Search results for: healthcare service
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5003

Search results for: healthcare service

683 Supporting International Student’s Acculturation Through Chatbot Technology: A Proposed Study

Authors: Sylvie Studente

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Despite the increase in international students migrating to the UK, the transition from home environment to a host institution abroad can be overwhelming for many students due to acculturative stressors. These stressors are reported to peak within the first six months of transitioning into study abroad which has determinantal impacts for Higher Education Institutions. These impacts include; increased drop-out rates and overall decreases in academic performance. Research suggests that belongingness can negate acculturative stressors through providing opportunities for students to form necessary social connections. In response to this universities have focussed on utilising technology to create learning communities with the most commonly deployed being social media, blogs, and discussion forums. Despite these attempts, the application of technology in supporting international students is still ambiguous. With the reported growing popularity of mobile devices among students and accelerations in learning technology owing to the COVID-19 pandemic, the potential is recognised to address this challenge via the use of chatbot technology. Whilst traditionally, chatbots were deployed as conversational agents in business domains, they have since been applied to the field of education. Within this emerging area of research, a gap exists in addressing the educational value of chatbots over and above the traditional service orientation categorisation. The proposed study seeks to extend upon current understandings by investigating the challenges faced by international students in studying abroad and exploring the potential of chatbots as a solution to assist students’ acculturation. There has been growing interest in the application of chatbot technology to education accelerated by the shift to online learning during the COVID-19 pandemic. Although interest in educational chatbots has surged, there is a lack of consistency in the research area in terms of guidance on the design to support international students in HE. This gap is widened when considering the additional challenge of supporting multicultural international students with diverse. Diversification in education is rising due to increases in migration trends for international study. As global opportunities for education increase, so does the need for multiculturally inclusive learning support.

Keywords: chatbots, education, international students, acculturation

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682 Effect of Nigella Sativa Seeds and Ajwa Date on Blood Glucose Level in Saudi Patients with Type 2 Diabetes Mellitus

Authors: Reham Algheshairy, Khaled Tayeb, Christopher Smith, Rebecca Gregg, Haruna Musa

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Background: Diabetes is a medical condition that refers to the pancreas’ inability to secrete sufficient insulin levels, a hormone responsible for controlling glucose levels in the body. Any surplus glucose in the blood stream is excreted through the urinary system. Insulin resistance in blood cells can also cause this condition despite the fact that the pancreas is producing the required amount of insulin A number of researchers claim that the prevalence of diabetes in Saudi Arabia has reached epidemic proportions, although one study did observe one positive in the rise in the awareness of diabetes, possibly indicative of Saudi Arabia’s improving healthcare system. While a number of factors can cause diabetes, the ever-increasing incidence of the disease in Saudi Arabia has been blamed primarily on low levels of physical activity and high levels of obesity. Objectives: The project has two aims. The first aim of the project is to investigate the regulatory effects of consumption of Nigella seeds and Ajwah dates on blood glucose levels in diabetic patients with type 2 diabetes. The second aim of the project is to investigate whether these dietary factors may have potentially beneficial effects in controlling the complications that associated with type 2 diabetes. Methods: This use a random-cross intervention trail of 75 Saudi male and female with type 2 diabetes in Al-Noor hospital in Makkah ( KSA) aged between 18 and 70 years were divided into 3 groups. Group 1 will consume 2g of Nigella Sativa seeds daily along with a modified diet for 12 weeks, group 2 will be given Ajwah dates daily with a modified diet for 12 weeks and group 3 will follow a modified diet for 12 weeks. Anthropometric measurements were taken at baseline, along with bloods for HbA1c, fasting blood sugar and at the end of 12 weeks. Results: This study found significant decrease in blood level (FBG & 2PPBG) and HbA1c in the groups with diet and Nigella seeds) compared to Ajwa date. However, there is no significant change were found in HbA1c, FBG and 2hrpp regarding Ajwa group. Conclusion: This study illustrated a significant improvement in some markers of glycaemia following 2 g of Ns and diet for 12 weeks. The dose of 2g/day of consumed Nigella seeds was found to be more effective in controlling BGL and HbA1c than control and Ajwa groups. This suggests that Nigella seeds and following a diet may have a potential effect (a role in controlling outcomes for type 2 diabetes and controlling the disease). Further research is needed on a large scale to determine the optimum dose and duration of Nigella and Ajwa in order to achieve the desired results.

Keywords: type 2 diabetes, Nigella seeds, Ajwa dates, fasting blood glucose, control

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681 Industry 4.0 Platforms as 'Cluster' ecosystems for small and medium enterprises (SMEs)

Authors: Vivek Anand, Rainer Naegele

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Industry 4.0 is a global mega-trend revolutionizing the world of advanced manufacturing, but also bringing up challenges for SMEs. In response, many regional, as well as digital Industry 4.0 Platforms, have been set up to boost the competencies of established enterprises as well as SMEs. The concept of 'Clusters' is a policy tool that aims to be a starting point to establish sustainable and self-supporting structures in industries of a region by identifying competencies and supporting cluster actors with services that match their growth needs. This paper is motivated by the idea that Clusters have the potential to enable firms, particularly SMEs, to accelerate the innovation process and transition to digital technologies. In this research, the efficacy of Industry 4.0 platforms as Cluster ecosystems is evaluated, especially for SMEs. Focusing on the Baden Wurttemberg region in Germany, an action research method is employed to study how SMEs leverage other actors on Industry 4.0 Platforms to further their Industry 4.0 journeys. The aim is to evaluate how such Industry 4.0 platforms stimulate innovation, cooperation and competitiveness. Additionally, the barriers to these platforms fulfilling their promise to serve as capacity building cluster ecosystems for SMEs in a region will also be identified. The findings will be helpful for academicians and policymakers alike, who can leverage a ‘cluster policy’ to enable Industry 4.0 ecosystems in their regions. Furthermore, relevant management and policy implications stem from the analysis. This will also be of interest to the various players in a cluster ecosystem - like SMEs and service providers - who benefit from the cooperation and competition. The paper will improve the understanding of how a dialogue orientation, a bottom-up approach and active integration of all involved cluster actors enhance the potential of Industry 4.0 Platforms. A strong collaborative culture is a key driver of digital transformation and technology adoption across sectors, value chains and supply chains; and will position Industry 4.0 Platforms at the forefront of the industrial renaissance. Motivated by this argument and based on the results of the qualitative research, a roadmap will be proposed to position Industry 4.0 Platforms as effective clusters ecosystems to support Industry 4.0 adoption in a region.

