTS as per patient’s convenience through community DOT Providers with periodic monitoring may reduce the treatment Default. We explore RNTCP objectives interventions that can have directly managed by private community pharmacy shop. Objectives: Survey of anti-tuberculosis drugs in Community pharmacy shop in Belgaum city. Interested community pharmacist who are willing to become DOTS (Directly observed treatment short course) Provider. Major Findings:Most of the community pharmacist are dispensing anti-tuberculosis drugs without having knowledge of DOTS therapy and RNTCP objectives. No community pharmacist is aware of RNTCP and Tuberculosis burden in India. Most of the Pharmacist agreed to come for RNTCP Training module for the community pharmacist. Some of the community pharmacist not dispensing anti-tuberculosis drugs and they agreed to become official DOTS provider. Concluding Statement: Awareness of role of community pharmacist on tuberculosis control and care has been neglected. More than 50% of tuberculosis patients seeking treatments from privatesector. In this study finds the major gap between government and private sector on tuberculosis treatment.

Keywords: community pharmacist, directly observed treatment short course(DOTS), revised national tuberculosis control programme (RNTCP), private pharmacies, anti-tuberculosis drugs

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570 Neuronal Mechanisms of Observational Motor Learning in Mice

Authors: Yi Li, Yinan Zheng, Ya Ke, Yungwing Ho

Abstract:

Motor learning is a process that frequently happens among humans and rodents, which is defined as the changes in the capability to perform a skill that is conformed to have a relatively permanent improvement through practice or experience. There are many ways to learn a behavior, among which is observational learning. Observational learning is the process of learning by watching the behaviors of others, for example, a child imitating parents, learning a new sport by watching the training videos or solving puzzles by watching the solutions. Many research explores observational learning in humans and primates. However, the neuronal mechanism of which, especially observational motor learning, was uncertain. It’s well accepted that mirror neurons are essential in the observational learning process. These neurons fire when the primate performs a goal-directed action and sees someone else demonstrating the same action, which suggests they have high firing activity both completing and watching the behavior. The mirror neurons are assumed to mediate imitation or play a critical and fundamental role in action understanding. They are distributed in many brain areas of primates, i.e., posterior parietal cortex (PPC), premotor cortex (M2), and primary motor cortex (M1) of the macaque brain. However, few researchers report the existence of mirror neurons in rodents. To verify the existence of mirror neurons and the possible role in motor learning in rodents, we performed customised string-pulling behavior combined with multiple behavior analysis methods, photometry, electrophysiology recording, c-fos staining and optogenetics in healthy mice. After five days of training, the demonstrator (demo) mice showed a significantly quicker response and shorter time to reach the string; fast, steady and accurate performance to pull down the string; and more precisely grasping the beads. During three days of observation, the mice showed more facial motions when the demo mice performed behaviors. On the first training day, the observer reduced the number of trials to find and pull the string. However, the time to find beads and pull down string were unchanged in the successful attempts on the first day and other training days, which indicated successful action understanding but failed motor learning through observation in mice. After observation, the post-hoc staining revealed that the c-fos expression was increased in the cognitive-related brain areas (medial prefrontal cortex) and motor cortices (M1, M2). In conclusion, this project indicated that the observation led to a better understanding of behaviors and activated the cognitive and motor-related brain areas, which suggested the possible existence of mirror neurons in these brain areas.

Keywords: observation, motor learning, string-pulling behavior, prefrontal cortex, motor cortex, cognitive

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569 Measuring the Level of Knowledge of Construction Contracts Procedures: A Case Study of Botswana

Authors: Babulayi B. Wilson

Abstract:

Unsatisfactory performance of construction projects in both the industrialised and developing countries indicate that there could be several defects in construction projects phases. Notwithstanding the fact that some project defects are often conceived at the initiation phase of construction projects, insufficient knowledge of contract procedures has been identified as one of the major sources of construction disputes. Contract procedures are a set of rules that outlines the primary obligations and liabilities of parties involved in the implementation of a construction project. Engineering professional bodies often codify contract procedures into standard forms of contract such as the Institution of Civil Engineers (ICE, UK) and Association of Consulting Engineers (ACE, UK) and keep them under constant review by updating any clause to reflect any change in case law or relevant piece of legislation. Even so, it is the responsibility of a professional body or conditions of contract draftsperson to introduce contract-specific clauses that may be necessary for business efficacy but not covered in the chosen standard conditions of contract. In Botswana, the use of clients’ drafted and/or un-adapted for environment of use international forms of contract in conjunction with client-drafted pricing schedules is common. The product of the latter often impact negatively upon contractors’ claims and payments, in that, tender rates and prices can only be deemed to be sufficient if the chosen conditions of contract compliment the pricing schedule (use of standardised procurement documents). In addition, client drafted and the use of borrowed forms of contract such as FIDIC often conflict with domicile law resulting in costly disputes on the part of the client. It is upon the preceding text that the object of the research is to measure the level of knowledge of contract procedures amongst key stakeholders in the Botswana construction industry by requesting a representative sample from the industry and academia to respond to tutorial questions prepared from two commonly used forms of contract for civil works, that is, FIDIC (International Form of Contract) and ICE (UK). The questions were prepared under the following captions: (a) preparation of tender documents (b) obligations of the parties (c) contract administration; and (d) claims, variations, and valuation of variations. After ascertaining that the level of knowledge of contract procedures is insufficient among most practitioners in the Botswana construction industry, major procurement entities, and engineering institutions of learning; a guide to drafting a condition of a construction contract was developed and then validated through seminars and workshops. In the present, the effectiveness of the guide is not yet measured but feedback from seminars and workshops conducted indicates an appreciation of the guide by the majority of major construction industry stakeholders.

Keywords: contract procedures, conditions of contract, professional practice, construction law, forms of contract

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