Keywords: cluster policy, digital transformation, industry 4.0, innovation clusters, innovation policy, SMEs and startups

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680 The Effect of Slum Neighborhoods on Pregnancy Outcomes in Tanzania: Secondary Analysis of the 2015-2016 Tanzania Demographic and Health Survey Data

Authors: Luisa Windhagen, Atsumi Hirose, Alex Bottle

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Global urbanization has resulted in the expansion of slums, leaving over 10 million Tanzanians in urban poverty and at risk of poor health. Whilst rural residence has historically been associated with an increased risk of adverse pregnancy outcomes, recent studies found higher perinatal mortality rates in urban Tanzania. This study aims to understand to what extent slum neighborhoods may account for the spatial disparities seen in Tanzania. We generated a slum indicator based on UN-HABITAT criteria to identify slum clusters within the 2015-2016 Tanzania Demographic and Health Survey. Descriptive statistics, disaggregated by urban slum, urban non-slum, and rural areas, were produced. Simple and multivariable logistic regression examined the association between cluster residence type and neonatal mortality and stillbirth. For neonatal mortality, we additionally built a multilevel logistic regression model, adjusting for confounding and clustering. The neonatal mortality ratio was highest in slums (38.3 deaths per 1000 live births); the stillbirth rate was three times higher in slums (32.4 deaths per 1000 births) than in urban non-slums. Neonatal death was more likely to occur in slums than in urban non-slums (aOR=2.15, 95% CI=1.02-4.56) and rural areas (aOR=1.78, 95% CI=1.15-2.77). Odds of stillbirth were over five times higher among rural than urban non-slum residents (aOR=5.25, 95% CI=1.31-20.96). The results suggest that slums contribute to the urban disadvantage in Tanzanian neonatal health. Higher neonatal mortality in slums may be attributable to lack of education, lower socioeconomic status, poor healthcare access, and environmental factors, including indoor and outdoor air pollution and unsanitary conditions from inadequate housing. However, further research is required to ascertain specific causalities as well as significant associations between residence type and other pregnancy outcomes. The high neonatal mortality, stillbirth, and slum formation rates in Tanzania signify that considerable change is necessary to achieve international goals for health and human settlements. Disparities in access to adequate housing, safe water and sanitation, high standard antenatal, intrapartum, and neonatal care, and maternal education need to urgently be addressed. This study highlights the spatial neonatal mortality shift from rural settings to urban informal settlements in Tanzania. Importantly, other low- and middle-income countries experiencing overwhelming urbanization and slum expansion may also be at risk of a reversing trend in residential neonatal health differences.

Keywords: urban health, slum residence, neonatal mortality, stillbirth, global urbanisation

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679 Characters of Developing Commercial Employment Sub-Centres and Employment Density in Ahmedabad City

Authors: Bhaumik Patel, Amit Gotecha

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Commercial centres of different hierarchy and sizes play a vital role in the growth and development of the city. Economic uncertainty and demand for space leads to more urban sprawl and emerging more commercial spaces. The study was focused on the understanding of various indicators affecting the commercial development that can help to solve many issues related to commercial urban development and can guide for future employment growth centre development, Accessibility, Infrastructure, Planning and development regulations and Market forces. The aim of the study was to review characteristics and identifying employment density of Commercial Employment Sub-centres by achieving objectives Understanding various employment sub-centres, Identifying characteristics and deriving behaviour of employment densities and Evaluating and comparing employment sub-centres for the Ahmedabad city. Commercial employment sub-centres one in old city (Kalupur), second in highly developed commercial (C.G.road-Ashram road) and third in the latest developing commercial area (Prahladnagar) were identified by distance from city centre, Land use diversity, Access to Major roads and Public transport, Population density in proximity, Complimentary land uses in proximity and Land price. Commercial activities were categorised into retail, wholesale and service sector and sub categorised into various activities. From the study, Time period of establishment of the unit is a critical parameter for commercial activity, building height, and land-use diversity. Employment diversity is also one parameter for the commercial centre. The old city has retail, wholesale and trading and higher commercial density concerning units and employment both. Prahladnagar area functioned as commercial due to market pressure and developed as more units rather than a requirement. Employment density is higher in the centre of the city, as far as distance increases from city centre employment density and unit density decreases. Characters of influencing employment density and unit density are distance from city centre, development type, establishment time period, building density, unit density, public transport accessibility and road connectivity.

Keywords: commercial employment sub-centres, employment density, employment diversity, unit density

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678 [Keynote Talk]: Mental Health Challenges among Women in Dubai, Mental Health Needs Assessment for Dubai (2015), Public Health and Safety Department - Dubai Health Authority (DHA)

Authors: Kadhim Alabady

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Purpose: Mental health problems affect women and men equally, but some are more common among women. To Provide a baseline of the current picture of major mental health challenges among women in Dubai. which can then be used to measure the impact of interventions or service development. Method: We have used mixed methods evaluation approaches. This was used to increase the validity of findings by using a variety of data collection techniques. We have integrated qualitative and quantitative methods in this piece of work. Conducting the two approaches is to explore issues that might not be highlighted enough through one method. Results: The key findings are: The prevalence of people who suffer from different types of mental disorders remains largely unknown, many women are unwilling to seek professional help because of lack of awareness or the stigma attached to it. -It is estimated there were around 2,928–4,392 mothers in Dubai (2014) suffering from postnatal depression of which 858–1,287, early intervention can be effective. -The system for managing health care for women with mental illness is fragmented and contains gaps and duplications. -It is estimated 1,029 girl aged 13–19 years affected with anorexia nervosa and there would be an estimated 1,029 girl aged 13–19 years affected with anorexia nervosa. Recommendations: -Work is required with primary health care in order to identify women with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. -It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions that are not routinely collected to get a clear sense of what is needed and to assist decision and policy making in getting a complete picture on what services are required. -Emergency Mental Health Care – there is a need for a crisis response team to respond to emergencies in the community. -Continuum of care – a significant gap in the services for women once they diagnosed with mental disorder.

Keywords: mental health, depression, schizophrenia, women

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677 Use of Telephone Counselling in Employee Assistance Program

Authors: Andy S.K. Cheng, Samuel Leung, Cindy Kwok, Hector Tsang

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Background: Telephone counselling is one of the essential interventions that can be found in most of the Employee Assistance Programs (EAP). The purposes of this study were to (1) explore the trend of the telephone counselling from 2003-2016 in Hong Kong; (2) explore which EAP issue requires more follow-up; and 3) examine the relationship between the EAP issues and demographic data such as gender and job ranking. Method: Date of EAP services usage was collected from EAP providers in Hong Kong during 2003-2016. EAP issues were categorized into two domains, namely workplace issues and personal issues. Each domain has 12 sub-categories. Two hypotheses were formulated in this study (1) there was a gender difference in EAP issues and the follow-up hours; and (2) there was a significant difference between job ranking, EAP issues and follow-up hours. Results: A total of eight hundred and ninety-three valid cases were identified for analysis. Of them, three hundred and forty-three cases sought for follow-up. The duration of follow-up by hours was calculated for each of the follow-up cases. The results of the study shows that the top three workplace issues that required the longest duration of follow-up were (1) workload, (2) supervisor-subordinate relationship; and (3) team member’s relationship. On the other hand, the top three personal issues that required the longest duration of follow-up were (1) parenting/parent-child relationship, (2) family care, and (3) marital relationship. Two-way ANOVA was performed to compare the total follow-up hours (excluding first intake) between gender and EAP issues. There was no statistical significance for gender (p =.891), but a statistically significant main effect for EAP issues (p <.001) was found. Post-hoc analysis (Tukey’s test) showed that total follow-up hour in personal issues was statistically significant higher than that in handling workplace issues (p <.001). However, there was no statistically significant interaction effect between gender and EAP issues (p=.879) and between job ranking and EAP issues (p=.843). Conclusion: Telephone counselling is a very common intervention in addressing EAP issues arising from workplace and personal level in Hong Kong. It was frequently used to handle interpersonal relationships and the service usage was independent of gender and job ranking.

Keywords: employee assistance program, follow-up time, interpersonal relationships, telephone counselling

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676 Disabled Young People’s Hopes and Dreams in a Rapidly Changing Society: Co-Production Peer Research

Authors: Tillie Curran

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This co-production project aimed for an expansive exploration of disabled young people’s hopes and dreams in the context of unprecedented societal changes. The research questions developed with disabled young people acting as peer researchers, ask ‘what does a good life look like now, and, what are your hopes and dreams for the future?’ Disabled children’s childhood studies and an asset-based approach placed the voice of disabled young people at the centre of the research process and inviting participants to ‘think big’! Over 18 months, academics, members of a Centre for Independent Living and peer researchers, came together to facilitate knowledge cafes with fifty disabled young people aged between 14 and 25 in a college and youth club setting. Methods used included trigger questions, photos voice, video, and cartooning. The peer researchers also investigated how house robots and connected autonomous vehicles might support their future aspirations and sense of freedom in this new era with a trip to the university robotic laboratory. Key themes arising from participants’ hopes and dream were about ‘being responsible’, ‘loving’, ‘freedom and happiness’ and a ‘strong sense of self and togetherness’ and suggest alternative narratives and rich visions of the future possibilities for disabled young people. The five key messages peer researchers produced for the report emphasised freedom to define their futures, desires to make the world a better place, to belong and have the chance of their own family life. Thematic analysis, production of the report and impact activities were all co-produced and as the project progressed peer researchers increasingly demonstrated a role as ‘change makers’ and have formed a young people’s co-production group going on into the future. Discussion of the project highlights the factors that made these processes successful and the ethical dilemmas encountered in the context of normalcy. Finally, we consider the implications for all involved as we rethink ‘the future’, not in terms of normative ideals or trajectories, or seeing service ‘transition’ as an end, but in terms of disabled young people’s contribution, participation, freedoms, and possibilities.

Keywords: co-production, disability, robotic, youth

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675 Sero-Prevalence of Hepatitis B Surface Antigen and Associated Factors among Pregnant Mothers Attending Antenatal Care Service, Mekelle, Ethiopia: Evidence from Institutional Based Quantitative Cross-Sectional Study

Authors: Semaw A., Awet H., Yohannes M.

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Background: Hepatitis B Virus (HBV) is a major global public health problem. Individuals living in Sub-Sahara Africa have 60% lifetime risk of acquiring HBV infection. Evidences showed that 80-90% of those born from infected mothers developed chronic HBV. Perinatal HBV transmission is a major determinant of HBV carrier status, its chronic squeal and maintains HBV transmission across generations. Method: Institution based cross-sectional study was conducted among 406 pregnant mothers attending Antenatal clinics at Mekelle and Ayder referral hospital from January 30 to April 1/2014. Epidata version 3.1 was used for data entry and SPSS version 21 statistical software was used for data cleaning, management and finally determine associated factors of hepatitis B surface antigen adjusting important confounders using multivariable logistic regression analysis at 5% level of significance. Result: The overall prevalence of hepatitis B surface antigen among pregnant women was 33 (8.1%). The socio-demographic characteristic of the study population showed that there is high positivity among secondary school 189 (46.6%). In the multivariable logistic regression analysis, history of a contact with individuals who had history of hepatitis B infection or jaundice and lifetime number of multiple sexual partners were found to be significantly associated with HBsAg positivity at AOR = 3.73 95%C.I (1.373-10.182) and AOR = 2.57 95%C.I (1.173-5.654), respectively. Moreover, Human Immunodeficiency Virus (HIV) and HBV confection rate was found 3.6%. Conclusion: This study has shown that HBV prevalence in pregnant women is highly prevalent (8.1%) in the study area. Contact with individuals who had a history of hepatitis or have jaundice and report of multiple lifetime sexual partnership were associated with hepatitis B infection. Education about HBV transmission and prevention as well as screening all pregnant mothers shall be sought to reduce the serious public health crisis of HBV.

Keywords: HBsAg, hepatitis B, pregnant women, prevalence

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674 Informing, Enabling and Inspiring Social Innovation by Geographic Systems Mapping: A Case Study in Workforce Development

Authors: Cassandra A. Skinner, Linda R. Chamberlain

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The nonprofit and public sectors are increasingly turning to Geographic Information Systems for data visualizations which can better inform programmatic and policy decisions. Additionally, the private and nonprofit sectors are turning to systems mapping to better understand the ecosystems within which they operate. This study explores the potential which combining these data visualization methods—a method which is called geographic systems mapping—to create an exhaustive and comprehensive understanding of a social problem’s ecosystem may have in social innovation efforts. Researchers with Grand Valley State University collaborated with Talent 2025 of West Michigan to conduct a mixed-methods research study to paint a comprehensive picture of the workforce development ecosystem in West Michigan. Using semi-structured interviewing, observation, secondary research, and quantitative analysis, data were compiled on workforce development organizations’ locations, programming, metrics for success, partnerships, funding sources, and service language. To best visualize and disseminate the data, a geographic system map was created which identifies programmatic, operational, and geographic gaps in workforce development services of West Michigan. By combining geographic and systems mapping methods, the geographic system map provides insight into the cross-sector relationships, collaboration, and competition which exists among and between workforce development organizations. These insights identify opportunities for and constraints around cross-sectoral social innovation in the West Michigan workforce development ecosystem. This paper will discuss the process utilized to prepare the geographic systems map, explain the results and outcomes, and demonstrate how geographic systems mapping illuminated the needs of the community and opportunities for social innovation. As complicated social problems like unemployment often require cross-sectoral and multi-stakeholder solutions, there is potential for geographic systems mapping to be a tool which informs, enables, and inspires these solutions.

Keywords: cross-sector collaboration, data visualization, geographic systems mapping, social innovation, workforce development

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673 The Moderating Role of Payment Platform Applications’ Relationship with Increasing Purchase Intention Among Customers in Kuwait - Unified Theory of Acceptance and Sustainable Use of Technology Model

Authors: Ahmad Alsaber

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This paper aims to understand the intermediary role of the payment platform applications by analyzing the various factors that can influence the desirability of utilizing said payment services in Kuwait, as well as to determine the effect of the presence of different types of payment platforms on the variables of the “Unified Theory of Acceptance and Use of Technology” (UTAUT) model. The UTAUT model's findings will provide an important understanding of the moderating role of payment platform mobile applications. This study will explore the influence of payment platform mobile applications on customer purchase intentions in Kuwait by employing a quantitative survey of 200 local customers. Questions will cover their usage of payment platforms, purchase intent, and overall satisfaction. The information gathered is then analyzed using descriptive statistics and correlation analysis in order to gain insights. The research hopes to provide greater insight into the effect of mobile payment platforms on customer purchase intentions in Kuwait. This research will provide important implications to marketers and customer service providers, informing their strategies and initiatives, as well as offer recommendations to payment platform providers on how to improve customer satisfaction and security. The study results suggest that the likelihood of a purchase is affected by performance expectancy, effort expectancy, social influence, risk, and trust. The purpose of this research is to understand the advancements in the different variables that Kuwaiti customers consider while dealing with mobile banking applications. With the implementation of stronger security measures, progressively more payment platform applications are being utilized in the Kuwaiti marketplace, making them more desirable with their accessibility and usability. With the development of the Kuwaiti digital economy, it is expected that mobile banking will have a greater impact on banking transactions and services in the future.

Keywords: purchase intention, UTAUT, performance expectancy, social influence, risk, trust

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672 Interprofessional School-Based Mental Health Services for Rural Adolescents in South Australia

Authors: Garreth Kestell, Lukah Dykes, Danielle Zerk, Kyla Trewartha, Rhianon Marshall, Elena Rudnik

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Adolescent mental health is an international priority and the impact of innovative service models must be evaluated. Secondary school-based mental health services (SBMHS) involving private general practitioners and psychologists are a model of care being trialed in South Australia. Measures of depression, anxiety, and stress are routinely collected throughout psychotherapy sessions. This research set out to quantify the impact of psychotherapy for rural adolescents in a school setting and explore the importance of session frequency. Methods: Demographics, session date and DASS21 scores from students (n=65) seen in 2016 by three psychologists working at the SBMHS were recorded. Students were aged 13-18 years (M=15.43, SD= 1.24), mostly female (F=51, M=14), attended between 1 and 23 sessions with a median of 6 sessions (MAD 5.93) in one-year. The treating psychologist collected self-administered DASS21 scores. A mixed model analysis was used with age, sex, treating psychologist, months from first session, and session number as fixed effects, with response variables of DASS depression, anxiety, and stress scores. Results: 71.5% were classified as having extreme or severe anxiety and half had extreme or severe depression and/or stress scores. On average males had a greater increase in DASS scores over time but males attending more sessions benefited most from therapy. Discussion: Psychologists are treating rural adolescents in schools for severe anxiety, depression, and stress. This pilot study indicates that a predictive model combining demographics, session frequency, and DASS scores may help identify who is most likely to benefit from individual psychotherapy. Variations in DAS scores of individuals over time indicate the need for the collection of information such as living situation and exposure to alcohol. A larger sample size and additional data are currently being collected to allow for a more robust analysis.

Keywords: adolescent health, psychotherapy, school based mental health services, DAS21

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671 Belonging in South Africa: Networks among African Immigrants and South African Natives

Authors: Efe Mary Isike

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The variety of relationships between migrants and host communities is an enduring theme of migration studies. On one extreme, there are numerous examples of hostility towards ‘strangers’ who are either ejected from society or denied access to jobs, housing, education, healthcare and other aspects of normal life. More moderate treatments of those identified as different include expectations of assimilation in which host communities expect socially marginalized groups to conform to norms that they define. Both exclusion and assimilation attempt to manage the problem of difference by removing it. South Africa experienced great influx of African immigrants who worked in mines and farms under harsh and exploitative conditions before and after the institutionalization of apartheid. Although these labour migrants contributed a great deal to the economic development of South Africa, they were not given citizenship status. The formal democratization in 1994 came with dreams and expectations of a more inclusive South Africa, where black South Africans hoped to maximize their potential in a more free, fair and equal society. In the same vein, it also opened spaces for an influx of especially African immigrants into the country which set the stage for a new form of contest for belonging between South African citizens and African migrant settlers. One major manifestation of this contest was the violent xenophobic attacks against African immigrants which predate that of May 2008 and has continued with lower intensity across the country since then. While it is doubtless possible to find abundant evidence of antagonism in the relations between South Africans and African immigrants, the purpose of this study is to investigate the everyday realities of migrants in ordinary places who interact with a variety of people through their livelihood activities, marriages and social relationships, moving around towns and cities, in their residential areas, in faith-based organizations and other elements of everyday life. Rather than assuming all relations are hostile, this study intends to look at the breadth of everyday relationships within a specific context. Based on the foregoing, the main task of this study is to holistically examine and explain the nature of interactions between African migrants and South African citizens by analysing the social network ties that connect them in the specific case of Umhlathuze municipality. It will also investigate the variety of networks that exists between African migrants and South Africans and examine the nature of the linkages in the various networks identified between these two groups in Umhlathuze Municipality. Apart from a review of relevant literature, policies and other official documents, this paper will employ a purposive sample survey and in-depth interview of African immigrants and South Africans within their networks in selected suburbs in KwaZulu-Natal.

Keywords: migration, networks, development, host communities

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670 The Effect of the Contributory Pension Scheme on Employees’ Performance

Authors: Oladipo Jimoh Ayanda, Fashagba Mathew Olasehinde

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Pension is a post retirement benefit paid to employees after retirement to cushion the effects of severance from monthly emoluments. It serves the dual purpose of providing financial succour to retired employees as well as motivating employees currently in service to greater performance on duty. However, the scheme, as operated in Nigeria, is prone to some pitfalls such as delayed and irregular payments, inadequate budgetary provisions, employee sufferings and deaths arising from the rigors of verification exercises, among others. This necessitated the replacement of the old scheme with the contributory pension scheme through an enabling law in 2004. The implementation of the new scheme has its own challenges especially in connection with administration. These challenges pose a fundamental problem of establishing a nexus between pension benefits and work performance which represent the focus of the study. The study objectives were to: determine the effect of contributory pension scheme on employees’ performance. The study population consisted of National Universities Commission recognized public and private universities in the South West Nigeria. Multi-stage sampling method involving stratified sampling and systematic sampling was used in selecting 359 respondents while data were collected through questionnaire administration. The procedure for analyzing the data included descriptive statistic, normal distribution test and cross-tabulation (gamma coefficient). The findings of the study showed that the existence of the scheme positively enhances employees’ performance as indicated by normal distribution test with Z-score (10.169) which is greater than the table value (1.96) at 0.05 level. The study concluded that the scope for enhancing employee current job performance can be quite elastic if future retirement benefits are guaranteed through proper and efficient administration and management of the contributory pension scheme. The study recommended that certain factors such as employers’ commitment which account for different levels of confidence between public and private universities should be looked into in order to improve confidence across board while the provisions of the scheme as they affect the PFAs should be properly monitored to ensure compliance.

Keywords: pension, retirement, performance, employees, benefit

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669 Open Innovation for Crowdsourced Product Development: The Case Study of Quirky.com

Authors: Ana Bilandzic, Marcus Foth, Greg Hearn

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In a narrow sense, innovation is the invention and commercialisation of a new product or service in the marketplace. The literature suggests places that support knowledge exchange and social interaction, e.g. coffee shops, to nurture innovative ideas. With the widespread success of Internet, interpersonal communication and interaction changed. Online platforms complement physical places for idea exchange and innovation – the rise of hybrid, ‘net localities.’ Further, since its introduction in 2003 by Chesbrough, the concept of open innovation received increased attention as a topic in academic research as well as an innovation strategy applied by companies. Open innovation allows companies to seek and release intellectual property and new ideas from outside of their own company. As a consequence, the innovation process is no longer only managed within the company, but it is pursued in a co-creation process with customers, suppliers, and other stakeholders. Quirky.com (Quirky), a company founded by Ben Kaufman in 2009, recognised the opportunity given by the Internet for knowledge exchange and open innovation. Quirky developed an online platform that makes innovation available to everyone. This paper reports on a study that analysed Quirky’s business process in an extended event-driven process chain (eEPC). The aim was to determine how the platform enabled crowdsourced innovation for physical products on the Internet. The analysis reveals that key elements of the business model are based on open innovation. Quirky is an example of how open innovation can support crowdsourced and crowdfunded product ideation, development and selling. The company opened up various stages in the innovation process to its members to contribute in the product development, e.g. product ideation, design, and market research. Throughout the process, members earn influence through participating in the product development. Based on the influence they receive, shares on the product’s turnover. The outcomes of the study’s analysis highlighted certain benefits of open innovation for product development. The paper concludes with recommendations for future research to look into opportunities of open innovation approaches to be adopted by tertiary institutions as a novel way to commercialise research intellectual property.

Keywords: business process, crowdsourced innovation, open innovation, Quirky

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668 Critical Appraisal, Smart City Initiative: China vs. India

Authors: Suneet Jagdev, Siddharth Singhal, Dhrubajyoti Bordoloi, Peesari Vamshidhar Reddy

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There is no universally accepted definition of what constitutes a Smart City. It means different things to different people. The definition varies from place to place depending on the level of development and the willingness of people to change and reform. It tries to improve the quality of resource management and service provisions for the people living in the cities. Smart city is an urban development vision to integrate multiple information and communication technology (ICT) solutions in a secure fashion to manage the assets of a city. But most of these projects are misinterpreted as being technology projects only. Due to urbanization, a lot of informal as well government funded settlements have come up during the last few decades, thus increasing the consumption of the limited resources available. The people of each city have their own definition of Smart City. In the imagination of any city dweller in India is the picture of a Smart City which contains a wish list of infrastructure and services that describe his or her level of aspiration. The research involved a comparative study of the Smart City models in India and in China. Behavioral changes experienced by the people living in the pilot/first ever smart cities have been identified and compared. This paper discussed what is the target of the quality of life for the people in India and in China and how well could that be realized with the facilities being included in these Smart City projects. Logical and comparative analyses of important data have been done, collected from government sources, government papers and research papers by various experts on the topic. Existing cities with historically grown infrastructure and administration systems will require a more moderate step-by-step approach to modernization. The models were compared using many different motivators and the data is collected from past journals, interacting with the people involved, videos and past submissions. In conclusion, we have identified how these projects could be combined with the ongoing small scale initiatives by the local people/ small group of individuals and what might be the outcome if these existing practices were implemented on a bigger scale.

Keywords: behavior change, mission monitoring, pilot smart cities, social capital

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667 Transit Facility Planning in Fringe Areas of Kolkata Metropolitan Region

Authors: Soumen Mitra, Aparna Saha

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The perceived link between the city and the countryside is evolving rapidly and is getting shifted away from the assumptions of mainstream paradigms to new conceptual networks where rural-urban links are being redefined. In this conceptual field, the fringe interface is still considered as a transitional zone between city and countryside, and is defined as a diffused area rather than a discrete territory. In developing countries fringe areas are said to have both rural and urban characteristics but are devoid of basic municipal facilities. Again, when the urban core areas envelopes the fringe areas along with it the character of fringe changes but services are not well facilitated which in turn results to uneven growth, rapid and haphazard development. One of the major services present in fringe areas is inter-linkages in terms of transit corridors. Planning for the appropriate and sustainable future of fringe areas requires a sheer focus on these corridors pertaining to transit facility, for better accessibility and mobility. Inducing a transit facility plan enhances the various facilities and also increases their proximity for user groups. The study focuses on the western fringe region of Kolkata metropolis which is a major source of industrial hub and housing sector, thus converting the agricultural lands into non-agricultural use. The study emphasizes on providing transit facilities both physical (stops, sheds, terminals, etc.) and operational (ticketing system, route prioritization, integration of transit modes, etc.), to facilitate the region as well as accelerate the growth pattern systematically. Hence, the scope of this work is on the basis of prevailing conditions in fringe areas and attempts for an effective transit facility plan. The strategies and recommendations are in terms of road widening, service coverage, feeder route prioritization, bus stops facilitation, pedestrian facilities, etc, which in turn enhances the region’s growth pattern. Thus, this context of transit facility planning acts as a catalytic agent to avoid the future unplanned growth and accelerates it towards an integrated development.

Keywords: feeder route, fringe, municipal planning, transit facility

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666 Tale of Massive Distressed Migration from Rural to Urban Areas: A Study of Mumbai City

Authors: Vidya Yadav

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Migration is the demographic process that links rural to urban areas, generating or spurring the growth of cities. Evidence shows the role of the city as a production processes. It looks the city as a power of centre, and a centre of change. It has been observed that not only the professionals want to settle down in an urban area but rural labourers are also coming to cities for employment. These are the people who are compelled to migrate to metropolises because of lack of employment opportunities in their place of residence. However, the cities also fail to provide adequate employment because of limited job opportunity creation and capital-intensive industrialization. So these masses of incoming migrants are force to take up whatever employment absorption is available to them particularly in urban informal activities. Ultimately with this informal job they are compelled to stay in the slum areas, which is another form of deprived housing colonies. The paper seeks to examine the evidences of poverty induced migration from rural to urban areas (particularly in urban agglomeration). The present paper utilizes an abundant rich source of census migration data (D-Series) of 1991-2001. Result shows that Mumbai remain as the most attractive place to migrate. The migrants are mainly from the major states like Uttar Pradesh, Bihar, West Bengal, Jharkhand, Odisha, and Rajasthan. Male dominated migration is related mostly for employment and females due to marriages. The picture of occupational absorption of migrants who moved for employment, cross classified with educational status. Result shows that illiterate males are primarily engaged in low grade production processing work. Illiterate’s females engaged in service sectors; but these are actually very low grade services in urban informal sectors in India like maid servants, domestic help, hawkers, vendors or vegetables sellers. Among the higher educational level, a small percentage of males and females got absorbed in professional or clerical work but the percentage has been increased in the period 1991-2001.

Keywords: informal, job, migration, urban

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665 Women’s Experience of Managing Pre-Existing Lymphoedema during Pregnancy and the Early Postnatal Period

Authors: Kim Toyer, Belinda Thompson, Louise Koelmeyer

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Lymphoedema is a chronic condition caused by dysfunction of the lymphatic system, which limits the drainage of fluid and tissue waste from the interstitial space of the affected body part. The normal physiological changes in pregnancy cause an increased load on a normal lymphatic system which can result in a transient lymphatic overload (oedema). The interaction between lymphoedema and pregnancy oedema is unclear. Women with pre-existing lymphoedema require accurate information and additional strategies to manage their lymphoedema during pregnancy. Currently, no resources are available to guide women or their healthcare providers with accurate advice and additional management strategies for coping with lymphoedema during pregnancy until they have recovered postnatally. This study explored the experiences of Australian women with pre-existing lymphoedema during recent pregnancy and the early postnatal period to determine how their usual lymphoedema management strategies were adapted and what were their additional or unmet needs. Interactions with their obstetric care providers, the hospital maternity services, and usual lymphoedema therapy services were detailed. Participants were sourced from several Australian lymphoedema community groups, including therapist networks. Opportunistic sampling is appropriate to explore this topic in a small target population as lymphoedema in women of childbearing age is uncommon, with prevalence data unavailable. Inclusion criteria were aged over 18 years, diagnosed with primary or secondary lymphoedema of the arm or leg, pregnant within the preceding ten years (since 2012), and had their pregnancy and postnatal care in Australia. Exclusion criteria were a diagnosis of lipedema and if unable to read or understand a reasonable level of English. A mixed-method qualitative design was used in two phases. This involved an online survey (REDCap platform) of the participants followed by online semi-structured interviews or focus groups to provide the transcript data for inductive thematic analysis to gain an in-depth understanding of issues raised. Women with well-managed pre-existing lymphoedema coped well with the additional oedema load of pregnancy; however, those with limited access to quality conservative care prior to pregnancy were found to be significantly impacted by pregnancy, including many reporting deterioration of their chronic lymphoedema. Misinformation and a lack of support increased fear and apprehension in planning and enjoying their pregnancy experience. Collaboration between maternity and lymphoedema therapy services did not happen despite study participants suggesting it. Helpful resources and unmet needs were identified in the recent Australian context to inform further research and the development of resources to assist women with lymphoedema who are considering or are pregnant and their supporters, including health care providers.

Keywords: lymphoedema, management strategies, pregnancy, qualitative

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664 Artificial Neural Network Based Model for Detecting Attacks in Smart Grid Cloud

Authors: Sandeep Mehmi, Harsh Verma, A. L. Sangal

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Ever since the idea of using computing services as commodity that can be delivered like other utilities e.g. electric and telephone has been floated, the scientific fraternity has diverted their research towards a new area called utility computing. New paradigms like cluster computing and grid computing came into existence while edging closer to utility computing. With the advent of internet the demand of anytime, anywhere access of the resources that could be provisioned dynamically as a service, gave rise to the next generation computing paradigm known as cloud computing. Today, cloud computing has become one of the most aggressively growing computer paradigm, resulting in growing rate of applications in area of IT outsourcing. Besides catering the computational and storage demands, cloud computing has economically benefitted almost all the fields, education, research, entertainment, medical, banking, military operations, weather forecasting, business and finance to name a few. Smart grid is another discipline that direly needs to be benefitted from the cloud computing advantages. Smart grid system is a new technology that has revolutionized the power sector by automating the transmission and distribution system and integration of smart devices. Cloud based smart grid can fulfill the storage requirement of unstructured and uncorrelated data generated by smart sensors as well as computational needs for self-healing, load balancing and demand response features. But, security issues such as confidentiality, integrity, availability, accountability and privacy need to be resolved for the development of smart grid cloud. In recent years, a number of intrusion prevention techniques have been proposed in the cloud, but hackers/intruders still manage to bypass the security of the cloud. Therefore, precise intrusion detection systems need to be developed in order to secure the critical information infrastructure like smart grid cloud. Considering the success of artificial neural networks in building robust intrusion detection, this research proposes an artificial neural network based model for detecting attacks in smart grid cloud.

Keywords: artificial neural networks, cloud computing, intrusion detection systems, security issues, smart grid

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663 Spirituality, Sense of Community and Economic Welfare: A Case of Mawlynnong Village, India

Authors: Ricky A. J. Syngkon, Santi Gopal Maji

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Decent work and inclusive economic growth, social development, environmental protection, eradication of poverty and hunger as well as clean water and sanitation are the rudiments of 2030 agenda of sustainable development goals of the United Nations. On the other hand, spirituality is deeply entwined in the fabric of daily lives that helps in shaping attitudes, opinions, and behaviors of common people and ensuring quality of lives and overall sustainable development through protection of environment and natural resources. Mawlynnong, a small village in North-Eastern part of India, is a vivid example of how spirituality influences the development of sense of community leading to upliftment of the economic conditions of the people. Mawlynnong as a small hamlet has been in existence for a couple of centuries and it was acknowledged as the cleanest village of Asia in 2004 by BBC and National Geographic and subsequently endorsed by UNESCO in 2006. Consequently, it has attracted large number of tourists over the years from India and other parts of the world. This paper tries to explore how spirituality leads to a sense of community and the economic benefits for the people. Further, this paper also tries to find out the answer whether such an informal collective effort is sustainable or not for achieving solidarity economy. The study is based on both primary and secondary data collected from the local people and the State Government records. The findings of the study indicate that over the last one and a half decade the tourist footfall has increased to a great extent in Mawlynnong and this has brought about a paradigm shift in the occupational structure of its inhabitants from plantation to service sector particularly tourism and tourism related activities. As a result, from the economic standpoint, it is observed that life is much better off now as compared to before. But from the socio-cultural standpoint, the study finds a drift in terms of the cohesiveness and community bonding which was the hallmark of this village. This drift puts a question mark about the sustainability of such practices and consequently the development of solidarity economy.

Keywords: spirituality, sense of community, economic welfare, solidarity economy, Mawlynnong village

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662 The Spatial Potential of the Croatian Adriatic Area for the Development of an Indigenous Form of Cruising Tourism - Mini Croatian Cruiser

Authors: Srećko Favro, Dora Mužinić

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The eastern coast of the Adriatic Sea has been a significant part of the most important traffic corridors since Antiquity due to its position as the deepest indented bay of the Mediterranean and numerous bays on the coast and is-lands. The central place throughout history was occupied by the central part - Split-Dalmatia County, with its center in Antica in Salona and later in Split. Nowadays, in addition to its traffic and economic importance, this area is also important for tourism, an area where Croatia develops its economy and realizing its economic growth. Nautical tourism is the most important form of the tourist economic sector that uses the geographical features of the Croatian Adriatic water area and achieves the greatest growth based on tour-ist trends in the world (coronavirus - separation from the masses, adventure tourism - own arrangements) and thus opens up the possibility of develop-ment for other parts of the tourist economy. This will be described in the ex-ample of the business of the Split-Dalmatia County shipping company from Krilo Jesenice, which operates as a mini-cruising service provider, the lead-ing form of cruising in Croatia. The advantages that this type of tourism provides to travelers in terms of customized itineraries, high-quality services, an intimate atmosphere, and a unique experience through familiarization with local culture and tradition will be considered. Through direct primary research and analysis of available secondary research data, an attempt will be made to show how traditional Croatian mini cruisers manage to stand out in a competitive tourist environment. Their impact on the local economy, sus-tainability, and environmental protection will be considered, as well as how they are integrated into the tourist offer of other destinations in Croatia. In addition, the challenges and opportunities that arise in the maintenance and development of traditional Croatian mini cruisers will be discussed, includ-ing issues such as infrastructure, staff training, and market trends.

Keywords: croatia, adriatic, cruising, nautical tourism, mini cruise

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661 Opportunities and Challenges of Digital Diplomacy in the Public Diplomacy of the Islamic Republic of Iran

Authors: Somayeh Pashaee

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The ever-increasing growth of the Internet and the development of information and communication technology have prompted the politicians of different countries to use virtual networks as an efficient tool for their foreign policy. The communication of governments and countries, even in the farthest places from each other, through electronic networks, has caused vast changes in the way of statecraft and governance. Importantly, in the meantime, diplomacy, which is always based on information and communication, has been affected by the new prevailing conditions and new technologies more than other areas and has faced greater changes. The emergence of virtual space and the formation of new communication tools in the field of public diplomacy has led to the redefinition of the framework of diplomacy and politics in the international arena and the appearance of a new aspect of diplomacy called digital diplomacy. Digital diplomacy is in the concept of changing relations from a face-to-face and traditional way to a non-face-to-face and new way, and its purpose is to solve foreign policy issues using virtual space. Digital diplomacy, by affecting diplomatic procedures and its change, explains the role of technology in the visualization and implementation of diplomacy in different ways. The purpose of this paper is to investigate the position of digital diplomacy in the public diplomacy of the Islamic Republic of Iran. The paper tries to answer these two questions in a descriptive-analytical way, considering the progress of communication and the role of virtual space in the service of diplomacy, what is the approach of the Islamic Republic of Iran towards digital diplomacy and the use of a new way of establishing foreign relations in public diplomacy? What capacities and damages are facing the country after the use of this type of new diplomacy? In this paper, various theoretical concepts in the field of public diplomacy and modern diplomacy, including Geoff Berridge, Charles Kegley, Hans Tuch and Ronald Peter Barston, as well as the theoretical framework of Marcus Holmes on digital diplomacy, will be used as a conceptual basis to support the analysis. As a result, in order to better achieve the political goals of the country, especially in foreign policy, the approach of the Islamic Republic of Iran to public diplomacy with a focus on digital diplomacy should be strengthened and revised. Today, only emphasizing on advancing diplomacy through traditional methods may weaken Iran's position in the public opinion level from other countries.

Keywords: digital diplomacy, public diplomacy, islamic republic of Iran, foreign policy, opportunities and challenges

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660 Family and Community Care for the Elderly: An Implementation Research in Local Community, Thailand

Authors: Sumattana Glangkarn, Vorapoj Promasatayaprot

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Background: Proportion of population ageing in Thailand has been increased rapidly in the past decades according to living longer and the fertility rates have decreased. The most important challenge related to this situation is to consider how to improve quality and years of healthy of life. This study aimed to implement the older persons’ long term care (LTC) system for elderly care by family and community. Method: The Consolidated Framework for Implementation Research (CFIR) was employed for guiding and evaluating an implementation process in ageing care. The CFIR composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Results: most elderly participants were couples, educating primary school and living with children and grandchildren. More than half of them had chronic diseases such as diabetes mellitus and hypertension. Factor analysis revealed factors related to health care of older participants which consisted of exercise, diet, accidental prevention, relaxation, self-care capacity, joyfulness, family relationship, and personal hygiene. A pre-implementation phase showed intervention characteristics included facilities and services of the LTC policy from the Ministry of Public Health. The complexities of the LTC and relative advantages were explained. Community leaders, public health volunteers, care givers and health professionals had participated in the LTC activities. Outer and inner settings consisted of context of community, culture, and readiness. Characteristics of the individuals related to knowledge, self-efficacy, perceptions, and believes. The process consisted of planning, acting, observing, and reflecting. The implementation outcomes and service outcomes had been evaluated during-implementation phase. Conclusion: the participation of caregivers, community leaders, public health volunteers, and health professionals had supported the LTC services. Thus, family and community care could improve quality of life of the ageing.

Keywords: ageing, CFIR, long term care, implementation

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659 Access to Financial Services to Rural Poor in Nepal: Challenges and Way Forward

Authors: Krishna Prasad Sharma

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Nepal’s financial sector has become deeper and wider, and the number and types of financial intermediaries have grown rapidly over the past two decades. However, access to financial services remains limited for many people in many parts of rural Nepal. While financial institutions have been expanding rapidly in an urban area in recent years, the access to the rural poor is excessively inadequate due to financial illiteracy and limited numbers of financial institutions that confined only to the district headquarters. Based on the focus group discussion, semi-structured interview of key people and literature review, this paper aims to examine the supply of and demand for financial services in Nepal and the constraints to increasing access to them, and offers way forward for making the financial sector work for all of Nepal’s people, especially the rural poor. While Nepal’s government has tried to increase access to formal financial services for small businesses and low-income households through directed lending programs for small businesses and low-income households, created specialized wholesale and retail institutions, and lowered market entry requirements, formal financial services are declining, and financial intermediation is stagnating. Supply and demand indicators show that, despite government efforts, formal financial institutions do not serve the needs of most of the Nepalese population. While access to and use of formal financial services are limited, in general, the problem is acute for small businesses and low-income households. Indeed, both access and use are closely correlated with business loan size and household income. This study concludes that banks and microfinance institutions with the use of mobile phones can connect hundreds of millions of unbanked and low-income people, especially rural poor to financial services at low costs. While there are many challenges ahead in expanding the service to rural areas, the mobile financial services will be beneficial that makes payments faster and cheaper, more convenient and accessible to a greater number of senders and recipients in rural areas. In rural areas, clients will benefit from money transfer and other mobile and online services.

Keywords: financial inclusion, financial enabling environment, microfinance, branchless banking, rural poor

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658 Teaching Business Process Management using IBM’s INNOV8 BPM Simulation Game

Authors: Hossam Ali-Hassan, Michael Bliemel

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This poster reflects upon our experiences using INNOV8, IBM’s Business Process Management (BPM) simulation game, in online MBA and undergraduate MIS classes over a period of 2 years. The game is designed to gives both business and information technology players a better understanding of how effective BPM impacts an entire business ecosystem. The game includes three different scenarios: Smarter Traffic, which is used to evaluate existing traffic patterns and re-route traffic based on incoming metrics; Smarter Customer Service where players develop more efficient ways to respond to customers in a call centre environment; and Smarter Supply Chains where players balance supply and demand and reduce environmental impact in a traditional supply chain model. We use the game as an experiential learning tool, where students have to act as managers making real time changes to business processes to meet changing business demands and environments. The students learn how information technology (IT) and information systems (IS) can be used to intelligently solve different problems and how computer simulations can be used to test different scenarios or models based on business decisions without having to actually make the potentially costly and/or disruptive changes to business processes. Moreover, when students play the three different scenarios, they quickly see how practical process improvements can help meet profitability, customer satisfaction and environmental goals while addressing real problems faced by municipalities and businesses today. After spending approximately two hours in the game, students reflect on their experience from it to apply several BPM principles that were presented in their textbook through the use of a structured set of assignment questions. For each final scenario students submit a screenshot of their solution followed by one paragraph explaining what criteria you were trying to optimize, and why they picked their input variables. In this poster we outline the course and the module’s learning objectives where we used the game to place this into context. We illustrate key features of the INNOV8 Simulation Game, and describe how we used them to reinforce theoretical concepts. The poster will also illustrate examples from the simulation, assignment, and learning outcomes.

Keywords: experiential learning, business process management, BPM, INNOV8, simulation, game

Procedia PDF Downloads 328
657 An In-Depth Comparison Study of Canadian and Danish's Entrepreneurship and Education System

Authors: Amna Khaliq

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In this research paper, a comparison study has been undertaken between Canada and Denmark to analyze the education system between the countries in entrepreneurship. Denmark, a land of high wages and high taxes, and Canada, a land of immigrants and opportunities, have seen a positive relationship in entrepreneurs' growth. They are both considered one of the top ten countries to start a business and to have government support globally. However, education is entirely free to Danish students, including university degrees, compared to Canadians, which can further hurdle for Canadian millennials to grow in the business world—the business experience more growth with educated entrepreneurs with international backgrounds in new immigrants. Denmark has seen a gradual increase in female entrepreneurs over the decade but is still lower than OECD countries. Compassionate management and work-life balance are prioritized in Denmark, unlike in Canada. Danish are early adopters of technology and have excellent infrastructure to support the technology industry, whereas Canada is still a service-oriented and manufacturer-based country. 2018 has been the highest number of opening businesses for Canada and Denmark. Some companies offer high wages, hiring bonuses, flexible working hours, wellness, and mental health benefits during Pandemic to keep the companies running and keep their workers' morale high. Pandemic has taught consumers new patterns to shop online. It is essential now to use technology and automation to increase productivity in businesses. Only those companies will survive that are applying this strategy. The Pandemic has ultimately changed entrepreneurs' and employees' behavior in the business world. Along with Ph.D. professors, entrepreneurs should be allowed to teach at learning intuitions. Millennials turn out to be the most entrepreneurial generation in both countries. Entrepreneurship education will only be beneficial when students create businesses and learn from real-life experiences. Managing physical, mental, emotional, and psychological health while dealing with high pressure in entrepreneurship are soft skills learned through practical work.

Keywords: entrepreneurship education, millennials, pandemic, Denmark, Canada

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656 Human Immuno-Deficiency Virus Co-Infection with Hepatitis B Virus and Baseline Cd4+ T Cell Count among Patients Attending a Tertiary Care Hospital, Nepal

Authors: Soma Kanta Baral

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Background: Since 1981, when the first AIDS case was reported, worldwide, more than 34 million people have been infected with HIV. Almost 95 percent of the people infected with HIV live in developing countries. As HBV & HIV share similar routes of transmission by sexual intercourse or drug use by parenteral injection, co-infection is common. Because of the limited access to healthcare & HIV treatment in developing countries, HIV-infected individuals are present late for care. Enumeration of CD4+ T cell count at the time of diagnosis has been useful to initiate the therapy in HIV infected individuals. The baseline CD4+ T cell count shows high immunological variability among patients. Methods: This prospective study was done in the serology section of the Department of Microbiology over a period of one year from august 2012 to July 2013. A total of 13037 individuals subjected for HIV test were included in the study comprising of 4982 males & 8055 females. Blood sample was collected by vein puncture aseptically with standard operational procedure in clean & dry test-tube. All blood samples were screened for HIV as described by WHO algorithm by Immuno-chromatography rapid kits. Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. After informed consent, HIV positive individuals were screened for HBsAg by Immuno-chromatography rapid kits (Hepacard). Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. EDTA blood samples were collected from the HIV sero-positive individuals for baseline CD4+ T count. Then, CD4+ T cells count was determined by using FACS Calibur Flow Cytometer (BD). Results: Among 13037 individuals screened for HIV, 104 (0.8%) were found to be infected comprising of 69(66.34%) males & 35 (33.65%) females. The study showed that the high infection was noted in housewives (28.7%), active age group (30.76%), rural area (56.7%) & in heterosexual route (80.9%) of transmission. Out of total HIV infected individuals, distribution of HBV co-infection was found to be 6(5.7%). All co- infected individuals were married, male, above the age of 25 years & heterosexual route of transmission. Baseline CD4+ T cell count of HIV infected patient was found higher (mean CD4+ T cell count; 283cells/cu.mm) than HBV co-infected patients (mean CD4+ T cell count; 91 cells/cu.mm). Majority (77.2%) of HIV infected & all co-infected individuals were presented in our center late (CD4+ T cell count;< 350/cu. mm) for diagnosis and care. Majority of co- infected 4 (80%) were late presented with advanced AIDS stage (CD4+ count; <200/cu.mm). Conclusions: The study showed a high percentage of HIV sero-positive & co- infected individuals. Baseline CD4+ T cell count of majority of HIV infected individuals was found to be low. Hence, more sustained and vigorous awareness campaigns & counseling still need to be done in order to promote early diagnosis and management.

Keywords: HIV/AIDS, HBsAg, co-infection, CD4+

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655 Timely Screening for Palliative Needs in Ambulatory Oncology

Authors: Jaci Mastrandrea

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening is directly correlated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project is to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline from March 15th, 2022, to April 29th, 2022. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated and evidence-based PC referral criteria. The tool was initially implemented using paper forms and later was integrated into the Epic-Beacon EHR system. Patients were screened by registered nurses on the SLCTC treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher were considered to be a positive screen. Scores of five or higher triggered a PC referral order in the patient’s EHR for the oncologist to review and approve. All patients with a positive screen received an educational handout on the topic of PC, and the EHR was flagged for follow-up. Results: Prior to implementation of the PSCNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the first 100 patient screenings completed within the eight-week data collection period. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting the criteria were flagged in the EHR for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative care, symptom management, symptom screening, ambulatory oncology, cancer, supportive care

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654 Transnational Initiatives, Local Perspectives: The Potential of Australia-Asia BRIDGE School Partnerships Project to Support Teacher Professional Development in India

Authors: Atiya Khan

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Recent research on the condition of school education in India has reaffirmed the importance of quality teacher professional development, especially in light of the rapid changes in teaching methods, learning theories, curriculum, and major shifts in information and technology that education systems are experiencing around the world. However, the quality of programs of teacher professional development in India is often uneven, in some cases non-existing. The educational authorities in India have long recognized this and have developed a range of programs to assist in-service teacher education. But, these programs have been mostly inadequate at improving the quality of teachers in India. Policy literature and reports indicate that the unevenness of these programs and more generally the lack of quality teacher professional development in India are due to factors such as a large number of teachers, budgetary constraints, top-down decision making, teacher overload, lack of infrastructure, and little or no follow-up. The disparity between the government stated goals for quality teacher professional development in India and its inability to meet the learning needs of teachers suggests that new interventions are needed. The realization that globalization has brought about an increase in the social, cultural, political and economic interconnectedness between countries has also given rise to transnational opportunities for education systems, such as India’s, aiming to build their capacity to support teacher professional development. Moreover, new developments in communication technologies seem to present a plausible means of achieving high-quality professional development for teachers through the creation of social learning spaces, such as transnational learning networks. This case study investigates the potential of one such transnational learning network to support the quality of teacher professional development in India, namely the Australia-Asia BRIDGE School Partnerships Project. It explores the participation of some fifteen teachers and their principals from BRIDGE participating schools in Delhi region of India; focusing on their professional development expectations from the BRIDGE program and account for their experiences in the program, in order to determine the program’s potential for the professional development of teachers in this study.

Keywords: case study, Australia-Asia BRIDGE Project, teacher professional development, transnational learning networks

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